DBT Summary Letter

This is a follow up to my post “A roadbump while looking for records”. You should read that first.

I googled the office address of the DBT therapist that I got off of his website. I found the therapist who moved into his office after him. I figured it was a long shot, but called her anyway.

She got back to me promptly and was very kind and apologetic, she said that she didn’t know how to contact him.
But then the next day I got a voicemail message from the DBT therapist. Apparently she had found a way to get in contact with him. He didn’t leave a number in the message, but said he would call again to try to reach me later.

I waited a bit over 2 weeks without a call back from him. I had no phone number to call him at. I called back the therapist who had moved into his old office and left her a message. Shortly after, I got a call from the DBT therapist. I wasn’t able to get him to agree to send full records (not a surprise) but he agreed to send a summary letter.

Finally I got a letter from him in the mail. No return address listed. I think he must not be practicing right now, because I never got a contact phone number for him and the letter doesn’t even have an office address as a heading or footer. Also, after speaking with him he took down the entire website with his outdated contact information.

I scanned the letter and put it up here. Edited out some identifying bits.

The envelope was post marked April 9th. So it took over a month from when I started at the end of February trying to contact him to when I got the letter in the mail.

This was probably the most work I have gone through to get any records and the least fulfilling.

It reads mostly like a textbook explanation of DBT. So little of the content of the letter feels specific to me.
I got a kick out of the bit where he wrote “We discovered several vital functions and reinforcing properties of her self harm..” as if I hadn’t already had an understanding of these before meeting him.

I realize 12 sessions is not a huge number of sessions, but I don’t think it is an insignificant number either. I get the feeling reading the letter and based on our no-pleasantries-exchanged-phone-conversation that he didn’t remember me and struggled to write the letter based on a few scribbles in a notepad.

I was most interested in how he would describe terminating the treatment.
He kept telling me that I needed to call him if I was going to cut. If I couldn’t agree to call him then he told me we couldn’t meet any more.

Phone anxiety aside (This has gotten better over the years, but never completely gone), I didn’t want to do this because it is hard for me to judge if I am going to cut in a situation or not. I don’t really know if I’m going to cut until I’ve done it. I think about cutting a lot. Only a very small percentage of the time do I act on it. If I called him and then did not cut after the phone call (even though the purpose of speaking to him was to help me avoid cutting) I would have felt guilty for making the phone call. If I didn’t cut then, I would have bothered him for no reason. I’d have worried I had called him during a time when I wasn’t going to cut anyways. I probably would have half-heartedly made a small injury to ease my guilt.
His request for me to phone him would actually increase my self injury rather than decrease it. And I’m fine with my self-injury in general (I was pressured into going to the DBT and was very ambivalent about it) but that doesn’t mean I want to intentionally enter into a situation that will needlessly increase it.
I’m not sure how well I articulated that to him. I’m better at expressing some of these things now, because my meta-cognition has further developed.

Whatever the reason, he doesn’t appear to have understood my objection to the phone calls. Still I had often wondered if he realized he messed up when he told me ‘phone calls or no therapy’. I imagine he thought the ultimatum would get me to fall in line with his rules, but it backfired and I left.
His letter reads as if it were more of a mutual agreement, instead of a “do this or leave” command.

Would people be interested in more posts like this where I post some of my records with comments? I have a few other topics I want to talk about here first, but if people are interested, I can also do more like this one later.

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15 thoughts on “DBT Summary Letter

  1. I understand having phone anxiety and I would be hesitant about calling my psychologist if I wanted to cut too. My previous psychologist has said that if I needed to call her if i was in a crisis situation I could, but I never did. It doesn’t sound helpful for you to be forced to call, if it would’ve increased your self harm, and your therapist should have worked around that.
    I’d be interested if you did more of these, or if you did other topics. Whatever, really :)
    Take care,
    Cassie

    Reply
  2. Yeah I love seeing this stuff! It’s all new to me and makes me wonder what is in “THE FILE” by my current therapist. He said I could look at it but I feel weird about reading anything he’s written.

    Love to hear your experiences – unique and intriguing as always!

    Reply
    • This is completely odd and almost weird to say but I also threw back a ton of Motrin, amongst other things. It’s probably silly, but it’s nice to know, even if it was awhile ago, someone else went through the same thing.

      Reply
      • Yea, I’ve done the Motrin thing quite a few times. Having a PRN medication (klonopin) has helped a lot with that. I still tend to fee luneasy about keeping motrin for legitimate purposes in my home though.

        Reply
    • It’s always wierd to read these things and realize places where there were misunderstandings that no one realized we misunderstandings. I’ve never read one those with a person I was currently in therapy with. The closest I’ve come to it is that I got a summary letter from a therapist I later returned to.

      Reply
  3. Your right it does sound like a textbook letter (although having seen the letters passed between professionals – they tend to read along a similar way to this too).

    I too am interested in posts like this – gives an insight into the minds of the “professionals”, which is always interesting.

    Makes me want to get my notes too…

    Take care,
    Differently

    Reply
  4. The “phone calls or no therapy” thing strikes me as odd and controlling. If you didn’t consider self-harm to be a significant problem at that time, in the context of everything else that was going on, then i can’t see any reason for him to have been so fixated on it (assuming your injuries weren’t putting you at any real medical risk). Sounds like he was just freaked out by it, but that’s really his own issue and he should have dealt with it on his own time.

    Also, “two additional non-suicidal self-harm incidents”? Two? And then he gave up? Not much patience there.

    I don’t think i would be brave enough to read my old therapy records. Fortunately i don’t have any reason to.

    Reply
  5. This is fascinating, and I’m sorry your experiences were so negative. Especially the ultimatum crap, I hate that. I wonder what my records would say, but my t says he doesn’t take many notes. Maybe so he can avoid ever having to give them to anyone. I also would never call my t if I am in crisis, I can’t bring myself to do that. I can email though.

    Reply
  6. It is interesting to read. I really hear where you’re coming from about the phone calls (or not)….i can definitely relate to it feeling like an ultimatum…because it is!

    On the other hand, and not particularly in his defense because I don’t know or particularly care about him, and you clearly had a terrible experience with him, but agreeing to call before self-harming is a very standard part of the DBT treatment frame. In fact, it’s one of the most core tenets. I’m not saying it works for everyone or is appropriate for everyone, but it is a pretty basic piece of the standard DBT treatment frame. I’m actually surprised that he agreed to continue treatment with you for 12 weeks with you so opposed to it. Maybe because you were relatively young – I know it sounds weird that he actually sounds quite flexible, but like I said – it’s a core part of the DBT frame, and from a DBT practioner perspective (not me personally, but I have done substantial professional research in that field as well as working closely with DBT therapists), it’s really surprising that he continued to see you for that long. (Again, not saying it’s appropriate for everyone, or for all the time.)

    Definitely interested in hearing more about any records you get, as well as any part of the process that you’d be willing to share.

    Reply
  7. Hi! There were various sections of your blog that I read and wanted to comment on a few but figured one simple message would be better. So here it is :)

    You are a wonderful girl. I’m amazed with your blog, to call it interesting would be a cheap use of words, but I’ve been at work and so my brain’s a bit on the dead side.

    Nothing specific is coming into my thoughts now, but you know you have another reader now :)

    OH! http://www.dailystrength.com is an all right on-line support group for various things from cancer to mental illness to well a wide assortment of things that I never even knew existed. Check it out if you can, I’ve been a member for over two years but I use it sparingly unless I’m doing one of my many months of isolation from the real world.

    Adios!

    -m-

    Reply

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