Balanced Precariously At The Edge Of A Ledge, Trying Not To Fall Off (Send Help)

Things aren’t going so well with Nikki at the moment. Or maybe everything is completely normal and I just have unrealistic ideas of how things are supposed to be after too many therapists with unhealthy boundaries. Or maybe my constant over-analysis is fucking things up and it’d all be fine if I didn’t examine every little thing with all the intensity of Animal from the Muppets playing a drum solo.

I’m feeling pretty mixed up at the moment.

Our session on Tuesday was probably the biggest waste of $200 I’ve ever spent (and I once bought the complete collector’s edition box set of Xena). And that’s completely my own fault – a couple of things went kind of wonky, but instead of using that as an opportunity to work through things and share and grow as a person (you know, the POINT of GOING TO THERAPY), I just sat there.

The afternoon of my appointment, Nikki texted to see if I wanted to come earlier since she was free until my session. When I replied to tell that I was still at work and was likely to be a bit late, she replied “That’s cool but I can’t stay after 7.30 I’m afraid. See you in a bit.”

The idea that she would ever have to tell me that our session needs to end on time seems beyond ridiculous to me. Of course it does. It should be a given that we’ll end on time, though it’s not, because she always start at least 5 minutes late and usually ends at least 10 minutes over. At the time it just registered as a mild discomfort, probably because her setting a boundary seemed to imply that I wasn’t already completely aware that it existed, and I’m always more reactive to perceived rejection of something I didn’t even ask for in the first place, because it feels unjust as well as embarrassing.

I raced home to pick up Lily, my new foster baby (everybody, meet Lily!), skipped getting changed and rushed to her office…then spent almost 20 minutes in the waiting room. The receptionist said she was with someone, and I figured she must have got a crisis call or something, so I texted her to let her know I’d arrived and then settled in to focus on pretending I didn’t have a cat turning somersaults in my handbag.

2016-11-18-16-49-28
Lily crashed out taking a nap on Nikki’s lap

 

 

As it turns out, Nikki had actually been talking to the psychiatrist I was meant to see two days later, and my control/independence issues came rising up with a vengeance.

Psychiatrist #10 kind of browbeat me into going back and doing DBT again, but that means I have to transition to another new psychiatrist, because you have to be seen by one of the people affiliated with the private hospital that runs the program.

I hate seeing new psychiatrists. I hate it. My biggest rupture with my last therapist, Anna, was over her lack of understanding of how much I struggle with seeing new psychiatrists. The worst self harm I’ve ever done was over a first appointment with a new psychiatrist. I hate seeing new psychiatrists. 

So I picked Psychiatrist #11 on the basis that:

  1. I’ve already seen her once before, and I didn’t love her, but I know she’s not awful.
  2. She works at the same consulting rooms as Nikki, so I don’t have to deal with any anxiety about where do I go? am I going to get lost? how do I get in the building? if there’s an intercom what I do I say when they answer? do I turn left or right when I come out of the elevator?
  3. She works at the same consulting rooms as Nikki, so it’ll be easy for them to connect if there’s a crisis.

But when Nikki finally called me in, she said she hoped I didn’t mind but she’d just met with #11, because she wasn’t sure if the intention was for #11 to just assess me for the group, and so she’d asked #11 there were other psychiatrists I could see. #11 had given her two names of male psychiatrists, and one of them is experienced with complex cases.

“So I probably should have asked you if that was okay, but I said ‘That sounds really good! That sounds really good! Call him! Call him!‘”

It did not sound really good. Suddenly I’d gone from a set appointment with a relatively safe person at a safe place to seeing a male psychiatrist (I never see male clinicians) at an unknown place and time, and it’d all been taken out of my hands. She didn’t know that I’d been planning to keep seeing #11 after the intake assessment…because she didn’t ask. But Nikki was so excited, and she’d been trying to help and I couldn’t bring myself to trample all over her good intentions, so I summoned a wan smile, and said “Great!“.

That was pretty much the last thing I said for the rest of the session. I wasn’t angry or upset, but I felt kind of helplessly despairing and numb, and like there was no point in saying anything and I didn’t have the energy to anyway. Nikki kept trying to safety plan, because it was only two days until November 24, and for the past two years I’ve taken overdoses and ended up in hospital on that date. Last year I overdosed then slashed my arm, and if my psychologist hadn’t called the police rescue squad to break into my apartment and carry me off to the hospital half-unconscious, I would have died. But I really didn’t care about safety planning. I cared a little bit about the difficult position I was putting Nikki in, but not enough to summon the willpower to be helpful and constructive.

When she found out that I’d been waiting for more than 15 minutes, because the receptionist is new and didn’t know she should interrupt her conversation with #11, Nikki was incredibly apologetic, and much more upset about it than I was. And she immediately offered another 15 minutes.

I hated that. She’d made a point of telling me she had to leave at 7.30, and now suddenly she could stay until 7.45? I hate the inconsistency, and I felt like she’d lied to me – lied for the purpose of making sure she wouldn’t have to spend any extra time with me, which I don’t expect and which wouldn’t even come up as an issue if she would just manage session time properly. I flat-out refused to stay, and made a point of checking the clock and scooping up Lily to leave right on 7.30, against her protest of “No, Rea, honestly, I’m going to feel really bad if you go“.

I was standing at the door of reception, and she called out to me “Come here. What’s wrong? What’s wrong? Tell me what’s wrong.” 

I looked at her and wavered for a second, but time was up, and I’d chosen not to talk to her in session, so it wasn’t okay to talk to her now. I walked away without saying goodbye.

 

I’m such a shitty, shitty client.

On Thursday, the dangerous anniversary day, I decided to text her. My instinct was to shut her out completely, to just show up for session the next day all casual and ‘oh yeah no big deal I have everything under control without your input‘. That seemed like a bad idea, and if I’m honest, I kind of wanted a small point of connection. So I texted to let her know that Kim had picked me up for work, and a friend was staying the night – in my tiny studio apartment, that means sleeping on the floor right next to my bed, so I couldn’t get up in the night to overdose without literally stepping on her face. About as solid as a safety plan can get.

I know I didn’t communicate much on Tuesday so wanted to make sure I didn’t leave you in the dark.

She sent a nice reply, insisting I get rid of the pills I have stockpiled just in case, telling me to look after myself and that she was free for the next couple of hours if I needed to talk. All nice and all good, and no need to reply, so I didn’t.

Then a couple of hours later, she sent another message that she’d received from #11 about arrangements for me to see the male psychiatrist she’d recommended, and tagged on the end “Good news! I’m hoping this one will be a good one!”

Everything overflowed. Hoping this will be a good one, she says, the unwritten implication being but oh well, if he’s not then we’ll just find another one, no harm no foul. Only it is harmful and I hate it, I’ve told her how horrible it is for me, why is she so fucking goddamn blasé about it? I was angry, and suddenly I hated her.

Good news for you – I would literally rather die than see another psychiatrist, though I suppose that’s not saying much. This is what I was so upset about on Tuesday. Thanks for the info though.

Her response threw a whole fucking shipping container full of fuel onto the fire.

Please don’t judge too soon. He might be exactly right for you. Hope you’re feeling better now that you have people around you.

Nikki is the least validating psychologist I’ve ever had. Any time I say I’m upset about something or struggling with something, there’s always an ‘Oh, but what about this?‘. She always argues with me. I just want her to listen and be affirming, but instead she makes me feel like my feelings are wrong. And I know I’m not taking one incident and blowing it out to encompass her whole personality, because this complete and systemic failure to ever respond in a helpful way was the entire point of this email that I sent her a month ago.

Here are the responses I didn’t send:

Fuck you.”

You’re such a cunt.”

What the fuck is wrong with you?

Here is the response I did send, after two minutes and a lot of deep breaths.

I’m not judging. Whether he’s good or not it’s fucking shit that I have to go see my 11th psychiatrist. I fucking hate it. No, I’m not feeling better.

Would you believe it got worse? Yeah, it got worse.

Ok. Maybe you should get your friends to take you for a walk. Forget about psychiatrists for now!

I was crying pretty hard at this point, and angry enough to want to throw my phone at the wall. Minimising? Check. Completely ignoring what I’ve told you about throwing basic strategies at me being unhelpful, further proving that you don’t listen to me? Check. A completely stupid and inappropriate response to being told that something is so upsetting it makes me want to die (‘how about you go for a walk and just forget about it?‘) – Check. Especially fucking stupid on a day where I have a greatly increased probability of committing suicide? Check, check, check.

I’m happy with the response I sent. Overall, I think I was able to be reasonably effective through this conversation, considering I was at a pretty massive level of distress. We wrapped it up with this:

This is one of those times you’re not listening. Don’t give me information like that over text if you don’t have the attention or ability to deal with it.

I’m sorry that you feel I’m not listening to you. I had no idea that you were upset about my making an appointment for you with a new psychiatrist as you didn’t communicate that at the time. As I said in my last text, I’m free over the next hour or so if you want to call me for a chat.

“I’m upset about seeing a new psychiatrist – that’s not about you. I just don’t get why you never just say “Yeah, that sucks, I’m sorry”. Banal problem-solving really sounds like you’re either not listening or don’t get it, and if you’re not listening and you don’t get it then why would I share anything with you?”

“You sound really angry and we should talk about that when I see you tomorrow. It’s not really appropriate to have this conversation over text as things can too easily be misconstrued.”

‘Appropriate’ was a stupid word to pick. She should have said ‘Not a good idea’, or something like that, instead of making it sound like I was doing something inappropriate. I texted back a little tongue-in-cheek, telling her I really wanted to reactively cancel my session, but that since I don’t do that, I’d fucking goddamn see her tomorrow.

Then I pulled myself together and went to see a movie with a friend, but I cried myself to sleep that night.

Our session on Friday was, again, a total waste of time, but this time Nikki colluded with my avoidance.

We’d agreed to have a park session, and I texted her beforehand to ask if she could just meet me there – I didn’t want to do the awkward walk from the office to the park with her, trying to make small talk at traffic lights with strangers clustered around us. She said that sounded good, but pointed out that it would eat into our session because she needed to leave on time, and since I still understand the basic concepts of time and space and was completely aware of that before I suggested it, I agreed that that was fine.

We hadn’t set a clear meeting place beforehand, and she couldn’t find me, so we ended up starting more than half an hour into the session. I was lying in the grass reading a home decoration magazine when she finally found me, and while she flipped through it we chatted idly about her landlord refusing to renovate her tiny apartment – she seemed nervous and awkward, probably unsure of what the hell she was supposed to do with the 15 minutes we had left. She commented about our city being so expensive you have to marry a banker to be able to afford to buy a home, then rambled straight on to:

“Oh, dear, self-disclosures all over the place. I didn’t marry a banker – I’m not married.”

I had no idea what to say to that. I was glad that she wasn’t pushing to talk about the rupture, and I was happy to talk amiably and superficially, but I was only happy on a surface level. Underneath, I really wanted to process the rupture we’d had last night, so I didn’t have to keep imagining the conversation in my head all weekend.

Again, after telling me via text she had to leave on time, she changed her mind and said she could stay longer and she didn’t have to pick her son up until 6pm (AAAAARRRRGH  JUST BE CONSISTENT), but I was pushing her to go, and it didn’t give us the space to get into anything. Instead, we both just touched on it in passive-aggressive, indirect ways.

Nikki: “Do you ever call people up on a Friday night and say ‘let’s go to the pub?’

Me [very flatly, having told her 5 minutes earlier that I mixed codeine and vodka for the first time on Monday and cut the worst I ever have]: “I don’t drink.

Nikki: “Sorry. That’s a good thing. Banal and inappropriate problem-solving.”

Me: “Good to see you’re always improving.

Nikki [after telling me that I had to text her a safety plan by 6pm or she’d call the crisis team, and me refusing]: “You seem to be more agreeable when I’m not here…actually, no, not the other day. HA HA HA HA HA.

She kept saying ‘okay, I need to go‘ and then not actually leaving, and eventually I pulled the magazine back over to me, said “Bye, Nikki” and started pretending to read.

Okay. I’ll hear from you at 6. Okay? See you.” She started walking off, then walked back and said “Say goodbye, because it feels weird otherwise.

I’m such a shitty, shitty client.

I need some help, guys. I mean, I’m stubborn as a rock and I’m going to do whatever I’m going to do no matter what anybody says, but I’m way too embroiled in this and I need some outside perspective. I’m wondering if maybe we should set some therapy ground rules, for her and for me, the first of which would be STOP FUCKING TEXTING ME AND TELLING ME YOU NEED TO LEAVE ON TIME.

I don’t want to find a new psychologist. I want this to work. But I’m not completely sure why it’s not working, so I don’t know what I need to fix. Is it all me? Is it both of us? I see her again in two days – what do I do?

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Balanced Precariously At The Edge Of A Ledge, Trying Not To Fall Off (Send Help)

24 thoughts on “Balanced Precariously At The Edge Of A Ledge, Trying Not To Fall Off (Send Help)

  1. Hi Rea. I love Lily, she is so pretty! My current cat is not much of a snuggler, worse luck.

    I don’t think you’re a shitty client. I think that the vast majority of therapists, Nikki included, are oblivious to how much tiny details matter, and so the more reactive clients end up picking everything to pieces in an attempt to find something – anything – that will make therapy work despite that.

    My perspective is based on where I’m at in therapy right now. After a honeymoon period of 3 months with my new therapist where I thought she was pretty wonderful I’ve just had my first falling out, over difficulties making email contact. It led me to take a more critical view of some of the things that were happening in our relationship and I’ve basically come to the conclusion that I’m not going to feel safe enough to let go my tendency to control everything until she can prove that she is able to provide some degree of consistency and stability for me. She thinks she is doing that, and talks about it a lot, but she isn’t really.

    Stability for me would mean having a regular time-slot, good time management within the session, either consistently available or *no* outside contact, and having some kind plan and actually sticking to it instead of veering off on tangents all the time. I’m intending to ask that we have a written agreement about this for a trial period, and see how this works. Haven’t told her any of this yet – all she knows is that I cancelled last session, am very pissed off and considering ending therapy with her and plan to discuss it next session.

    My experience of making this sort of agreement and having it work is outside the context of therapy altogether. My brother and I bought a house together and drafted a very detailed agreement about what would happen under every circumstance we could think of, including a clause where we agreed that if the arrangement was having any sort of negative effect on our relationship we would sell up with no blame attached to either of us. The lesson I learned from this was that the discussion and negotiation that goes into making the agreement is at least as important as the actual end result (well I actually learnt this concept from an episode of an old tv show called Paper Chase, about law students, but that’s another story). How Nikki reacts to the idea of having an agreement will tell you something in itself e.g. whether she frames it as creating stability and safe boundaries, or tries to frame it as you being too rigid.

    I don’t know exactly what would work for you, but negotiating some sort of rules sounds like a really good idea. In which case, I’d be spending the next couple of days thinking about what those rules might be and the explanations behind them.

    Hope I haven’t raved on for too long.

    Liked by 1 person

  2. This sounds discombobulating. I wouldn’t feel so safe and contained in this situation. I can’t really assess the situation objectively, but it certainly does sound like a conversation about boundaries could be helpful. I’m glad that you are safe right now. It sounds like it has been very intense and I’m glad you’re posting and sharing how you feel. I’m sorry that you’re struggling.

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  3. Sorry, that probably all came across more lecturish than supportive. I can see why the things Nikki does drive you nuts. It’s definitely not just you. Aside from all the time management and texting issues, I’d be furious if the unasked-for discussion with psychiatrist #11 had happened to me. You are very resourceful though, so I’m hoping you can find a way to get Nikki to see things from your perspective and make some progress.

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  4. I do not think you are a shitty client. In fact, I think you outwardly react the way I inwardly did with other therapists when boundary issues were at play.

    This is coming from my perspective as someone with 7 shitty therapists, 2 okay ones, and now an amazing one – I’ve been around the block and seen a variety of boundaries set and not set.

    Regardless of what the boundaries are, it is Nikki’s job to set them and follow them, in order to keep you safe. That is the basics of how this works. From what I can see is she sets them and then goes back (time ending, etc) or doesn’t explain a changing boundary (because as A has showed me they can and will be adjusted if my safety is at risk). But most importantly I’m not sure she’s taking ownership for the boundaries she is and isn’t setting and it is having a profound effect on you.

    I don’t know what you should do, or should not do, in this situation – but I would definitely chat about all this if you feel you can. Also – I want you to know that you are wonderful, are not a shitty client, that your new foster cat is adorable, and that I am thinking of you, sitting with you, and sending you so much love and care if you want it. Xx

    Liked by 1 person

  5. This.shaking says:

    Dear Rea: I’m not able to do a good analysis of this today (no sleep, no food, babysitting all day) but I do know two things: One – so glad you are here! Two: so MAD at Nikki! oh, Three: So So So glad you are here. Hugs – TS

    Liked by 1 person

    1. TS, my love! No sleep, no food? Please, can you make a batch of your famous cookies, and perhaps a smoothie to wash it down with? Can you and your babysitt-ee (your granddaughter?) take a nap? Play a game of Sleeping Lions, perhaps?

      A hug, and a gentle kiss on the cheek, if that’s okay. Take care of yourself the way you take care of us, with tender love.

      Liked by 2 people

  6. This.shaking says:

    Yes, Wow, Rea. I’m not used to getting such tenderness. I’m too tired for words, but not for tears.
    A (my 5 year old granddaughter) and I had a wonderful day. I’m going to rest now. Hugs. TS

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  7. Sorry, but she sounds awful all round. It’s her job to set boundaries, and she’s not doing it. What about client confidentiality – she is allowed to discuss you with others without your permission? She doesn’t seem to hear even the basics of what you’re trying to tell her. There must be a helpful side to her – I haven’t read that many of your posts. You must be seeing her for a reason. Good luck.

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    1. She’s definitely not perfect! At the moment I’m trying to see it as a good chance to practice advocating for myself, but it is hard, and frustrating.

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  8. 1.) Lily is adorable!! I had a calico cat once. She hated me, but she was cute and I have fond memories of that breed.
    2.) When you sit with all of your thoughts about Nikki and her (potential) inability to maintain a structured and consistent therapeutic frame for you, what do YOU think, Rea? Really, do you think Nikki is adequate for your needs? What does your mind say, your heart, the clearest space inside of yourself you can access?
    3.) That said (because I do think your own intuition already knows the answer, though I get that sometimes it can be very hard to access intuition and self-wisdom when things externally are so chaotic and charged) – do I think this is “you?” NO.
    Rea, this isn’t you. Nikki clearly has unresolved issues around boundaries and pleasing people and upsetting people, and that is shining through brightly in your therapy. The back and forth, the “I can’t” then recanting, is very unstable and difficult to find grounding around. Personally, I wouldn’t be able to work with a therapist with that communication style and inconsistency. I am far too unstable on my own, to manage someone else’s instability. Especially the person I am paying to provide a stables structure.
    I’m sorry this is happening, I know you really don’t want a new psychologist (or psychiatrist). I know that your adult self is really overwhelmed with how loud and destructive the younger parts are right now. I think you need someone who can provide more specific skill-building around healing dissociation and trauma responses.

    Liked by 4 people

    1. Hi Rea, this is my first time commenting, although I’ve been following you now for a little while. I so so soooo agree with everything Rachel just said! I also strongly believe that this is NOT you being a “shitty client”. Sorry if I’m going to come across as being blunt here…I think Nikki’s lack of boundaries and hugely lacking insight is appalling. I am forever amazed that there are people out there who call themselves therapists who just lack common sense. Nikki’s inconsistent behaviour would drive me insane and no, it’s definitely not you.

      I too, have had a number of therapists. I just finished with one after knowing her for 5 years due to continual inconsistent behaviour. I so did not want to pull the pin with this one, but it got to a point where I kept asking myself, “how many more times do I need to keep making allowances for her?” The truth was her inconsistent behaviour was only reactivating my trauma issues again and again and again. My PTSD symptoms were all over the place the whole time I was seeing her.

      I can also really relate to you saying that you don’t want to find another therapist. This was the number 1 reason why I hung on with my last one for as long as what I did, even though as mentioned, past trauma issues were constantly being reactivated. I did my best to communicate all of this and my therapist said all the ‘right’ things, however her behaviour very loudly communicated that she just did not understand. And the lack of ownership!!!!!! Far out!

      I am so sorry this is so difficult and it sucks. Also, the psychiatrist thing – I’d be bloody LIVID! That’s actually a breach of confidentiality, unless she has your permission in writing. It’s in their code of ethics. Mine contacted my doctor behind my back and then tried to palm me off by saying she was “under the impression” I had given her verbal permission. Bullshit I did. Total breach. I too, CANNOT STAND bloody psychiatrists!!!! I’m also guessing you are in Australia like me? Perhaps it’s something to do with Australian psychiatrists? Who knows….

      Anyway, please know that I think you are definitely not a shitty client. Feel free to email me if you would like?

      xx

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      1. 5 years…holy fucking jesus. I can’t even imagine how hard that would be. 5 years! I can’t believe you’re still upright and functioning. I kind of want to put you back to bed with a tub of icecream and be like “Stay there and cry for at least a month, you don’t have to do life right now”.

        Yeah, I’m in Australia too, and I really wish Medicare would give unlimited sessions with psychologists instead of with psychiatrists, because seriously…10 shitty psychiatrists in a row can’t be a coincidence, right?

        Thanks for commenting, AG. (Hmm, might have to rethink that nickname, too much like Attorney General’s Department.) It’s so nice to meet you. If you ever decide you want to share some of your therapy story, I’d love to read about it.

        Liked by 1 person

  9. Hi Rea, just wanted to say thanks again for your helpful comment the other morning. I hope you are a little closer to working out how to handle this whole business with Nikki, it is so unfair that you are not being cared for properly. Give Lily a pat for me. xx

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  10. Attorney General’s Dept….you made me laugh at that one!

    I love your reply too about putting me to bed with ice cream. Yummo!!!

    Just to clarify too – I met my now ex-therapist 5 years ago. I started seeing her though as my therapist in 2013 – after I’d been let down very badly by yet another therapist who told me that she “had my back”, she was “never going anywhere”, etc etc. The worst thing about this last therapist I stopped seeing some months ago this year, is that she knew all about the horrendous therapy experiences I have been subjected to and she still went ahead and did what she did anyway! She has since finally apologised via email of all things, however I truly believe she has no insight into what she is actually apologising for. It’s a bit of a long story!

    I’d love to share some of my stuff with you if you would like? I don’t have a blog….always been too chicken! Is there an email address I can email you at?

    Thanks for the reply.
    xxx

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    1. Hope you’re good, AG! I haven’t heard from you via email so assuming that you’re just busy enforcing law and order and haven’t got around to it 😉 but the offer is always there if you ever want to! I have so much empathy for your previous shitty therapy experiences – why do they make those promises that they can’t keep?? Argh.

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  11. I know I’ve come to this late, but just wanted to comment and take a moment to say how proud I am of you. None of this is easy and there are no clear cut answers. I think Rachel laid it out the best. I’ve never been a big Nicki fan, but she does care about you and I like that. If I could, I would sit by your bed and hum softly, or read stories aloud, or laugh with you over Lily and Everest’s antics, or whatever it is you need. I am glad you are still here.

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  12. that sorta invalidation would drive me nuts. I am so sorry she is so invalidating. That so so unhelpful. You sound so distressed. I hope you were able to get through thanksgiving. You matter. Hugs. xxx

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  13. Honey, it isn’t your job to be any kind of client. It is the therapist’s job to set boundaries and maintain professionalism. Period. Enjoy your beautiful kitty. It’s hard for you to trust anyone so your therapist really has to work heard to meet you where you are. Your kitty’s job is to be cute. Your job is to be you. That’s it. Hugs.

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