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Dr. Bob is Robert Hsiung, MD,
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Posted by cricket on June 2, 2005, at 9:29:33
In reply to Re: Approximate relationships, posted by alexandra_k on June 2, 2005, at 3:35:28
Alexandra,
You're right, it is supposed to be about 'understanding the client' and I'm sure that my therapist would agree and operates that way with most of his clients.
However, I think that there are cases, (probably those coming from situations of extreme abuse and neglect) where the client's main issue is allowing another human being to get anywhere close to them. The issue becomes not so much 'understanding the client' as giving the client the ability to relate to the therapist as another human being. That's where the damage is, that's where the healing lies.
Yes, real relationships are probably better except in my case I am just too damaged to have one of those and if I allow myself (and right now that's a big if) to get close to my therapist it will be a major life accomplishment.
And please don't be sorry. I like when people respond back with differing view points it helps me think things through.
Posted by Dinah on June 6, 2005, at 20:44:51
In reply to Re: Approximate relationships, posted by cricket on June 1, 2005, at 11:49:45
I think what he says is true for people like me, at least. Having a relationship is a stretch for me, and my usual reaction to difficulty in a relationship is to emotionally withdraw and eventually, if it continues, to emotionally divorce and keep a superficial and cordial relationship with none of what I want in it.
For my therapist, the challenge has been to teach me that I can stay connected and work through problems and reach new levels of intimacy. So the therapeutic relationship has been the teaching vehicle for that.
Unfortunately, the other people in my life (my family) don't work with me like he does, and I still choose to emotionally withdraw and divorce. I have a lot of cordial relationships. :(
He hurt me to my core today though. Or he should have, if I had been feeling close to him. He was talking about how the therapeutic relationship was a real one. But in doing so he pointed out that it was also clearly unreal.
Ouch.
I really ought to be hurt and angry.
Posted by littleone on June 6, 2005, at 21:41:38
In reply to Re: Other aspects of Chapter 2, posted by daisym on May 27, 2005, at 1:32:58
> And I consider time slots "mine" so I don't want them given away if I can't make it, or if I change. Not rational, not rational at all.
Oh, me too. I book my times a couple of months in advance, but only remember to book the next lot when I only have 1 or 2 appointments to go. Then I can't get *MY* times.
And I always feel so hurt. They *know* I always take the same times and it is very rare indeed for me to miss a session. I don't understand why they don't just block them all out for me. I mean, it's not like I'm gonna graduate from therapy any time soon. It just hurts.
> Therapist's Presence Brings Comfort -
>
> Usually. Not always. Sometimes it brings on anxiety.Oh, I'm so glad you raised this. I yearn for my T between sessions and usually find comfort in the waiting room. But as soon as my T steps out to get me my anxiety goes through the roof and stays that way for the whole time I'm with him.
It always bamboozles me why I'm so keen to see my T when it brings on so much anxiety. And I think how it's because he's so nice to me. But if he's so nice, why do I have the high anxiety? He thinks that's because of the content of our discussions. But I don't know. Like I said, the anxiety skyrockets just by seeing him walk out of his office to get coffee or whatever.
Posted by daisym on June 6, 2005, at 22:55:52
In reply to Re: Other aspects of Chapter 2 » daisym, posted by littleone on June 6, 2005, at 21:41:38
I think for me that the anxiety is linked to both the session content (opening those dark places is painful) and about my abandonment fears.
I think, "Is he different? Has he changed his mind about working with me? What kind of mood will he be in?" And on and on...
I think this is really old, having to assess someone's mood over and over again. And the more attached I am to him, the more power he has over me. The more aware I am about my feelings and my needs, the more scared I get.
Sometimes think I'd be best served never actually having my sessions, but instead knowing that they are scheduled.
Which reminds me, I'd ask that they simply reserve your spot "forever". I'm sure the receptionist can do that. There is no way I'd move around every few months. I'd forget, but then again, I'm old...
Posted by cricket on June 7, 2005, at 10:08:10
In reply to Re: Approximate relationships » cricket, posted by Dinah on June 6, 2005, at 20:44:51
Hi Dinah,
Glad to have you back.
I too have a lot of cordial relationships, for the exact same reason you mention - my own emotional withdrawal. For now, it's what helps me function in the world. I do wonder if one day I will ever be able to have anything else.
I am so sorry to hear that wasn't a great session. When do you see him next? I guess one of the advantages of going more than once a week is that it feels like there is less riding on every session.
It is interesting that you said you didn't feel close. Was that before his "relationship unreal" comment? I am wondering if he was somehow reacting to your own shut down. Sometimes I feel like my therapist does that. I go in feeling like I don't want to talk to him, refusing to reveal any of myself, but another part of me is desperately looking for closeness. My therapist distances himself I think he would say out of respect for the part of me that wants to withdraw, but it winds up feeling punitive to the part that is desperate to be close. Is it anything like that?
If you have a chance, Jazzed posted an article in a thread for Pinkeye - towards the bottom of the list. It's about PTSD, but it has a couple of interesting charts on attachment styles of both clients and therapists. I would love to get your thoughts on it, because it seems we both struggle with the same attachment issues, even if they manifest themselves in different ways.
Posted by cricket on June 7, 2005, at 10:36:38
In reply to Re: Approximate relationships, posted by cricket on June 7, 2005, at 10:08:10
Posted by Dinah on June 7, 2005, at 19:47:19
In reply to Re: Approximate relationships, posted by cricket on June 7, 2005, at 10:08:10
I read that article a while ago, and found it very helpful in sorting things out. It's on my bookmarks list.
It may have been his comment that exacerbated the situation. I was already feeling unconnected, but the comment might have made me angry on top of it.
I think I'm just not myself the last day or two. But it will pass. It always does.
Posted by Dinah on June 7, 2005, at 19:50:10
In reply to Re: Approximate relationships, posted by cricket on June 7, 2005, at 10:08:10
Ooops. Like I said, my attention span is nil right now.
I meant to say that emotional withdrawal and cordial relationships are frequently the best sort, depending on the person you're with. I want to have deeper relationships with people, but only ones I can trust to be intimate with. So I guess I just need to find more people I trust.
I rather suspect I get that need met here, though.
Posted by partlycloudy on June 7, 2005, at 20:26:06
In reply to Re: Approximate relationships » cricket, posted by Dinah on June 7, 2005, at 19:50:10
How did it feel to meet the Babblers in person - was it comfortable for you?
pc
Posted by pegasus on June 8, 2005, at 8:46:17
In reply to Chapter 3.The Therapist's Power, posted by Dinah on May 29, 2005, at 9:48:25
Is anyone ready to talk about chapter 4 yet? Sorry if I'm rushing you.
This chapter is probably the reason that I originally bought the book. Boundaries are so confusing when you first get into therapy. No one explains them completely ahead of time. And if they do discuss them, it's so confusing to understand the reasons behind them. This is where I had the most trouble with my ex-T, and where this book helped me the most.
And then there's the titillation factor with this chapter. Freud took clients on vacation with him? Ferenczi let clients sit on his lap and kiss him? Lazarus invites them to play tennis with him and his wife? Hoo ha! It's appalling, and appealing all at the same time. I think, "If only!" and then, "Thank god I didn't get caught up in that mess!"
Beyond that, though, I loved the section on Basic Rules. Finally, someone lays it all out. And, then right away I notice that my ex-T violated some of these. Rule: Should not self disclose particularly intimate material. He told me when he got a vasectomy, for heavens sake! But he was making a point (no, not that one) that was relevant to my therapy, so it was ok.
But the really great part of this chapter is the section on Thinking about Boundaries and the Symbolic Meaning of Boundaries. Once I read this, I could really make sense of the confusing therapy relationship a lot better. I finally was able to see the boundaries as protecting me, and as facilitating my therapy. I think the key is in asking myself, why would I want these boundaries to shift? What do these boundaries represent to me? And then I start to see them as valuable to *me* and not just protecting my T.
It makes me think of the time I asked my T if I could hug him, fully expecting that he'd say yes. It just seemed natural within the moment. But instead, he said that although he had the same impulse, he wanted to talk about it first, because we'd never touched each other in any way, and adding in a physical dimension was a big deal. At the time I felt misunderstood, and incorrectly suspected of bad motives. But after reading this chapter, I could see that he was respecting the potential symbolism behind the hug, and the power that it could have for me. Basically, he was being a good therapist.
Oh, but too bad I couldn't appreciate that at the time!
I'll be interested to see what comes up for the rest of you around boundaries.
pegasus
Posted by Jazzed on June 8, 2005, at 11:10:38
In reply to Chapter 4, posted by pegasus on June 8, 2005, at 8:46:17
In thinking about boundary violations, my first shrink was SO bad that he told me how much he hated my father and wished he could be my father, talked about other patients to me - under the guise of it being in my best interest, talked to me about his wife and her problems, and finally told me that if I moved away from home, he'd help me find an apartment and he'd take care of me! That put such an intense fear in me, and of course I didn't do it, but I wonder what would've happened to me if I had! About a year after I'd left therapy with him, he married a patient. I do think he loved me in a paternal sense, and really did want to take care of me, but good golly! BTW, He never made any sexual overatures toward me, thank goodness. I sure wish I had known then what I now know about therapy, and I'm sure things would have gone much differently, but I was a teen when I started with him.Jazzy
Posted by messadivoce on June 8, 2005, at 21:05:07
In reply to Re: Chapter 4 Extreme boundary violations, posted by Jazzed on June 8, 2005, at 11:10:38
I have to admit that this is the second chapter in the book that I skipped to, after the chapter on "I'm in love with my Therapist." I was kind of disappointed in how general the "rules" were, in a way. And it makes me paranoid about my relationship with my former T. He was very professional all of the time, it's true. But there were moments, here and there, where the professional context of the relationship was forgotten by both of us, and we were just two people in the room.
These moments are hard to explain. But even though I know pretty much no hard facts about his life, I did get glimpses into how he felt about me. He liked me, I know that. He got swept up into the high emotionalism of the termination. He let me write him after termination and he wrote back. He responded in a therapeutic capacity, as far as the context of his replies.
It was three weeks after my termination that I stopped by to say hi. That was when he told me that he could no longer write me, that it was a boundary violation, and that he was not doing me any favors by staying in constant contact with me. It was the closest he every came to admitting a mistake. Of course, I was crushed. I felt like it was all my fault, that somehow I should have known not to write to him and be happy with his responses.
That was his biggest flaw, I think. Not being able to admit his mistakes. In the end, that hurt me more than the boundaries themselves. I can relate to the "good cop bad cop" thing too. Even though my head knows that he cut off communication to protect me, my heart has been screaming that he did it to protect *himself* from how much I needed him; so that he could go on his merry way with his postdoctoral fellowship and license and family and leave me with...
He left me with a lot. Good things and bad.
Today all day I felt as though something was not right. I kept thinking about him, more than usual, and wondering if it had been a full year since that last time I saw him. I came home and checked through my old e-mail messages. Sure enough. It will be one year ago tomorrow.
Posted by Jazzed on June 8, 2005, at 22:08:21
In reply to Re: Chapter 4, posted by messadivoce on June 8, 2005, at 21:05:07
Posted by Tamar on June 9, 2005, at 17:40:39
In reply to Re: Chapter 4, posted by messadivoce on June 8, 2005, at 21:05:07
> Today all day I felt as though something was not right. I kept thinking about him, more than usual, and wondering if it had been a full year since that last time I saw him. I came home and checked through my old e-mail messages. Sure enough. It will be one year ago tomorrow.Awww... that's tough. I'm thinking of you. I hope your memories are very sweet and not too bitter.
Big hugs,
Tamar
Posted by annierose on June 10, 2005, at 21:28:17
In reply to Re: Chapter 4 » messadivoce, posted by Tamar on June 9, 2005, at 17:40:39
Having just finshed this chapter, I just wanted to quickly comment, that she uses the expression "approximate relationship" frequently throughout this chapter. One that I could easily find was near the end:
"Boundaries remind client and therapist that their relationship is approximate, that in its therapeutic capacity there are things that it can never be, but that what it is can be relied upon."
Regarding this chapter, I feel my T has solid boundaries. I know very little about her. She has rarely shared any personal stories and never speaks of other clients (even in a general sense). But I feel I know her. I don't know her in a specific sense of what is her favorite color, what music she listens to, what books she reads ... I know her heart. I'm comfortable within the boundaries. I rarely will ask a personal question (I can think of only one question I asked, how many children she had & their sexes, and she did answer).
Yes, part of me would like to know more. But another part asks "why?". I don't push the boundaries. I accept them as part of the process.
I saw another T quite briefly, maybe 2 or 3 sessions, decades ago, and she had NO boundaries. It actually drove me nuts. My 45 minute session, lasted 2 hours. I needed to go back to work and I didn't know how to say "time's up". And she talked on and on about herself and other clients. I remember thinking, I think I prefer a blank slate to this mumble jumble.
Posted by Dinah on June 11, 2005, at 10:43:36
In reply to Re: Chapter 4 and approximate relationships, posted by annierose on June 10, 2005, at 21:28:17
Posted by gardenergirl on June 11, 2005, at 12:01:42
In reply to Re: Chapter 4 - I need to catch up. :( (nm), posted by Dinah on June 11, 2005, at 10:43:36
Posted by littleone on June 11, 2005, at 18:36:32
In reply to Chapter 3.The Therapist's Power, posted by Dinah on May 29, 2005, at 9:48:25
Chapter 3 was a big one for me. In my head, I know a lot of these things are completely wrong, but below are my beliefs about my T's power:
He has the power to make me feel good or bad.
He knows how therapy works. He knows how far along the therapy process I am, what I can expect next. Knowledge is power.
He knows how to fix me. He knows what my faulty beliefs are. When we talk about an issue, he knows a lot more than what he shares.
He has control over the whole therapy process. It seems like he tries to give me control by directing what we talk about, but he knows that I would talk about anything *he* wants to.
He has the power to make *anything* therapeautic. I could go in wanting to talk about lamps/aardvarks/Bruce Springsteen and he could still make it a therapeautic session.
I don't blindly follow his advice, but I'm highly suggestable by him. He has that power over me.
He controls what I know about him. He knows more about me than I know about him.
He knows the secrets of life. All the answers. He knows how to be happy.
He knows what "healthy" is like.
I need him to like/love me. He couldn't care less what I thought of him.
I am one client of many.
He can see things in me that I can't.
I need to fit into his schedule. His busyness decides if I can see him extra or not. Regardless of my perceived need.
He controls the boundaries.
He's always cool, calm and collected. I react strongly to things.
Every single word he utters has huge power.
He can see more clearly how much I have/haven't progressed.
He knows my "tells". I am unable to lie or hide from him.
He has the power to hurt or heal me. That's a biggy.
Posted by annierose on June 12, 2005, at 6:50:23
In reply to Re: Chapter 3.The Therapist's Power, posted by littleone on June 11, 2005, at 18:36:32
To quote Glenda, the good witch
"You had the power all along."Yes, therapists are important figures in one's life. But don't forget about you! From your list, I was surprised how much "power" you give your T. It's your therapy.
Posted by pegasus on June 15, 2005, at 16:33:53
In reply to Re: Chapter 4 and approximate relationships, posted by annierose on June 10, 2005, at 21:28:17
Thanks for pointing out her use of the term approximate relationship. I think this might be the most clear explanation for the term that she provides. I guess it is meant to indicate that the therapy relationship is limited or lacking. Frankly, I don't really like framing it that way. I disagree that the relationship is approximating anything else. It can bring up things from other relationships, but it is really an approximation of them? I liked my definition better. :)
pegasus
Posted by Dinah on June 16, 2005, at 17:43:46
In reply to Re: Chapter 4, posted by messadivoce on June 8, 2005, at 21:05:07
Posted by Dinah on June 16, 2005, at 17:45:41
In reply to Re: Chapter 4 and approximate relationships » annierose, posted by pegasus on June 15, 2005, at 16:33:53
I agree. I tend to think it's a therapeutic relationship. As different and well defined as a friendship relationship, or a love relationship, or a family relationship. It's special in itself.
Posted by Dinah on June 16, 2005, at 17:51:12
In reply to Chapter 4, posted by pegasus on June 8, 2005, at 8:46:17
I have always liked this chapter. I think it did help me figure out how and why the boundaries came to be where they are. One of my favorite stories in the book comes from this chapter, where the therapist offers her sweater. And one of the saddest, where the therapist asks for a hug when he's upset, then calls the client greedy when she wants to continue them.
I generally like my therapist's boundaries. He's not really strict with some of them. I know his wife's name and child's name. I don't think that was on purpose, but once he called them by name once, I guess he figured it was silly and obvious to go back to impersonal ways of referring to them. I know bits of his life and his history. Generally the facts come up in the course of my therapy.
Right now I think the boundaries are working against me. I'm having trouble connecting, and the boundaries aren't helping any.
But in general, I like the way Lott explains them as being for our benefit as well as theirs.
But......
I guess I dislike the idea, however sensible, that my therapist needs protection from me, or that he wouldn't be able to maintain our relationship without those boundaries.
Posted by Dinah on June 19, 2005, at 21:15:19
In reply to Re: Chapter 4 - Boundaries, posted by Dinah on June 16, 2005, at 17:51:12
That was my favorite message from this chapter. That transference is not a therapy limited phenomenon. By discussing how the same thing is at work in other relationships in our lives, it takes the idea out of that nasty place that therapists seem to place it when they dismiss our feelings as transference. (Especially if they just so happen to be uncomfortable or defensive at the moment.)
Yeah, maybe so, and so what?
Many of our feelings toward many people in our lives contain elements of transference. That doesn't make them any less real.
I don't think it's possible to deny that transference exists. I remember her story at the beginning of the chapter about the three women going to see the same female therapist, and the different person each described. It made me smile.
You only need to look at the Admin board to see how different people see Dr. Bob. He gives us such limited information about himself, and different people build different visions of who he is based on that limited information, and doubtless also based on past experiences with people in authority, or people with similar styles, or who knows what other of the limited characteristics he objectively displays. The same thing happened with my favorite professor in college. He was as good as a Rorschach test. People described him completely differently, probably based more on them than him.
I know that there are one or two personal characteristics that can turn me off a person entirely because I base my opinion about their entire personality on that. Totally unfair of me.
The one thing she mentioned briefly, and maybe she gets back to later, is the role of the therapeutic situation in developing transference.
My personal opinion is that human brains are programmed to respond in certain ways to certain types of relationships. And therapy mimics other relationships. Since we haven't had therapy for millenia, or long enough to develop ingrained responses to the therapeutic situation, our brains respond as they might to similar situations.
So IMHO, a major cause for erotic transferences is the similarity of therapy to love relationships. There is increasing intimate disclosure (however one sided), acceptance, the listening and attentive posture most closely associated with a lover. I think it's sort of normal for erotic feelings to crop up in those circumstances because our brains are programmed to respond that way.
It can also mimic a parental relationship in some ways. Especially in the lack of reciprocity. And we can respond in the ways that are programmed in us to respond as children to parents.
Maybe our life circumstances can influence which of the ways we respond. My erotic potential is very stunted, so I would respond as a child to a parent.
I'm not sure if I buy into the analytic transference models. It's possible I guess.
Posted by Tamar on June 20, 2005, at 5:03:02
In reply to Ch 5 - Transference, Not Just for Therapy Anymore, posted by Dinah on June 19, 2005, at 21:15:19
> That was my favorite message from this chapter. That transference is not a therapy limited phenomenon. By discussing how the same thing is at work in other relationships in our lives, it takes the idea out of that nasty place that therapists seem to place it when they dismiss our feelings as transference. (Especially if they just so happen to be uncomfortable or defensive at the moment.)
Yeah, I agree. It’s made me think quite a bit about where transference happens outside therapy. For example I’ve always said that when I met my husband it was love at first sight, and now I realise how much of that was transference (but he did turn out to be a honey!). And I can see how my students might be affected by transference towards me, which helps me a lot, particularly if they’re annoyed about something.
> I know that there are one or two personal characteristics that can turn me off a person entirely because I base my opinion about their entire personality on that. Totally unfair of me.
And yet those are real feelings. It’s not like you can just switch them off. Besides, transference can be quite useful in helping people judge which kinds of people they’re likely to get along with (or not). Despite its apparent shortcomings, transference can work quite well as shorthand when getting to know new people.
> My personal opinion is that human brains are programmed to respond in certain ways to certain types of relationships. And therapy mimics other relationships. Since we haven't had therapy for millenia, or long enough to develop ingrained responses to the therapeutic situation, our brains respond as they might to similar situations.
Yes, I agree. And if our brains start recognising the therapeutic relationship as distinctive, maybe it won’t be so therapeutic any more!
> So IMHO, a major cause for erotic transferences is the similarity of therapy to love relationships. There is increasing intimate disclosure (however one sided), acceptance, the listening and attentive posture most closely associated with a lover. I think it's sort of normal for erotic feelings to crop up in those circumstances because our brains are programmed to respond that way.
Yes, and I also think it might have a lot to do with the reasons we’re in therapy (maybe that’s what you mean by life circumstances below?). In my case perhaps it’s about erotic potential that’s been neglected… or something like that.
> It can also mimic a parental relationship in some ways. Especially in the lack of reciprocity. And we can respond in the ways that are programmed in us to respond as children to parents.
>
> Maybe our life circumstances can influence which of the ways we respond. My erotic potential is very stunted, so I would respond as a child to a parent.I wonder about this. I wonder if it could go either way. Either a person who doesn’t experience much erotic inclination for others would experience no erotic transference in therapy, or that person might find that the therapeutic relationship is the one place where erotic feelings could develop. I suppose the latter possibility depends on the idea that erotic feelings can be deeply repressed. What struck me about this chapter is that it’s so hard to pin down the reasons why a person might have a particular kind of transference in a particular therapeutic relationship!
> I'm not sure if I buy into the analytic transference models. It's possible I guess.
Do you mean all that oedipal and pre-oedipal stuff? I think I’m willing to accept that there may be some basis in truth there, but I think its significance has often been rather overstated.
I liked the chapter on transference because although I knew it was normal, it was very helpful to read about different ways it could work. And I was particularly glad to see Lott call for some serious scientific enquiry into transference.
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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