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Deprivation in Therapy
Dr. Jeffrey Smith has hit another one out of the park on his blog Moments of Change. He recently put up an excellent post that discusses what a therapist does and does not provide for a client in therapy and how you deal with the pain of the deprivations and why deprivation is sometimes necessary. This has been a big theme in my healing and I think he does an excellent job explaining what is a very complex issue. If you have ever struggled with what you cannot have from your therapist (Lord knows, I have!) go read this article: Healing a Damaged Self.
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Tales of a Boundary Ninja 
I also read this and thought that it was excellent.
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Hi Cat,
Glad you liked it too. I think Dr. Smith does a great job of describing what goes on in therapy in very clear terms without a lot of technical language. My only complaint (and I have my nerve! 🙂 ) is that he doesn’t post more often.
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Hello AG! Have not been around for a while but I see you have not lost your touch in getting to the heart of matters. I always learn so much when I am in your neighbourhood! 😉
I stopped going to therapy for a few reasons. At Christmas I caught pneumnoccal meningitis and came within a whisker of dying. That tends to put many things into perspective. It was Christmas Eve when I finally had some time to think. T would be enjoying his first Christmas with his children and new girlfriend in his beautiful new house. As I am an orphan, Christmas is the absolute worst time of year for me. Being in the hospital was actually soothing to me.
I thought about how poorly our last two sessions had gone. He was tightening his boundaries but it meant we both had to put the genie back in the bottle. It was a snap for him. I believe his advisors are leaning heavily on him to do so. What bothered me was the callous way he did it. And then in the next breath he made a reference to my not being able to handle termination. I asked him where he got that notion and he reminded me how I had flipped out in the mid 80’s when my alliance with my first shrink terminated. I was frustrated with him not being able to solve my issues and he accused me of not being able to learn. He said he dreaded my appointment’s. I internalized the whole situation as “Wow, if a psychiatrist can’t stand me I really am a loser.” And I descended into an abyss of despair.
I reminded T that our dynamic was different and it would likely be me who terminated so his worries were misplaced. I also told him I felt the universe was unfolding as it should. His new girlfriend is a lovely person has known him for a decade and will be good for him. I came to realize he was the man of my dreams ten years down the road from now. I don’t quite understand his reaction when I told him. He angrily said “Why are you telling me this now?!
I was confused! I thought he would be please at my ability to face reality.
Anyway. our dynamic is one of peer to peer. Not of parent to child. As I sat in my hospital bed, I wondered if I could call him to tell him what had happened. It was still early in the afternoon. I realized at that moment that despite the fact I saw this as an emergency, I would never get through to him ie he would not take my call. He just was not there for me.
By the time my next appointment rolled around, I was still dealing with the after effects of my illness and I could not face him because my emotions were all over the place. Especially the fact that he was not there for me ( unfair I know) and that he had some nerve thinking I could not take my leave of him. I stayed in bed. I did not even call to cancel. His secretary called to cancel my last two appointments as he would not be available. Bear in mind I only see him once a month. So I have not seen him since my holidays in the hospital. On one level I find it irksome that he never cared enough to see if I was alright. And we all know the old saying “I could have been dead for all you know!” So my final appointment with him is April Fool’s. And I just don’t know whether to let is slide and sail on or at least meet with him one last time for closure’s sake. I cannot see going back as he has the power to hurt me. Or at least did in the past. I am trying to determine if anything good can come of it. Part of me suspects his attraction to me was merely seeing me as “narcissistic supply.” Which ironically happens to me in real-life and something I need to deal with! I feel caught between a rock and (his) hard place. ( No I mean his emotions! LOL!)
Should I go or should i stay???
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Hi Jello,
Good to hear from you! Although I am sorry to hear you were so ill over Christmas as I know that is a very difficult time of year for you already. Do you mind my asking, is this the same therapist as the one you posted about previously here? If it is, I will tell you unequivocably that my opinion (which you are welcome to ignore, you know the right choice for you, but since you asked…) is go. Run. Flee. I’m not sure what you are doing with this man, but it doesn’t sound much like therapy.
I want to ask a gentle question for you to think about, no need to answer. I hear a strong streak of you seeing yourself as the big sister, the mentor, the older wiser person and that is the reverse of what our experience should be in therapy. I wonder if part of the draw with him is that you are in control in some sense, since he seems unable to manage his own boundaries, and that feels less threatening? I ask that only because I spent a LOT of time trying to control therapy and defend against my own needs.
I know how close to impossible it can feel to leave when there is strong attachment, but please believe me, in my experience, situations like this always, always end in disaster for the client with them retraumatized. I thought I was wrong about it in one case, but it just lasted longer than usual. There is a strong possibility I am calling this wrong as I know only what you have written, so you are a much better judge of what is going on than I am. You are also quite knowlegable. So here’s a way to approach it. I want you to imagine that a close friend comes to you and tells you about her (your) experience in therapy? What would you tell her to do? You should extend the same, loving care to yourself. I believe there is a better therapist out there who could help you to heal. Forgive me if I am coming on too strong, and please, honestly, feel free to ignore what I am saying as I really am aware I could be way off base; it’s just that I’ve seen people badly hurt and it breaks my heart that they are so injured by the person they trusted to help them, adding another layer of pain and confusion to what is already the very difficult task of healing. Take good care of yourself. xx AG
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Greetings!
Please never worry about challenging me – feedback is always appreciated from the experts. ie Those of us in therapy makes us experts. Of course you hit the dynamic on the head. In real life I am always seen as the bridesmaid never the bride. Being an eldest I like to boss people around. Solve all their problems for them. And when I have put Humpty Dumpty back together again, he gets into a relationship overnight with someone else. I give too much and I am a target for narcissists. If I were Little Red Riding Hood, I would give the fox a gps to Granny’s house! I have always been too naive for my own good. But I have learned this lesson far too many times. I fooled myself into thinking this time it really was different (not something I do routinely.) The control angle is an interesting one. It’s hard to see someone you care about hurt themselves. But in retrospect I ought to have trusted him to sort his own mess out. Truthfully, I don’t think he ever followed through on one suggestion I made! So I won’t be doing that again. Shutting up is underrated! I did manage to impart to him that no woman worth her salt wants a man who is a little boy, because it’s just not sexy.
I also told him long ago that women like me need to avoid men like him. I quickly figured out he has never lived alone and cannot. He goes from woman to woman to take care of him. He no doubt has emotional affairs routinely. In essence he is a façade – I don’t think he has shown his real self to me very often. I did learn to call him on his crappy behaviour routinely which was helpful for real life. I think I need closure. I have a few things I have to share with him which won’t be pretty – stuff one of his 3 therapists can take up with him! And what our code of conduct will be if we run into each other since we live in the same neck of the woods.
But then letting it hang might be healthy and delicious for me. I am at the point of indifference, so getting hurt does not play into it. Like the song says ” I just came back to say goodbye”
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Regarding the whole spiral that goes on with therapy, if you don’t mind, I will post a link to one of my very favorite sites (besides yours, AG) that sort of resonates with the same subject. And I love me some Kevin Smith, But most, I love hearing how you speak and how incredible you depth of commitment and emotion and kindness.
Here’s the link: He’s insanely great btw, sort of like you.
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Next,
Had to laugh when I saw this. I LOVE Monkeytraps (and have a deep envy for his ability to convey so much in so few words). I have followed him for a while now, and he has been on my blogroll since I created my blog. And last but not least, I posted a link to this particular post when responding to someone on the Psychcafe forum. I take is as a very deep compliment that you would even consider comparing me to Steve, thank you.
OK, can I geek out for a moment? The title should really have been Helix, which is a three dimensional object. A spiral goes around but is two-dimensional and flat, while a helix goes up and down as well as around. 😀 That insanely trivial quibble aside, I have long since therapy that way as I keep circling around to the same issues but dig deeper on each pass,
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AG, Thank you for referring us to this article! I somewhat understand the frustration of the client! I felt the therapist’s answer was well thought out and not at all dismissive. I don’t know Jelllocactus’ whole story, but it appears this is a situation Dr. Smith would consider unhealthy for a client. Maybe I am being to harsh, but it appears he (J’s therapist) has shared way too much personal info with J. My BN would never talk about his personal family life, even if I put a gun to his head! :-). Now he has started to backtrack which would be confusing to any client! Dr. Smith’s reply to Cynthia shows a deep awareness of not making promises he cannot fulfill and trying to keep the client’s best interest as the primary focus. It is a hard job and unfortunately their are many well-intentioned therapists who have difficulty managing this balance! Also, I also loved the article recommended by Next inLine! AG, I hope you are experiencing some progress along your own “spring”. (What a great analogy!) Thank you again for taking such a great risk in sharing you own struggles. I know you have touched a lot of your readers, me included! Xoxo Ann
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Ann,
Somewhat understand? I have lived, cried and screamed that frustration. LOL I am walking into my session tomorrow to tell BN how pissed I am at how he handled this kind of issue at our last appointment. 🙂 That’s why I so appreciated this article. It really does help to remember what a fine line a therapist can walk. But I am also glad that I know it is still ok to go express my feelings about this even if they’re not really fair to BN. As he has told me countless times, it’s not about fairness in his office. 😀
If you read my reply above to Jello, you’ll see I very much concur with your opinion. And as for Monkeytraps go read in his archive and follow his blog, he writes great stuff.
And as for the risk and being touched, that is most definitely a two-way street, You have been such a support in my healing (and of my blog) so I want to say thank you in return. xx, AG
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thanks. an interesting piece.
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Glad you enjoyed it!
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How interesting, AG! You mention the concept of your feelings not being fair to BN. Could you give an example to illustrate your point? I need to better understand how it is unfair to the therapist. Make one up if you would rather not share, which is perfectly ok.
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Hi Jello,
While I don’t feel free to discuss that particular situation, I have myriad real life examples. 😀 It’s not true anymore, but when I was in my heavily dependent phase of therapy, I would often feel angry and abandoned when BN went on vacation. Now, obviously BN was doing nothing wrong by taking time off, so it felt as if my anger was not fair. He was also not abandoning me, I am just not the only person in his life (by a far shot) who needs tending. I have spent years waiting for him to abandon me, or act in a sexually predatory manner, despite having experienced NOTHING in his behavior to warrant such a fear.
BN has always, always welcomed any and all of my feelings and does an amazing job of remaining non-defensive and works to accept and normalize how I am feeling. However, I only get an apology if he feels like his behavior requires one (rare, but it does happen 🙂 ). I remember the first time in session when I kind of snapped at him about something and I immediately backtracked and said I was sorry, what I said wasn’t really fair (can’t remember what it was about). It’s one of the few times BN has shown annoyance. He quite strongly told me it was not about fairness in his office. That it was about me being able to express how I felt. My very favorite was after a really intense session where I dug up some deep-seated fears (including some emotional flashbacks) about what BN might do to me, I told him I knew it was not about fair in his office, but I really wanted to apologize for comparing him to an incestuous pedophile. His response? That the real tragedy here was that I was so mistreated that even in a safe relationship I still carried this fear.
I am also grateful he doesn’t take a lot of my feelings personally but understands their origin. The man has been completely steadfast and trustworthy, doing the perfect job of being a secure base that holds still while I work through all my stuff. He provides 24/7 contact, including vacations, outside of session time. Is completely accepting and understanding of my feelings, works really hard to understand me and help me understand myself, yet has had to endure years of me asking “will you still be here?” “are you really safe?” “is this relationship real?” “do you really care?” From a purely human standpoint, if not my therapist, I think he would be completely justified to look at me and say “really?! I have done nothing to deserve your doubt or your fear! Haven’t I proved what kind of person I am? I’ve had it, I’m out of here!” But he doesn’t make it about his feelings (my guess is that in the privacy of his own mind he has at least had a moment of “really? again? give me a break, enough already!” although, like a good parent, he has never shown that to me).
So while I truly understand I am doing nothing wrong, and a lot right, in expressing these feelings and part of his role as my therapist is to hear them, I also can understand why it would be hard to be on the receiving end of my feelings. One of the reasons I think that therapy has been so crucial for me is that my neediness and deep fears would have tried the patience of a saint if this were a normal, adult relationship. Hope that provides some clarity about what I meant. 🙂
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Ditto! I will be reading Monkey Traps regularly. I need a bedspring for my bathroom mirror!
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Thank you for sharing AG! I hope I did not stir up any negative emotions for you. I do get it now though – thank you for clarifying. So it is about feelings that are aimed directly at him. Many are negative, which is par for the course.. So in essence you are “ghosting” him, attributing past hurts to him, innocent bystander..(Don’t we all?) When I read your words I thought the opposite, ie expressing positive feedback. Technically that could be attributed from the past as well if transference is in place. I thought you might have meant putting your feelings on the table about BN and the unfairness came with his inability to comment/react despite similar feelings. (He once told me that if I actually knew how he felt, he would have to discontinue treatment. Duh?!) And that was possibly something torturous to do to him! Am I making any sense? As T’s ought not take negative emotions personally, nor should they take positive ones personally. Because it’s really not about them is it?! Prince Charming no longer exists. Now he comes with a Beamer and needs help with the payments! To think he had the nerve to tell me I was jaded. Well, doc, let’s explore how that came about!!! I once kidded him that I should send him a bill. Hmm. Where are my templates?! LOL! 😉
(Read #5 above.)
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That was the million dollar question, Ann. What prompted it? My guess is one of his therapists asked him if I was stalker material! I was sooo insulted! She had no evidence to suggest such a thing! It made me realize shrinks can be dead wrong about things. My T used to work in another department and switched to the clinic I attend. He is at the beginning of his learning curve. He is well respected and everybody loves him ( his false self that is) So true to form his older female shrink wants to protect him from being accused of any impropriety. Lord knows the hospital does not want a lawsuit on their hands! So I agree this was something he had to be cautioned about especially when vulnerable due to not having his ducks in a row in his personal life. I told him outright I would not take advantage of that simply because it’s hot ethical and I wanted him to see how he felt when his head was on straight and he was functioning at at a higher level. I did not want to be the low-bearing fruit! And I believe that when he accused me of putting him on a pedestal ( Gee, I tend to be able to focus on people’s positive attributes) I told him I saw the whole picture warts and all. And I did not fantasize about his abilities. I could envision what I felt he could and ought to accomplish realistically. And not living up to what he thought I was expecting scared the living daylights out of him. That I would bolt once I really got to know him. What a cliché, and a sad one at that.
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JC, I just had to smile when you were told by your therapist that you had him on a pedestal! The only time I had really gotten into it with my T was when he had told me that I idealized him!? I said no woman who has been married for 30 years would idealize any man! 🙂 Later he finally said that all patients idealize their T’s. I could handle that, because that belonged to his therapeutic framework, but I did not have to own it as mine.( And that is called boundaries-even patients can set them.) I know therapy can bring up a ton of emotions and strong attachment. Even that was confusing for me, but I think many patients/clients are a bit more psychologically savvy now than they were 20-30 years ago. As a client, I can experience a myriad of emotions, desires and fantasies around my T, but recognize that it is not reality! Just because I think Leonardo di Caprio is hot, doesn’t mean he wants me or my desire for a ton of money means I will get it. In fact, if I experience a strong emotional reaction toward my T, the first thing I will journal about is, what need am I experiencing and how can I get it met outside of therapy? I also (imperfectly) try to separate his stuff from mine. Why? Because therapists are human, and at times are unaware when they bring their own stuff in the room. Some are more self-aware than others. I am willing to entertain anything my T bring up about me. However, if it doesn’t feel true, I will put it on the back burner. Down the line, I may recognize the truth of what he says, but also there are times I ill disagree. That is ok. And it certainly doesn’t mean therapy isn’t helping me! To me, a good therapist has experience, empathy, boundaries, and strong self awareness. Also they need to model appropriate behavior by apologizing when they are wrong. I am sorry he set you up with a false promise and he is now in the position to abandon you. It sucks for you, but I think it is a common mistake with new therapists. It can have harsh consequences for the client. Fortunately there are good therapists out there who can help you process this. Good luck! Ann
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Hi Ann,
You know, I have had my share of shrinks and not once did it ever occur to me to idealize them. Until this guy. He has not learnt the ‘cruel to be kind’ tool yet. So rather than hurt me he said nothing. I came right out and told him the professional restrictions he continually cited were nothing but a red herring, and that he had indeed rejected me and that the feedback as to why would be really helpful to me in real life. As liars do he looked to the left and down as if to appear thoughtful and said No I can’t think of anything. I then countered with are you trying to tell me it has nothing to do with me per se? He shook his head yes. Then his nose grew a few inches. Now I could be jaded ( he says I am) and maybe it was really about him – Lord knows it usually was. Your description of a good therapist is bang on and sadly he does not possess any of those qualities, least of all empathy. I knew in my third session he had little to offer me, but shrinks take about a year to see in this town. I did ask for a referral and he did not follow through-probably because of subsequent therapist syndrome and they would know it was him I was snarking about! LOL!
Believe it or not he has done me a lot of good – without knowing it! 🙂 Oddly enough Ann, I am past the point of feeling abandoned. I haven’t seen him in three months and I can’t truly feel abandoned by someone who has very little to offer me. Note to self : run from emotionally constipated men !!! Check! 😉
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JC, I am glad that you are in a good place with your situation. Actually it has helped me understand a very painful experience with my T about 3 months ago. He is generally very good and has helped me a lot. However he said something that caused me great pain. The next couple sessions were excruciating for me, as he didn’t recognize how hurtful it was and kept defending his statement, his experience etc. and seemed totally indifferent to the pain he had caused me. We finally got on track, but I was very confused about his defensiveness. Now I realize that for some reason he was feeling attacked and was unable to focus on my emotional experience. One thing I do know about him is a big part of his practice includes forensic testimony in court. In that situation, the opposing lawyer probably tries to discredit his credibility and expertise. I can imagine there might be times that trying to switch between “proving” your competency in court, and switching on your empathy skills with a client could prove to be challenging at times. As I said earlier, we worked it out and he is helping me tremendously. However, we never know when a therapist may be triggered by something from outside of the room. It sounds like your T is unable to work through the bumps in the road that can occur in therapy. He doesn’t seem to recognize his responsibility in not holding his boundary and that can be crazy making for a client! Also, by not showing any insight into his own mistakes, he is a poor role model for his clients! I hope that you are able to find someone who is empathic, but holds strong boundaries and has enough confidence to own his/her own mistakes. By admitting their humanity, therapists can show clients that mistakes are not the end of the world! AG- thank you for letting me rant! JC-keep believing in yourself! AG has helped me gain confidence in trusting my own ability to work towards emotional health. Xoxo Ann
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Ann,
You are always welcome to rant on my blog. 🙂 I am very much enjoying reading the conversation between you and Jello and am certain that it is benefiting a lot of people. xx AG
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Thank you for sharing this link AG. I went to JS’s blog and read it. Very helpful to me.
I guess I might have been a cow in a past life….a ruminant… I feel like I have to ruminate on these writings before I can write any of my own thoughts. The topic of what to do if you didn’t experience good secure attachment at a very young age is a big one for me. So I will add this latest post to my pot and ruminate and mull it over for a while.
Thank you again for your wonderful helpful contributions here.
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Gel,
Ruminate away! 🙂 I do not think it is any kind of fault or weakness. In fact, I think an ability to take in what we learn and reflect upon it and how it fits into what we know about ourselves is a true strength. And the wait is always worth it, as I am always better for reading the reflections that emerge. xx AG
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