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Dr. Bob is Robert Hsiung, MD,
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Posted by Dinah on May 18, 2005, at 19:44:47
In reply to Re: The Introduction (In Session) » gardenergirl, posted by daisym on May 17, 2005, at 22:52:54
> I think we should debate what she wrote about therapists' authenticity. She offers that much of her group worried that their therapist was different outside the consulting room. And later, she goes on to say that "good therapists are able to bring the essence of their real selves into the therapy room without having their needs compete with the client's. They are able to be authentic while maintaining clear boundaries." I agree that they should keep their needs out of the room. But, does it matter if they act differently outside of the consulting room if they are consistent with us? If so, why? Aren't we different outside the therapy room than we are in it? Don't we put on our "therapy patient" hat, just like they put on their "therapist" hat? Don't you think we all, to some degree, play roles in certain settings? And, do you think men are better at this than women? Universally it is believed that men can go to work and leave their personal lives at home, unlike women. Do you think this applies to therapists as well?
Hmmm... I agree completely. From what my therapist has said, he's way more patient and, well, therapeutic in the therapy room than outside it. And that's perfectly ok with me. My husband is known for his great interpersonal skills at work, but they're rarely seen at home. I don't mind being on the other side of that phenomenon. :)
Posted by Dinah on May 18, 2005, at 19:53:03
In reply to Re: The Introduction (In Session), posted by pegasus on May 18, 2005, at 17:10:18
> Dinah, oh, I have to disagree with your stance on the paragraph about therapy being tragic! I've always felt that way very strongly. It's part of what charges the relationship for me. Maybe the difference between us is that I do expect to one day stop seeing my therapist. If only because of lack of money. My life isn't stable enough to sustain therapy forever. And anyway, I think the therapists generally do expect to terminate with each client eventually, for one reason or another (your therapist excepted - I know he expects to see you forever, so you're safe). So, that being so, I wish they could more often acknowledge the tragedy in forming such a close relationship that is expected to end.
Thank you for that exception!!! :)
As I said, I think that has more to do with my stage of development than anything else. My fear of abandonment is so enormous that literally all other work has to grind to a standstill when that is acting up. In fact, my therapist and I were talking about it today. It's reared its ugly head again, we're back to square one, and I was apologizing for being as annoying as I am about it. He was so nice about it. He said "Dinah (and he almost never uses my name), I don't think you realize how much you were abandoned when you were young. And the real tragedy was that you were made to feel special about it." It really made me want to cry. That he so much understood how scary I find abandonment.
I can't bear to see that tragic ordained outcome right now. Just the imagined thought of it with no basis in reality gives the relationship more than enough charge for me.
>
> The thing that hit me hardest about the intro is the discussion about how all the literature about therapy is from the therapists' point of view. I always thought that was a bit goofy. Who better to comment on the effectiveness, or even the effect of therapy than the client? I don't have the book in front of me, but she mentions at one point how therapy theories are often proposed and implemented without checking in with the clients who've experienced those methods. Whatever evaluation is done is based on external metrics that are observable by the researcher, not on what the client says about their therapy. What an oversight!That's why I think all therapists but mine should read this board. And all therapists should read this book. Daisy's wonderful therapist is the exception, I fear. Mine hasn't a clue what's actually going on in therapy. At least not in this subset of the therapy client population.
> P.S. I just read Yalom's new novel "The Schopenhauer Cure". It's essentially about an idealized therapy group, where every member is a perfect, idealized group member. (Well, allegedly it's about a collision between Schopenhauer's philosophy and modern psychotherapy, where therapy wins, of course.)
>
>
Was it any good? Aside from Yalom's legendary idealization. :) Which I sort of like. I just bought it and it's on my soon to read pile.
Posted by pegasus on May 18, 2005, at 22:23:55
In reply to Re: The Introduction (In Session), posted by Dinah on May 18, 2005, at 19:53:03
Hmmm, well it was pretty readable. Not as good as his other novels, which weren't great literature to begin with. As usual, the most interesting aspect was the glimpse of the world from a therapist's point of view. Every other chapter is about Schopenhauer's life, which is moderately interesting. But when I started a new chapter, I was always glad when it turned out to be about the therapy group. The juxtaposition of the two wasn't done in the most skillful way. But I love everything by Yalom, just because he's so . . . into therapy.
Have fun reading it.
pegasus
Posted by cricket on May 19, 2005, at 9:01:44
In reply to The Introduction (In Session), posted by Dinah on May 16, 2005, at 19:29:08
I think this first chapter and all of your insightful comments on it made me realize how differently I experience therapy than most of you all and I guess pretty much everyone else who has had the wherewithal to write about the experience.
That difference in turn made me realize that I am probably not capable of real therapy. There just wasn't enough of any kind of care in my childhood to build anything on. I think that initially my therapist hoped that there might be.
He was always asking me to think about how I felt when I was just sitting watching my grandmother, what things I remember about her, what I used to tell her. I clearly remember the way my T's eyes lit up when I told him my grandmother was 48 when I was taken away from her, which is the same age my T is now. So I think he was actually trying to encourage a bit of transference to him but it's never really worked.
But now after 3 years, I think we've both kind of given up. He's said I don't ever have to talk again, and he'll just sit there with me once a week for as long as we're both alive.
There is no longing, at least that I am consciously aware of, for him. Mostly I just dread my appointments although I rarely cancel so there is some need there for him that I just don't understand.
Most of you talked about much your therapists understood you and how aware they are of your feelings and reactions. Not true for us either. I think my reactions take my T by surprise almost each and every time. I think that he would readily admit that he never knows when something is going to bother me or not. Part of this is due to our extreme differences in backgroud but also also due to the fact as he says that people like me rarely ever make it to therapy. With his other clients I am sure that he is very insightful.
I also never wonder about how he is outside of therapy. It's just never concerned me. I mean I hope he's happy and fufilled, but I don't want to know anything about it. So I don't worry about whether he's real or authentic with me. There is nothing real and authentic about 2 people sitting in silence every week.
Also, as far as going more than 1x a week, no how no way. It takes every ounce of will I have to drag myself there once a week.
So the question really is why do I go there at all? Part of me, a very non-verbal part, just really needs to sit there for an hour a week and pick at my coat and know that he's looking at me and sometimes praying, sometimes just smiling, once in a while asking questions even though he knows I won't be able to respond.
So I guess what we're doing isn't really therapy at all and this book won't be relevant to me but I am enjoying hearing everyone discuss it.
Posted by Dinah on May 19, 2005, at 9:16:45
In reply to Re: The Introduction (In Session), posted by cricket on May 19, 2005, at 9:01:44
It doesn't necessarily mean any of those things. In my tumultuous first five years of therapy, I quit a million times. I was always honest with him, but never emotional. He didn't like me, much less understand me.
But like you, there was a reason that I always went back. And the reasons became so clear when I finally opened to him, after reading the book "The Myth of Sanity". Now I understand why he's so important to me.
If it is really not important to you to go, then you may be right. But if there is an internal pressure to go, something that yells "NOOOOOOO" when you think of quitting, then there is more likely something going on beneath the surface.
I used to wonder why on earth I did the things I did. It was my overwhelming obsession. And now I know! My therapist stuck through it with me in those first five years, even though he didn't much like me, and he was never unkind. I'm so glad he didn't do what he later admitted he sometimes wanted to do. Admit that he didn't know what to do with me and refer me on. Admit that he didn't think therapy was a help to me and refer me on.
It's a question only you can answer.
I'll admit that "In Session: The Bond Between Women and Their Therapists" was most helpful to me after those five years, but if it's available at your library you'll probably find it's an interesting read even if not all of it applies at the moment.
And I still really don't care what my therapist is like outside session, as long as he feels like himself within session. If I walk in and he doesn't feel like himself, if he feels distracted or not quite there, I'll do everything I can do to bring out "therapy him", and if that doesn't work I just tell him he doesn't seem all here.
Posted by Dinah on May 19, 2005, at 9:17:31
In reply to Re: The Introduction (In Session) » Dinah, posted by pegasus on May 18, 2005, at 22:23:55
Posted by cricket on May 19, 2005, at 11:22:48
In reply to Re: The Introduction (In Session) » cricket, posted by Dinah on May 19, 2005, at 9:16:45
Dinah,
There's definitely something that screams Noooooooo when I think of quitting and I do think about quitting just about every week.
I'm sure that my T would love to refer me on. But he hasn't yet done that. And he's certainly talked about therapy not being right for me but since I just keep coming he's not been talking about that lately either.
And, I have to say that last week, when I said that I wanted to talk to him but that I didn't know how, that I didn't have the words yet, he did lean forward and say with what seemed to be a real look of commitment on his face and in his voice "I can wait. For as long as we're both still alive, I can wait."
Hmm, "The Myth of Sanity". Now that seems like a book I should read. Did your T recommend it? Did it trigger you in any way?
Posted by Dinah on May 19, 2005, at 12:03:09
In reply to Re: The Introduction (In Session) » Dinah, posted by cricket on May 19, 2005, at 11:22:48
No, my therapist didn't recommend it. I probably saw it mentioned here.
I wouldn't say it triggered me, exactly. But I kept falling asleep the first few times I read it. :) Now I can get through it with no problem.
Posted by Tamar on May 19, 2005, at 17:41:53
In reply to The Introduction (In Session), posted by Dinah on May 16, 2005, at 19:29:08
Yippee! My book arrived today. I'll read it tonight and then post.
But having read what you guys have said, I was really struck by the idea of the therapy relationship as having a tragic dimension. The word 'tragic' is very significant to me (I read quite a few Greek tragedies a few years ago).
In classical tragedy there's often a collision between two things that are equally right but nevertheless opposing forces. Like Antigone, whose brother is killed in the process of attacking her city. She has a sisterly duty to bury her brother, but a civic duty to leave his body to the dogs. Both potential courses of action are right, but either will get her into trouble.
I do think the therapy relationship is tragic because one good thing (a real relationship) collides with a contrary good thing (professional boundaries limiting the relationship).
And the other significant thing is that tragic heroes (that's us!) often devote their lives to a search for meaning in suffering. If there were no search for meaning, it wouldn't really be tragic.
And furthermore, tragic heroes suffer because of circumstances entirely beyond their control - usually circumstances arranged by the gods, though not necessarily. Admittedly, tragic heroes are flawed, but who isn't? They are ultimately not fully responsible for what happens to them. I find this a comforting idea when considering mental health, and considering the therapeutic relationship, in which our only control is in how much we tell.
Hmmm... I'll go read the book now...
Posted by pegasus on May 19, 2005, at 18:18:48
In reply to Re: The Introduction (In Session), posted by Tamar on May 19, 2005, at 17:41:53
Posted by Annierose on May 19, 2005, at 18:57:55
In reply to Re: The Introduction (In Session), posted by Tamar on May 19, 2005, at 17:41:53
I am enjoying this discussion very much. I am finishing up my current book before re-reading this one. Everyone's insights are so interesting ... lots of hmmmm and a-ha moments. I will catch up, I promise.
But having read the book last year, I am following along nicely.
Posted by pegasus on May 21, 2005, at 12:34:56
In reply to The Introduction (In Session), posted by Dinah on May 16, 2005, at 19:29:08
One thing in the intro to this book I'd like to hear what y'all think is about the discussion of the therapist-client relationship being "approximate". She calls it approximate because it is both real (actually happening in the room) and symbolic. Both times I read the book, and just now when I skimmed this chapter again, I didn't really understand that idea. It's important because she talks about it all during the rest of the book. Can anyone help me understand why the relationship is "approximate", and exactly what she means by it being symbolic? I kind of understand, but not really. Is this just a new way of talking about transference?
pegasus
Posted by Dinah on May 21, 2005, at 12:48:58
In reply to Approximate relationship, posted by pegasus on May 21, 2005, at 12:34:56
I took it to refer to the boundaries of the relationship. It *feels* as real as any relationship, and in many ways it is. But it can't survive outside the boundaries. It lives in the therapy room only, is supported by the payment of fees. It's unlike any other sort of relationship. Intensely intimate yet limited.
So while it might feel like a friendship or romantic relationship, it's only an approximation? of that??
I think I prefer to think of it as a *different* relationship rather than an approximate one. Because it's every bit as real as other relationships. And all relationships have boundaries. The therapy relationship boundaries are just more clearly defined. But it's because those boundaries are so well defined that the boundaries or rules that apply in other relationships don't apply to the therapeutic relationship.
That was my understanding of it. Perhaps others can sort me out if I'm wrong. :)
Posted by daisym on May 21, 2005, at 18:59:23
In reply to Re: Approximate relationship » pegasus, posted by Dinah on May 21, 2005, at 12:48:58
I think Dinah is right as to how Lott is using this term. It is a concept that is really hard to understand. I think in so many ways we *know* the relationship is real, but it is so unbalanced, and with such formulized boundaries that we have to question "how real is it for THEM?" I think that gets to the heart of it. If anyone asked us, we'd say, "absolutely." I mean, look at how much brain power and time and emotion we invest in thinking about it OUTSIDE the sessions. We aren't thinking so much about ourselves, our past, our inner life, as we are thinking about our sessions, our therapist and our reactions to what happens with them. I don't think couples in marriage counseling (I could be wrong) do this as much because the relationship in the room being worked on is theirs. No so for individual therapy. (Which is a weird name if you think about it because there is nothing individual about it!)
Sorry to ramble. It just struck a nerve with me. I would guess that therapists like the word approximate because it does explain more about how they feel about us.
Posted by messadivoce on May 22, 2005, at 0:55:41
In reply to Re: Approximate relationship » pegasus, posted by Dinah on May 21, 2005, at 12:48:58
When I read the word "approximate" it really didn't resonate with me. I thought, but my relationship with my T is very specific!! I mean, my T was of psychodynamic orientation so our relationship was obviously the focal point of a lot of sessions. I like Dinah's idea of calling it "different". It's like romance at times, and frienship too, but it's not.
My relationship with my 2nd T was more approximate. Maybe because I didn't get to know her as well, and our relationship didn't have the same intensity that my female-to-male relationship did with my first T. I think it depends on the therapy relationship, that is, how "approximate" it is. A lot of it is up to how close the T will get to the client.
Posted by pegasus on May 22, 2005, at 1:06:40
In reply to Re: Approximate relationship, posted by daisym on May 21, 2005, at 18:59:23
Well, ok, but what is the relationship approximating? A relationship IRL? That seems to be what Dinah's saying.
I think that's where I get stuck. It seems genuine and complete to me, even with the boundaries, which are part of what makes it rich. And I never thought of it as being approximately anything else. Thinking of it as approximately a friendship, or approximately a parent-child relationship seems unhelpful.
Oh . . . ok, so I'm figuring something out as I type. Maybe she's talking about how we sometimes see the T-client relationship as symbolic of other relationships (via transference). So, it's approximating those other relationships for us? At least in part.
Well, maybe I'm making it more complicated than it really is. Maybe she's just talking about how the relationship has inherent, important limits.
pegasus
Posted by Dinah on May 22, 2005, at 1:40:44
In reply to Re: Approximate relationship, posted by pegasus on May 22, 2005, at 1:06:40
Posted by pegasus on May 22, 2005, at 9:38:14
In reply to We'll put it on our list of questions? :) (nm) » pegasus, posted by Dinah on May 22, 2005, at 1:40:44
Posted by Dinah on May 22, 2005, at 9:42:01
In reply to Sorry, what list of Qs? (nm) » Dinah, posted by pegasus on May 22, 2005, at 9:38:14
in late July.
We could start a list of questions.
Posted by pegasus on May 22, 2005, at 11:27:25
In reply to For Deborah Lott, when she's guest expert, posted by Dinah on May 22, 2005, at 9:42:01
Oh, Cool! I missed that that was going to happen. I *would* like to ask Ms. Lott about this.
And regarding the approximate relationship thing, I've been thinking, and rereading, and what I now think she's trying to say is that the therapy relationship is *more* than it seems, not *less*. I think "approximate" is probably an unfortunate word for it. I think she's saying that the therapy relationship is real, in the sense that we have actual relationships with our therapists. And in addition to that it's also approximating important relationships from the past that we need to work on. That's the symbolic part. So, I guess I'd rather call it a complex relationship with real and symbolic parts.
Not to beat a dead horse or anything . . .
pegasus
Posted by Dinah on May 22, 2005, at 12:00:05
In reply to Re: For Deborah Lott, when she's guest expert » Dinah, posted by pegasus on May 22, 2005, at 11:27:25
You may have it there.
So the real relationship would be the real relationship between us, but he's also my therapist/mommy.
Posted by gardenergirl on May 22, 2005, at 13:55:39
In reply to Re: For Deborah Lott, when she's guest expert » pegasus, posted by Dinah on May 22, 2005, at 12:00:05
I've been struggling with understanding what she means by "approximate", too. Pegasus, I think your explanation makes a lot of sense.
gg
Posted by Dinah on May 23, 2005, at 9:43:41
In reply to approximate relationships...pegasus, posted by gardenergirl on May 22, 2005, at 13:55:39
I'll start with the "golden fantasy", just because I wrote below that my major delusional transference was thinking my therapeutic relationship was close to perfect.
I don't think I mean it in the rescue sort of way she's talking about. I do need for him to be in tune with me, at least to a certain extent, within session, or he doesn't *feel* like him, and I get a bit frantic. Like his body was there but he wasn't and that's scary. But I know he's not there for me constantly. I know his family comes first. I have a pretty good idea how he feels about me, and the limits of that. He would never hang out with me if I didn't pay him. We have nothing in common. But he is fond of me within the context of the therapeutic relationship, in that way you have when you're really familiar with someone and accept them.
I think I mean it that I know he'll never reject me. He might abandon me by moving (which is a whole different part of this chapter) or retiring or getting sick or dying. But there is nothing I could say or would do that would cause him to reject me. We may and will fight from time to time, and there will be misunderstanding, resentment, annoyance and anger on both our parts. But I know our relationship can withstand it.
I've told him everything that's happened in my life and in the relationship so far, and he's been accepting and has never run off screaming out of the room (one of his favorite, and sometimes annoying, expressions). And we've dicussed enough about things that happen here for me to know there's nothing I *could* say that would make him reject me. If such a thing were to ever happen, I could tell him I loved him romantically, I hated him, I was sexually aroused by him, and he'd be ok with it. Ok enough at least that he wouldn't end the relationship.
I think I mean it's perfect in that he accepts me and feels affection for me and finds me funny often enough to remind me of Daddy.
So that's my idea of a perfect relationship. I dont' know if that qualifies as the golden fantasy she talks about.
Posted by pegasus on May 23, 2005, at 18:13:37
In reply to Chapter 2. Too many buttons to mention., posted by Dinah on May 23, 2005, at 9:43:41
You know, Dinah, that doesn't sound like the golden fantasy to me. It sounds like a very reasonable and realistic therapy relationship. So, maybe your fantasy and reality are the same, lucky you. ;)
For me everything in this chapter strikes true. That's what's so great about this book. It's incredibly validating. In my first major therapy relationship, everything that happened was hugely important, and I had such dependency, and fantasies, etc.
We talked about it later after therapy (via email). He told me that he thought it was so intense relative to my current therapy relationship because it was the first time I'd talked about a lot of secret stuff. So, I'd needed to do a lot of relationship testing before we got into the big secrets. Once I'd done the testing and telling, the relationship was just really important and special.
So, here's a question: why does that happen in one therapy relationship but not in another? The way Ms. Lott describes these intense feelings and fantasies, they're just inevitable because of the therapy scenario. But I've experienced it with some therapists, and not with others. And all the therapists involved seemed warm, empathetic, and skilled. Am I just in a different place wrt my issues with each therapist?
pegasus
Posted by alexandra_k on May 23, 2005, at 18:18:06
In reply to Re: Chapter 2. Too many buttons to mention. » Dinah, posted by pegasus on May 23, 2005, at 18:13:37
I haven't been reading the thread...
But I'll start reading and join in any old day now...
:-)
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