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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Tabitha on March 19, 2003, at 3:46:49
My therapist's advice is really rubbing me the wrong way lately. I'm just not wanting it. I told her this weekend I was a little sad and empty and couldn't sort out the cause. One of the factors is a med reduction. She told me she thinks that's the cause of my feelings. I don't think she can know that and I resent having to fight off her opinion. Just her telling me that made my mood sink further. I started thinking I'm heading for the black pit of relapse, which is of course my fear, and for 30 minutes or so it felt very true. Then I got home, showered, got some good news, and the black pit evaporated.
I told her even if it's med related, it could be effect of discontinuing, not necessarily relapse. We also spent some time arguing about lexapro (had this discussion before), she's had some patients get great improvement from it, I pointed out I'm already on celexa, which I'm reducing due to insomnia and anxiety, and I don't see any reason to think lex is superior in this respect. Her other patients switched from other non-celexa meds to lexapro, it's not a fair comparison. It's like she's just thinking I ought to be on the new miracle drug, but we all know that's crap, there is no miracle drug, and even a miracle for some doesn't mean for me.
She also cut the session a bit short. At the start, she wanted to change next week's appt so she can go to a seminar. I agreed to come the day after my normal day, but she wanted me to come 1/2 hour earlier than my normal time. I had said I'd come 10 min earlier. Well, at end of session, she wanted me to come 15 min earlier instead of 10 min.
It just feels like our relationship is falling apart. Her cancelling and moving sessions is really the worst. She has been very reliable in that respect, now I don't know what to expect anymore. I did discuss it with her last time she cancelled my appt completely. She listens but nothing changes.
It's like I've decided to do 2 things on my own lately, things she did not advise -- planning the sabbatical from work, and getting off the SSRIs (which believe me I know is risky, and I'm terrified yet determined to find a way), and it seems like she's not supportive. She's given me so much bad advice I've tried to take, now I try to make my own decisions, and I want support, not more doubts. It's been so hard for me to decide to do these things and she's ready to declare failure. I think expecting relapse will drive me back on the meds, and it seems she's doing that for me.
If I don't trust her advice and judgement anymore and don't feel supported what's left?
I honestly don't know if I'm making good decisions, but somebody has to make decisions for me, and I don't see her or my pdoc making good decisions, so I'm doing it myself. I'm sick of assuming their decisions are better. My life is not getting better based on their advice! I'd rather make my own possibly bad decisions than keep taking theirs that I know are bad.
At the end I started talking about my hopes for my sabbatical and she was just trying to end the session early.
My fear is she's only 'supportive' when I'm needing her to run my life, interpret everything and tell me what to do. And when I'm following her belief system about therapy. That could be my projection, but things keep adding up to make it look that way. So if I grow up and live my own life (finally!) I lose my main support.
Posted by Dinah on March 19, 2003, at 4:05:08
In reply to Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 3:46:49
Ouch.
Have you discussed these things with her the way you've outlined them here with us (it kind of sounds like you have).
All relationships go through rocky patches, and while that may be true here, it sounds more and more like you've just grown in a different direction from her strengths. I hate to see you so unhappy about something that is supposed to be a support.
I've found, and perhaps you are finding too, that therapists have a bias towards keeping "productive". Mine thinks that my job is good for me, which in some ways it is, and tends to minimize the ways that it's not. I try not to think that it's because my job is paying his bills. I try to think that it is because one of their prime directives is to keep us functional in the world, which by the world's standards includes gainfully employment and the more gainful the better. I'm guessing if you suggested trying for a job of equal or greater stature, she'd be all for it.
I think they have this little checklist they run through when evaluating how we're doing. Are we managing to work? Are we keeping up on our personal grooming? Are we keeping our primary relationships afloat? A very utilitarian view.
But I understand from my reading that there are some therapists who are more quality of life oriented, who might applaud your taking a sabbatical to assess your options and get out of a situation that is toxic for you.
I wonder how you phrase that in a therapist interview question.
However, I understand your concern about maintaining your current supports while your life is changing so dramatically. It's a tough one.
I wish I had more productive thoughts on the issue, and I hope you can work this out (assuming that that's what you want to do.)
Posted by Medusa on March 19, 2003, at 6:33:23
In reply to Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 3:46:49
Dang girl, I've been where you are.
Do you have the energy to ditch the chick - write her a letter and tell her why - and then move on? a beach holiday and a cabana boy would probably cost less than the grief she's giving you.
I hope that didn't sound flippant.
I've let too many therapists push their ideas on me.
Posted by Ginjoint on March 19, 2003, at 8:17:27
In reply to Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 3:46:49
Yo hey Tabitha...
Nope. No miracle drugs, no matter what the commercials say. I started Lexapro a few weeks ago, and it has definitely helped, although I'm having to go on it VERY gradually due to physical side effects.
This sounds so stupid and obvious, but the consistency of appointments is like a security blanket, and your therp should realize this. If she's listening to your concerns but not making any effort to change anything, then maybe you need to find other support. I don't mean changing therapists if you're not ready for that, but perhaps adding an extra ingredient to the soup. Buh-LIEVE me, Tabitha, I know what a humungous step this can be. For the life changes you are about to make, you need someone behind you...any hope for a group therapy setting?
You spoke of how you feel your relationship is falling apart...maybe it's time to be brutally honest (no time for politeness here) about this with your therapist and carefully gauge her reaction, both during and after the session. At any rate, there's no excuse for her shortening sessions. At all. That's YOUR time.
I'm glad that you have the confidence to trust your inner voice as to what's a good choice for you! If your therapist's track record has been nothing short of lousy, I'd say that inner voice is starting to look mighty wise, hm? Just because someone managed to land the job of therapist doesn't mean they've got a head on their shoulders. Do you have any other family or friends you can lean a bit on, or are you on the more isolated side of things? Either way, Tabitha, I wish I could treat you to drinks or coffee or whatever. You deserve a supportive ear. Please keep me posted.
Ginjoint
P.S. You touched upon another powerful issue -- what happens when we get "better?" No more therapy costs, but a trusted friend is lost. What a conundrum. I know we're supposed to have other friends in place by that time, but still...
Posted by Tabitha on March 19, 2003, at 12:23:43
In reply to Re: Who runs this life? Me or therapist?, posted by Ginjoint on March 19, 2003, at 8:17:27
Thanks for the insights. Dinah I have the same suspicion about how they think we need a by the book life complete with job, mate, friends, etc. I already went through what felt like a struggle to get her to accept that right now and for the forseeable future, I'm happier single than mated. Now I want to be unemployed and go against my doctor's med advice. It does sound like a lot to ask, to get behind all that. But dangit that's my path right now!
GJ, maybe I painted too negative a picture about the sessions, I'm doing these extra-long sessions at the end of the day (and paying by the minute), so when I say she ended early, it's still well past 50 minutes. It's just a change is all. And asking me to change my time to accommodate her conferences just bugs me. My regular appointment should be a commitment, dang it! I have complained, I'll complain some more.
Uuuurgh. I don't know if this is normal stuff, rocky patch, etc, or time to leave her. It gets tough when so many sessions are spent fighting her, and therapy seems to add upset to my life rather than resolve it. Or is fighting her part of my growth? Uuuurgh.
Thanks for listening all.
Posted by Dinah on March 19, 2003, at 13:54:53
In reply to Re: Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 12:23:43
If so, Congratulations!! You've almost completed the therapy course. Continue on track and find yourself a self actualized person. :)
Posted by ShelliR on March 26, 2003, at 18:11:53
In reply to Re: Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 12:23:43
>
> Uuuurgh. I don't know if this is normal stuff, rocky patch, etc, or time to leave her. It gets tough when so many sessions are spent fighting her, and therapy seems to add upset to my life rather than resolve it. Or is fighting her part of my growth? Uuuurgh.
>
I think that disagreeing with your therapist is healthy, as long as it's based on what you really feel. Diagreeing only takes time if you need to convince her (or yourself) that you are right. If you're committed to the path you've chosen, then you should be spending your time working on things you need help with.I would worry about you leaving her. It shouldn't be all or nothing; maybe your goal should be to be able to get by with a 50 minute session (when you're ready). That way if you still need support, you might be forced to find it among friends, etc. and grow in the process. Also, as you grow more independent, small changes in time (like 1/2 hours should start to bother you less).
(speaking of which, my last therapist gave me an ultimum if I wanted to continue to work with her. I felt that what she wanted me to do was really wrong for me. So for the first time in many many years I am without a therapist. It was good for me to know that when push came to shove, I followed my own instincts and conscience. I'm still not sure whether I will go back into therapy, but I think you will be pleasantly surprised when you decide to terminate therapy, that you probably are a lot stronger and more independent than you thought.)
btw, I'm not suggesting you end therapy. YMMV; also I wish that I could have worked it out with my last therapist. I worked with her for four years and she helped me a lot. I've left therapists before (usually go right on to the next one) and I've always realized (after the fact) that I take with me the stuff I've learned from them.
Best wishes,
Shelli
Posted by Tabitha on March 27, 2003, at 1:36:48
In reply to Re: Who runs this life? Me or therapist? » Tabitha, posted by ShelliR on March 26, 2003, at 18:11:53
Shelli thanks, I always find it hard to see that middle path. Black and white thinking, textbook thought distortion. I think my therp is picking up on the fact that I'm wanting less advice lately. Last session was better, and shorter too. I wasn't too upset about anything that week, and it felt odd to just end. It felt like I'd forgotten some major crisis, but there wasn't one. I don't know how to be a therapy client when things are going smoothly I guess, but I'm willing to learn.
I have never left a good therapist. I had a marginal one move away, and stopped a couple of mediocre ones, and violently rejected a really awful one. I am curious about the ultimatum from yours that led to your terminating with your last one, if you want to share about it.
Posted by ShelliR on March 27, 2003, at 12:16:30
In reply to Re: Who runs this life? Me or therapist? » ShelliR, posted by Tabitha on March 27, 2003, at 1:36:48
<I am curious about the ultimatum from yours that <<led to your terminating with your last one, if you <want to share about it.
It's really hard for me to talk about it without being defensive.My AD (nardil) stopped working for me after almost twenty years. I tried almost every drug and combination my pdoc and I could come up with and I was still in a horrible depression, unable to work, etc.
I was prescribed opiates by a psychiatrist for depression and pain and inflammation in my chest. My therapist was not happy but said as long as I followed exactly what he prescribed she would still work with me. When I terminated the relationship with him and continued to take opiates prescribed by a pain doctor, she said that I refused to accept that I was an addict and the only way she would work with me was if I went into a drug treatment program.
She's totally freaked out about addiction in general--was really upset when my pdoc gave me benzos for anxiety, etc. I didn't fit the profile of an addict at all, never craved them, didn't get high, etc. I wasn't willing to give up opiates (methadone) until I found something that would help me. It seemed stupid to go into a hospital for addiction when I didn't believe I was an addict and I also didn't think I'd get the best care for treatment resistent depression, inpatient, on a drug unit.
So anyway, I wrote her a five page letter asking her to continue working with me. I even thought of going into the hospital just so I could continue to work with her, but I knew I really couldn't. (I ended up in the hospital anyway, and did get off of methadone, but it wasn't a drug program.)
She was the best therapist I'd ever had, but she was always very very opinioned. We'd had other major disagreements but this was the first ultimatum. And here I was in the worst depression of my life and she totally abandons me. It was awful. I had really bad dreams about her for months after the termination. I ended up going back to a previous therapist for a limited time just to get some perspective and confirm that I wasn't an addict (or an awful, horrible person).
Shelli
Posted by Tabitha on March 27, 2003, at 13:53:01
In reply to Re: Who runs this life? Me or therapist? » Tabitha, posted by ShelliR on March 27, 2003, at 12:16:30
Ugh, how awful. Some folks just go overboard with labeling everything an 'addiction'. It must have been crushing to have to go through that. I confess I might have given in to the therp's perspective and become convinced I was an addict. It really shows your strength that you were able to hang onto your own truth despite that violent opposition.
Posted by fi on April 2, 2003, at 16:02:21
In reply to Who runs this life? Me or therapist?, posted by Tabitha on March 19, 2003, at 3:46:49
I havent read all the responses, so sorry if this has been said already.
Just on one aspect, re the timing of sessions. This can be seen as a basic part of your mutual contract, which can be discussed on that level if you want to ie 'we agreed initially to meet for 50 minutes every * at *. I'm fulfilling that commitment but it now seems to be a problem for you. Is that the case? Can you commit to future sessions?' never mind the emotional level of 'how the hell do you think this makes me feel?' which is an optional extra!
I had a (private, not NHS)therapist like that- it was OK when I worked shifts and could go in the afternoon, but even then he kept making my sessions earlier. Then I got an office job and it was a nightmare- different days, short notice, different times. So I was fitted round his evening social life, which varied unpredictably!!
It stopped being a problem when he emigrated (aint that just wonderful for the course of therapy!)
So there's a layer of this which is what I should have said to him, but I do also think its true more generally that the basic contract is something both sides should commit to, and if any variation is needed this needs serious discussion on a practical as well as emotional level.
For example, another aspect of the contract is payment. How would your therapist react if you stopped paying the set amount each time, and started leaving out the occasional 10%?
Whatever, lots of luck and I hope you get the support you need, whether from the therapist or elsewhere.
Fi
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