I think I'm about to be terminated

[Kizzie]

I'm sorry it's not working out Radical.  Perhaps you have moved beyond her capabilities as a T and a person.  I say that because when I read about her reactions and yours I felt like I was back with my FOO trying to reach them and they just couldn't or wouldn't see me, connect with me.  For whatever reason, it just wasn't going to happen with them and it seems this may be true of your T.

I can see why it has been gutting, and it likely will continue to be if you to try to find in her what she doesn't have to give, to get her to see what she cannot because of her own psychological makeup.  It may be time to let go, acknowledge the good you and she accomplished, and move on to a T who can connect with you where you are in recovery now.  If there is any silver lining in this, it is perhaps that you have recovered to such a place that you have need of someone who can go to new levels with you, who will let you speak your truth, and be who you need to be as you move out of the chaos of CPTSD. 

[radical]

Thanks Kizzie,

I don't know what has gone wrong, but i don't think this problem is any reflection on her capabilities.

I'm in a pretty good place these last few days, but earlier, when I was suffering badly I felt despair about this.  My therapist got me here.  She didn't give up on me when I gave up on myself, and had faith in me when I couldn't find any of my own.  She was the person I learned to trust.  All the things I was too scared to show anyone - I literally couldn't make myself before, little by little I found I could.  There is no way that the love, wisdom and generosity I've experienced can ever be expected of anyone, and no amount of money could pay for it.

It feels like she doesn't really like the person I'm becoming, that she is disappointed by the direction I'm choosing, yet it has been her love that has got me to the place of taking such risks and having choices. I recently wrote in my journal "when did I make the decision to risk everything"?  because I saw that I was willing to risk losing my relationship with her.  Ironically, the very relationship that got me to a place where I was able to take risks in relationships, to stand up for and stand with myself for the first time.  I hope she doesn't see the result as a failure, because I don't.  It has certainly led to some radical decisions (and consequences), but I needed to make them. 

This has been a difficult time, so much turmoil and upheaval.  It has been hard on her being with me through this.  It may be that we are coming to the place where our paths diverge, but maybe that is part of the process, and maybe there is no pain and conflict-free way of getting through it.

[woodsgnome]

Your reflections on this are very touching, Radical.

I once had a T who seemed 'the perfect fit' and it didn't last long. For many reasons, it soon was obvious I needed to pull back from what I sensed was going on. When I expressed this to her and declared I was opting out, she blew a cork and insisted that at the very least I needed 'closure'. I felt open to exploring this but she seemed to have a predetermined outcome override any of my doubts, with no discussion as an option that would disrupt her 'plan'.

My answer to her was along the lines of huh--does any therapy really ever end? Doesn't it evolve like the rest of life?.. Closure? As if I've reached the promised land of 'just get over it'? While in fact I learned much from our early sessions, as we progressed I felt as if I was only being made to fit into her grand scheme, what she referred to as her patented/trademarked 'life script' program; based on a graduate thesis she apparently never allowed to flex. This left me feeling like I was some round peg being manipulated to fit into someone else's game-board on which there was no wriggle-room; and I was just her latest game-piece. What started with promise ended with agonized withdrawal; but I still feel we'd had an early rapport where it seemed we connected well and from which I found some relief--'til the cracks became too wide to repair.

What resonates from what you say is that, whatever the reason, you know and appreciate the good that came from the relationship, but also seem aware of the current impasse. While you've worked hard to bridge that, it seems you realize the hazards of letting it drift further off course. The key is not to feel as if that's a failure, on either part; that there are no sides (and, if I read you right, you still are open to other explanations).

Thanks for sharing those insights. Therapy is like life in microcosm, I guess, with its unexpected twists and turns. Hopefully the pain doesn't keep us from seeing the good parts, and vice-versa.

[radical]

I'm still with this problem. 

It is probably for the best that there will be no therapy for another three or four weeks because of the holidays.  I keep trying to think of ways of bridging the impasse, but all my attempts so far have made things worse, just added another layer of misunderstanding.  I've tried hard to not be confrontational, but there doesn't seem to be any way of addressing my concerns that don't coming across as challenging and distrusting my therapist.  At the lowest level, I haven't been heard, and as soon as I break through the barrier of being heard, I seem to hurt her and make her defensive, and I hate that.

There have been problems with our differences and misunderstandings throughout our time together, but I valued her insights and our relationship, so I looked into what she said where the content felt 'off' and, when despite this, I continued to feel that I was misunderstood or unheard I either forgot, or decided to let it go and get on with what worked.   When things were going really well or I was extremely vulnerable and needed her most, I completely forgot . I know there are always differences of opinion and understanding between people.  Much of it really doesn't matter.  Now, unfortunately, I've reached a place in therapy where it does matter, a place where it seems to have created a fork in the road and I don't feel I can progress any further, or move in the direction I need to go, and I can't see a way past this. 

I feel my most important task is integrating much more of the different aspects of my "self" (or "selves") into being accessible in the moment - to make parts of myself that I need to look after myself in relation to others, and just as importantly, to be authentic, whole, and real to myself and others.  I can't carry on living in narrowed-down versions of myself that arose out of fear, abuse and powerlessness, and keep accumulating abuse and disrespect as a result.  In their split-off forms these parts probably seem horrible, and in accessing them (what Walker talks of as "angering" in therapy), it might seem like I'm moving in the direction of becoming hostile, aggressive and vengeful, but it's not about that, it's about integrating them.  I believe I need to be able to feel all of my feelings in the moment, and and access to the whole 'menu' of possible responses, especially at a low level when there are just signs of something amiss that I need to respond to at that same low level.  Reacting reflexively with increased appeasement or shut-down, to any sense of social or interpersonal threat has been disastrous for me.  It's not that I want to become an aggressor, or throw my weight around, it's about being able to feel what I actually feel and be able to make the most useful choice of response, in line with my values.

I feel like I've changed so much, especially these past two years.  It feels like there is little time in therapy to cover what has been happening that is important to me, and it has been hard to change my way of interacting with my therapist in a way that reflects the changes.  Often, what I need is to feel the security of the relationship, much more than I need to express myself. As a result, I think many things I've been processing in a variety of ways over a long period seem to come out of the blue, in stark contrast to the usual 'people-pleasing' and finding common, familiar ground.  I fear she may feel betrayed to be finding how much I've said what I felt she wanted to hear to try and protect a relationship I needed.  It's not that i was manipulating or being insincere, it is part of the problem for me, and after years of plugging into what other people apparently want, and disconnecting from myself, it's not something that has been a choice.  Now it is becoming a choice to not be that way, I choose to be authentic, and I fear it spells the end of the very relationship that allowed me to get to this place.

If anyone wants to respond, please don't misunderstand this as black and white.  The depth and caring in this relationship has saved my life.  It's probably much more complicated than I'm able to express.

[Dee]

Radical,

I am so sorry I missed this thread in December.  I wasn't in a good place then.  I am trying to get through it now, but it is a lot to catch up on.  I'll reply more after I read more, but I think you grown in therapy just by what you were able to tell her.

[sanmagic7]

radical, there are a few thoughts that came to mind.

one was that some relationships have a starting, middle, and end point.  that may be what's happening here.

another was that, from a professional viewpoint, i don't believe that a client can betray me.  my job is to help the client see his/her way out of the tangle they're in, give them tools and insights that they may not possess so that they don't get trapped again, and hopefully guide them to a place where they don't need me anymore.  whether that's because they're 'cured' or just need someone else's guidance now doesn't matter.   as a therapist, on one level, this is not a personal relationship.  the client is paying me, deciding whether s/he can trust me enough to be vulnerable in order to work on seminal issues, and, in turn, i give the client the best i have.  but, in all cases, there is an imbalance of power.  the therapist wields more power because the therapist is not the one to be vulnerable in this relationship.  the therapist has a job to do, and that is first and foremost the object of the day.

i've learned that there are no 'difficult' clients, only that i might be using the wrong strategy with them.  the working part of the relationship is on me.  the recovering part of the relationship is on the client, but it's on me as well to give him/her what they need to be able to recover.  therefore, it's all on me in a sense.  i can't be betrayed, have my feelings hurt, become irritated/angry at what the client is or isn't doing because if i am, then i'm doing something wrong, and need to explore that within myself and fix it within myself.  it's not up to the client to understand me - that's my job.  it's not up to the client to please me - that gets no one anywhere as far as recovery goes.  it's not up to the client to worry about hurting my feelings - my feelings don't belong in that relationship.  if i do have feelings, again, it's up to me to explore what's going on with me, but also to reassure the client that it's not his/her concern or fault.

the client's best interest is number one priority - always!  and that's totally on the therapist to make sure that priority stays in place and everything done in session and in the relationship is geared toward that.  when i fired this last therapist, it was over getting a hug at the end of a session.  she knew about the alexithymia, and we'd had a conversation about how that touch was something positive i could feel.  she's mexican, i'm not, and several times she reminded me that maybe that was a cultural custom in the states, but not necessarily in mexico.  while i was going thru my training, one thing that was pointed out to me over and over was that a client's culture must be recognized and respected.  as long as no one was getting hurt, of course.  in my case, this therapist refused to do something that would help me, her client, to feel better simply because she didn't feel comfortable with it (and, before this particular session, i'd seen her probably 2 doz. times, and she gave me hugs at the end of each session when i asked, saying 'it's what you need'.)  where that thinking went, i don't know, but i do know that it was not putting me first, which, as a client, is where i belonged.

so, that's my two cents worth on therapist/client relationships.  radical, i know you'll do what's best for yourself, and that it is a difficult dilemma you find yourself in.  this kind of thing is rarely easy or simple.  there are always layers to consider.  i just hope you go with your gut - if it doesn't feel right there, it's probably not.  big hug, dear radical. 

[radical]

I agree there is an imbalance of power.  I know i have a problem with 'people pleasing' though i don't think that term does justice to the issues involved in the problem, but there are two people in every relationship,and i don't believe one person's feelings, in any relationship, can ever not matter, or just be put to one side.

I believe your therapist should have told you she couldn't give you what you needed if you needed a hug after every session, I don't believe she should have ignored her own feelings about touch and been inauthentic.

I understand I'm messed up over this problem.  But i don't think anyone can just act out what another wants or needs and for that to be genuinely healing to another suffering the effects of cPTSD.

[radical]

I wanted to come back to this briefly.  I need to get right away from the computer today after this.

I'm trying to tease out what i mean, for my own benefit.  I guess when i talk about equality it is part of two things i believe.  One is that all people are equal, and that imbalances of power and need don't change that fact.  Such imbalances exist in every relationship.  The imbalance is extreme and therefore potentially dangerous in psychotherapy, but I can't see how a different format that might lessen that imbalance could be equally potentially healing.

The other belief is that for a relationship to be deeply healing, it must be authentic on both sides.  That doesn't entail some kind of free-for-all expression of any feeling that comes up (it never does in any relationship), it doesn't mean the therapist isn't focusing on the client's needs rather than their own in the session, that the relationship must be as important to the therapist as it is to the client, or that it function in the way non-therapy relationships do.  Obviously, therapy for a therapist is a job, and when the session ends they have another client, and then another, and at the end of the day they go home and get on with their personal life.  What it means to me, is that within the confines of the therapy relationship, they are relating from their own authenticity and integrity.  To me, an honest relationship between two people involves enacting the truth of  what I believe is a fundamental human equality, beyond all superficial externalities.  Building trust and healing comes from that place, from moments of truth.  It doesn't require anyone to be perfect or to be more or less than they actually are.

[sanmagic7]

i agree with you, radical, that both people in a therapeutic relationship need to be authentic, and that integrity is important.  maybe i came off too harshly, maybe i didn't explain myself clearly, or maybe i just didn't use the right words.  if so, i apologize.  that wasn't my intention.

let's see if i can say this differently.  when i'm in my therapist's chair, i am the one responsible.  i'm there to serve my client, not the other way around.  i don't believe it is the same type of relationship as that of two friends.  to me, two friends are equal, have equal power in the relationship.  both are responsible for the relationship in an equal manner.

in a therapeutic relationship, (and i'm only speaking from my point of view.  maybe you view it differently, and that's your right), i am a guide.  just like if i hired a guide to take me through a national forest - the guide has more knowledge, more experience with the territory and terrain, knows more about the pitfalls, and can point out vistas of beauty that i might otherwise miss.  it's the guide's job to make this the best experience for me as possible, not the other way around - an imbalance of power.   the guide answers my questions as best as s/he can, and will acknowledge if s/he doesn't know the answer, but doesn't argue with me or get mad at me if i say something not to his/her liking.  the guide's training has hopefully covered such incidents and how to tactfully handle them.

i see it the same way in a therapeutic relationship.  the client chooses the goals (like i chose the national forest), but then it's my job to be the guide that gets the client through everything in order to reach those goals.  if there is a disagreement, we can explore it.  i believe that a client's feelings are part of the process of getting to the goals.  i am with the client in the role of helper.  my personal emotions, if they are somehow neg. to the situation, do not benefit the client, and it's on me not to let my emotions get in the way of the client's process.  hopefully my training and experience allow me to not have that problem.  i don't see this as being inauthentic, but rather caring and considerate of the client's process.

not to say i'm perfect at it, or that i won't make mistakes.  we therapists are human, too.  and, for many of us, it's not just a job, but a responsibility to the people who sit in that other chair in distress, confused, suffering and wanting to find answers.  everything i can do to help ease, untangle, nurture, and provide the necessary information is what i want to do.   i chose to be a helper because it makes my heart sing to see someone find their way through the darkness into the light.  i found a personal satisfaction that made me excited to see the next person, and the next.   it was never just a job.  in fact, my goal was always to put myself out of business, to help people find their way in their lives so that they didn't need me anymore.  when that happened, i was happiest of all.

again, this is all my opinion.  every therapist works differently, every client responds differently, and every therapeutic relationship has its own dynamic.  there is no cut-and-dried way to do therapy, just like there's no cut-and-dried way to be a client.  but the best progress will be made if the fit is there between  the client and the therapist.

as far as me and my ex-therapist, well, it just didn't work for me.  so i left.

i know this is difficult for you radical, and i wish you only the best.  i hope you know that.  i'm really sorry if i've confused you even more.   it's such a personal experience.  if you had 10 different therapists writing here, you might get 10 different perspectives.  mine is only what works for me.  if it doesn't work for you, there's no problem.  i'm glad you have time for contemplation on this.  it's a big decision.  big hug, my friend.

[Max]

Radical,
I'm sorry for what you are going through with your T.  The hugs and then no hugs would have hurt me too.  Especially with no explanation or warning.  What you wrote in your last post is so on point.  The client at the very least needs to be able to trust there is authenticity from the T.  When there is not it can be re-traumatizing with child hood trauma.  I like SMs analogy of them being a guide from darkness to the light.  Mistakes can happen but when they do it is important to acknowledge them and clear them up vs blow them off or ignore them.  Otherwise our 'guide' could set off many triggers and lead us back into darkness which is harmful.  I am coming up on an anniversary of having gone through a very bad ending with a T and it was re-traumatizing.  I don't think many are aware of how harmful it can be for a client. I hope your situation improves. 

[radical]

Thanks Max and San.

I was thinking about this as I did my chores and this is sounding more and more nuts even to my ears.  I could be wayyyyy off with this and if so, I need to know, so I'll try to explain.

Here's how it feels to me.  I understand your tour guide analogy, and for most kinds of therapy it is apt. For problems like anxiety, depression, major life transitions, relationship problems etc, I'd say that the model you describe is a good one. Well trained therapists know the terrain, and the hazards to steer away from.  They are well-versed in knowledge and wisdom and strategies.    But though cPTSD can have elements of the above and more, and sufferers can be helped by such an approach, at the heart of the condition is a profound breakdown in trust.  As useful as knowledge  and skills are, it is the experience of an authentic relationship, not with a guide, but a real person, that can possibly allow healing this breakdown.

[mourningdove]

Radical, you seem to be talking about healing attachment trauma. I agree that it is a different process with different requirements. At least, that has been my experience. Everything you wrote makes perfect sense to me.

[sanmagic7]

ok, i get it, radical.  it's a different dynamic for a different issue.  the genuineness plays another role in the relationship that is required for the healing to be able to take place.  i think that's what you're saying.  and, mourningdove, i have to admit, i haven't heard of healing attachment trauma.  something new every day.

     

[mourningdove]

Sanmagic, the following is a quote from It's Not You, It's What Happened To You, by Christine Courtois. (I'm sharing it because I'm not knowledgeable enough to explain the idea of attachment trauma in my own words.)

a. Attachment Trauma (Relational Trauma) is a form of interpersonal trauma that occurs in relationships where there is primary dependency or a close personal bond, such as a parent-child relationship or a romantic partnership (marriage or the equivalent). Neglect, emotional abuse, physical abuse, sexual abuse, and domestic violence are common forms of attachment trauma. Attachment trauma, especially when it occurs over the course of childhood, has severe developmental consequences that can set the victim up for additional traumatization later in life. This is referred to as developmental attachment trauma because it can have a profound impact on a child's development.

i. Betrayal Trauma involves the abuse of a relationship or a role for purposes of exploitation. There is often a close relationship between the victim and the perpetrator, such a parent-child bond or a spousal bond. Domestic violence and various forms of in-the-home child abuse are common forms of betrayal trauma. The difficulty for the victim is that the mistreatment occurs in the context of a relationship that fosters needed attachment and dependency and has other, more positive elements that may obscure the true meaning of the abuse. The relationship may be used to obscure or misrepresent abuse, and victims may be "groomed" into relationships where they are later abused and exploited. In these circumstances, the victim and the perpetrator often develop what is known as a "trauma bond" as part of their relationship, something that often causes a great deal of later confusion for the victim.

ii. Secondary Trauma (also known as the "second injury") occurs when the insensitivity or a lack of assistance on the part of those whose role requires them to provide assistance, intervention, or protection in the face of danger. Essentially, "insult to injury" occurs when a person or institution that should provide help does not and/or does additional damage. Take, for instance, a child being bullied at school who is told by a teacher or administrator to either suck it up or to fight back, with no other assistance or intervention. Rape victims in particular have long complained that insensitive and even degrading treatment by police, criminal justice workers, and medical personnel is often as bad, if not worse, than the actual rape – making the overall experience much more painful.

iii. Institutional Trauma refers to lack of response, assistance, protection, or intervention at an instituational level, especially when that institution or agency is charged with providing services to or protecting its members. This sort of cover-up can involve the scapegoating or punishment of a disclosing or complaining individual (the victim) or those who might be protecting or supporting that person (such as relatives or coworkers). Common examples of institutional trauma include abuse by clergy that is covered up by a church's hierarchy, sexual abuse by coaches that is covered up (i.e., Penn State), and sexual abuse in the military when a cover-up within the chain of command protects the perpetrator(s) at the expense of the victim(s).

[Contessa]

Oh boy! Thanks Mourning Dove. Great description and so very necessary to know.

Definitely identify with seconday trauma.