![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by wishingstar on August 6, 2008, at 13:39:07
I cant find a better word than "uncomfortable" to describe how I'm feeling regarding therapy right now.
The very brief backstory since I dont post often anymore is that I've been seeing the same T for almost two years now. I've had a lot of concerns about not being "real" with her and it feeling more like a friendship sometimes than a therapy relationship. I work in the mental health/social work field myself, in the same town, so we have contacts with some of the same people professionally (but never each other).
In the last month or so, I've been dancing with an eating disorder and lost a bit of weight. I was small to begin with so now I'd say I'm slightly underweight but not terribly so. Until last Monday (I go once a week), we'd talked about it but not too seriously. She was gone for a week weeks and then when I saw her this week, something was different. She felt like I'd lost more weight (I actually hadnt, not since the last session) and she got much more serious with me. That's probably warrented. I've seen her "concerned" face/reaction before and Monday was partly that but partly frustration. I was telling her that I was trying (I truly am) and cited the fact that I hadnt lost weight since last session, and she said "yes, but you didnt gain any either". True, but the way she said it felt like "that doesnt matter, if you were really trying you'd have gained". I AM trying, I swear. I felt like I had a different therapist that day and I walked away feeling sort of angry and unsupported. I know she's concerned and it's probably coming out of that, but I just didnt the feeling I got from her overall. I told her how very uncomfortable I am talking about body image, self-worth, etc (but didnt refuse to) and she suggested we limit talking about any of that to 20 min per session and talk about other stuff (boyfriend, etc which is "easy") the rest of the sessions. I feel like (and told her) doing that is just avoiding the issues. I know it's my responsibiltiy to talk and she cant drag anything out of me, but I guess I just feel like she's not taking me seriously. To be honest, I think that's a small part of what's driving my weight loss right now. If I'm drastic enough, she'll take me seriously. Yes, I plan to tell her this. My bad feelings about therapy arent really about any of these interactions in particular... just an overall feeling of "hear me! something IS wrong!". Last session, I felt like I lost my regular T for awhile. She agreed to let me send her an email this week because I said things were hard to verbalize and I plan to do it before my next session.
The other seperate issue happened today. I've been considering driving about 2 hours to see an old T for one session. Long story why, but I think it'd be useful. Old T agreed to do it even though I'm seeing current T and I want current Ts permission before I do it because I dont want to step on anyones feet. I left a message for current T Tues morning asking about this and referring to what I'm going through right now. Not the most personal message in the world, but not stuff I'd share with just anyone either. I didnt realize it, but shes out of the office the rest of the week. Usually she checks her messages anyway, but isnt this week. I got a voicemail from another counselor at the center this morning saying she'd heard my message as she was checking my Ts voicemails for her and when she'd be back etc. The issue is, I have a professional relationship (though a small one) with this T. My T is the director of the center and there are 5ish other Ts there. I've referred a few of my clients to this other T and talked with her professionally maybe 3-4 times about shared cases. This T knows I see my T and I'm just fine with that, but I feel like I'm mixing worlds here and feel very uncomfortable receiving a message about a personal issue meant for my T from this T. I will mention it to my T Monday, no problem, and I think the key is to stop referring to them because of this potential conflict, but it never occured to me that this could happen. I'm sure my T never even thought about it and I dont blame her, but ick.
Those two things combined make me feel very weird about therapy in general. I'm feeling a bit abandoned. She ALWAYS checks her voicemail when she's gone for the week etc, and I do believe that she really isnt this week, but her sudden unavailability, combined with my session Monday, just feels very bad. I'm strongly reminded of the professional nature of our relationship and I feel a little rejected and disliked by her right now.
I will talk to her about this. I dont quite know why I'm posting... just for someone to understand I guess.
I think I may go ahead and go see the other T the one time as planned tomorrow even without current Ts permission, since shes gone. My only fear there is that my relationship with this old T has been very special and I hold on to it, even though I dont see her anymore, and seeing her would risk a bad session and messing up that relationship in my mind. We'll see.
Thanks for reading. Sorry for rambling.
Posted by Lucie Lu on August 6, 2008, at 16:14:58
In reply to Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 13:39:07
It sounds like you are caught between two worlds therapist and patient. You are feeling vulnerable and needy because you want some help of the eating disorder, but you are also feeling disappointed and frustrated because you know how helpful good therapy can be... but this just isn't. (Or hasn't been yet, anyway.) I'm not a therapist but can imagine that it can be hard to fully put down the mantle when you yourself need help. Perhaps on one level, you can't feel comfortable opening up to your present T because of all the professional issues and conflicts that interfere with your mutual relationship Yet on another level, you have a problem that is potentially serious and anxiety-provoking, and you want another, caring person to hear your distress and come to your aid - what any patient/client would reasonably want. That's more than enough basis for a very ambivalent and uncomfortable experience of therapy.
Perhaps your current T is also sensing your ambivalence or feeling some herself. Might she be treading carefully with you because she's unsure of how to proceed? Could she be afraid to delve too deeply or too quickly/slowly with you because she's afraid she might fall short professionally in your eyes and maybe others as well? Do you sense any competition between the two of you? Her suggestion of splitting the session by topic sounds reasonable but also sounds as if she really isn't sure where you are going or how your needs will be best met. And there may be all this other background static, complicating the relationship between you, making you, and maybe her as well, feel uncomfortable. Another, maybe throwaway, question what are her weight and body type like?
Sorry if my answer is rambling (although I didn't find yours rambling at all).
Glad you're posting.
Lucie
Posted by wishingstar on August 6, 2008, at 17:09:18
In reply to Re: Uncomfortable... (very long) » wishingstar, posted by Lucie Lu on August 6, 2008, at 16:14:58
Lucie.. thanks for the great response. Not rambling at all. I think what you said in the first paragraph is exactly right. I work in a very confrontational job and have to be "on" all day long. I want to be able to drop the competent, intelligent, whatever thing while I'm in therapy but I dont feel comfortable doing it for the most part. I want to so badly, but I dont feel like I can. I know what I need in therapy, but not well enough to verbalize it clearly enough for anyone to get it I guess.
I should note that I'm not actually a regular old therapist myself. I'm currently working for social services/child welfare, but previous to this (a year ago) I was doing in-home therapy with children/parents who needed therapy more intense than outpatient. Similar to being a regular T I guess, but also very different. I cant imagine my current T feels any sort of competition with me. If she feels uncomfortable, I think it would be less because I'm in the field and more because, as we've discussed, insight and understanding comes very easily to me and I really dont need her help with that. I can generally figure out why I feel a certain way before she can. What I need help with is trust, vulnerability.. the feelings side. Not the thinking side. She told me once a year ago maybe that doing therapy with me is a learning experience because she has to think of things from a different angle. I dont know. Spouting insight and thoughts is very much a defense mechanism for me, and I've said that very thing to her, but I guess neither of us know where to go. I've sent emails that are very emotional and honest (written while I was very upset, etc) and shes mentioned them but never sees the importance. I think she always feels like they were just things I felt in the midst of a crisis and arent real in my day to day life. I guess I could be more clear on that but that's where it gets so hard for me. I once (over a year ago) gave her a list of reasons I felt like I should kill myself at the time. She said she didnt want to talk too much then because she didnt want to push too hard (I was definitely in crisis) but then a few months later said she didnt want to talk about it because I was doing so much better and didnt want to trigger the bad stuff again. It never did get talked about.
I think eating disorders are not her specialty. She is not overweight at all.. shes thin but not too thin and looks good. She's probably late 30s and fairly pretty. She told me 2 or 3 weeks ago she has 2 other clients with eating disorders, one of whom is about to go inpatient and the other who is emaciated. I may be underweight, but I'm not emaciated. I was very triggered and my immediate reaction was "you're not doing a good enough job at this". Of course that isnt what she meant, but I think comparing patients is something a person who specializes in EDs wouldnt do.
I think her frustration may be partly that she feels like I know better and I'm smarter than this. She's right, of course I KNOW better, but if we always did what we know to be healthy, no one would be in therapy. I dont think she knows what to do with me. I dont either. Of course I'm not blaming her completely (it probably sounds like it). I know I have to do the real work and push what is important. She cant read my mind. I do try, but I could probably try harder. It's just very hard for me and I feel like I have to be really blunt with it for it to get through right now. Mentioning gently is hard but manageable for me, but being direct and persistent feels almost impossible right now. I'm about to slip into "blame myself" mode so I'll stop there... :)
Posted by Lemonaide on August 6, 2008, at 18:18:36
In reply to Re: Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 17:09:18
I think when our T's know either we are T's or we are going to some day, changes on how they do therapy with us. They expect us to know certain stuff. With my T he is surprised on what I do know since I am only an undergrad.
Well anyway, I hope this is okay to say, but I think you are on a verge of a breakthrough. When I describe my childhood and life, it is a very intellectualized way. I knew the theories, etc. BUT a huge breakthrough for me was when I realized in therapy that I didn't "FEEL" the emotions. I could explain on WHY I felt the way I did, but if my T would directly ask me HOW did that feel. I couldn't say. It is a bid day when you know how you felt. Maybe it is different for you, but that is how it felt to me at first.
I remember talking to my current T about my old T, saying that when I would get teary eyed with him, he would make me laugh, and distract me from feeling. But with my current T, he goes with it, it is like he is searching for it to nail in on. lol I can't HIDE anything from him, he knows me well now. So when your T "forgets" things that are important, if it isn't all the time, it should be okay. But if it gets to where you don't feel you could show emotion with her or to tell how bad you might really be, than it isn't a good thing.
It is funny to me when people think that just because someone is a T, they must have the perfect families and can handle all their own problems. My T says is can help others, but sometimes many T's are blind to themselves.
Posted by Dinah on August 6, 2008, at 18:31:02
In reply to Re: Uncomfortable... (very long), posted by Lemonaide on August 6, 2008, at 18:18:36
Too true. I *know* my personal life is more stable than my therapist's.
I imagine it's difficult for someone who is a therapist to be a client and put away therapist-thoughts. Even I evaluate how my therapist is performing while I'm in session. I can only imagine if I were a therapist myself. I'd be thinking "Nice technique. I'll have to remember that." or "I think I could have handled that better."
My therapist said last session that he sees us as collaborators in my treatment. I asked him if that was even possible. He laughed and said that it certainly is the most collaborative therapy he does with anyone.
Would it help to think of it more that way? To take a bit more initiative in turning the therapy to a different direction if you think it's off course?
I'm just wondering, also, if talking about your own cases can exacerbate this problem. I find that when I talk about certain things, I can't help but switching to my rational self. Then I have to be quiet and go deep again to reach the emotional core. If you find both of you slipping into a peer relationship, it might be partially because that sort of discussion will bring out that part of each of you. It's ok to discuss it of course if that's part of your issues that week. Just as it's ok for me to discuss those things that kick me right into superrational mode. But maybe it's also important to stop and segue into the you who isn't a therapist.
And maybe find someone else to discuss your cases with? For when your cases aren't the core of your issues that week?
Posted by Lucie Lu on August 6, 2008, at 19:01:20
In reply to Re: Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 17:09:18
Wishingstar, I can't help but wonder if a change in therapists wouldn't be helpful for you. Maybe someone older, certainly more experienced both in general and with EDs, and who could help you get to the root of things. Lots of things can lie underneath ED symptoms and it would be a shame to have a T who wouldn't (or couldn't) at least try to look beneath the surface with you. Since you say feelings are an important part of what you feel are most important now, maybe a T with a psychodynamic orientation would be better able to help you? Somehow, given the dynamics you describe, I just can't really see things working out with this T...
Posted by Poet on August 6, 2008, at 19:27:32
In reply to Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 13:39:07
Hi Wishingstar,
My T once told me that if my ED got completely out of control that she would refer me to a T that has experience with eating disorders. Your T was probably thinking that she wasn't able to really help you and her frustration/fear came out sounding like she was blaming you for not gaining weight.
If you think seeing your old T would help you, I think you should do it. I just don't want it to end up hurting you because you'll only see old T once. I hope new T calls you back.
Poet
Posted by onceupon on August 6, 2008, at 20:26:12
In reply to Re: Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 17:09:18
Just wanted to mention that I got an icky feeling about the second issue you described. I imagine it would be *very* awkward to have someone with whom you have a professional relationship know personal, if mostly innocuous things about you.
But around the first issue, I get what you mean about having a hard time dropping the "competent, intelligent, whatever thing" in therapy. It's funny that we (OK, I) don't see emotions as competent. Intellectually, I *know* that having and expressing emotions does not undermine my "competence," but sometimes it's like I want to present this front to my therapist that conveys the message "I'm really OK" or "I'm not as crazy as I must sound." But then again, I really want to drop that front too, because I know it's holding me back in therapy.
I do find that forcing myself on occasion to talk about our relationship helps me to drop the front, so to speak. It sounds like your therapist might not be hearing some of your concerns very well (both the ones you are trying to express and the ones that you aren't). Might a more "process" oriented conversation be helpful at this point?
Posted by raisinb on August 6, 2008, at 21:56:21
In reply to Uncomfortable... (very long), posted by wishingstar on August 6, 2008, at 13:39:07
Hi Wishingstar--
I'm sorry you're going through a tough time. When I was reading your post, it sounded familiar--I guess it seems like you've had similar conflicts with her before? (correct me if I'm wrong or you have a different therapist now). Something like--you need to be seen and validated and supported, and she judges you for not trying hard enough instead. Also--paradoxically, maybe--that she doesn't push you to reveal the real, vulnerable parts of you. Or doesn't "see" them well enough to get at them.So, is there a reason why you're staying with her? I guess lots of us stay in therapy relationships that might or might not be helping simply because we're life-and-death attached (in other words, the therapy's meeting critical, long-buried needs, even if it doesn't seem to be doing anything in the short term). But it doesn't seem like that's the case with you, from your post (again, sorry if I'm wrong here). But it might be helpful to assess what exactly you're getting from it, if it isn't the real help you need.
Take this with a grain of salt; stuff like this raises my hackles. Anytime an authority figure says anything remotely judgmental to me, I banish them from my life forever. I had enough of that from my mother!
Posted by healing928 on August 7, 2008, at 1:05:47
In reply to Re: Uncomfortable... (very long), posted by Lemonaide on August 6, 2008, at 18:18:36
Lemonaide,
Wow that post sounds like how I feel. Sometimes my t will go into detail about something, like I am one of HIS graduate students. I am just finishing up undergrad, grad who knows! But sometimes I feel like he expects more out of me because of what I did for a career before going back to school.
Posted by Phillipa on August 7, 2008, at 13:08:24
In reply to Re: Uncomfortable... (very long), posted by healing928 on August 7, 2008, at 1:05:47
Wishingstar late on the thread but I may have missed it but if you're in the same office it might be really hard if not then maybe an eating disorder therapist would be better. What do you think? Phillipa
Posted by wishingstar on August 7, 2008, at 17:02:04
In reply to Re: Uncomfortable... (very long), posted by Phillipa on August 7, 2008, at 13:08:24
Wow, thanks everyone for all the great responses... a lot to think about. There are some particular things I want to respond to but I'm feeling pretty sick (physically) right now so I'll do it later tonight hopefully.
I just want to drop out of therapy and "mental health treatment" and everything that includes. I saw my pdoc today. For some reason, she thinks I lie to her and evade her questions. I DONT. I couldnt be more honest and upfront with her if I had to. Today she was unhappy with me because she asked me how I felt in one word and I told her I couldnt do it in one word. In terms of my depression, I said I feel great. In terms of anxiety/eating disorder/etc, I told her I feel pretty bad.. uncomfortable and anxious. I then said I couldnt rate it overall on a scale or in one word because of these two opposing feelings. All of that was probably about a one minute explanation. She was unhappy and lectured me on how its important to be able to give an overall sense of how you feel without referring to any specific issue. I'm sorry but I dont always agree. I spent years at the beginning of therapy learning that people can feel more than one thing at once and that it's okay to hold opposing feelings. And I spent years, literally, learning to be able to describe how I felt in more than one word (when one word really wasnt enough). I didnt ramble on to pdoc for 30 min.. I have her a MAYBE one minute summary because I felt like picking a number on a 1-10 scale, or one word, would describe one half of me but ignore the other, as the two sides are quite opposites right now. I'M NOT WRONG for needing two words to describe my feelings rather than one. When I finished my 1 minute answer, he response was "well that was evasive". NO IT WASNT! It was as honest and real as I could possibly be. Yes, I spoke up about my frustration and no, it didnt make a difference. I called her and left a voicemail 30 min later with a concise explanation of my frustration but said I didnt need a call back. I did also call my T and leave her a message invalidating the release form I've signed to allow them to talk until I'm able to talk to T again myself. I dont want pdoc telling T things about me that arent true. I hate them all. I really just want to stop all mental health treatment of any sort. I swear it just makes things harder. **** them all. This is not the first time pdoc has done things similar to this. She thinks she has me all figured out, but she doesnt.
(Of course there's also the part where now I'll sit all night and beat myself up, wondering if I really am just worthless and avoiding any help anyone tries to give me and therefore at blame for still having the problems I have.)
Posted by Lucie Lu on August 7, 2008, at 17:59:00
In reply to I hate therapy., posted by wishingstar on August 7, 2008, at 17:02:04
Wishingstar,
There's nothing wrong with you - your clinicians could use a tune up, if not outright replacement. Last time I saw my pdoc, he was going down the list and said, "alcohol?" I said "You offering?" And he just threw back his head and laughed. You need more laughter in your therapy. Or different therapists! You are OK, wishingstar. You have a problem that you want attended to. That's good!! Don't get discouraged. You want and deserve help with your concerns. Your clinicians seem to be having a major dork attack. Tell them to shape up or ship out. You don't need that garbage. There are plenty of caring clinicians out there who would be moved by your efforts to make your life better. And give you the respect that is due you.
Sorry you're feeling poorly. Hope you feel better soon.
Lucie
Posted by Dinah on August 7, 2008, at 18:01:49
In reply to I hate therapy., posted by wishingstar on August 7, 2008, at 17:02:04
Your pdoc? My pdoc doesn't want to hear anything at all about me except if I think I'm in need of a medication change or if I'm having directly related side effects. Hormonal changes affecting my mood? Tell my ob/gyn. Stress? Tell my therapist. He just doesn't want to hear it.
My pdoc before this one I used to call "Dr Just the Facts, Ma'am."
My pdocs don't really want to know all that much. I don't know how common that is.
He allots me about five minutes. Last time he even moved his client chair about six + feet from his desk as I walked in the office door. I swear I bathed and brushed my teeth before I went. If he wanted to be out of touching range of clients, shouldn't he move the dang chair before the client enters the room?
My therapist is an entirely different matter. If he were to ask me to sum up how I'm doing in exactly one word, he wouldn't be shocked to hear "annoyed".
I'm sorry you had a frustrating experience with your pdoc. Pdocs can be like that, at least in my experience. May blessings shower down on the ones who seem to care.
Posted by wishingstar on August 7, 2008, at 18:21:56
In reply to Re: I hate therapy. » wishingstar, posted by Dinah on August 7, 2008, at 18:01:49
Dinah, that has always been my experience of pdocs as well, until this one. All the docs I've had in the past havent wanted the details and I've been just fine with that. I dont need (or even really want) a meaningful relationship with my pdoc beyond medication and straight symptoms. I started with my new doc maybe 5mos ago. She is actually a therapist as well and has "just therapy" clients and "meds" clients. I'm just there for meds of course. She very much wants (and demands really) more than one word answers most of the time, and will ask therapist-like questions sometimes in response to my answers. Sometimes I'm with her 15min, once I was there an entire hour. That time, we were arguing basically about whether or not I'm trying to get better and whether or not I should switch to a certain other therapist she thinks I should see for a reason that imo isnt valid. I'd be just fine giving her one word answers, and would have chosen one today, if the one word was all she wanted. But even if I had chosen one word, the next question would have been delving into the word I'd chosen, not about medication etc.
My last pdoc sounds very similar to yours. He never moved the chair away (I think I'd be offended!) but he did sit behind a large cherry desk with my chart spread in front of him. I switched only because of problems with getting appointments and location. He wasnt interested in emotions and I was okay with not sharing them. That's what my T is for.
What an odd bunch, pdocs are...
Posted by wishingstar on August 7, 2008, at 18:24:41
In reply to Re: I hate therapy., posted by Lucie Lu on August 7, 2008, at 17:59:00
Thanks Lucie.... I do feel like there is something wrong with me though. The idea that if one person says you're a certain way, they may be wrong, but if 5 people say it, you should probably consider the truth that probably is behind it. Is it really possible I'm just finding all the nutty professionals? I guess it is, but I dont know. I should add that my T DOES have positive, helpful qualities about her as well as these things that frustrate me.. I'm sure I'm not giving a fair picture. Thank you for your positive words though. It helps.
Posted by Dinah on August 7, 2008, at 18:27:19
In reply to Re: I hate therapy. » Dinah, posted by wishingstar on August 7, 2008, at 18:21:56
I think that would make me angry then. She can want one or the other, but to insist on both seems arbitrary.
Posted by Dinah on August 7, 2008, at 18:28:02
In reply to Re: I hate therapy. » wishingstar, posted by Dinah on August 7, 2008, at 18:27:19
Not to say it *is* arbitrary. I don't know her thoughts. But I'd interpret it that way if my pdoc did it.
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
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.