Search Terms Answered #6

This post is part of a series where I respond to questions that have brought people from google to this blog which the blog does not answer well at present.

 

Today someone found the blog by searching:

“therapist tells me her problems. is this part of the therapy?”

Dear Google Searcher,

This not not something that should be a part of a good therapy relationship. Therapists are allowed to self disclose at times but it is something that much be done very carefully and rarely and only in ways that prioritize patient interests. If it feels like your therapists is using you for support in some way this is a giant red flag. Part of what makes therapy unique from a friendship is that the focus of attention should be on the patient rather than the bi-directional type of focus seen in friendships. If something does not feel right in your therapy remember that you can always get a consult with another clinician for a new perspective.

It still happens: Involuntary Medical Leaves in Higher Education

Here is a post by a young woman who was put on an involuntary leave similar to what I went through about 7 years ago.

She does a much more eloquent job of explaining it than me. She also tells the story without a pseudonym and shares it with her school community. I really hope the best for her and that she is able to enact change.

A lot of why the involuntary leave has continued to haunt me so much is due to the terror it induced in me about the risk of it happening again. It created this giant ripple effect in my life with the measures I take to avoid letting it happen.

I hope that maybe for her, being open about the experience rather than hiding will minimize the long term damage. For me, I just can’t take the risk. Maybe 40 years from now if I get tenure somewhere and have loads of funding I’ll do a Marsha Linehan or Scott Barry Kaufman style reveal, but right now I will stay in hiding.

Maybe when I returned to the school that kicked me out I should have shared it with everyone. Perhaps I would have been better off if I had told everyone exactly what happened. Maybe also moved off campus to remove the school’s power over my living arrangements. Maybe I would be long over it if I have done that. I don’t know. All I know is that in this present moment it feels unsafe to share.

It’s a terrible situation that hiding is what makes it worse but not hiding could mean losing my ability to pursue my goals. I have no doubt that if I were not exerting so much effort to hide parts of myself my symptoms would be considerably lower. This is what mental health stigma does. It takes a bad situation and makes it worse. The vast majority of my therapy in some way or another always gets back to my belief (which was elevated to core belief status from the event) that if people know me fully I will lose things I care about.

I wish so strongly that someone somewhere would be able to create greater awareness for students of their rights in these situations. It’s clear that schools will continue to do this even though the government rules against the schools when complaints are filed through appropriate channels.

As much as I know that ruminating over the past is not constructive I wish I had known what my rights and options were at the time. I knew it felt unjust, but I didn’t know the right details. I didn’t know that I should have been provided information about appeal procedures. I didn’t know the specific laws that were being violated and which resources could help me. I think if at the time had known more about my rights that a quick call from a lawyer could have stopped the entire process.

I feel like the reason this persists is that at the time it occurs people are so vulnerable. I wasn’t clearheaded enough to do research on what to do. The hospital only even allowed me internet access for brief period each day. I didn’t have access to resources to look up my rights even if I had been capable of doing that research. My parents were well intentioned advocates who did their best to fight to keep me in the school, but their approach involved meeting with people who ignored their input. For all of my difficulties in my relationship with my mom, one of her highest priorities is to protect her kids. Her perseveration on topics, which often infuriates me, has at many times protected me when it has come to fighting battles to help me (For example I would probably never have gotten access to special education in 1st grade to help with my reading delay without her advocating). But persistance is useless when none of us knew what to do.

When it happened to me I was so taken my surprise. I didn’t see it coming. I didn’t even know it was something possible. It’s hard to fight a system while simultaneously fumbling to learn the rules. The decision to kick me out happened so fast. I think it was over less than 3 days.

One fear of mine is that I might someday get caught is a situation that could force me to do this same thing to someone else. At some point I will see patients of my own. I will be starting off with undergraduate students at my school. I have no idea of whether this is something done here, but given the high prevalence of schools making these decisions it is probable my school might do this same thing. As a PhD student I would be powerless to stop it. I’d be a cog in the system. More and more I start worrying not just about having this happen to me but what if I am forced to do this to someone else? I have more power to enact change from within a system but right now I don’t have any of the power yet.

It is terrible that this problem has not improved over the past 7 years and its occurrence is still not more common knowledge. People can’t have outrage about situations no one knows about. As long as higher education institutions continue to enact this process in relative obscurity, fostered by the shame victims of the procedure feel, I worry that this will continue to harm more and more people.

Please share this young woman’s post on whatever social media you use. She has done an excellent job of explaining the emotional consequences of these discriminatory procedures and I hope that increasing awareness can long term provide more tools to fight back.

My sense of humor: Self injury lego robot

I was going through old photos and found some pictures from around 7 years ago. Apparently back in 2006, I decided to make a self-injurying lego robot. I took pictures of it but am not sure I ever shared them with anyone.

I put the photos under the cut. I don’t believe in trigger warnings, and I think this is more comical/absurd than anything else, but I can respect that some might disagree with me.

Continue reading

The problem when therapists bring their emotions into therapy: Firing #28

I wrote in my last post about my plan for therapist #28. That I planed to ask her to do med management and that I would see someone else for therapy. Although this was my plan I went into my session with the willingness to be open to making therapy with her work if at all possible. So I didn’t mention this plan right away in my session this week.

I’ve been so desperate to avoid restarting the therapist firing cycle I went through as an undergraduate where I went through 16 therapists in 4 years. I moved here and started seeing #28. I was incredibly determined to make this work. If anyone had asked me what my main goal in therapy was I would have said that my goal was to not fire my therapist. Unfortunately I think this determination allowed me to stick around in therapy that was detrimental to my well being and stability.

My therapist firing cycle was part of a reaction to bad therapy. Bad therapy scares me so much that I have been inclined to leave at early signs of problems. With #28 I was so focused on avoiding the awful cycle of firing therapists (fire therapist -> relief -> panic -> new therapist) that I partially lost sight of the adaptive parts of this process. I didn’t see the red flags for what they were.

With #28 the problem was in 2 phases. The first phase was before school started. I wasn’t feeling any desire to talk to her about things. I didn’t feel any attachment. I was feeling like we had no therapeutic alliance. It wasn’t bad other than that it was not good. Then with school starting my stress increased and I brought more emotionally charged issues into therapy. The problem of a lack of a therapeutic relationship became dramatically highlighted. #28 made interpretation comments, but outside the context of a safe supportive relationship these comments just felt critical and unempathetic which furthered the problem of lack of alliance.

But I was determined to make this work. I tried to explain what I explained above. I tried to point out examples of these problems as they happened. The problem is that #28 ended up taking my comments personally. It wasn’t obvious right away that this was what was happening.

I was making comments about behaviors that were making me perceive her actions as unempathetic and she interpreted that as a judgement against her. Read that sentence again. Doesn’t that feel backwards?

The problem is when a therapist brings their emotions into therapy it fall outside of the pattern therapy is expected to follow. She was trying to interpret my comments about her as part of my pathology. I know myself well enough to know that it didn’t fully ring true. But at the same time I could see that she was activating things I am touchy about and see some truth in it.

A big source of my conflict with my mom is that she takes my problems and makes them into her own problem to the point where I have to put my emotions aside and deal with hers. So when #28 was telling me that ‘most of her other patients think she is very empathetic’ and I tried to explain (without success) that a comment like that is exactly what I am upset about, it makes things very messy. It plants this doubt that maybe I am blowing things out of proportion. Maybe I am imagining slights that are not there. Especially when #28 is trying to make interpretations about my interpretations about her.

I have been in enough therapy to know it’s okay to sometime leave feeling a little more upset. But that also that should not be the norm and therapy should not be making me feel worse about myself as a person. At the same time I was feeling desperate to work things out. I was feeling worse because I desperately wanted to find a way to explain what was wrong and therefore fix the problem to avoid my therapist firing cycle. The problem is that the more I desperately tried to explain, the more #28 took things I said personally.

I went into my last session with her open to trying to resolve it (but with an alternative plan in mind). #28 gave me the push I needed to be clear that the problem was not all in my head. Before telling her about any plans to leave, she in a very angry tone and raise voice started scolding me for being too negative and telling me how she felt like I was never going to forgive her for one mistake. I responded that it wasn’t about one mistake it was about how she kept responding to my attempts to discuss the mistake. I’ve never had a therapist be so openly hostile towards me before. It was scary. But it  made me realize that I wasn’t wrong for seeing hostility in the sarcastic comments she had been making in other sessions. #28 even admitted that she was experiencing countertransference. I had been seeing anger leaking out in little ways and when I tried to talk about those angry responses as being unempathetic she had been trying to place the problem onto me.

What makes a therapist bringing their emotions into therapy so damaging is that there are no witnesses. There’s no one I can ask to say, am I overreacting? That should be the therapist’s role, but when the therapist steps far enough out of the role of neutrality I can’t get a fair judgment on my emotional state. I spent the past month on edge, feeling crazier than normal. I’ve been feeling like I went back to emotionally being age 18, like years of progress were erased. And then her reaction became obvious enough that there was no way I could doubt it was happening. Before that though I had to wonder if it was me. Am I too critical? Am I not giving her a chance? Am I overreacting?

#28 refused to meet with me only for medication. She said she does not see people for med management only and that if I even just needed a stop-gap until I find someone else it would need to be on a different day of the week (A day which I spend in class and can not go to therapy). I realize now that this is for the best. But right after the session I spent an hour sobbing in a parking lot down the street from her office as I panicked about the possibility of running out of my ADHD medication.

I had to pull myself together enough for a class at school. I hid myself in a corner before hand and booked an appointment online with the therapist who was the top of my list I selected last weekend. I was able to get an appointment for the following morning.

This post is too long so I won’t go into detail about that but I will say that meeting with this new therapist (#29) made it clear to me how bad things had been with #28.

#29 did all the things he’s supposed to with forming a therapeutic alliance. Even though I know the basic strategies he was using to convey warmth, understanding and empathy they still work and they work really well.

I’m upset with myself that I left myself stay with someone like #28 when it was having such a negative impact on my well being. After all the therapy I’ve been through, it is terrifying to realize I can still miss warning signs like I did. When I talked with #29 I got to talk about some major stressors I have been experiencing in the past month. None of these things had been things I had been able to talk to #28 about because all of our sessions were spent with me trying to explain why I didn’t feel safe talking to her and her doing more things to make me feel less safe talking. With #29 I was alternating between sobbing about things I am upset about and gleeful relief over finally being able to talk about them.

I still need to solve my issue of getting a prescriber because #29 is a PsyD and therefore can not give me medications, but at least I have someone on my side now to help me navigate the situation. I’m very glad I was able to get that appointment with #29 for the day after firing #28 because the anxiety of not knowing if the situation will work out well is unbearable. I’m already feeling myself coming out of the emotional hole I’d been falling into because now I have a little bit of hope.

Privacy when receiving mental health treatment: My tired theme of professional boundaries with a new twist of opening up a little

I’m still dealing with figuring out what to do with my therapy situation. Things with therapist #28 are still not working and I’ve given it beyond what I think is a fair chance. I think I might have generated a working plan, but first a little about stuff that happened in between.

I opened up a little and surprised myself

My academic advisor met with me this week and asked if I was okay. I tried at first to give a vague, ‘there’s a problem but I’m fixing it’ type response but ended up sobbing in her office. I’m shocked with myself about how much I said. In reality I actually provided very little information but it was far more information than I’ve shared with anyone who knows me academically or professionally. I shared that I am having trouble with my new therapist, that I had a confidentiality issue in the past and alluded to a problem of firing therapists and having gone through a lot of therapists. For those who have maybe not read other posts in my blog, that is a giant thing for me to share. I shared nothing about the specifics of my psychopathology, but shared about the extent to which I have received treatment. This is something I don’t talk about with people.

I’m so concerned about keeping personal and professional separate. I realized this was the first time I ever talked to someone who is part of my professional work about this dilemma of treatment vs privacy and boundaries. Of course I’ve talked to my therapists about it, but the issue never quite sinks in properly. They are in my field but not my exact professional context. They also can’t fully understand my concerns about confidentiality because they all think they they personally would never do anything to compromise it. They lose the bigger picture somehow.

Confidentiality and risk

It was helpful to hear my advisor validate that confidentiality breaches are a thing that happen even though people don’t like to talk about it. It makes me realize how much of my therapy (even my good therapy) over the past 6 years has put the problem on me (for my reaction to it) and pushed aside the reality that it is a thing that occurs. It hasn’t necessarily been denied, but it has certainly been sidestepped. Certainly my reaction is excessive, I won’t deny that. But I am also reacting to a real risk, even if my response to that risk is too big. In a way I wonder how much of this sidestepping is a process that makes me feel more like I need to respond dramatically. If everyone else is sidestepping it then it is all on me to protect myself from it since no one else is handling it.

I want to put an example of this into another context. Suppose someone had a snake phobia. Let’s say everyone around this person loves snakes. Some even have pet snakes. Everyone is telling the person with the snake phobia that their reaction is out of proportion with the situation. But some snakes can be dangerous. Not always, but it is a possibility. It might even be hard to distinguish between safe ones and unsafe ones. So this environment might make the person with the phobia even more likely to take excessive measures for safety. On the other hand if people acknowledge risks but instead teach the person how to identify types of snakes and how to handle risky situations should they arise it could create support and provide tools to deal with real risks in a way that is appropriate to the situation.

I had this realization that for all the time I’ve talked about privacy concerns in therapy. No one had ever before talked to me about realistic suggestions to manage real risk. Both of confidentiality and of simple professional boundaries (I can’t be in therapy with a professor who teaches in my program for example). I think everyone has been so scared of introducing more ways for me to avoid risks that no one has helped me assess how to handle the risks that really do exist. Most fears have some kernel of reality behind them. It’s part of how they are maintained. But something about my anxiety being so connected to the process of therapy I think has made people respond to it differently than they might with other types of anxiety.

It was wonderful to share a little about that with someone who is really able to get the context I am working within. And it was nice to get some empathy about how difficult it can be and perspective on an approach I may have been overlooking. She said some things I have heard from other people but those things cary more weight when said by someone who is in my context.

Unexpectedly helpful

The conversation also really highlighted how bad things are with #28. My interaction with my advisor was this beautiful interaction with a mix of validation and goal directed conversation interspersed with appropriate humor and joking.  On some level I feel very guilty for letting this bleed into my professional life. My advisor is a therapist but not my therapist. But she basically did far more to help me in 15-20 minutes that my actual therapist has done in the past month. The conversation made me think about some things in new ways and reflecting on it has helped me generate some new possible solutions to me problem.

I need to make sure I keep our professional boundaries in place, but it’s good to know that I maybe don’t need to be as scared if the mask of normality I hide behind slips a little sometimes in her presence.

The new plan

It’s taken several days for some of the conversation with my advisor to sink in fully enough to help me generate a new plan. I am not sure if my plan will work. But having a plan is giving me that glimmer of hope that I need.

Something clicked for me last night after searching for hours for a psychiatrist and not finding anyone who met my criteria.  I finally came up with a plan. My plan (which may not work at all) is PsyDs and maybe social workers. To those of you who have said this to me a millions times, I’m sorry for not giving it much weight. My conversation with my advisor shifted my perspective a bit which made me feel like this is more of an option than I had considered before. I am going to ask #28 to do med management. I really do not like her, but I can suck it up and tolerate her for a once a month meeting for a script. The key to my plan is her going along with this. If she does not then it falls apart. Assuming she cooperates, I have made a list of 3 possible therapists (1 psyd and 2 social workers) who seem like they could work out. I know it seems like a simple, maybe obvious solution, but I had been so stuck on psychiatrists.

I wrote a paragraph here trying to explain why I had been so stuck with psychiatrists, but it was very convoluted and overgeneralized a lot of professional degrees unfairly so I deleted it. It was really my rationalizations for something else. The simplest shortest answer is I have been trying to replicate my relationship with SM (a psychiatrist) and have been stuck on this idea that it will be more likely to occur with other psychiatrists.

My process of therapist searching

Trying to find a new therapist is a scary process. This is separate from pure professional concerns as it also includes the general vulnerability of sharing so much with someone new and the power they wield to hurt me. The process of finding one is difficult. The databases to search just do not have the information needed. Some of this is basic information (like populations served) but also there is the issue of personality match. There is nothing that can estimate if the therapist will be a good personality match. Can someone make an okcupid alternative for therapists? Have the therapists respond to questions about their therapy style, theoretical orientation and populations treated. Then clients can anonymously fill out a survey on symptoms, need in a therapy relationship and desired course of action. Then get a list of match percentages.

No one would ever want the liability. And I suppose most patients don’t know what they want until they’ve seen some who they know are what they don’t want. I can dream though.

Before my decision to branch out to clinicians other than psychiatrists my search was not going well.

I went through the entire psychiatrist data base for my insurance.

I google every therapist before considering seeing them.

Things that make me feel uncomfortable seeing someone or indicate other problems:

  • At least 2 had their license suspended in the past and reinstated. One of whom the reason for suspension was very scary and google searches indicated that this person has some really distorted body image issues (think professional photo on websites being scarily over-photoshopped). Obviously will skip those ones.

My insurance does not let me search by anything other than location and ability to prescribe. This is a problem because it means wading through tons of people who are not options because I am not the type of person they work with. This is a common problem with insurance. They make their list look bigger because they don’t give specific search terms. Also anyone who had multiple offices got listed multiple times. For some academics this meant being listed as many as 5 times because each title they had somehow generated them an extra entry in the database.

  • A ton of the list was of people who only meet with children
  • A bunch of people upon google searches clearly only handle one type of problem (e.g. Sleep)

Then we get into reviews on doctor sites. I don’t weigh the ones that are just numbers highly. Like 3/5 stars is meaningless to me. But the sites that have comments can have important and scary information. I obviously take comments with a grain of salt, but there are different types of negative comments out there.

  • If a lot of people have billing disputes that says something about the doctor’s priorities
  • I use those comments more to identify problems than identify strengths because I am wary of astroturfing
  • If the complaint seems very convoluted or is an ethics complaint that somehow was not made to an official ethics board I am skeptical of it unless there seems to be a pattern or evidence

I look on linkedin

  • How many degrees away is this person from me? I’ve decided that 3rd degree is okay (so many people are 3rd degree connections I would rule out almost everyone). But 2nd degree connection is too close.
  • For 3rd degree connections the people who know people who know the clinician also give me some information about the clinician and their connection to me. If it’s through a lot of academics that makes me more nervous. But if it’s through some of my non-researcher connections that’s less of an issue.
  • I can also estimate their theoretical orientation is they are a 3rd degree connection based on which people I know who are connected to someone they know.

I look on their website if they have one

  • I read any new patient forms they have and any policy forms. I found a ton of people with very hard nosed policies listed on their websites. Things like fees to fill out forms. That’s their first impression to new patients. I understand wanting to make the context clear but there’s a balance. Your website is your first impression. Yes people should be informed of your policies. But if your entire first impression is telling people rules and financial penalties for breaking them this makes me concerned about what it is like to interact with you. I have never no-showed an appointment (I had 2 travel related issues but these were largely outside of my control. In 11 years of therapy 2 missed appointments is pretty good) intentionally. Even if I am unhappy with the therapy I at least show up to the appointment. I don’t do any less than 24 hours cancelations. But when I see extensively detailed policies (I’m talking pages) about missed sessions it puts me on edge. Even though it is not a thing I will do, it concerns me about what this says about the therapist as a person. It makes the therapist look inflexible and cold.
  • I also find it very scary when there are detailed history forms to fill out before the first session. Some history forms can be useful I think, but there’s a line and it concerns me when the quantity of information I’d be asked to provide on a form before even meeting the person is too high. Basic demographics, presenting problem, medications, history of hospitalization, past diagnoses, fine. But there is a point where it is asking too much.
  • I’m noticing a new trend of younger therapist’s having social media policies on their website. I really like this a lot. It makes the boundaries clear and shows that the therapist is adapting to the changing world. The good ones I’ve seen explain what the therapist will and won’t do along with the reasons for it. I also like when the state that they will not look up their clients online unless it is due to an immediate safety concern. Things like this need to be spelled out and can be done in a way that is not authoritarian.

I look at the context of where the person is working. Big medical centers make me nervous.

  • This is where the line between my realistic worrys and unrealistic ones is blurry.
  • I don’t like the idea of going to therapy in a place using EMRs. I want my therapy notes and session dates on paper in a locked file cabinet. If they go on a computer I don’t want the database linked in a way that makes it part of a larger medical record. So, a private practice clinician could use a full disk encrypted computer for notes and records and I would be okay with that as long as it isn’t merged into another database. EMRs are great for some things, like saving me the trouble of needing to know when my last tetnus shot was because an ER doc already has it in the record. But with therapy is can mean things from bad therapy could stick with me even after that therapy has terminated. A diagnosis, a misunderstanding. It can follow me.
  • Going to a session at a big medical center means more people to walk past. I have a greater chance of running into someone unexpected who would then figure out I am there for therapy.
  • I do not know what my future practicum sites will be but it is fair to say any big medical centers might be on the table. I don’t want to feel uncomfortable applying somewhere in the future because of this.

Smaller therapy organizations that emphasize multidisciplinary teams also make me nervous.

  • I know that this is code for the fact that they will regularly review cases with each other and this is confirmed in privacy notice paperwork about who get’s access to what.
  • This means that in going to a place like that, instead of just sharing my information with one therapist I am agreeing to share my information with the whole practice. It may be 6 people or so, but it means losing control over my information.

I search through my gmail for the person’s name.

  • I make sure I don’t have any indication that this person is too closely connected with my work.

I check academic and professional affiliations

  • If they have an academic title at my school this is a problem. I am moving towards being more flexible if they only teach areas far removed from me, but it’s still hard to predict.
  • If they work closely with faculty at my school but do not work there this is also a problem

Through these criteria every single psychiatrist on my insurance list was ruled out.

Now that I’ve opened my search to non-psychiatrists I have options to pick from. So feeling more hopeful. But I guess I wanted to share my search process. I have this odd situation where if I had a patient (don’t have those yet) who needed a referral, I could easily generate a list of good clinicians who I know professionally. But for myself I struggle because all of these great clinicians I know are not options for me because I know them in a professional context.

I’d be curious to see how other people search for therapists. Feel free to share in the comments.

Fear of cycle

I don’t think I can come up with words to describe how terrifying it is to me to not feel like I have a stable therapist situation. I don’t want to go back to my cycle of firing a therapist every few months but I also don’t want to be hospitalized. When therapy is unstable, the risk of me doing something impulsive that gets me hospitalized becomes much higher.

I wrote in my last post about #28 http://psychologytales.com/2013/09/16/lay-off-with-the-psychoeducation-28/

I feel like I’m taking a million emotional steps backwards.

I did about the best job imaginable explaining to #28 where the problems are in therapy with her. But still nothing has happened to give me even a tiny glimmer of hope that it could work out. To make matters worse we have to skip a week. So I have another week of being a mess and terrified about my complete lack of any support. I can’t stand the uncertainty about if this will work out.

I am too busy to have time to be this much of an emotional mess.

I think I would feel better if I had a referral I could hand on to to know it’s a option if nothing works. I literally can not find a single psychiatrist on google in my area who is not affiliated with my training program. I don’t know if I even have any other options at all, let alone one who will be a good match.

Lay off with the psychoeducation #28

I guess I was wrong about not writing in here. I have no where else to talk about this stuff.

I had a really terrible day at school. Worked very hard to avoid crying at school. Hung in there until therapy.

Until  today I’d really been feeling apathy about therapist #28. There wasn’t anything I really liked, but nothing I really disliked strongly either. That’s a problem because really there need to be SOME positive feelings towards a therapist to get things going even if it’s just something little giving some hope.

The part where any problems with therapists become clearest is when I come in having my first meltdown which was what today was. The only positive of the session is that I did a good job of telling her what she was doing wrong so there can be no doubt that I did not make a good effort to explain where the problems where.

She started off talking scheduling which was frustrating, because I was pretty clearly upset but somehow she was interpreting my being upset as be being stressed about my schedule.

I had been franticly working to hold things together all day and all my anxiety exploded out of me with me talking a million miles a minute about everything I had been trying to keep under-wrap all day.

Her response:  To tell me I am catastrophizing, define catastrophizing and talk about the problems with it.

I snapped back that I am well aware of what catastrophizing is and I do not need it defined.

Her response: Well with the way you are acting it seems like you don’t know it.

Me: I can understand things intellectually but that is not the same as being able to apply them.

I switched to jargon filled language (I usually try to avoid this in therapy) and explained all the ways I had attempted to handle my emotions. I had tried suppression, reappraisal, multiple types of distraction. I can know about these methods but that does not make them work.

Then I stopped talking for awhile. Frozen up with anger.

When I began talking again I told her that it felt like she was not being empathetic and that she was falsely assuming due to our number of sessions that we have more of a therapeutic alliance than we do.

Again, she responded poorly by asking sarcastically if she was “still on trial” and saying that I seemed to want too specific of a reaction from her to be realistic.

I told her that I had been containing these feelings all day and he first step was to try to stop me from expressing them.

The session ended awkwardly and even included a billing debate (I think she is accidentally overcharging me though a misunderstanding about my insurance).

The session was upsetting on so many levels. #28 felt very out of sync with me. She wanted to jump in and interpret but has awful timing. What’s worse is that her interpretation about catastrophizing is what I’d expect from a cognitive therapist. I’m going there looking for psychodynamic therapy. So I feel like I’m just getting cognitive therapy from someone without proper training in it, because a good cognitive therapist would have realized how terrible the timing of that comment was.

I feel like she’s evoking feelings in me that make me feel “borderline” and that she’s responding with the same thing in mind which I think it making her less empathetic. I’m getting angry over emotion invalidating things from her. Which is turn is making her think I’m excessively sensitive to feeling invalidated. The comment about being “on trial” really gets me. It makes it seem like it’s somehow wrong for me to be evaluating whether the therapy relationship is a good fit. I’ve seen her less than 10 times. It is perfectly reasonable for me to be evaluating how I feel about her. And if this therapy really is psychodynamic I should never stop evaluating that, because the transference should matter.

She responded to my anger about her defining catastrophizing as if I was offended that she thought I did not know it. This was not the case at all. I was upset that she was trying to shut down my emotions. It’s not so simple as turning it on or off. It’s not like I can say ‘Oh I am catastrophizing let me just stop now.’ and have it work. If I could do that I would not be in therapy.

I just feel like we were so out of sync and she was not able to adapt well from feedback (instead turing any feedback around on me as my flaw). I don’t know what to do.

I need someone who uses a good amount of warm Rodgerian skills. I need someone supportive. A therapist can not only be that though. I want interpretations but interpretations without warmth just gets you Albert Ellis.

I left SM a sobbing voicemail. I feel bad bothering him. I just feel so lost.

Sorry that this post is not on the level of posting that I usually try to create. I just have no where else to talk.