![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by fallsfall on June 1, 2003, at 21:54:26
I am overly dependent on my therapist. Dependency became the focus of therapy about 3 months ago when I did a bad thing. She was justifiably angry and decided that it was time to tackle the dependency issue. We have determined that I figure out what my self worth is, but any negative input from her (or any input that I perceive as negative) overrules my idea of that part of my self worth. So she has a negative influence, but not a positive influence. I've been doing some reading on self worth and I know that she shouldn't be getting an inordinate amount of say, but I don't know how to do it yet. This is what I've been working on.
I have been diagnosed with Major Depression (severe) and Borderline Personality Disorder. Part of BPD is a fear of abandonment ("Frantic efforts to avoid real or imagined abandonment" or something like that). This certainly applies to me.
So this brings me to the real dilemma: is it time to change therapists? I have such mixed feelings about this.
The last 3 months have been incredibly painful. The last 18 months I have been sensing discontent from her (mainly boredom). For the most part, I've been able to work despite those vibes from her, but I'm sure that it has impacted our progress. If I left her, then my dependency would be broken - one might hope that I wouldn't repeat this with the next therapist (particularly if they know about the problem I have now).
But she is so central to my life - she controls my self worth. I have seen her for almost 8 1/2 years. That is a large chunk of my life. This fear of abandonment is more accurately called terror. I feel as if I will literally cease to exist without her.
8 1/2 years ago I entered therapy (in part because I was overly dependent on my best friend). 6 months later I was hospitalized and stopped working (I am a software engineer). It took 4 years for me to get back to work (I did some volunteering before that to ease into things). I worked successfully (but not completely free of depression) for 2 years. Then there were 3 significant stressors that hit at the same time and I crashed again. I stopped working again. I was hospitalized for a second time 6 months later. For most of the last year and a half I have been unable to do anything. For a significant period of time I wasn't eating or showering enough. I haven't cleaned my house in 18 months. I am doing laundry and grocery shopping once a month instead of once a week. All of the friends that I have have mental illnesses (except one person who I have just started dating - they took the initiative to get the relationship going). 3 months ago I started some promising drugs, but I haven't had a chance to see what they can do because of this turmoil.
I guess the most convincing argument is that when I think of staying with her I feel hopeless, and when I think of leaving I have hope.
I don't know how I would tell her, or how I would live through it. Therapy is on Tuesday.
Thanks for helping me think this through.
Posted by Tabitha on June 2, 2003, at 0:50:09
In reply to Is it time to change therapists?, posted by fallsfall on June 1, 2003, at 21:54:26
> I guess the most convincing argument is that when I think of staying with her I feel hopeless, and when I think of leaving I have hope.
>Sounds like you've made a decision? Here's wishing you the courage to do what's best for you.
Posted by Dinah on June 2, 2003, at 8:41:35
In reply to Is it time to change therapists?, posted by fallsfall on June 1, 2003, at 21:54:26
>
> I guess the most convincing argument is that when I think of staying with her I feel hopeless, and when I think of leaving I have hope.
>That's a pretty compelling reason, if it is really deep down to the bone true. But you are the only one who can make that decision.
Ordinarily, I would think that working these feelings out with your present therapist would be valuable. Since you've identified your feelings as a terror of abandonment. But I haven't been overly impressed with what you've told us of your therapist's ability to work with that terror, or to be compassionate with it.
Actually, my first reaction would be to say to talk this through with your therapist, and get her input into whether she feels capable of working this through with you, and how much she thinks of this as a stage in therapy. But I understand that fear of abandonment all too well. If I were going to ditch my therapist, I would just want to ditch my therapist. I would be horrified to discuss the notion with him and find that he thought my leaving him for a new therapist would be a good idea. The possibilities for feeling rejected would terrify me. It would be way less scary to do the rejecting myself.
I think you did say that you had another therapist candidate in mind? So you'd be able to start processing your feelings pretty quickly.
I wish you the best of luck in sorting out your feelings and determining what is best and most growth producing for yourself. I know you can do it.
Posted by stjames on June 2, 2003, at 10:46:48
In reply to Is it time to change therapists?, posted by fallsfall on June 1, 2003, at 21:54:26
> But she is so central to my life - she controls my self worth. I have seen her for almost 8 1/2 years. That is a large chunk of my life. This fear of abandonment is more accurately called terror. I feel as if I will literally cease to exist without her.
This does not sound very healthy, kinda sounds like a rut. I would change to another therapist
Posted by judy1 on June 2, 2003, at 12:05:34
In reply to Re: Is it time to change therapists?, posted by stjames on June 2, 2003, at 10:46:48
I'm going to have to agree with everyone here- it sounds very much like you have gone as far as you can with her. BPD is a tough disorder, not only on the client but the therapist. At one point (I've pretty much 'outgrown' this disorder), my own therapist asked me to see someone else because of lack of progress. While that sure got the 'abandonment' issues flying, it was the best thing I could have done. I wish you all the best (and ditto to make sure you have another therapist lined up first). take care, judy
Posted by fallsfall on June 2, 2003, at 14:41:48
In reply to Re: Is it time to change therapists?, posted by judy1 on June 2, 2003, at 12:05:34
Thank you all for your input.
I am sure that if I tell her that I will be looking for a new therapist that she will support me until I am settled. If she surprises me and refuses to do that I have a former group therapist who I saw a couple of months ago who would see me (and she may be who I transfer to, I don't know yet).
I've drafted a letter to my therapist. If I am Herculean tomorrow I will tell her that I think I should move on. If I am strong I will read the letter to her. If I am crumbling I will give it to her for her to read.
11:00 EDT.
Thanks for the support.
Posted by Dinah on June 2, 2003, at 14:52:44
In reply to Re: Is it time to change therapists?, posted by fallsfall on June 2, 2003, at 14:41:48
Posted by deirdrehbrt on June 2, 2003, at 22:31:11
In reply to Re: Is it time to change therapists?, posted by fallsfall on June 2, 2003, at 14:41:48
Good luck.
I'm hoping for herculean, but I'm sure that whatever happens will be what is right under the circumstances. In the end it is what best serves your health that is needed. If you can't do something that you think you wanted to do, then it's probably time to just admit that you can't do it, don't beat yourself up over it, and do something for yourself..... comfort food, long comfortable bath, quiet walk on the beach.
You are in my thoughts,
Dee.
Posted by fallsfall on June 4, 2003, at 9:09:50
In reply to Re: Is it time to change therapists?, posted by deirdrehbrt on June 2, 2003, at 22:31:11
Posted by fallsfall on June 4, 2003, at 18:19:27
In reply to Re: Is it time to change therapists?, posted by deirdrehbrt on June 2, 2003, at 22:31:11
Yesterday I saw my therapist. I read my letter to her. It talked about how miserable I was. It described the last session from my view point. It said that I felt hope when I thought about changing therapists. It had a long paragraph about all the things that I have learned (that gray exists, not to be a workaholic etc. etc.). It said that I thought it was time for me to move on, that the thought was terrifying, and that I hoped she would support me through the transition. Then it said "Love, Fallsfall" (well, not exactly...). She was almost crying. She said "This is unusual, I don't have anything to say". She said that she thought it was a good idea, and that she would certainly support me through the transition (yeah!!).
She does CBT (and I did DBT). I told her that I thought that she was an excellent therapist so I didn't think that another CBT therapist would add much. I told her I wanted to try something else. "Not analysis 3 days a week!!" she said in horror. I told her I wanted to do Art Therapy and she looked at me like I had 3 heads. She told me to do art at home (no, that's not the same). I said art once a month and regular therapy the rest. She said that I had surprised her (and all this time I thought she had a list of names for me in her desk). I don't think that she had ever considered anything other than CBT. But she did talk about my group therapist, and she certainly isn't CBT. She gave me 1 Art therapist and a couple of CBT names. She'll have more next week. Next week we'll define what "transition" means. She thanked me for the paragraph about what I've learned, and said that she thought we had a really nice relationship. I agreed.
What types of therapy should I consider. It is true that the #1 therapy for Borderline Personality Disorder is CBT, but that doesn't mean it is the only one. They say that the therapy needs to be fairly structured (not completely free association). I know that I am not an easy client (because of the dependency and abandonment and stuff), so I figure I need someone who has quite a bit of experience.
What types of therapy do you each have? What is it like? What do you like? What do you dislike? Would you recommend it? Do you have a man/woman (and which are you)?
I'll get 4 lists of candidates from 4 doctors (her, my pdoc, my group therapist, my GP), and I have 2 friends who are therapists so I'll get lists from them, too. Any name that comes up more than once is a real winner! Then I'll look at what kind of therapy and whether they are on my insurance's list (though that will only continue another year). I'll look them up on the internet (do you believe I just said that??). Call and talk to them for a couple of minutes. Priorize and then probably see 2 or 3 (or more if I have to). Does that sound reasonable?
I was so tired this morning after getting my kids to school that I took a nap. When I woke up all I could do for an hour was sit on the couch with my dog, with my eyes closed but not sleeping. I'm starting to get a little more energy. I am much less distressed than before. And tomorrow I see my pdoc (good timing).
:: Sigh of relief ::
Thanks for your help!!
Posted by mair on June 5, 2003, at 17:19:48
In reply to Re: Changing Therapists - What type of therapy??, posted by fallsfall on June 4, 2003, at 18:19:27
You sound like you feel empowered. I'm so impressed with the way you've approached this. I'm particularly impressed that you were able to read your letter to her without backing off or trying to soft peddle your feelings or take blame for your lack of progress. If you find a new therapist with the same sort of direction and resolve you've demonstrated here, you'll do well.
I was initially referred to my therapist for CBT. I had told my pdoc I wanted something more short term and directed than I had with him when I was seeing him as a regular therapy patient. Really though I just felt I needed to get back into therapy and I didn't want to start up with him again. I didn't have the courage to deal with him in as an upfront manner as you did.
My current therapist started out using just CBT - so much so that she didn't want me talking about anything other than the present. I hadn't really been seeing her for all that long when therapy became more dynamic than CBT usually is. About 2+ years ago she totally threw everything out the window, started having me come twice a week and started taking copious notes in all of our sessions. She'll introduce some CBT techniques ocassionally but mostly she said I just didn't seem to "buy" anything she tried with CBT. It's really kind of amusing to me that my CBT therapist now sounds far more freudian than my pdoc/therapist ever did and he was a trained psychoanalyst. I just chalk it up to how difficult I am to work with.
Periodically I start thinking that my therapist is fed up with me and that she must be feeling she can't ever get anywhere with me. I think I've always felt like I arrived on her doorstep under false pretenses (like she thought she was getting someone for 10 sessions of stress management and she ended up with a lifetime albatross). I'm also convinced that she'd like to cut me loose but that she can't since I have so many obvious rejection issues. When I've been able to talk to her about some of this, she's been able to convince me that she's in it for the long haul with me but those rejection fears are tough to shake and I know I'll start ruminating about this all over again in the future.
My hat's off to you for having the courage to see that what you were doing had ceased being effective and having the courage to address this with her without burning a bridge. Please keep us posted on the therapist search.
Mair
Posted by Dinah on June 5, 2003, at 19:24:34
In reply to Re: Changing Therapists - What type of therapy??, posted by fallsfall on June 4, 2003, at 18:19:27
I am so pleased for you!! She should be proud of the work that she did with you, that you could handle this so maturely. And it sounds like you're trying to be very sensible and systematic about finding a new therapist as well.
Wow. I hope if the situation ever comes up, I can handle it as well as you did.
I'm no help with type of therapy, I'm afraid. My therapist is also CBT by nature, but like Mair's discovered that wasn't the best style for me. He mainly does CBT and reparenting, with some counselling thrown in. He's more directive than a lot of therapists, I think. But then, my therapy is supportive in nature to a certain extent. A lot of the emphasis is just keeping me stable, sort of like diabetes and insulin. I've been leaning towards getting some outside EMDR sessions, but some of what I've read on the internet seems to indicate that it might be a bit too destabilizing for me.
I'd love to hear about your explorations in types of therapy.
Good luck, and congratulations on a difficult task well done.
Posted by fallsfall on June 5, 2003, at 20:07:02
In reply to Re: Changing Therapists - What type of therapy?? » fallsfall, posted by Dinah on June 5, 2003, at 19:24:34
Thanks for the cheering section. It really helps. It lets me know that other people think I'm doing the right thing.
I met with my pdoc today. He sits across the hall from my therapist, and they talk (she uses him when she needs a consult, for example). I told him I wanted to be sure that I wasn't running away, that it wouldn't be more productive to stay and work this out with her. He said I should leave. He's the only one who knows both sides of the story. He will remain my pdoc.
So it is time for me to jump in with both feet. It is such an important decision ('cause I know I'll be a long termer), it's kind of scary that I will be the only one who knows everything.
Mair, I liked how you put it: "she said I just didn't seem to "buy" anything she tried with CBT". I'm not sure I bought it, either. We did make a lot of progress over a long period of time, but I don't think most of it was really CBT.
Dinah, I have a friend who does EMDR if you have specific questions.
Trying to get the nerve up to make the first phone call...
Posted by dissociative jane on June 7, 2003, at 10:50:44
In reply to Re: Changing Therapists - What type of therapy??, posted by fallsfall on June 5, 2003, at 20:07:02
i was wondering if someone will give me an example of what CBT is. I have read about it but I would be interested in an example.
I am not sure what type of therapy I am receiving but we are working a lot on recalling memories from my childhood.
Posted by Dinah on June 7, 2003, at 11:36:27
In reply to Re: Changing Therapists - What type of therapy??, posted by dissociative jane on June 7, 2003, at 10:50:44
Here's a website that can explain it better than I can.
http://www.cognitive-behavior-therapy.org/basics.html
In it is a link to an example of treatment for social phobia.
I doubt the therapy you're doing is CBT. It sounds more like traditional therapy. CBT stays very much in the present moment. It only looks backwards to identify behavior patterns and ways of thinking that you have that have proved troublesome to you. It assumes that whatever the root causes of your problems, what really matters is what you do now about them. There's a lot of homework where you identify your thoughts and behaviors in certain situations. An example would be if if you run into a traffic jam in the morning and think "Oh great, now I'm going to be late and lose my job. My whole day is ruined." Cognitive therapy would have you stop those automatic thoughts and replace them with more helpful thoughts.
From your posting name, I'm assuming dissociation is a problem for you. CBT therapy may be focussed first on teaching you to stay grounded, to teach you mindfulness so that you don't "go away". Then when you're staying in the moment and able to identify your thoughts, it might work on some automatic thoughts that are causing you anxiety and making you want to dissociate. There might be very little emphasis on what was the historical basis for the automatic thoughts.
My therapist is primarily CBT in orientation, although we do interpersonal therapy as well. Yesterday, I was upset about financial woes, and he was trying to keep me in the present and point out my distorted thinking. A tight budget did not mean the end of the world, there are other ways of enjoying yourself that don't involve money. I was catastrophizing, and fortune telling, and all sorts of cognitive distorting. I'm sure he's correct and one day I might even want to hear it. Yesterday I wanted to shove his oh so reasonable attitude down his throat. :)
Posted by judy1 on June 7, 2003, at 11:36:51
In reply to Re: Changing Therapists - What type of therapy??, posted by fallsfall on June 4, 2003, at 18:19:27
Congrats on being able to stick to your plan, I'm sure it wasn't easy (but obviously the right decision). I'm also glad you are keeping your pdoc since that will give you some continuity. I do have experience transitioning, it took about a month (of 1-2x/week). I like your plan to find a new therapist, I also found mine by speaking on the phone to several candidates- telling them about myself, asking about their experience, etc. My therapist uses a very eclectic approach, especially since my stressors and moods are changing all the time. My therp is a woman and my pdoc a man- I get therapy from both and each brings a unique perspective. best of luck-judy
Posted by Dinah on June 7, 2003, at 11:36:59
In reply to Re: Changing Therapists - What type of therapy??, posted by dissociative jane on June 7, 2003, at 10:50:44
Posted by fallsfall on June 7, 2003, at 18:56:17
In reply to Re: Changing Therapists - What type of therapy?? » fallsfall, posted by judy1 on June 7, 2003, at 11:36:51
Thanks. I actually made 2 (unreturned so far) phone calls on Friday.
My current therapist (a woman) thinks I should go to a man. I don't have a reason yet - I'll ask on Tuesday.
My biggest issue is becoming dependent on people - first my best friend (a woman), and now my therapist (a woman).
My pdoc referred to those relationships and said "So you should see a man". I asked "But won't that make it less likely to run into this issue, and therefore be harder to work on it?". He shrugged his shoulders. It makes me think that he is just telling me what my therapist told him.
Based on all my reading, I would think I should see a woman. (I'm lesbian, by the way)
Am I missing something?
Posted by dissociative jane on June 8, 2003, at 9:27:05
In reply to Re: Changing Therapists - What type of therapy??, posted by Dinah on June 7, 2003, at 11:36:27
Dear Dinah,
Thank you so much for the info regarding CBT. Your posts really do offer so much insight and I look forward to reading more of them.
I began therapy last summer due to a family crisis and depression. Although my family crisis has resolved, I was informed that I have DID and continue to be in therapy.
I always knew there was something wrong with me but never knew it was this.
Posted by judy1 on June 8, 2003, at 12:19:02
In reply to Re: Changing Therapists - What Sex?? » judy1, posted by fallsfall on June 7, 2003, at 18:56:17
I would think you should see whoever makes you comfortable. My therapist (who also happens to be lesbian) felt because of my history of abuse I would be more comfortable with a woman shrink. While I could see her point, my male pdoc is a warm and compassionate individual- qualities that are more important to me then gender. Let us know how it works out- judy
P.S. another thing that is interesting, it turns out both my shrink and therapist have a history of a mental disorder (which is probably why they went into the field), but I feel allows them to understand me better. I wonder how many mental health workers have this kind of history.
Posted by judy1 on June 8, 2003, at 12:25:14
In reply to Re: Changing Therapists - What type of therapy??, posted by dissociative jane on June 8, 2003, at 9:27:05
Hi,
Hope you don't mind me intruding, but something you wrote struck a cord- "I always knew there was something wrong with me but never knew it was this." I think that's how it is with dissociative disorders, you don't know what is 'normal' until a professional points it out. You go your whole life thinking everyone is probably hearing voices or losing time, but you're not quite sure. That's the beauty of psychotherapy- the understanding of why, the acceptance and the coping skills. take care-judy
Posted by Dinah on June 8, 2003, at 15:42:06
In reply to Re: Changing Therapists - What type of therapy??, posted by dissociative jane on June 8, 2003, at 9:27:05
I guess it was a relief to have a name to put to that general feeling that something is wrong. I kind of wish I could pin things down myself.
Do you find that your therapy is helping you deal with your DID?
Posted by bookgurl99 on June 9, 2003, at 15:56:52
In reply to Re: Changing Therapists - What Sex?? » judy1, posted by fallsfall on June 7, 2003, at 18:56:17
Falls,
this is funny because the vibe i get from my (lesbian) therapist is that she thinks i should also see a male therapist in the future. this is because in the beginning, i had a little crush on her -- even if i did get over it and never mentioned it, it was still there.
it might be useful, because you're not as likely to have those crush-like feelings on a guy.
but, i'd still rather go to a woman therapist. preferably a lesbian. i just feel like having the same cultural background from which to draw is important for me.
oh -- and i can admit that part of me would sort of like to kiss her sometime. in another lifetime and body maybe, i could be a dreamy butch woman and waltz in and solve all her problems in life. i think this says more about my relationship with women in general -- i have a generally protective attitude towards them -- than with just my therapist, though.
books
Posted by Giget on June 10, 2003, at 11:03:56
In reply to Re: Changing Therapists - What Sex?? » fallsfall, posted by bookgurl99 on June 9, 2003, at 15:56:52
I have recently had problems with any man in my life, I just don't get them. Yes I am les, but in trying to find a theripist it may not matter.
I was in such deep depression that I just started down the phone book of doctors, seeing which one could see me asap.
He seemed concerned about me and got me in that day. He understands what is going on and all the problems I have. I never thought I could trust or work with a male doctor, but it has been the best thing around!!
It is all up to where you are mentally, if you have the time to look around and how you feel.
Everyone is different, so follow your heart.
> Falls,
>
> this is funny because the vibe i get from my (lesbian) therapist is that she thinks i should also see a male therapist in the future. this is because in the beginning, i had a little crush on her -- even if i did get over it and never mentioned it, it was still there.
>
> it might be useful, because you're not as likely to have those crush-like feelings on a guy.
>
> but, i'd still rather go to a woman therapist. preferably a lesbian. i just feel like having the same cultural background from which to draw is important for me.
>
> oh -- and i can admit that part of me would sort of like to kiss her sometime. in another lifetime and body maybe, i could be a dreamy butch woman and waltz in and solve all her problems in life. i think this says more about my relationship with women in general -- i have a generally protective attitude towards them -- than with just my therapist, though.
>
> books
Posted by DissociativeJane on June 11, 2003, at 10:05:32
In reply to Re: Changing Therapists - What type of therapy?? » dissociative jane, posted by Dinah on June 8, 2003, at 15:42:06
> I guess it was a relief to have a name to put to that general feeling that something is wrong. I kind of wish I could pin things down myself.
>
> Do you find that your therapy is helping you deal with your DID?At this point i am becoming more aware of when i am dissociating so, i guess this is how therapy is helping me with my DID. I am in treatment for depression but DID is an addition.
I do not have multiple personalities but more dissociative experiences and derealization.
I also have a fetish I am trying to understand and hopefully get rid of too.
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.