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MarkintheDark

Firing my T?

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If I'm gonna go on about this for a while, might as well make it it's own thread.  This is a long one.

I've had a T since last summer who's the first one in years with whom I've clicked.  He wasn't some inexperienced intern.  He understood particularly well the unique issues facing long-term HIV survivors like me (i.e., those diagnosed prior to the availability of anti-retrovirals in the mid-90s).  In the course of our relationship, he was my fierce advocate in filing a grievance with an office whose staff had been abusive towards me right after a particularly scary hospital stay in October.

My depression, however, suddenly became significantly worse last month, despite meds (at least I have a pdoc).  And I added anxiety attacks to the mix in January.  I had a falling out with my PCP a couple weeks ago when he became patronizing, effectively shutting me down.  At least I was able to get a new PCP almost immediately.

In the course of this, my T reacted badly to a figure of speech that, "I'd chew [the PCP's] head off" - like you'd "chew someone out." He apparently took that as a threat and admonished me to be careful what I said or he'd have to report it.  I felt like a child who'd just been scolded sternly.  I could feel the color draining out of my face.  I virtually froze.

A week later I nevertheless challenged his assertion.  I felt he'd overreacted to a figure of speech.  Until then I'd relied on his ability to discern the difference between figurative and literal.  He stonewalled me and kept repeating his "therapeutic obligation."  I told him I felt intimidated and didn't know if I could trust him with my stuff if I couldn't express myself freely.  I told him I'd had sleepless nights over it all week.  His response was uncharacteristically detached..."That's unfortunate, but...."  I ended the session after 20 minutes.

I'm shell shocked.  I've tried to figure out what the hell happened.  I'd already been shut down by that PCP the same week with, "That's protocol.  That's just the way it is.  Don't argue with me."   This was ten times worse...and at the worst time.  In addition to the deeper depression and increasing anxiety attacks, I'm dealing with a scary new health issue.  I'm gonna need a lot of support in the next month and, if I dump him, I'll have none.  I don't have the strength to break in a new, untested T.

I've resolved to try again next week b/c I've been confused about the lack of direction our sessions have taken recently.  He's identified a new, seemingly unrelated issue each session...and almost nothing about my depression or anxiety attacks.  There's no pattern, no cohesiveness.  In the course of my experience with him, this is completely uncharacteristic as is his detachment.  I'm afraid of dropping him b/c I know my suicidal tendencies will blossom.  And, hell, he should know that I'm at risk.  He even expressed that he was afraid he'd lose me last summer.  tbh, however, I'm expecting the worst on Thursday.  I don't know him any more.

Edited by MarkintheDark

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That is odd. I say things like that all the time, but of course there is never any intention of actually hurting the person - it is just venting. It seems like you have previously viewed him as an ally - and someone who gets you. But this current behavior is making you question that - understandably. It almost sounds like he had you in a specific box in his head - and for some reason your offhand comment made him question if that was the right box. So instead of going to a place of understanding - he went to a place of distancing and re-evaluation.

My thought is to go into the next session expecting the best and see what happens. You could have unintentionally triggered something in him that caused this reaction. Therapists are, after all, only human - and many of them have stuff in their past that caused understanding the human mind and mental illness to be compelling. In a perfect world, that stuff would not bleed over to their patients - but we do not live in a perfect world. However, if things continue to be distant and you do not feel that you are making any progress - it might be time to move on. ((hugs))

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16 minutes ago, JessiesMom said:

But this current behavior is making you question that - understandably. It almost sounds like he had you in a specific box in his head - and for some reason your offhand comment made him question if that was the right box.

I'm glad you said it before I did, JM.  So I'll just spill my thought here.

At the time of his advocacy, he mentioned that his boss was concerned he'd become too enmeshed in the issue.  I was surprised and flattered that he'd share that kind of vulnerability with me.  It certainly cemented my trust in him.  (He'd also mentioned that portions of my four-page grievance had almost brought him to tears).

I'll add that, again uncharacteristically, he seemed to monopolize our last session with his "professional" justifications.  My intuition said he was trying to convince himself more than me.  otoh, hell, I could be completely wrong.  I'm no psychologist, despite my years of experience with 'em.

This certainly is like the breakup on any relationship.  For me, the timing's particularly lousy, too.  I've been fighting my inclination to flee.  Nevertheless, I don't like being put in the position of having to be HIS therapist.  That is NOT my job.

I've already decided to bring up the cohesiveness issue.  Since you're bringing it up, JM, I guess I may have to ask him flat out if/why he's distancing himself from me.  I dunno.  Hell, it may not matter.  At least you're giving me food for thought.  I appreciate the perspective.

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Well, that information adds another layer. Is it possible that he is getting pressure from his boss to not continue his "enmeshment" with you and that his distancing behavior is his attempt to do so? Perhaps the "professional" justifications did not feel authentic because they were not coming from him but rather from advice he got from someone else. You are correct - however - that it is not your job to be his therapist. It seems that, if you are to continue to see him, you need to clear the air a bit and regain some trust. This situation has somethings in common with a break-up - but the reality is that the only obligation you have in this situation is to yourself and your own mental health. He is, after all, essentially an employee - and if it is time to move on, move on. You may find that a new therapist could offer you some new perspectives and/or techniques to combat your symptoms. That being said - it is a bit like entering the dating pool again. 😜

 

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I'm not sure what the answer is.  It's your decision but your appointments have become phone appointments which I didn't know existed until you mentioned it which means you're afraid to walk into his office.  I don't know how things can continue and I'm not sure why you would want to continue if you are afraid to talk to him in person.

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1 hour ago, sober4life said:

I'm not sure what the answer is.  It's your decision but your appointments have become phone appointments which I didn't know existed until you mentioned it which means you're afraid to walk into his office.  I don't know how things can continue and I'm not sure why you would want to continue if you are afraid to talk to him in person.

To be perfectly candid, sober, the phone sessions aren't so much about my feeling afraid.  You and I are well practiced in the art of being able to pull it together, how ever briefly, to get something done.  Particularly following last week, I'm no longer comfortable being vulnerable with him in any situation.

I was going to characterize it as a shot across his bow, but there I go again using a figure of speech to which he'd probably object.  Yeah, I'm being sarcastic.  It's more like a tangible message to him that I'm not comfortable meeting face to face.  I want(ed) to see if he picked up on that.  Although I'll grant, too, it enables me to end a conversation as quickly as I wish.  The last time I used the phone option was when I was just out of the hospital.  You recall how serious my condition was at the time.  My message is, yeah, this is serious.

I'm letting him know Monday that we'll be doing the phone again Thursday.  And that's a bottom line.  As I did last week, too, I'm making notes on exactly what I want to say.  (Years ago I did voiceover work, so I can make it sound natural). 

I've already decided that a rehash of last week's brief session would serve no purpose.  My primary interest this week is framing it in light of the past month's disjointed sessions, just for perspective.

I'm still somewhat conflicted.  I don't see a positive way forward with this.  But In my mind, hell, HE'S the therapist.  If he's not going to put forth any solutions then, yes, we're done.

Edited by MarkintheDark

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Sure I understand.  Make sure you say everything you need to say but also make sure you hear the right answers he should say.  I don't see a positive way forward with this either.  Not only does it have to be a phone conversation but an acting performance as well.  You say you're no longer comfortable being vulnerable with him anymore so you will never talk about your biggest issues with him because you don't trust him.  I don't see things working at this point.

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18 minutes ago, sober4life said:

Make sure you say everything you need to say but also make sure you hear the right answers he should say.

That's a good suggestion to write down.  I have an idea of what I need to hear.  I may even express it directly to him.  In short, I need validation and reassurance.  Suddenly I'm not getting that from him any more and it's confounded me.  He knows damn well I'm already feeling fragile much of the time.  But I feel like what I'm getting is some programmed AI response.

Edited by MarkintheDark

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I guess that not sleeping at night and waking up every day with an anxiety attack are gonna be the new normal for a while.  I guess, too, suicidal thoughts are gonna be my companions.  I feel helpless to do a damn thing about it.   Between the emotional and physical pain from the more recent medical issue, I mostly feel like just giving up.

As I've played the past couple of weeks over in my head, my thoughts have shifted the past 24 is towards acknowledging I simply can't trust this T again.  Though no one else will give me credit, I've been able to tell myself that I did what I could last week to steer the conversation towards some kind of reconciliation.  I shared my feelings, my sleeplessness, my hurt, my distrust.  What I remember is that he paid only lip service to my pain before resuming his defense of his "therapeutic obligations."  I realized I let him go on like that for at least half the session, perhaps longer.  Under the circumstances, that was a pretty tall order, but I filled it.  In short, I gave him his chance and he blew it...spectacularly, imo.

At the moment I'm thinking I'll simply jump in headlong and lead off the next session with something like, "After our last session, you've probably surmised I'm ending our therapy."  I absolutely will not let him steer the conversation to the whys.  I'm shutting him out, if only for the sake of my own emotional preservation.  I'll briefly review the unrelated issues that had built up and given me pause in the weeks preceding - context, if you will - and leave it at that.  I most certainly will not share anything that puts me in a vulnerable emotional position.  I certainly won't be able to express any anger, lest he decide to report it to his boss.  I'll be full-on channeling my inner Spock.

Nor am I interested in his comments.  If necessary, I'll calmly but firmly shut him down.  At this point, any expression from him of so-called concern is meaningless to me.  Whether or not it's true, I consider that almost anything coming out of his mouth is nothing more than a disingenuous "therapeutic obligation."  Again, this is information I won't and don't need to share with him.

I still haven't quite figured out how to then handle my pdoc appointment 24 hours later on Friday.  In general, I'd like to keep the issues with the T brief - I won't let his sh#t poison more of my care - and concentrate on getting some relief from the worsening depression and now daily anxiety attacks that start the moment I'm awake.

Edited by MarkintheDark

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Yes it's the right choice to let him go.  It's his job to make you better mentally.  It's his job to tell you how to live your life better.  It can't work if you don't trust him whatsoever.  He's making you worse.  Your experience is like a lot of my experiences with doctors.  I was a disaster leading into every appointment.  I wondered how I would make it through the appointment.  It doesn't make sense.  You have very serious health issues and you can't have this extra stress in your life right now.  Any toxic people should be cut out of your life immediately because your survival depends on it.

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I don’t know what to say, except that I’m surprised that someone else has had feelings this intense over their therapist. I thought I was the only one. I don’t mean to imply that your feelings and thoughts are the same as mine. I’m honestly sort of afraid to say anything else because I have no idea what I might say that could possibly be a trigger for anyone feeling this way. 

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4 hours ago, sober4life said:

You have very serious health issues and you can't have this extra stress in your life right now.

As often happens, you nailed it.  He's particularly aware of the details of the medical issues...and that makes his intransigence and distancing all the more confounding.  On some level, he knows damn well I'll respond badly to all this.  That's just effin' irresponsible, imo.  And I'm frustrated I feel I have to resort to my own stonewalling in this case.  But I cannot let him hurt me further.

4 hours ago, SqueezeWax said:

I don’t know what to say, except that I’m surprised that someone else has had feelings this intense over their therapist. I thought I was the only one.

That's wonderful feedback for me.  Thank you.  We're both pretty damn good at expressing ourselves in writing.  I hadn't realized the intensity of my expression.  Getting that kinda feedback is a helpful barometer.  Of course, too, it gives you an indication of how difficult it is for me to then channel Spock.  But I have some practice and I can do it.  It helps my self-control that I can lay it out here before any appointment.

If I can offer some encouragement, Squeeze, I think the fact you identified with the situation is all the more reason to share.  (Put indelicately, you're not responsible for my sh#t 😁).   Sure, venting helps me.  But, often I'm not aware of how it helps others here on DF.  So, honestly, say/share what you like.

Edited by MarkintheDark

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I see why this decision is so tough to make, you've worked with this T for so long.

I don't view a relationship with a therapist in the same way I would just another service provider, it's a different set of criteria because I"m investing in the relationship. If it were merely a transactional relationship I could move on but it's not. 

Because any relationship of worth in my life has its strife I'd be more inclined to assess whether this was a radical and permanent change in how the T is going to relate to me or if it's an incident.

Of course l'd be upset and like yours, this upset won't go away with a wave of a hand. I'd have to determine what I felt I needed from the T in terms of a repair or acknowledgment for what's happened. 

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4 hours ago, Atra said:

Because any relationship of worth in my life has its strife I'd be more inclined to assess whether this was a radical and permanent change in how the T is going to relate to me or if it's an incident.

I'm always amazed at how I often get the comments I need on an issue exactly when I need them.  You've managed to precisely divine my thoughts today.  You've also given me food for thought on making that list of what I'd need from him to reconcile.

I was still shut down most of the day today, although I managed an email to him that Thurs would be a phone appointment to which I received an affirmative (uh, terse?) two-word reply.   My anxiety attacks somewhat subsided today.  Indeed, I've been reevaluating if this is salvageable and if, as someone mentioned, he's doing me more harm than good.

I can't escape the impression he could have taken charge and nipped it in the bud at any time.  I'd already noticed changes in the past six weeks that seemed like a psychological whack-a-mole approach whereas there'd been a clear, relevant path he'd usually weave previously, whatever else was going on with me.  Nor can I deny he's been stuck on this "therapeutic obligation" issue for two sessions, going as far as to sidestep any discussion of my obvious upset.

Sounds like I'm stuck in a loop - I guess I am - but it seems clear he's distancing himself.  My best path is to "go on strike," so to speak.  Calmly and firmly take charge of the conversation.  Finish speaking my piece briefly, succinctly.  Refuse to talk about my feelings.  In short, go Spock on him.  (tbh, that in itself is a bad sign for any therapeutic relationship that I'd have to perform those kinds of gymnastics)

 

Edited by MarkintheDark

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22 hours ago, Atra said:

 

Because any relationship of worth in my life has its strife I'd be more inclined to assess whether this was a radical and permanent change in how the T is going to relate to me or if it's an incident.

Of course l'd be upset and like yours, this upset won't go away with a wave of a hand. I'd have to determine what I felt I needed from the T in terms of a repair or acknowledgment for what's happened. 

This is more or less what I would’ve said before. I feel funny giving anyone else advice, especially to someone who, unlike me, is a full-fledged ‘adult’. I think I have a pretty good idea of what you’re feeling, though. I felt betrayed and disappointed in my therapist when I had that trouble a few months ago. I became disillusioned with them, and I wasn’t sure any longer how much they genuinely cared. Maybe I put myself in danger by deciding to stick with them. I wanted to see if the disappointment would eventually subside, and it did. When I considered the bigger picture, I felt I had benefitted enough from working with him that I could overlook the things that bothered me about his personal beliefs. 

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Trust me, being an "adult" is overrated.  A younger local photographer I know, also a depression sufferer, went thru Marine boot last summer and we messaged as he fought it...basically, everything we talk about here on DF.  His path was tougher than that for a typical Marine.  He'll now be a lance corporal this summer.  He's more of an adult than civvies I know who are twice his age.  May sound odd, but he's a hero in my book.  I'd be proud to be his dad.

53 minutes ago, SqueezeWax said:

I became disillusioned with them, and I wasn’t sure any longer how much they genuinely cared. Maybe I put myself in danger by deciding to stick with them. I wanted to see if the disappointment would eventually subside, and it did.

I recall the whole incident and how conflicted you were.  I'm glad it worked out.  I have considerable preconceptions/prejudices of my own on one type you mentioned at the time and I don't know if I'd have stuck it out like you did.

I've developed a pretty clear route I want to take Thursday and it doesn't involve being open at all.  I'm determined to protect myself.  tbh, I've thought that even if he apologized, I know my inclination would be to blow him off, telling him he's about a week too late for that.  And that kind of intransigence in myself bothers me.

otoh, I know from experience that when my gut tells me to get out I've always done better, sometimes considerably better, by listening to that. (Even that is not information he needs to have)
 

Edited by MarkintheDark

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I need to put this out there, guys, just to get it outta my head...which I suppose speaks to how badly this whole affair has affected me.

A few times recently I've found myself thinking that offing myself would be an "appropriate" eff you to this T who's betrayed me, my feelings, and my trust.  I know just enough about him to surmise he wouldn't take it well, knowing he'd been a contributing factor.

(I also felt this way about the abusive medical staff last fall.  If ever I had a reason to leave, that was a good one).

And, no, I'm not in danger.  But it doesn't do me any good to let this rattle around in my head either.

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58 minutes ago, MarkintheDark said:

I need to put this out there, guys, just to get it outta my head...which I suppose speaks to how badly this whole affair has affected me.

A few times recently I've found myself thinking that offing myself would be an "appropriate" eff you to this T who's betrayed me, my feelings, and my trust.  I know just enough about him to surmise he wouldn't take it well, knowing he'd been a contributing factor.

(I also felt this way about the abusive medical staff last fall.  If ever I had a reason to leave, that was a good one).

And, no, I'm not in danger.  But it doesn't do me any good to let this rattle around in my head either.

Again, I am surprised that anyone else has felt this much disappointment in their therapist. When I wrote about my issue three months ago, I felt I was being told over and over that ‘a therapist isn’t a friend’ ‘a therapist isn’t a friend’. And therefore, I shouldn’t have become as enmeshed in and effected by their thoughts and feelings and behavior as I was. I began to think I might have borderline personality disorder, if I felt suicidal at all over someone who is meant to be regarded as no more a ‘friend’ than a dentist or chiropractor. That only led me to be all the more confused and discouraged. 

Edited by SqueezeWax

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3 hours ago, MarkintheDark said:

I need to put this out there, guys, just to get it outta my head...which I suppose speaks to how badly this whole affair has affected me.

A few times recently I've found myself thinking that offing myself would be an "appropriate" eff you to this T who's betrayed me, my feelings, and my trust.  I know just enough about him to surmise he wouldn't take it well, knowing he'd been a contributing factor.

(I also felt this way about the abusive medical staff last fall.  If ever I had a reason to leave, that was a good one).

And, no, I'm not in danger.  But it doesn't do me any good to let this rattle around in my head either.

If this is the state of mind you're in don't even call him tomorrow.  If you have the feelings in you that you have to show him blow off his appointment and never speak to him again.  I know how you feel.  You were attacked for no logical reason whatsoever and your thoughts are if you want to report my actions I will really give you something to talk about.  I have that kind of thinking when dealing with toxic people.  I know how you feel.  Like I said if you want to show him blow him off and don't call and show he means nothing to you.  He's not important enough to even call and cancel the appointment.  You're done with him.

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8 hours ago, SqueezeWax said:

Again, I am surprised that anyone else has felt this much disappointment in their therapist.

Then I guess that makes two of us.  I don't think I can recall anyone else here expressing that kind of feeling.  Helps to know I'm not alone on that count.

6 hours ago, sober4life said:

If this is the state of mind you're in don't even call him tomorrow.  If you have the feelings in you that you have to show him blow off his appointment and never speak to him again.

fwiw, I've calmed down a bit.  I'm determined to make the call tomorrow - lord, izzit tomorrow already? - if only to deny him the ammo to shoot me down for ghosting him, which would be out of character for me.  I think I'll have more veracity if I'm consistent.  So, too, I'll then feel more confident facing my pdoc Friday and explaining the situation to him.  Makes my narrative stronger.

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9 hours ago, SqueezeWax said:

if I felt suicidal at all over someone who is meant to be regarded as no more a ‘friend’ than a dentist or chiropractor.

If it helps, I put Ts, pdocs and, in my case, my PCP, in a different category.  In order for them to be effective, I have to sometimes reluctantly share some intimate vulnerabilities with them.  They're not "friends," per se, but I have to trust them with details about myself that even some of my besties don't know.

If they're gonna be harsh or judgmental then I'm less likely to give up the information they'll need to treat me effectively.  Maybe something I've learned is to not d*ck around when that kinda relationship goes south.  I'd even venture that I've actually developed an intuition for those situations.

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Just effin' relieved...though some post-anxiety shakiness.  The call lasted only seven minutes.

Glad I had my MSWord cheat sheet to keep me on track with the salient points.  Decided to start off with that he probably already surmised I was ending our therapy.  Wasn't gonna be sneaky about it.  Worked my way thru a few contextual points that we'd been gradually going off track, but the past two weeks were the worst of it b/c of his continued justification of "therapeutic obligations" over an innocuous figure of speech.  Though I'd tried to get us back on track last week, I said that meanwhile my POV hadn't been ever acknowledged or explored.  So I gave up.

Yes, I said, he can keep his "therapeutic obligations" he'd been repeating, but I did emphasize I no longer trusted him.  I wasn't going to continue to let myself be hurt.  Thank god he just kept his damn mouth shut this time. 

I bit my tongue about "therapeutic obligations" when he offered to set me up with another T.  Just sounded like more disingenuous "this is what they told me to do in psychologist school."  And I sure as hell won't be seeing another one until I decompress.

I ended the call by saying I only needed him to cancel my remaining appointments...could he do that?  Thank you.  Goodbye. [giving myself a five-star rating]

 

Edited by MarkintheDark

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Emotionally worn out from a couple weeks of this sh#t, but relieved.  Having had several hours to digest, I'm struck that his first and only reaction was that, "I can refer you to another therapist."  No comment otherwise.

I'd like to believe he was, ah, speechless (or even contrite), but I think it's more likely he just went stone cold detached.  I doubt he heard much of anything I had to say...which tells me I was right to get outta Dodge.

All I have next is the pdoc tomorrow and notifying him I've dumped the T.  At least I feel I can be honest with him about my feelings.

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I think it’s great you at least explained why you were leaving. That is something I didn’t do with the one therapist I ever ‘broke up’ with three years ago. I only mumbled something about having felt that we’d ‘covered eveything’. I regret to this day that I wasn’t truthful about how discouraged and frustrated I’d become. I even wrote him a lengthy, unsigned e-mail a few weeks ago that I ended up not sending describing how difficult the experience was. He probably would of figgered I was simply attention seeking.

Edited by SqueezeWax

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