“I’ve just finished my therapy with a difficult self-harming patient….hospitalised a couple of times this year with self-harm, very rigid views and belief systems…very controlling about what can be said and what’s said…”
Those words have been playing over and over in my head for four months now. Difficult. Rigid. Controlling. Those are the words my last therapist, Anna, used to describe me when she was referring me on to a new therapist, after she abruptly cut and run, even though she promised over and over that she’d never leave me.
Anna, who took me on walks to the park with her dog and visited me in the hospital and read me poetry over the phone, who was willing to be there for me all the time, any time, if I’d only reach out. Anna, who told me I was funny and kind and smart, who poured warmth into all the empty spaces inside of me.
I know that they aren’t mutually exclusive. I know that people can be kind, and smart, and rigid, and controlling all at the same time. But it’s thrown me off balance. I didn’t know that she thought those things about me – what else don’t I know? It makes me feel naive, and afraid, and I don’t know what to trust any more.
Almost two months ago, impulsively, I wrote to Anna, requesting a copy of my notes. It was a short, clipped email, and part of me feels bad about it. It was polite, and I don’t think I owe her anything more than politeness, but it also doesn’t feel good to be so cold. The last time I’d been in touch with her, it was right after she’d quit, and I was sending venomous email after venomous email, wanting to make her feel as terrible as I did. I hadn’t intended to contact her ever again, and I didn’t want to, but I just couldn’t get it out of my head. Difficult. Rigid. Controlling.
A week later, she wrote back, three sentences, informing me that she did not consider it in my best interests to release the information to me, but that she was happy to speak with my current practitioner. I was expecting it, and I was enraged.
You don’t get to tell me what to do any more. You don’t get to make decisions about my best interests any more.
It isn’t about the notes any more. It’s about power, and about taking the control back from her, and it’s about winning. I know she doesn’t want to give me the notes, and I want to make her do it anyway.
I guess she was right about me being controlling.
I wrote back, informing her that she had breached the legislation about access to health records, not only by failing to give a proper reason for withholding them (it has to be based on a serious risk to my life and health, not just my “best interests“), but also by failing to inform me that I’m entitled to nominate a GP and have the records sent to them instead.
Maybe it was just ignorance. After all, she knows I’m a lawyer, and it took me less than ten minutes to find the legislation and the relevant provisions. It would be a pretty stupid way to try to keep me from getting access to them. But it still makes me furious, because I’m lucky enough to have five years of law school behind me, but what about people who don’t know their rights, and can’t advocate for themselves?
(But I also know she’s right, that I am a danger to myself, and when I do finally get my hands on those notes, there will probably be a lot of blood.)
Last week’s session with Nikki was tough. After her disclosure the previous week, where she’d cried, and told me she feels the urge to protect me, I’d been feeling excited, and happy, and like I couldn’t wait to be back there again. I wanted to talk to her, suddenly. Her emotions had flipped some kind of switch, and I wanted to share difficult things. And I wanted to tell her what had happened with Anna. I’ve been seeing Nikki for over four months now, but I still feel raw about Anna abandoning me, too raw to even mention it to Nikki. She thinks we parted on good terms.
Over the weekend, I’d drawn out a therapy timeline, and sketched the name of each therapist I’ve seen. Aisha was written out on the keyboard of a laptop, with teardrops on the screen, and Anna was growing up out of the grass like a flower, but with clouds lurking overhead. It felt embarrassing, and vulnerable, showing it to her, but I remembered Lily’s box, and I made myself be brave.
We never made it to Anna, and it went really badly. I was talking about Jen, the kinesiologist I love and miss, the only person who’s ever really been able to comfort me, and I told Nikki that I think the thing that made the most difference was that she would just sit and hold my hand or rub my back, and that I’m much more tactile than verbal.
Nikki talked about how the therapy relationship is all verbal, and that “it’d probably feel pretty weird if I was sitting here holding your hand right now“, and that Jen “had to touch you because it was her job“, and then she put a hand on my shoe in a pointed, kind of mocking way, and I went home feeling dirty and disgusting and like I needed to tear myself apart.
I barely slept, and woke up the next morning feeling anxious. I was on the verge of tears all morning, and I felt like I had to self harm. Like I should self harm. I was still triggered by the therapy session the day before, and I felt clenched and sick whenever I thought about Nikki touching my shoe, but I also felt small and sad, and I wanted to reach out to her. For comfort, for reassurance, for understanding – for a verbal hug.
“Can you remind me that it’s okay not to self harm? Is it okay not to self harm?”
And as always, she was incredibly responsive – within two minutes, she’d replied, telling me it’s more than okay not to self harm, that it doesn’t help me at all in the long term, to do something to just get through the moment, and asking if something had happened.
I felt about a million times worse. Upset that the message somehow didn’t have the validation or attunement or care I’d wanted, angry at myself for reaching out when it never helps and I should have known better, angry at myself because you should feel better, normal people would feel better, and ashamed of bothering Nikki, of disrupting her day and then not even being grateful.
She asked if I needed to talk – she had a client in 5 minutes but could talk right now if it would help, or she could call me in an hour. But I didn’t want to – I was at work, and anyway, what would I say?
I tried so hard, though. I was feeling triggered and bad and she didn’t feel safe, but I texted her back, and told her I felt like I’d done the wrong thing, and I needed a “You don’t need to self harm for being an idiot and disrupting Nikki’s day for no reason” message. I’m proud of that, of pushing hard to stay open and keep reaching for what I needed when I wanted to withdraw.
I got the message I asked for, and then she told me she was going in with a couple of clients and that she hoped the rest of my day was nicer to me. That stung, and I felt shut down and abandoned, even though I’d chosen not to take her offer of a call.
About half an hour later, I got a cold email from Anna with an invoice for preparation of my file – once it was paid, she would courier the file to my GP.
She’d charged me over $700 for her time photocopying it.
(In the state next door to me, the absolute cap a psychologist can charge is $33. The recommended fee set by the Psychological Society is $140. And worst, worst of all, Anna’s hourly rate is $180, but she billed me at $238, the maximum hourly fee for a clinical psychologist. That’s the malicious part, the part that cuts deep.)
I can’t reconcile my kind, loving therapist with this person who hates me so much. Literally, I can’t; they’re split into two separate people in my mind. Oh, maybe she doesn’t hate you, maybe she just really wants to protect you from hurting yourself when you read it. Okay, but if she’s concerned about me, why not say that instead of just being a bitch?
I reached back out to Nikki, to ask her advice, and she thinks I’m angry with Anna. I’m not. I’m just so, so sad and hurt. What did I do wrong?
One way or another, I’m getting those notes. I wrote back to Anna asking her to reduce the fee, given it’s more than $550 above the recommendation from the Society, and I called the government department responsible for information privacy to find out about making a complaint if she refuses. If all else fails, I’ll skip a month of therapy with Nikki and I’ll pay the $820 for them.
But I’m terrified of getting them, too. What the hell is in there that’s making her so determined to stop me seeing them?