I’m too upset to be thoughtful or analytical or eloquent – I just need to write out what happened today.
It was my first session back after the whole overdose-rejection by hospital crisis-Skype failure-maternity leave misunderstanding debacle, and I was feeling more unsettled and uncomfortable than usual; when she came out to get me I was even stammering, which I rarely do.
There was this distance and disconnection right from the start. We were both being super cheerful and ‘friendly’ on the surface but there was an undercurrent of restrained tension that kept on building.
She started talking about strategies again and how I’ve been resistant so she’s been hesitant to suggest any, and I agreed. I am resistant. I have lists of skills coming out my ass, I have DBT group, and Nikki telling me to go for a walk or take a cold shower doesn’t add any benefit for me; it just upsets me that she’s trying to superficially problem-solve something that’s so much more complicated. Which prompted:
“What’s the point in coming here, then, if you can do it all yourself?”
“How was I supposed to know that?” [that I swim regularly]
“I’m not saying you should stop coming; if you want to keep coming it’s completely up to you.”
“If we can get to the stage where I can say to you ‘Rea, you’re being a dick, and if I was your mate I’d be really pissed off with you right now’, and if you can trust me enough that you can not think that that’s the end of the world, and I can trust you to not go away and think that it’s the end of the world – are you not getting it? Do you not get what I’m talking about? I think it’s an important piece of the picture.”
That’s going to be playing on repeat in my head for a long time.
The hurt and rejection boiled over at the end of the session, when she asked what had prompted the crisis two weeks ago, and I said I didn’t know; that it feels like it just happens.
“I wonder if that’s an important thing to know, because you seem to get it in your head that around anniversaries things get bad, and I wonder whether it actually is the anniversary or whether it’s just getting it stuck in your head. And so does that not give you some evidence that it’s not necessarily about anniversaries, it’s just about getting stuff stuck in your head, so actually taking the potency away from anniversaries?”
I lost all control at that point; I took a couple of gasps of air, tears came to my eyes and I tucked my knees up to my chest and wrapped my arms around them, without any conscious intent to move.
“That’s the most stupid fucking thing. What the fuck.”
The confusion and betrayal are so intense; every time, for every anniversary, I’ve told her that I know it’s all in my head, that it’s so frustrating to feel compelled to harm myself when I know it’s completely arbitrary and meaningless. Where was she? If I could just change my thinking about it then I would; if I could just stop having obsessive-compulsive thoughts then I would. What the fuck.
It got her back up.
“I’m not saying I’m going to come up with pearls of wisdom all the time!”
I made her leave the room. I couldn’t sit there with her.
When she came back in, she asked “You okay?”, in a flat, almost irritated voice, and I blocked her out, calling for Leia so that I could put her in the bag and leave. Nikki wasn’t safe, at all.
She knelt down so that she was at my eye level, and asked again, calmer this time: “You okay?”
I didn’t respond.
“I’ve just had a thought; you said you didn’t want to come on Tuesdays [today] while you were on the DBT group, but I haven’t deleted them from the calendar.”
“That’s probably because I didn’t say that.”
Back before I started DBT, Nikki said that maybe two sessions a week would be too much while I was also doing group once a week, and I told her I’d have to wait and see how it went; I felt pressured to drop back to one and like I was being too needy if I said I wanted to keep two, so I equivocated. She apparently took that as a solid decision.
She’s so misattuned. The last time I did DBT I had much, much more intensive support (two psychologists and a kinesiologist) but Anna still built in extra support when I started DBT because it was so triggering for me. And Nikki just doesn’t hear me at all.
“Inside each of us are two wolves. One is evil, one is good, and they are always at war.”
“Grandfather, which wolf wins?”
“The one you feed.”
The next day, Nikki texts me at midday to ask whether she’s seeing me at 6pm or whether she should cancel our appointment.
For fuck’s sake, I think, anger settling in my belly and spreading out through my arms. Last night you said to text you when I get back – why are you now asking me if I still want my session today? I feel like you’re hurling me around in the air like one of those gymnast ribbon things.
For a couple of hours, I can’t decide what to do, and I don’t really want to think about it. I’m annoyed with her for disrupting my day again, after I’d mentally shelved her until next week.
I could text her back and tell her yes, please cancel the session; I even start writing the message in my head, but it doesn’t feel good. It feels hostile, and closed, and distancing. I have this feeling in my chest like I’ve taken a big black ball of gooey tar, wrapped it up in clingfilm and pressed it in just above my heart. I know if I choose to step away instead of move towards her, that ball will stay inside my chest for a while.
So I text her back, and tell her that I made a doctor’s appointment because I got the impression we were cancelling, but as long as they’re running on time then I can Skype at 6pm.
(Though I’m tempted to, I don’t say Take a beginner’s class in scheduling and learn how to have the barest, most basic level of stability, you scatty idiot. That would definitely be feeding the bad wolf.)
We don’t actually connect until 6.40 – technological difficulties again – and part of me is hoping she’ll say forget it, sorry, this isn’t going to work tonight. I feel shut down and protective and I don’t know what I’m going to say to her.
Not much, it turns out. She asks how I’m doing, and I don’t trust her with any kind of real answer, so I say I don’t know how to answer that. (I still think this is progress from “okay“.) She asks a few questions about how long I’m staying at home, and she’s engaged, tender, leaning right in to the camera.
How was the weekend? she asks, and I shrug, take a breath, and think for a moment, eyes slipping off the screen. The true answer is that it was fine, that I took Everest and Leia to a studio to get professional photos, I went to a concert, I came home to my brother. But the full answer is that it was fine, and I’m relieved that it was fine, lucky and grateful that it was fine, because it almost wasn’t and that still scares me.
I’m not ready to open that up with her yet. It was okay, I say, with the quirk of my lips that acknowledges I know there’s a lot I’m not saying.
Okay, she says. Her brows are furrowed, and she has both hands resting around her neck. She pauses for a second, then gives a quick, almost imperceptible shrug and says I worried about you the whole weekend.
Another momentary pause. I’m doing that face I do when people say caring things that feel like they can’t really be true; kind of a mix between skeptical and patronising.
I woke up worrying about you.
Sorry, I say, but only because I can’t think of anything else to say, not because I mean it. I wonder if she should be telling me this, whether this is a boundary issue again, but it has its intended effect; I thaw a little.
The camera freezes as she starts to respond, and when she unfreezes, she has tears in her voice. I interrupt to tell her that she’d frozen, but I wish I hadn’t, because she doesn’t repeat whatever she was saying.
It keeps freezing every 30 seconds or so, and it’s just impossible to have a conversation. 6 minutes in to the call, I’m done. We’ve touched base, our relationship is okay, and there’s no point trying to talk about anything meaningful when it’s this disjointed. But I still feel an aching distress in my chest after I hang up.
With the contact barrier broken, I don’t really hesitate when I want to text her the next day. I’ve been thinking about the options for her maternity leave, prompted by her raising it on Friday, and seeming frustrated when I insisted that I didn’t want to see anyone while she was gone, that I wanted to take a break. And there’s a kernel of doubt in me, planted by Dr S last week, when he brought up Nikki’s maternity leave, and asked whether she was leaving “for a year or indefinitely“.
The last time we talked about the length of her leave was in October, when she said she was “barely taking any time off” and she’d “probably only be gone a couple of months, 8 weeks“. I want to be sure of how long she’ll be gone before I sit down and make pro and con lists for each of the options. I want clarification, but mostly I want reassurance that yes, she won’t be gone too long.
Meant to ask yesterday. When you told me last year that you were pregnant you said you’d be taking a couple of months maternity leave (which I mentally rounded up to three because two doesn’t sound like enough). But when you were talking on Friday about plans for when you’re away it sounded like you’re going to be away for quite awhile? Have plans changed?
It’s a bad day today, the worst I’ve had since I’ve been home. My brother is back at work, and I’m home alone and failing to be productive, fighting the urge to go back to bed. Nikki doesn’t reply for a long time, and I’m unsettled, uneasy, expecting that she’ll tell me no, nothing has changed, but unable to really focus on anything until she does.
Hours later, her reply comes through. I’ve been sitting by my phone, sometimes just holding it, so I open it immediately.
I don’t think I ever said there was a set in stone amount of time I was taking off. Pretty sure I said I would have to get my head around how long I would take. So sorry if I’ve confused things. I think I would have to say four months is realistic so not that much longer than the three you thought. I think I may have said we might have to start with Skype sessions at first? It’s really difficult to predict that early on with the new baby. Can we discuss this further when you get back!
For a moment, I’m too thrown by the phrasing of the message to really register the content. I feel attacked. She sounds hostile and defensive, and the fight part of me rises up to obscure the hurt and confused: what did I do wrong?
Then it hits me. She’s going to be gone at least until August. Given that both of our Skype sessions have been total disasters, probably at least until September.
The urge to self harm rises up, coils around me. Oh my god. There are tears pressing at the back of my eyes. I was insistent that I didn’t want to see anybody else because I didn’t see the point; I really wanted, needed to save the money, and seeing somebody for two months wouldn’t help me make progress; we’d barely get past the introductory stuff in two months. But five months? That’s too long. Oh my god.
The shock is like I’m getting the news of her pregnancy for the first time. I’m so glad I didn’t find out in session; I don’t think I could have poker faced my way through. And I’m so glad I didn’t find out at home, or I’d be bleeding.
Instead, I put on a meditation app, and I notice how the tears fall harder on each exhale. I go out for a walk, and when my brother comes home, he puts on his focus pads and we box. I try to use my feelings to feed the good wolf, not the bad.
(I can’t believe she’s so fucking unprofessional she gave me misleading information about how long she’ll be gone and then never corrected it because she’s never mentioned it again in the last three months becomes: You did such a good job to ask her to confirm, Rea, you’re getting so much better at raising things, I’m so proud of you, and This feels a lot like the way my parents never spoke to me about self harm because they knew I didn’t want to talk about it, this would be a great chance to explore that dynamic, the way I subtly intimidate people into being afraid to bring things up.
Five months, oh my god, that doesn’t even fucking make sense, if she can Skype then she can come to the office, it’s only 10 minutes from her apartment – is she planning to do sessions alone with the baby, which is not okay, or with her partner at home in their tiny one-bedroom apartment, which is also not okay, and I wouldn’t even know she has a one-bedroom apartment if she wasn’t so fucking unprofessional becomes I’m so upset she’s going to be gone for so long, and this is also a great opportunity to have the time and money to explore other things; I could do private yoga therapy or take a Buddhism class or focus on physical health and fitness.)
I’m probably trying too hard to run straight past grief and into acceptance. This sucks. It fucking sucks. No; it’s devastating. I’m afraid to feel the full weight of it.
I can’t make myself work, even though I told my boss I would, so in the afternoon, I push myself to use a DBT distraction skill. I bought some brush lettering pens a couple of months ago, and I like the focus on pressing hard on the downstroke and lightly on the upstroke. It’s rhythmic, engrossing, calming. I pick whatever words come to mind and feel right; shit; sad; cry; stab; hurt. Bitch keeps coming to mind, but it doesn’t feel right.
And then another word comes to mind, and the tears well up again, and I don’t write any more. I realise why I’m so upset about the length of the break, and that what I’m feeling is grief. I don’t think I can go five months without therapy, I don’t think I can stick to my plan of just taking a break, but if I start seeing someone else, then I don’t think I’ll go back to Nikki.
“Hi Rea. Sorry, haven’t had a second to call you today. Crazy busy. Dr S sent a message to say he did hear from you on Saturday and that you’ve gone back to [home] for a week. Sounds like a good plan! Hope you have a good break! Text me when you get back and we can organise another session. Thanks for paying those fees too! Talk soon. N.”
I wanted her to throw herself on the ground and grovel, I think. Failing that, I wanted her to be solidly, repeatedly sorry in a self-reflective way. I wanted a meā culpā. Not much to ask, right?
That’s not what I got. I got “I am sorry that I didn’t validate your experience“, in a tone that might have been emphatic or might have been defensive. I got “I mean, I thought I apologised when we spoke about it last time, but obviously it didn’t come across” and “I can see I didn’t pick up on the distress and it’s important I do that“.
On the surface, that seems fine, and it was, I guess. But it left me hollow. It was too detached, I think. Too therapist-y. I mean, she didn’t even attribute the distress to me: it was just ‘the distress‘, like it was floating out in space somewhere.
“I can see now that you were really distressed and I didn’t pick up on that, even though I should have – I’m really sorry.”
That’s what I wanted.
Then it was “Can we take it as a real positive that you felt you could tell me that? [i.e. share the letter]“. Like it was showing how solid and trusting our relationship is, instead of showing that I’d lost most of my faith in her, and was open to the idea of terminating therapy with her.
What probably upsets me the most, in hindsight, is when she was launching into explaining her ‘agenda’ for the last session, and she commented as a disclaimer “This doesn’t undermine the fact that I didn’t validate the emotion in what you said, and I’ve apologised for that”.
It just sounded so begrudging. That’s not quite the right word, but…it was like, ‘I’ve apologised once, that part of the conversation is closed, we’re moving on to something else now”.
Why not “This doesn’t undermine the fact that I didn’t respond in a helpful way, and I’m sorry for that – I really am. The agenda underlying some of the things I said last session was…“? Are genuine, non-defensive apologies usually rationed so strictly?
I can’t help comparing it to the apology my last therapist Anna gave me, when we had a rift earlier this year. It’s been firmly established that Anna was not a great therapist, and I know that comparing only ever ends in tears, but I can’t help it. Anna was present and genuine, and her apology didn’t give me those prickles of frustration in my chest. Nikki’s did.
She was a bit defensive of her good intentions to start with, but to her credit, she stuck with me, encouraging me to keep trying:
“It’s really important to tell me how you feel. I’m listening to it and I’m taking it on board, and I’m learning in my really slow way about it. I’m still not getting it though, I can feel it – I’m still not getting exactly what you’re saying to me, and I need to get it. I want to get it right.”
It took some time, but we got to a place where it felt okay – she told me openly that she’d offered so much because she’d really wanted me to know how much she wanted to support me and be there for me, but that she knew she’d made a mistake and put me at risk, and she was able to reflect on our last session and recognise that she’d been feeling guilty about not being able to follow through on the crisis plan and she’d overcompensated by telling me about the limits over and over again. And then she said, with tears in her eyes:
“It’s hard to stuff up, because I know how hard it is for you. I don’t want to hurt you more. But if I do, I want to do my best not to stuff up again. Having you calling me on it is a good thing.”
The thing is, my unrelenting standards and hyper-criticalness don’t just apply to myself – they apply to other people too. I’m picking apart everything Nikki said, and I’m filtering it through a critical lens. If I felt positive about what she said, I could probably package the exact same words and sell them to you in a way that made her sound like the most enlightened therapist in the world.
It just still hurts. I’m mad at her because I don’t want to be mad at her, and she didn’t say the perfect thing that would make us okay again. I can’t believe it’s been over two weeks and I’m still crying about this – but I am.
I don’t know what the learning opportunity I’m supposed to be taking from this is. To learn to accept that things won’t always be exactly the way I want them, and to let it go and move forward anyway? Or to learn to let go of relationships that hurt me more than they help me, and move on without them?
I don’t know whether this is any better – it might come off as equally ambivalent and not really add anything helpful. Maybe it’s even more confrontational. I like having you guys in there, and it feels more authentic to share the actual process, instead of just editing the original version, but maybe it sounds like I’m trying to gang up on her. I don’t know. I’m not sure if I even know my own name any more.
I’m trying to mentally prepare myself for her quitting, to picture myself walking out on Tuesday knowing that I’ll never see her again. But I don’t think I’ve actually accepted it as a realistic possibility, and if she actually does, it’s going to come as a horrible shock.
*continued – see previous post*
That was supposed to be the end of the letter. I posted it online, and I asked my friends for their feedback – too harsh? Too blame-y? Too ultimatum-y? As always, they were protective, and affirming, and insightful. DV talked about good therapist repairs, and said “I think that what’s underneath it is the therapist’s own confidence and inner strength – their belief in themselves that they are good enough and they’ll find a way through, and that it doesn’t diminish them in any way to recognise their misattunement and to apologise for not meeting their client’s needs at any given time.”
I really like that – I agree. I don’t think it diminishes you at all, to say you’re sorry. Probably the opposite, actually.
Some of them think the letter is perfect the way it is. Others think there’s something missing.
“I worry that you are almost inviting her to quit,” Q says. “She might even read it as though you want her to because you are dissatisfied but don’t want to make that decision. I wonder if you could instead invite her to work with you to create something that can be mutually acceptable.”
Meh. I don’t really want to do that…at least, I don’t want to do it more explicitly than I already have. It feels like too much of a risk. I really can’t predict how you’re going to respond to this, and if I invite you to work with me and you do decide that I would be better off seeing someone else, I’m going to feel a whole lot more stupid and naïve and ashamed.
We’ve put too much blood and sweat and tears into this to terminate over a misunderstanding, though. I know you can and have responded in a helpful way, like this time:
Thank you so much for sending this. I know it’s really hard for you to communicate difficult stuff like this. I want to reassure you that I understand you are trying REALLY hard to communicate in sessions and I get that you have come a long way from the early days of Aisha.
So, to be clear: I am not inviting you to quit. I’m inviting you to let go of the need to defend and to be ‘right’, and of the urge to explain to me why it was so crucial for you to explain. I’m inviting you to recognise and internalise that you did really hurt me, even though you didn’t mean to, and to tell me that you’re sorry. At the end of the day, though, really the only thing that makes sense is to invite you to be authentic, whether that leads us to termination or continuation.
I didn’t realise how hard I’d been crying, writing this, until I stroked Lily and my hand came away wet.
I went and got in the shower, and before long, I was sitting in the bottom, water streaming over me, sobbing. Something weird happened, though. I felt…real. I was actually inside my body. I wrapped my arms around myself, palms resting against my ribs, and I could feel that they were my arms, that they belonged to me, and having them around me felt comforting. I was crying hard, and shaking, and feeling intense grief, but I didn’t have any urges to harm myself, and the emotion felt safe.
It didn’t last that long – maybe a couple of minutes. I feel like you guys are probably the only people in the world who’ll understand this, but I felt excited. I want to do that again, I thought. Is that how emotions feel, for normal people?
The night before my next session with Nikki, I was awake until 6am, obsessively planning the conversation in my head. We needed to talk about why her text messages upset me so much, and I wanted to do it right, so that she’d really understand. So that things would finally change.
Usually when I try to raise something I’m upset about, it goes something like this: So I kind of wish you didn’t do that, but I totally get where you’re coming from, I think I was probably just grumpy because I was hungry actually, it was no big deal, let’s talk about something else, have you seen that new movie yet?
I didn’t want to do that. It feels even worse to bring it up and then immediately invalidate myself than it does just to never mention it at all.
I was profoundly anxious about it. Not about her reaction, but about whether I’d actually be able to do it or not. I was sure that if I explained it properly, she would get it, and she’d kick herself, and tell me she was sorry.
I couldn’t do it. We sat in silence for a while, and I tried and tried to summon the courage to bring it up, but I couldn’t get the words out of my mouth. I had an opening line in my head, and I kept taking a breath and preparing to say it, but I couldn’t do it. The thought of being vulnerable made me want to bleed.
Instead we played with Lily for a while, and then went over my list of coping strategies. I wanted to ask her if I could pay her for an extra half hour, because I was so desperate to get the conversation over with and I didn’t want to leave the room with it still dangling over my head like a sword, ready to impale me. But for once she was scrupulous about ending right on time – when she looked at the clock and told me ‘We’re going to have to finish in a couple of minutes‘, I felt intensely despairing and….I don’t even know what, but whatever it was, it was intense. She greeted the next client in the waiting room, and I could hear them in her office laughing together while I was paying, and I wanted to kill myself.
We finally had the conversation yesterday, and it went so, so badly.
She was all “In the spirit of perspective, can you see how I was doing as much for you as I could?“, and “It was chaotic at my place – there were shits in nappies – and I was texting, and I was like ‘Aaargh!’, and so I was trying to shut the conversation down“, and “Can you see how we were both making assumptions about what the other one’s thinking and doing at the time?” and “We need to be able to sit with the negative emotion, but it’s difficult to hold that in a text” and “Do you feel like you have a clearer understanding of where I was at and where I was coming from?“.
I was on the verge of tears the whole conversation. It just felt like she was making excuses and she was more interested in trying to make me understand her perspective than she was in listening to mine.
She did say “It sounds like you need more affirmation and confirmation – it goes without saying that things are shit for you, but maybe it needs to be said“, but she was also all “I do believe in positive psychology, and it feels like you’re saying that it’s a blanket no, and to be honest that feels slightly uncomfortable“.
At the end, we were sitting in this tense, awkward silence. Neither of us were making eye contact, and neither of us knew what to say. It was all very civil, and ostensibly resolved, but I think we both felt defensive and misunderstood. She said something generic about how talking things through when you’re upset is one of the most important things to be able to do, and that she hoped the conversation hadn’t brought me down when I’d been in a good mood, and I left feeling like I was on fire.
I burned myself when I got home, and I felt a little calmer, less physically anxious, but still just as sad. I lay in bed with Lily stretched out between my breasts, her head on my shoulder and paws soft on my neck, and I could feel the grief tight in my chest. You feel so sad, baby, I said to myself gently, and the grief immediately spiked. I started sobbing, and I didn’t stop for a long, long time.
In my head I’m calling her a bitch and a cunt, but I know she’s neither. She’s just a person who wants to help me, and keeps hurting me instead.
This morning (okay, fine, afternoon), I woke up feeling better, but my mind kept going back to Nikki. Things that I wanted to say to her kept coming up, and so I started jotting them down, and it turned into a letter.
Back in March, when I was in this situation with my last therapist Anna, I emailed the letter to her, and asked her to tell me by email whether she was able to keep seeing me or not. (The answer was no). This time, I’m planning to take it to my session on Tuesday, and ask her to read it. That’s progress, I guess.
I’m not okay with where we left the conversation last week. It bothers me that you’ll apologise six times for something that I really don’t care about, like starting session fifteen minutes late, but when I explicitly tell you that something has really upset me, you don’t say you’re sorry. Maybe it’s “it goes without saying” again, maybe you’re not sorry, maybe you can hold the superficial things enough to be apologetic but it’s too confronting for you to really reflect when deeper things go wrong – I don’t know.
Rightly or wrongly, I get the impression that you still feel that the way you approached the text conversation made total sense, and that you’ve said you’ll try and listen more and affirm my position more, but that you’re kind of half-hearted about it.
You get to do therapy however you want to do therapy. There’s no point in me trying to dictate that. And if the feedback I’m giving seems unreasonable or off base to you, maybe that means we aren’t a good fit. I hope not – that would really suck – but I don’t feel at all sure that we’ve resolved anything, and I can’t even consider sharing anything meaningful with you without feeling more assured that you do get why I’ve found your responses invalidating and unhelpful and you do want to change things.
I’d like you to sit quietly for a minute and imagine that you just told someone that something is so upsetting you’d rather die, and they told you to go for a walk and forget about it.
I can hear your brain already saying “But…”.
Shut that off for a minute. Stop rationalising. You told someone you’re so upset you’re suicidal, and they told you not to judge, and maybe you should go for a walk and just forget about it.
How do you feel? Do you feel better?
I know that there’s so much going on and so many things you have to juggle in every conversation we have, and it’s hard. I really do have compassion for that, and for how you want to do the right thing but it seems impossible to figure out what that is. At the same time, though…this is your job. You chose this. I didn’t choose this, and my best day with you is harder than your worst day with me.
You have good intentions, and I always know that no matter how pissed off I am. I also know that sometimes you will get it wrong – we all get it wrong sometimes. And that’s okay, if you can accept that you fucked up, and apologise. Even though you mean well, it doesn’t change the fact that what you do has an impact. It isn’t enough to say “Well, I was trying to help” – I want you to acknowledge “I was trying to help, but I realise I didn’t. I’m sorry, and I want to do things better next time.”
I know I’m really pushing you here, and the easy, tempting thing for you to do is to say “Fuck this; I’ve worked so hard to do everything I can and nothing is good enough; I give up”. Part of me really wants to just drop this whole issue and not risk you quitting, but all that would do is defer immediate pain to later pain. And I know that it must be pretty scary for you to think about the possibility that I’ll do something destructive if you do step back, so I want to reassure you that it’s okay. You’re responsible for doing your best to help, and being honest if you don’t think you’re the right person to work with me. I’m responsible for the rest.
What do you think? Too harsh? Too blame-y? Too controlling? Too ultimatum-y?
If she quits, I’m going to be devastated. If she doesn’t quit, but still doesn’t apologise, or fake-apologises, like I’m sorry you got so upset about what I said, I’ll be just as wrecked, maybe more, because then I’ll have to quit. She’s maybe not the right therapist for me, but she does (did?) care about me, and I’m attached to her. I’ve been seeing her for 6 months – of course I’m attached to her. I’ve seen so many different people and I don’t want to get back on that treadmill again. This part of me doesn’t want to give her the letter, but it doesn’t feel safe with her either, so, I mean…what exactly is the plan, buddy? Keep sitting in silence week after week?
The other part of me knows that the emotion doesn’t fit the facts. If Nikki quits, I have a Jewish mama who will text me sweet messages on the weekend, and take me to the hospital if I need to go. I have another who will hug me as long and close as I need, another who will take me to the park for lunch, another who will pick me up for work in the morning. I’m surrounded by love and support, and even though it would suck to start looking for a therapist again, losing Nikki just isn’t that important.
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.
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:
I’ve already seen her once before, and I didn’t love her, but I know she’s not awful.
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?
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:
“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?