The One You Feed

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“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.

My last word is goodbye.

The One You Feed

She Used To Care, And Now She Hates Me

“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?

She Used To Care, And Now She Hates Me

Three Down, None to Go

* Trigger warning for thoughts of self harm

I replied to Jen almost straight away last night. Before I lost my courage, before I lost my mind from sitting with the pain, and (I hoped) before she went offline.

“No, I am not seeing the new psychiatrist and am not seeing Aisha any more either.

You’ve been a great support over the last couple of years and I really appreciate everything you’ve done – thank you.  But I am feeling very hurt and unsupported by you and am not sure when or if I’ll be back.”

I don’t regret it. It was honest, and as skillful as I knew how to be. I didn’t get a reply, and I’m not waiting for one.

I thought about cutting myself. I could see the blood, pooling around me while I sat in the bottom of my shower, and that triggered another thought – maybe I should overdose, too. I could already hear exactly what I’d tell myself: Jen hates you, you stupid bitch. She thinks you’re needy and clingy and too demanding and she wants you away from her. You’re a pathetic whiny little piece of shit and she doesn’t.fucking.care about you. I hate you, you bitch. You deserve this. You deserve this. 

I stopped, though.

Do you really want to hurt yourself? 

I pictured drawing a razor across my arm, and inwardly recoiled.

No. But I don’t want to feel this feeling and hurting myself will push it away. 

Already I don’t know how, or why, but I decided to stay with the feelings. It was probably Rachel’s fault. I sobbed until I was gasping, and I let myself feel all the rage and the hurt and the disbelief – how can this be happening again? why is this happening again? what did I do?

An hour later, I got another email in my inbox; from my friend R to Aisha, my last sort-of-remaining therapist (and his), with me cc’d. He and I are fighting, and he’d taken a screenshot of our text conversation and sent it to her. I was instantly diverted from my hurt over Jen to fury with him, and I decided it was time to terminate with Aisha.

I did hesitate, wondering if I was being reactive to Jen’s rejection and I’d regret it in the morning, but I felt very strongly that this was the push I’d been needing. I’ve been reluctant to contact her because I was scared of the feelings. I still am; I know there are a lot more to come. I love Aisha. I’m crying now, writing this. She’s given me so much unconditional affection that even with all my fears and insecurities, I really believe every part of me is accepted with her. I want her, so much. But that doesn’t mean she’s good for me. And while I’m already feeling crushed and devastated about Jen, I might as well get it over with.

So I typed out a quick email, Goodbye and thanks, and I sent it. The malicious part of me hoped that when she first opened her email, she would see the subject line and think it was a suicide note.

***

Hi Aisha

This [R’s email] has prompted me to write to you to formally terminate our therapeutic relationship.  It’s been 6 weeks since we spoke and 4 weeks since I got in touch to let you know Anna quit and you haven’t responded.  I feel very hurt and abandoned and it has brought home to me that I need a much higher level of support than you are able to provide.

I really regret that we are parting under these circumstances but I’m trying to remember that it’s not about right or wrong, just the reality that our relationship isn’t meeting my needs.  That said, I so appreciate all your patience and kindness and all the humour we’ve been able to share.  I’m very lucky to have had the opportunity to work with you; I’ll miss you and I wish you all the best. 

Everest also sends her regards – or she would, if she wasn’t busy trying to eat one of my pens.

Rea

***

I haven’t got a response, of course. If I do, it probably won’t be for weeks.

So this month has been a series of cascading failures. Anna, then Jen, then Aisha. I’m swinging wildly between emotional states – numb to angry to sad to relieved to self-loathing and back again. I don’t know what I did. It feels like it can’t be a coincidence, but I don’t know what I did. I’m trying to tell myself that even if it was because I’m too much or too hard or too something, that doesn’t mean that I’m bad or they’re bad, just that we aren’t the right fit for each other. It’s not helping much.

I was awake until 4am last night, restless, idly playing fetch with my kitten, but woke at 7am feeling okay, and determined that I have to start moving forward. I texted my GP, and asked her to call the psychiatrist I’d picked as my preference and see if she was available.

She’s not. I don’t even remember why, but she doesn’t feel she’s a good fit for me. She recommended a psychologist in my area she thinks would be perfect, and S pushed me really hard to do it, but the reality is that I can’t afford it. I’ve found 5 psychologists I would love to see, but even with the private health insurance that costs me $55 a week, it would cost another $400 to go twice a week. With what I earn, even if I went back to how I made it through law school, living in a condemned house and dumpster-diving/boiling pet bones for food, I couldn’t do it. Seeing a psychiatrist will cost me $40 – $80 to go twice a week. I know how lucky I am to have access to any level of care, but I’m still angry that my options are limited.

But I stayed calm, and gave her the number for my second preference. She got an international dial tone, and no message bank.

And then I started spinning out and catastrophising. There’s nobody else I can see. I can’t go to another male psychiatrist. Nobody is going to be able to help me. I should just give up. The universe hates me. Why do I even try when nothing ever works out? 

Being activated is full of contradictory states, for me. My head feels empty, but so heavy. My stomach feels like there is a rock resting at the base, but I feel the urge to eat, to fill it. My arms and legs can’t move but they want to flail and kick and lash out. I need to be very quiet and still but the silence feels blurry. I don’t know how silence can feel blurry, but it does.

I’m trying to be kind and gentle with myself. And when that doesn’t work, I play fetch with Everest. It has become apparent that the pen lid needs to be subdued with all possible force.

Three Down, None to Go

(My Therapist Says) I Am A Dog With Cancer

I think I’m going to stop seeing Aisha.

She was the first psychologist I ever saw. I’d been self harming for over a decade by then, but had never spoken to anybody about it, and she patiently sat through session after session of silence, waiting for me to feel comfortable enough to talk. It’s been over 18 months now, and when my emotions are so overwhelming they start spilling out in snark and snippiness with other people, she’s the only safe person I can break down and cry with.

But she isn’t here. She’s literally on the other side of the world.

I only started Skyping her because she was my friend/boss/surrogate father R’s therapist, and R was the one who talked me into trying therapy – it was just convenient to set me up with her because he knew she was good, I guess. By the time we realised I really needed to see someone on the ground who could work with me more fully, I was too attached to just snip the apron strings, and instead it became a case of finding a local psychologist and then slowly weaning off Aisha. Very slowly – I’d been seeing Anna for 8 months and nobody was anywhere near thinking it was time to transition away from Aisha.

But right now, I’ve got a knife and I’m hacking at those strings. I can’t tell whether this is coming from a wise place, or whether I’m being reactive because I feel abandoned, because she didn’t reach out to me after Anna quit and I’m hurt and sad.

Back when Aisha had been seeing me for a few months, she told R to think of his relationship with me as adopting a dog with cancer – to treat me with love and compassion, but not get too attached, because I’m probably going to die. I’m not supposed to know that, but I do.

To be clear, she has never, ever let that thought show in our therapy. She has always been optimistic and encouraging and told me to have hope for the future. But knowing that she thinks (or thought) that I’m not going to make it just makes everything seem disingenuous. It hurts, and it makes me angry, and I don’t really know why. I should be glad that she recognises how profound my emptiness is, that she can see how much I hurt and struggle. But only a very small part of me is glad.

I think she’s amazing at her job, and I love her. But I have some reservations. Like when she went away for four months last year with less than two weeks notice (even though it’s scheduled travel that she does every year), at a time when I was self-harming so badly I needed surgery and had lost other personal and professional sources of support. Like the fact that it generally takes upwards of two weeks for her to respond to simple (e.g. scheduling related) emails.

And I wonder about how much she discloses to me. This was a huge difference between Anna and Sue – I knew virtually nothing about Anna, so I couldn’t ease into session with 5-10 mins of small talk about her life the way I do with Aisha. It has definitely made me more comfortable with Aisha, but I do wonder if this is sidestepping part of the work by taking the spotlight off me.

In addition to what’s happening in her everyday life, here are some of the things Aisha has told me:

1. Her first husband was emotionally cold and didn’t express any feelings when his mother died. She left him when he started hitting her kids, and then later called Child Protection on him to restrict his custody of them – he suspects it was her but she’s never told him.

2. She started therapy when she was 28 and used to have major troubles saying no, so much that she’d white out in session when her therapist would get her to say it. In her early 40s she woke up with a body memory of what had happened to her. She’s had bad personal experiences with psychiatrists and she doesn’t trust them.

3. After her first children were born she had major postpartum psychosis and had recurring thoughts about killing her babies. Her three children are all autistic.

4. Her mother had very unrelenting standards and she has a terrible inner critic.

I feel uncomfortable about sharing this with anyone, even anonymously. I just want to work through all of my confused thoughts. I feel honored and proud that she shares with me. A lot of me loves it. But it also makes it harder for me to trust her judgment, because sometimes I think she sees so much of herself and her kids in me that it’s hard for her to see me. And I wonder whether the advice she gives is biased by her history. For example, she’s the one who set me up with Anna. At the time, I was looking for a psychiatrist who did psychotherapy, not a psychologist, and I made it clear I didn’t want to see Anna, but Aisha had connected with her and R pressured me into it so I went. Was the resulting shit storm influenced by her personal dislike of psychiatrists? I don’t know, but I wonder.

Earlier this year I woke to the sounds of a furious man yelling, banging and crashing and a woman screaming. I ran downstairs (in my pyjamas) to physically intervene, without calling the police, who fortunately arrived just as I stepped in between him and his girlfriend. I was, and still am, horrified that of an entire apartment building of people, most of whom are not 125 pound women with the upper body strength of a soggy bowl of cereal, I was the only person who showed up. I asked around and was even more upset to find that every one of my friends, family and colleagues said to call the police and not to intervene. So I asked Aisha, and she said I did the right thing, and that somebody has to step in and do something. That’s the answer I wanted. But I wonder. Her answer was so starkly opposed to everyone else’s, including Jen’s – is that influenced by her own experience with domestic violence?

I know that every therapist is going to be influenced by their own history. I’m never going to be able to take anyone’s opinion without examining it myself. Really, knowing something of her background is helpful because it helps me be aware of where some of the pitfalls might be. But it’s hard, sometimes. I don’t want to second guess her, but I do.

The care she has shown me is so humbling and has really touched me so many times. She used to cry after every session with me because she was so worried about me. Maybe she still does. I love that she cares so much, even though it feels weird, too. Even when I’ve been furious with her for repeatedly cancelling sessions, not responding to me, going away on short notice, I’ve felt secure in knowing that I matter to her.

I feel special. She’s told me that I’m the only person she breaks the rules for. She tells me she’s proud of me, and she signs her emails with “Hugs”, or sometimes, “Love”. She cries for me during sessions and she gets angry with my parents. No matter what I bring to therapy, she’s always calm and always accepting – if I’m cutting during session, if I’m completely silent for an hour, if I get up and walk away or ignore her and start texting – it’s okay. She has never got defensive and never been frustrated with me for not wanting to try something.

So why would I want to quit? Well, I don’t, really. Part of me wants to be able to crawl into her arms and hide my face in her neck and stay there. But at least I feel mostly numb about it right now. There’s pain and fear and need underneath it, but the numb goes pretty far down. It has to happen at some point, so why not now, when it’s going to hurt less? In a couple of months she’ll be going away again anyway.

I don’t know. I don’t know what to do.

(My Therapist Says) I Am A Dog With Cancer

To Close Our Work

On Wednesday, Anna sent me an email response titled ‘To close our work’. Just reading the subject line flooded me with so many emotions. It felt like she’d closed a door in my face. After I’d spent 8 months gradually getting to know her, trust her, reach out to her, in the space of a week she’d decided to terminate therapy, and two email responses was the only processing she was willing to give me. More crudely, I’ve spent over $10,000 in out of pocket costs for therapy with her – is that really all she owes me?

I was choking on tears while I read through it. It was a much nicer message than the last one – she acknowledged that she doesn’t have the skills to help me and that she knows that must be devastating for me, and she apologised. But that mostly just makes me angry. She wrote a nicer email because I walked her through exactly what she had done and needed to take responsibility for. So she is either just parroting what I wanted to hear, or she genuinely didn’t have the awareness to recognise her role in the situation and how the termination was going to impact me and acknowledge that before I spelt it out for her.

I do believe that this objectively sucks, but I’ve also been struck with the realisation of how intensely my reaction is linked to transference. The phrase that keeps stirring my emotions back up is “I’m so sick of always having to be the grown-up – I’m so angry that she basically made me terminate my own therapy because she couldn’t face the fact that she can’t help me until I directly asked her to think about it“. For days I kept ruminating on this, and the fury was so big it felt like it was going to explode out of me somehow, that I was going to start hitting and kicking like I did when I was a child because I just couldn’t hold it inside me any more.

When I stepped back, and asked myself what I meant by “always having to be the grown up”, I realised I was talking about my mother. Of course I was. I mean, the therapist uniform should be a t-shirt that says “This is about your mother“. Emotionally, I’ve always had to play the adult role with my mother, to the extent that when someone gives her a compliment and she starts running herself down, I step in and coach “Say thank you” and she complies. Like Anna, my mother cares about me but has no idea how to help me.

I’ve been filled with a lot of rage this week, and not just at Anna. When my brother (who is probably the most important person in the world to me) texted me to ask how my day was, I told him to fuck off. I wanted to physically push anyone who got close to me, lash out at anyone who wanted to talk about anything meaningful. Anna has shut the door and I don’t want her to open it again, but I’ve been kicking it, beating it with my fists and screaming my rage. I’ve sent three brief but abusive “fuck you” emails, telling her she has no idea what she’s doing and she shouldn’t be a therapist. And I have zero remorse.

The other thought that has been poisoning my emotions is how far she has “set me back“. That it’s going to take weeks to even go back to Aisha and Jen, months before I’m ready to see another psychologist, maybe years before I can trust a therapist again. I’ve been outraged that she has damaged me, that she has “wrecked” everything, all the progress and the effort I’ve made.

One afternoon after work, sitting in the park with Everest, I asked myself calmly “So what?”. It wasn’t a dismissive, critical statement, but a genuine question – so what? And my answer is that it sucks, but in the whole scheme of life, it doesn’t really matter if it takes a year before I’m ready to go back to therapy. It has consumed me so much, been so intense that I’ve fallen into the belief that therapy has to be happening and it has to be working or nothing is okay and everything is hopeless. In reality, I’m only 25. Assuming I survive to be 26 (and so far I have an impeccable track record of staying alive), then what does it matter if I take some time off and spend my therapy money on a trip to Hawaii instead? It isn’t ideal and this betrayal has affected me and will affect my therapy in the future, but it just isn’t worth being so angry about.

I have a long way to go. I’m still sad and angry and I miss her and hate her. I still want to cut up the stuffed dog she gave me and set fire to it, and I want to send her a photo of a puddle of blood and tell her This is what you did to me. I want to break things and cry, I want to be held and I don’t want anybody near me ever again. But it already hurts less than it did six days ago. Hopefully it will hurt a little less tomorrow.

To Close Our Work

Lies My Therapist Told Me

I told myself I couldn’t respond to Anna until at least the next day, once I’d had a little time to calm down. That lasted an hour.

I got her email while I was at work, and barely managed to hold it together long enough to get through the rest of the day. Once I left the building, I started crying before I even got to the end of the street, and kept crying all the way home.

In my heart, I was sure that she was going to step up and we would keep working, keep trying. I’d picked the day that would be the most convenient for a session, and mentally set aside the clothes I was going to wear. I’d thought about which goal I’d pick for us to focus on moving forward. She committed to me, over and over, that this was long term, that nothing could make her go away, and I thought this was just another bump in the road.

I am so, so devastated that she’s given up on me so easily, and I am so angry that she thinks that 400 word email is all she owes me after all the promises she’s broken. But I’m so sad that she’s gone. I keep having flashes of the moment I looked up from my hospital bed in the emergency room and saw her standing there, at midnight, holding a stuffed dog for me. Of her sitting next to me while I cried, and reaching out to wipe my nose. Of walking with her through the park, barefoot. It’s almost like she’s dead, in a way. I keep thinking of everything I’ll never get to tell her. After pressing me to call child protection, she won’t be there for the fallout. I’ll never get to say goodbye to her dog. She’ll never wish me a happy birthday again. If I’m admitted to hospital again, she won’t come. And I want her.

Part of me regrets ever sending that email. Regrets not just going back to another session and telling her my plan and moving forward. It’s so angry with me for letting her go away when I could have stayed quiet and kept her. Another part of me knows that the way she’s handled this situation proves that she is not a skilled therapist, however caring she is, and continuing to work with her probably wouldn’t have benefited me in the long run.

I was in bed, sobbing, feeling so much grief and anger pressing on my chest. I had to get some of it out, and I couldn’t let her get away with that bland, no-big-deal email. I wanted to tell her that this isn’t a pleasant, shake hands, lovely to meet you parting, but a gut-wrenching devastating completely derailing betrayal, and I want her to own that. So I got up, and I sent her a rapid series of short texts.

“So much for all your promises. It might be “a bit hard” to start from scratch with someone new? Fuck you. I can’t believe you’re making me do this again. You kept telling me this was long term and I thought you were going to be my last therapist.”

For a little while after I sent them, I felt a little calmer, but then a different part of me took over and sent her an email. I think the abandoned child has been texting, and the angry, ruthlessly logical teenager has been emailing.

“Hi Anna

I wish I didn’t have to do this, but I feel I need to hold you to account one last time.  Your email seems to be avoiding the real point.  The ideal may be for me to work with a single psychiatrist/psychologist, but if you were capable of continuing to work with me, then the best approach would have been for me to start seeing one of them while still seeing you, and over time decide whether I wanted to transition across to work solely with them.  In our last session you recognised that it’ll probably take me months to find a psychiatrist, and that’s on top of the months (years?) it’s going to take me to come to terms with this failure and loss of trust enough to try again.  That is not ideal.

Perhaps my truth is different to yours, but I believe if you were really being honest, your email would have said something like this:

“I have come to realise that as much as I have wanted to support you, I don’t have the skills to be able to help you.  I recognise that my inability to support you effectively and the mistakes I have made have given you additional burdens and have been painful and difficult, and I am truly sorry.  I also realise that my request during our last session was inappropriate and I apologise for that.  I know that starting again with someone new will be really difficult for you and I wish you didn’t have to go through that, but in the long term I believe it is in your best interests.  Even though I committed to working with you long-term, I would be doing you an injustice if I wasn’t honest about this, because you deserve to get the help you need and through no fault of yours, I am not able to provide it.  It’s unfair and it sucks and I’m sorry.  

With that in mind, I think the most optimum way for you to get the help you deserve…”

I am very, very upset about how this has turned out, and very angry with you for letting me down.  Despite everything, I still like you, and I would prefer to end with pleasant well-wishes, but this experience is not pleasant.”

I managed to get through some work for an hour or so, and then sobbed for the rest of the evening until my whole face ached. The vulnerable child was remembering everything kind she’s ever said to me – “I’m right here and we’re going to do this together, okay? I’m definitely not going to leave you. I’ll stay on the phone with you all night if I have to. Can you tell me where you are and I’ll come get you and sit with you? Please, Rea, I want to be there with you.” – and desperately wanting her back. The angry child wanted to punish her for how much she’s hurt me, and wanted to send her a text telling her that when I kill myself, I hope it haunts her forever.

I finally fell asleep after 1am and woke again at 4, and it wasn’t long before I was crying again. I got up, and the children each sent her a text message:

“All I asked you to do was start putting my feelings ahead of yours and start working with me instead of talking at me. If that’s so impossible for you to do then you shouldn’t be a therapist.”

“I didn’t want you to quit, I just wanted you to do better and I hate you for giving up on me so easily.”

I cried all the way to work today, and all the way home. It’s so shocking and abrupt that I don’t know how to even start dealing with it. A week ago, she was telling me that we needed a psychiatrist to support our work, not to replace her, and she offered to set up 4 or 5 appointments with different psychs and come with me to each. And now she’s gone. How did she go away so quickly?

Tonight I sent her another email:

“Let’s talk some more about this pathetic excuse for a termination email, shall we?

“Whatever happens, I’m not going to go away.  I’m not going to go anywhere for a long time.  I’m committed to this.  I want you to know that.” 

Apparently this wasn’t true, but I believed you.

“I’m not going to get it right all the time, but I am willing to own it and try to do it better next time. Having you calling me on it is a good thing.  It’s not going to make me stop working with you.”

Apparently this wasn’t true either, but I believed you.

So when you were writing that email, what made you think you didn’t owe me an actual explanation of why you’ve abruptly decided you can’t work with me any more?  Not “I think it would be optimal for you to work with a single psychiatrist”.  The question was never about the most ideal way to do therapy, it was whether you can help or not, and a week ago you were offering to come with me to see a psychiatrist, not suggesting that I see one instead of you.  Why did you think I didn’t deserve an explanation of why you can’t offer the help I need?

At the very, very least, why didn’t you think you owe me an apology?”

It’s been over 24 hours, and she hasn’t responded to any of my messages. Today is her day off, so she doesn’t have any other clients.

Through all of this pain and anger, I’m still holding out hope. Hope that she’s going to come back and say “You’re right, I made a stupid, terrible mistake. I was wrong to give up on you and now I know you want me, I want to keep working with you. I’m so sorry, and I’m going to make it up to you.” A lot of me really believes that’s going to happen, and it’ll all be okay. Because she promised.

Lies My Therapist Told Me

Terminated

Hi Rea

I’ve taken a bit of time to get back to you, as I’ve been considering what you’ve said and the work that we have done to date. I agree that this year our therapy has been disjointed and just really focused on containment. However, I also think I am not able to offer you the help that you really do need. Over the course of our work together, it has been clearer to me that the most optimum way for you to get the help you deserve is to work regularly with a single therapist, and in my opinion, this should be a psychiatrist that can help you with meds and also psychotherapy. Another alternative is for you to become an inpatient in a dbt clinic where you can get the benefit of a team approach. I know that probably neither these options are something that you will like, but in my professional opinion it feels that they could give you the best chance of living a life that you can enjoy.

I really do hope you connect to the psychiatrist we tried to get you into. I am also giving you the names of two others that also do psychotherapy.  I’d be happy to advocate on your behalf if it would help in facilitating you to get into any of these services.

I have also notified the mental health crisis team at [hospital] and they have a list of psychiatrist they can tee you up with.

I have enjoyed getting to know you. You are a highly intelligent, creative and caring person. I wish you all the best and I hope that you will consider trying to work with a good female psychiatrist, even though the start may be a bit hard for you.

Kind regards

Anna

Terminated