Trying to Hold Onto Connection

My therapist is officially on vacation now. *Sigh*

Today’s session went pretty well. There’s nothing that was bad or negative about it, I’m just sad that she’s going to out of the office for 12 damn days. Boo.

I opened the session by asking if she was ready for vacation. She said,

“Well not yet! Are you still mad that I’m going on vacation?”

I said yes and then outlined many of the things I spoke about in my last post. I was very honest with her. She figured I was worried about the usual fears (abandonment) but I added my concern that we would lose the momentum we’d worked so hard to build up over the last several weeks. She agreed and said that although it could (and likely will) be difficult to pick up where we left off, we also won’t be starting over again.

True.

But I’m still concerned. I feel so good right now about where we are, relationally. I feel so relaxed in the relationship, in a way I’ve never experienced in therapy before. I found myself beginning to jump to conclusions during session today regarding her thoughts about me, but then I “reality checked” myself and realized I don’t actually believe she’s thinking anything bad about me. I suppose I have a different level of trust with her. I feel very calm and open right now.

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The Elephant

After I published my post about yesterday’s session, I called my therapist. I left a voicemail that went something like this:

“Hi. I’m calling because I think we probably need to talk before Monday because that’s a long ways away and this feels important. I know you’re out of the office tomorrow, and potentially all weekend, so you may not be able to call me back, but I’m asking anyway. I *think* I need to talk to you, but I don’t know…because I don’t really know what that even means! Anyway, if you have a chance between now and then, can you please call me?”

Oy.

She called back an hour or so later and we were able to speak for about ten minutes. I told her just about everything I was feeling and thinking. I essentially outlined much of what I’d written in my previous post, specifically that I felt like she was not necessary putting conditions on affection for me, but just withholding it entirely.

I also said that although she is certainly entitled to conduct therapy in the ways she thinks are most helpful, I’m not sure that my feeling as though she won’t offer me compassion or reassurance, even when I really need it, is a good match for me. I explained that I’d imagined I didn’t feel those things from her because I simply hadn’t been asking for them (or asking in the right way). But upon finally finding a way to point out this specific need, I learned that it wasn’t something she was even considering offering to me and that was absolutely devastating. I further told her that this realization not only undermined my relationship with her, but my relationship with therapy in general. I was questioning everything!

I was somewhat surprised by her reaction to all of this.

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The End?

Wow. I seriously feel like the floor just fell out from underneath me. Not just for today, or with this therapist, but for therapy in general. Its the type of realization that I’m not sure has the potential to be reparable because my very understanding of the therapeutic process and relationship has shifted.

I wonder if it’s always been this way. Am I just now seeing this? Have I been hoping and reaching for something this entire time that never actually even existed??! Am I really that fucking naïve and stupid?

Probably. Let me try to explain.

I went into session today hoping to expand on yesterday’s session. Since I had written so much on the topic, I figured I could just pull from that material. But I didn’t want to get into vulnerable stuff if my therapist had somehow changed her mind about allowing me to call her to connect between sessions (something I do maybe a couple times a month). So I went about asking about the phone calls in an admittedly less-than-ideal manner. I playfully said,

So did you have a chance to think about our conversation yesterday? Are you going to take away phone calls or..?”

I get that there were better ways to ask this question, or address the issue, but that’s something I’m actively working on, and still really struggle with. She responded by being a bit snarky and saying that she felt like there was no way for her to really answer that question. Why? I cannot tell you. I know she explained it several times, but it all seems like nonsensical bullshit to me right now.

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Want v. Need

When I was a kid, my parents would send my siblings and I outside to play. I didn’t really mind because I honestly loved being outside. As soon as it was nice enough, I was playing outdoors until the street lights came on. During the cooler months, they’d send us to our playroom – a room that evolved from something for small children (with endless toys) to something more appropriate for older kids (with a cool fold-out couch, TV, stereo, and many posters torn out from the pages of Teen Beat magazine).

I kinda loved having the separate spaces. My parents were often boring, annoying, or outright scary. But, also, they would tell us not to disturb them. Common phrases I heard were, “Don’t bother me unless you are dying” or “That scream better be because your arm was just cut off!”

Whether or not they meant that in the literal sense? Who knows. But I know my siblings and I certainly thought they were serious. And so my very difficult relationship with “needing” pretty much anything continued to develop.

My therapist and I have been having a deliberate conversation around boundaries. This is always the toughest subject for us in session. It just triggers such HUGE emotional pain for me. In a recent session, I asked her two questions that she interpreted as me “mocking the boundaries”. That statement felt very confusing to me because my intent was simply to try and open up a conversation about something that was really hard to talk about. I didn’t experience myself as consciously doing anything at all with the boundaries, but she clearly did.

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Regret

I wish I had written a post on Friday, after I’d gotten out of session. It was a difficult session, intense and uncomfortable. But also profoundly intimate and full of rich connection.

When I left, it took me roughly two hours of slowly browsing through a bookstore to restore my nervous system to something resembling calm.

The long and short of it is that I’d begun to feel quite disconnected from my therapist. I’ve written previously about my struggles with an eating disorder and how that has tremendous power to pull me out of connection with everyone (myself included). My therapist has certainly not been an exception.

In making the decision to increase my food intake and actively fight back against my ED, the lack of connection between her and I has been that much more painful. I’m still not entirely sure what possessed me to do this, but last week after a particularly challenging (failed) attempt to connect with her, I came home from session and did a web search on her.

I put in her name and location. I’ve done this before – when I first began to see her. In another life, when I had therapists with poor boundaries and even worse communication skills, “googling” a therapist seemed like what you just did. So naturally I searched her online to see what came up. The answer: not much. Just professional stuff like her education , work history, and licensing information.

Which, I suppose, is what I imagined I would find this time around as well. Sometimes I go directly to her profile page on PsychologyToday to feel close to her and to remind myself that she wants to be doing this work and that this is literally her job. It’s soothing.

But I was wrong. There was more.

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Truth and Transitions

Since I had to go to therapy right after the rather disastrous appointment with my shrink on Monday, I was in a difficult emotional space. I felt intense rejection and a sense that the world was caving in. I think I also felt like I had very little left to lose, since I was now in conflict with both my therapist and psychiatrist, which emboldened me in a much needed way.

So when I got to session, I opened with about as much truth as I could handle. I said,

“I feel like we should just end this: therapy, sessions. Because I feel like you are dangerously close to bailing on me and I can’t tolerate that thought. I can’t be in that space, dealing with all of this fear. I can’t be waiting for that. I can’t be imagining it. I don’t want to think or feel or do anything that has to do with you abandoning me. So I just want to walk away now, before you can really hurt me.”

She first assured me that she has (still) not had any thoughts about bailing on me or ending our treatment, but then she asked if perhaps her comment from last week had left me feeling afraid and concerned that she was at a limit with me?

“Yes, absolutely.”

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More Thoughts on Boundaries

I went into session yesterday with the idea that I would simply have a conversation with my therapist. I didn’t prepare anything ahead of time, but I was okay with that. I felt calm. I essentially took the pressure off of myself to be or do anything specific and allowed the dialogue to unfold as naturally as possible.

We ended up talking about a lot of really important things, including our relationship. I relayed a story about a friend who is facing a very difficult situation involving her therapist that primarily stems from poorly managed boundaries. I told my therapist that listening to my friend talk about this incident gave me a lot of perspective on our therapeutic boundaries and the way my thoughts have shifted a lot on this topic in the last year.

The long and short of it is that I can really see the value of having solid boundaries. This friend of mine is in a place where she now knows something about her therapist that neither of them wanted her to know. She found out about it because her therapist said she had a “personal emergency” and would be out of work for a while. The only reason my friend was able to find out what that personal emergency was is because of the way that relationship was managed; she knew enough about her therapist’s life to do a simple google search that led her to both a news story and video clip that she otherwise would have never discovered.

And she really wishes she hadn’t.

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Special

When I went into session today, I knew I wanted to discuss the threatening feelings around the relationship I have with my therapist, but I also knew it would be challenging to feel that extraordinarily vulnerable.

As with most difficult topics, I thought using the Zooey situation as a medium to communicate about our relationship would suffice for now. So I chose to share an email I’d written to Zooey last July; an email that I’d describe as one of the most shameful things I’ve ever written.

As a preface, Zooey and I had been having a conversation in session about boundaries and the nature of our relationship. I told her I was concerned that the relationship had become “unhealthy” and that I was struggling with the inconsistencies in regards to out-of-session contact. I wasn’t sure what I felt or thought, but I wanted to talk with her about it.

She responded by saying. “I don’t normally text or email with clients. It’s not that you’re special, I just think that works well for you.”

Seems innocuous enough, right? But it devastated me.

Here is that email, written and sent within 40 minutes after session had ended. In fact, I was so upset that I called my wife right afterwards, then hung up and drafted this email from my iPhone while sitting on a stoop at a realty office on Broadway. That is how strong my reaction was.

I was terrified out of my mind to share this, but I did. And now I’ll share it here:

Zooey,

The first thing I did when I left your office today was pull out my journal and write this quote down:

“Well I don’t normally text and e-mail with people. It’s not that you’re special or I like you better, but…”

Thanks, Zooey. Thank you so very much for the reminder that I am in fact not special. The decades of various forms of neglect, abuse, and torture we’ve endured had not made that quite apparent enough.

And here’s the thing: I know that as a therapist, you’re not supposed to play favorites or become over-invested in us or our treatment. I know that it’s important to have boundaries in order to keep the relationship therapeutic. So if you did feel that perhaps I am a special client that you particularly enjoy working with, it would be inappropriate for you to share that with me. Fine.

But to go out of your way to preface a statement by emphasizing that you do NOT think I am special, nor do you like me better was just…..I mean, what the actual fuck? That was so hurtful.

The fascinating part of all of this is that you made that statement on the final day of a month where we had fourteen sessions. We’d been in contact nearly every day (or at least someone had). You sought out a new supervisor to help with my case. You’ve called us at night and texted back when we were upset. You’ve been coordinating with Wife to help us. You stayed late at the hospital and were late to your personal plans to make sure we were safe. You got this workbook to help move forward with therapy with various alters. You’ve gone out of your way to make sure we get attentive and effective treatment. That feels special to me.

As clients, I think we all want to feel and believe we’re special….that our therapist loves and cares about us and secretly prefers us to other more boring or difficult clients. That’s our fantasy to do what we will with. For me, I struggle so much with accepting even basic compassion and care from you (or anyone, really). It has been a challenge to not counter every good interaction we have with an internal follow-up to remind myself that I’m just another client and you’re just doing your job and that you don’t actually care. Sometimes I tell myself that you really do care and maybe even do feel a little more invested in my treatment because I’m intelligent and interesting and generally cooperative and articulate. Whether that’s true or not is irrelevant – it helps me feel more worthy of treatment and it makes it a little more okay that sometimes we need a lot of extra treatment.

But now you’ve taken that from me. And that really fucking sucks.

Especially because earlier today I tried, but couldn’t find any words, to express how much I love you. Perhaps I could have just said the words themselves, but that felt both too raw and potentially inappropriate.

But I do love you. I love you so much it overwhelms me. The time in between talking or seeing you can feel excruciating. It’s hard to remember if you’re even real when I’m not directly communicating with you. Weekends are especially challenging because the time between Thursday and Monday feels eternal and I’m always convinced that by Monday afternoon, you’ll have forgotten about us or stopped caring altogether. If we (well, some of us) could text you every single day just to reassure ourselves that you’re alive and that you remember us, we would.

And THAT is what I meant today by “unhealthy.” I feel as though I shouldn’t feel as attached and invested in you as I do. It feels like I’m doing something wrong…like there is something perverse or damaging about the bond we share. I haven’t exactly had a model for what it means to have a healthy relationship with someone in a position of authority and responsibility. Most of my relationships have ended up perverted and damaged.

I know this isn’t the case. You didn’t neglect or abuse me. But you did hurt me. Us. I can’t believe you would say such a thing. I just can’t figure it out or make sense out of it. I mean, honestly: why?? What was the point?! People don’t just randomly say shit like that!

I can’t read your mind, so obviously I’d eventually like to hear your reasoning behind whatever the hell that even was. But I don’t want to come in next week. I think I just need a break. This week has been so traumatic and now you’ve hurt me in a way that feels unbearable. I know that’s dramatic and you’re probably going to pin this all on my own transference, but whatever. You play a part in this relationship, too. No matter what you say, I know it’s not all just about me and my needs and what I get out of it. Relationships don’t work like that, even therapeutic ones.

So I think after I get back from vacation might be a good time to resume sessions. I don’t know. I need to think about this a lot more. Maybe it’s time for us to just move on altogether.

Either way, one of us will let you know.

Until then, we’ll be replaying your quote over and over on a loop in our head….Thanks so much for that.
Andi

Her response, 90 minutes later:

Andi,
I am sorry for my poor choice of words, and I am sorry that I hurt you. I hope to see you on Monday so we can talk about this more.
Zooey

You can probably guess that I went to that Monday session, but nothing was resolved. We didn’t really address the comment she made. She did say, “Andi, you must know you’re special. Your willingness to be vulnerable, your self-awareness and ability to articulate yourself is unparalleled. You must know that about yourself.” (I mean, yes and no?). We also never made it back around to have a conversation about the potentially unhealthy nature of our relationship or my endless confusion over boundaries.
Because, like most things in my time with her, we never really talked about anything.

Protecting the Work

When I went to session on Friday, I opened by telling the therapist that I got her email.

I explained that I was impressed by how quickly and professionally she responded, but that it was also a bit activating to be emailing back and forth. She nodded and said, “Right, I can see that. And also, I said in my voicemail that we could just talk about it on Friday.” Which was true, so I appreciated that she understood why that subtle change might be difficult for me.

We talked about why she decided to write me back. She said she thought it would be easier for me to see the proposed session times in writing and compare it to my own schedule before we met again in person. That way we’d both know what did and did not work and could start there.

That makes sense because I could tell that neither of us really want to use session time on scheduling stuff. She also reminded me that this is the way she uses email, so she doesn’t see our exchange as anything more than administrative.

I agreed with her, but it still brought up a lot for me. I told her as much and she said she was glad I brought that into session so we could talk about it. This email conversation allowed us to talk more about boundaries.

When I first saw her, this therapist told me that therapeutic boundaries exist to “protect the work.” I remember thinking that was total bullshit. Boundaries never made sense to me. I talked about the contrast between having virtually NO boundaries at home and then entering mental health care, where the boundaries were both rigid and not.

Many of my clinicians have had very strict boundaries. As I’ve mentioned before, they would flinch at even basic questions, such as their birthday. This was hard for me – especially considering that I’d never had boundaries modeled for me. It felt arbitrary and punitive. And hurtful. Psychiatric hospitals are very lonely places.

The therapist said, “And, also, I’m sure it was this very ‘one-way’ experience for you, right? You were expected to be vulnerable and share so much of yourself with these people and yet you couldn’t know anything about them.”

I almost jumped out of my chair, “Yes!!! And that felt cruel. The boundaries were strict in that one direction – as if the staff needed ‘protection’ from us crazy kids. But then, in the other direction, the boundaries were impermeable. They had unlimited access to me. There was no one to protect my boundaries or to tell me that I could put a limit on who and what I allowed in my physical or emotional space. And I didn’t know how to do that for myself.”

Then I explained that I have often been accused of pushing boundaries, but I’m not sure I see it that way. I can understand how I’ve ended up in a place I shouldn’t have been, but I was often invited to that space.

My therapists would start out with specific parameters around the relationship; parameters that I was fine with. If anything, I am over-mindful of respecting boundaries and sort of obsess about it (something this therapist has pointed out to me more than once). But then, those other clinicians would begin to bend their rules and expand the boundaries.

I explained that a former therapist (from about six years ago) had an answering service for out-of-session contact. You had to call the service and someone would take your name and number and call her. She would call back, usually within 30 minutes. I was totally okay with using this service and found it to work well for me.

But then, for whatever reason, that therapist opened the boundaries further and gave me both her cell phone number and home phone number. I never called them, nor would I ever call them.

The therapist asked me why I would never call those numbers. I said, “Because I didn’t trust that she really wanted to give that information to me. It felt impulsive and as though it came from a place of helplessness. I didn’t believe she really wanted me to call her at home or on her cell phone. I didn’t want to risk calling and having her regret giving me those numbers.”

She paused for a moment and then said, “But sometimes the boundaries are allowed to expand and open. That actually can be part of the work, too. I wonder if we could do an experiment at some point – where we change and expand the boundaries in here – and see how you feel about that.”

I flinched. “Uhhhh…no. I mean, maybe. Probably not.”

She said that we could think about it and maybe explore that more a little later on.

I told her that I’m beginning to understand the ways that boundaries can, in fact, “protect the work.” It’s difficult to explain, but something about the way she holds boundaries feels less punitive and more protective. It’s like the dam that holds the water back – you need it to be strong and reliable.

She also has a way of using boundaries that doesn’t feel arbitrary. I get the sense that she absolutely uses boundaries as one of the many tools at her disposal that helps her in her work as a therapist. Most of the clinicians that I’ve encountered talk about boundaries as if they’re this annoying thing put in place by a third party. Either it’s the “agency’s rules” or just this broad idea of “the rules of psychotherapy”. They never took responsibility for the parameters around our work, but rather put the onus on some generic enforcer that they were helplessly bound to.

Which had the effect of making it seem as though they neither supported nor agreed with those rules. And, in many ways, I don’t think they did. Because I don’t think most (or at least many) therapists really understand what can be useful or even therapeutic about having said rules.

So if these clinicians don’t even understand or agree with the boundaries, how am I supposed to feel about them? And if they’re constantly pushing and shifting the rules around our work, why do they get upset or overwhelmed when I do the same?

The therapist said, “Boundaries are not perfect. They can change and shift and evolve with the work. Sometimes that works really well. Sometimes it doesn’t. And if a therapist makes a change that doesn’t seem to help the process, they need to talk about that. They need to say, ‘You know, now that we’ve tried this out, I don’t think it works too well for us so I’d like to try something different.’ They need to be willing to admit that and take the lead.”

To which I replied, “AND I WOULD HAVE BEEN TOTALLY FINE WITH THAT!”

She laughed. We both laughed. Because we both know that it’s true – if any of these previous therapists had admitted that they no longer felt comfortable with the expanded boundary, I would have absolutely handled it. I would have still been hurt and probably felt rejected or abandoned, but I also would have talked about that with them and worked through the emotions around such a change.

Then I explained that on top of having a growing understanding of the usefulness of boundaries in the therapeutic space, I believe that having this relationship with her is allowing me to develop my own boundaries.

“How so?” she asked.

I explained that when I was drafting the email to her, I’d written out all of my activities, so it basically looked something like this:

Thursday: Ortho 8-12pm, Neuro 12-2pm, Doctor 3pm, Concert 8pm

But once I copy and pasted the draft into an email for her, I changed it to look more like this:

Thursday: Class 8-2pm, Unavailable 3-4pm, Unavailable after 8pm

I realized that I didn’t need to share every detail of my schedule with her. And that didn’t come from a place of shame (i.e. “She won’t care about my life”), it came from a place of wanting to protect my own space. I realized I could draw a simple, but meaningful line around myself.

Then I said, “And to juxtapose that very small boundary with a much larger boundary – I did the same thing on Tuesday when I asked you to promise me you would never sexually abuse me. I was setting a boundary around myself and taking a stand for my own safety, rather than relying on you to hold that line.”

She smiled and said she thought this was all so great. Then she added, “I’m reminded of ‘Dr. Christmas Tree’ (the shrink who sexually assaulted me). It was his job to hold that boundary and he didn’t. But you didn’t know better because you’d had no one to show you how to protect yourself. So this is a big deal for you to do that – to create a boundary that keeps you safe.”

Yes. Exactly. So although boundaries are still very difficult for me, I have such renewed appreciation for them. I can see now how they do protect the work. And, perhaps more importantly, how they protect me.

Emailing The Therapist

As I’ve mentioned recently, my schedule is about to become a total clusterfuck.

I actually only have two classes with two labs this session, but since we also have our first clinical affiliation coming up, we can only hold those classes on two days of the week. Thus, we have to fit twelve lecture and lab hours into two days. Wednesdays are reserved for affiliation seminar (whatever that means), studio hour (whatever that is), and Physical Therapy Club (of which I am the President).

Therefore, the yet to be assigned clinic hours will happen on the remaining weekdays. As I understand it, we will have clinic on Monday and/or Fridays and it could be all day or half the day – which could be either morning, afternoon, or evenings. And we don’t yet know where these clinics are, so my commute could be twenty minutes or two fucking hours. We have no idea.

I also have to go to physical therapy 2-3/week for the next six weeks to treat my own janky hip/leg/back/everything. And, of course, I have psychotherapy 3x/week. Plus yoga class and regular gym time. And there should probably be time to sleep, eat (meh), study and occasionally talk to my spouse and friends (social life? haha). Also, although I attempted to respectfully resign from my job in the Anatomy Study Hall, I was told that was “unacceptable” and that I need to give hours. Oh sure! No fucking problem.

Anyway. I explained all of this to the therapist last week because she’s trying to figure out her Fall schedule. I was really overwhelmed by the task of fitting my schedule with hers so I just kinda blew it off in session. She gently reminded me that she can absolutely be flexible and make three sessions work around my schedule, but she does need some advance notice.

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