Therapy doubts

Different things to discuss. Different aspects of life. Feelings good and not good.

Therapy this week felt not good. I don’t feel particularly understood or cared about. I feel like Ron doesn’t ‘get’ me. I did feel distrustful of him before the session also though, I remember that. So trying to disentangle what’s what – what does he actually do or not do, what is my own bias and projection. It’s not easy.

The main disturbing thing was that towards the end of the session, we were talking about some odd parts type things that happen to me – I’ll suddenly be crying in the shower, then suddenly stop, without knowing what it’s about. I’ve been waking at five a.m., in a child part, who protests going to work. My fractured experience, where I feel plunged into emotions, without knowing why, and the emotions then leave, and I can cope again.

Ron asked me to think about when I’m crying in the shower, and try to feel what it’s about. So of course I switched into a part. The parts want to tell him their story. The thing is, they don’t seem to know very much of it. However, this time, I remembered being back in my abuser’s apartment, and being terribly upset, and my aunt (always kind to me), seemed to be tucking me into bed, trying to soothe me. That’s about it. Then just a lot of jumbled impressions of their stately old apartment.

This went pretty much right to the end of the session. Ron said something about stopping, and I realized we were out of time. I needed to sit and come back, so I apologized for needing a minute. I got myself together as soon as I could, in about a minute, said goodbye and left. There was a heavy downpour, so at the bottom of the stairs, I just stood at the glass door, looking out. I had an umbrella, but I felt so stunned and dissociated, I just stood there, staring. I was Ron’s last client, so he came past me, gave me a little smile as he went out the door. I wished him a good weekend, in my child voice, and he wished me the same, and off he went.

So I went home, left to deal with this. I felt so bad. I woke up at night every hour or so, the way I do when trauma is triggered out. At about 3 am, I wrote Ron an email. I haven’t written to him for a few weeks, but this time, I felt I needed to. I felt really angry with him for triggering this stuff out, then leaving me to deal. My email wasn’t that angry though. I just said I was having trouble dealing, I couldn’t sleep. I’m not sure this triggering stuff out is helping me at all. And that he doesn’t seem at all concerned with grounding me, or even just concerned when I end the session in a child state. He assumes I’ll switch back just fine. Or he doesn’t think. I didn’t say those last things though.

Then I asked whether he could tell me the name of anything on trauma he’s read, that I could search out, because I think if we had a theory that we both agreed on, it would be helpful.

So, he hasn’t replied. I asked for a reply. He tends to not reply very quickly to emails where I’m angry. This one was much more circumspect though than my usual angry email. I brought up my issues with therapy but didn’t accuse him of things.

Besides being left in a triggered state, another thing happened that makes me severely doubt he knows what to do about my dissociation issues. I was complaining about my problems functioning, and switching into moods that are difficult. He talked for a long time about his theory of integration. His theory doesn’t make sense. Plus, I’ve never seen this idea in anything I’ve read about dissociation, so in my mind, he’s making it up.

First he talked about the benefits of integration, how all parts would be available all the time, and i wouldn’t have to choose, and some wouldn’t need to be shut away. He was kind of talking as if I wouldn’t agree, but I did agree, and told him so. The difficulty is, how do I accomplish this?

Then he said he thinks I’m doing my part, by allowing time for parts to speak. But he seems to think it’s the parts themselves that are hanging on to separateness. They feel they will disappear if they merge with me.

Which to me is ridiculous. The parts are just there – they don’t will themselves into existence. All they know is they’re here.

So I say something about isn’t it more that parts need to tell their story and be heard?

So then somehow that morphs into me switching into the part that cries in the shower, and the flashback that happened.

I’m really leery of this strange theory Ron has about integration. The parts are willing themselves to be separate? Then the way he left me standing at the door, looking out at the rain, without a thought of asking whether I was OK….

After the session I started internet searching for trauma therapists. I have the strong urge to quit. Especially since he hasn’t bothered answering my email. I know he will eventually, who knows when.

There is a therapist who says she studied with Bessel van der Kolk. Whatever that means – could mean she took an online course he sponsored. It’s so hard evaluating therapists. The last one I tried before Ron was listed on the ISSD site. She was terrible. Turned out she’d taken some online course with them. She knew the obvious theory of trauma, but didn’t know how to connect. I mean, having a bit of theory about trauma doesn’t mean you have the other really deep skills of being a good therapist.

Then there are the psychologists. Whom I mostly can’t afford. It’s just daunting, thinking about finding someone else.

  1. Wow, letting you leave in a child state and even more, not checking on you when you hadn’t managed to make it out the front door? I can see why that would be upsetting to you and bring up your doubts. The connection that you have with him is worth a lot, but he also needs to be willing to listen to and respond to what you need in order to make therapy successful for you.

    I’m mad on your behalf that he doesn’t seem to get that flashbacks aren’t just intense emotions, but they are a re experiencing as if you are were once again the child from long ago. If you aren’t able to work with it in a state of dual awareness, then you don’t have an adult’s emotional coping capabilities. That’s why it’s so important for the therapist to make sure that you are as grounded as possible when you leave. Because you are in the child state and not capable of normal thought, it becomes the therapist’s job to make that evaluation as to whether you are ready to leave or not and to help you get there, if you aren’t. Of course you always have the right to go against their advice and leave. I get the feeling that he doesn’t understand how when a person is in a child state it isn’t just that they are remembering old memories and feeling old feelings, but they experience things and think as the child. I think that most people can’t understand just how profoundly a dissociative state affects a person. It isn’t superficial at all, is it. I think that people tend to think that it is the child aspects coming in and covering up the normal adult, but the adult still is access able if you really want to. But it’s a separation. The adult and the child are cut off from each other.

    Sorry to go on so much! It just annoys me when people think that they understand and just don’t.

    I hope that you can get to a point where you feel settled and safe again, soon.

    • Ellen said:

      Thanks Cat. You never go on too much – I appreciate your insights. You have a great combo of knowledge and personal experience to call on. That is exactly what it feels like – like I can’t think properly – my mind has become a child’s mind. It’s hard to just snap out of that. Even though I do specialize in coping pretty fast, buttoning things down, but it would be nice if my therapist could help more.

      To be fair, he likely didn’t realize how dissociated I still was. I could have been standing at the door just waiting a few minutes to see if the downpour let up. I suppose. It seems like he did use to care more – he’d offer a check in call if the session had involved trauma, but he no longer does that. He gets more concerned if I cry a lot, also. I didn’t cry during the session, so who knows, it might have looked like nothing much was happening, though I did describe it, and was obviously in a child state. I am obviously going back and forth about it in my mind.

      I think it’s just true that he doesn’t truly understand dissociative parts, and does not have an interest in learning more, because, as you are saying, he thinks he already knows. He completely doesn’t do dual awareness, grounding, or trying to limit trauma coming up. That whole method that was developed in the last ten years or so for dealing with trauma, I suspect he hasn’t read about at all. At the same time, I care about him an awful lot. So I’m hoping with time my path will become clearer.

      Thanks for the good wishes. I am feeling calmer since I wrote. It’s not a weekend from hell as I feared it might be. Take care.

      • Good luck on the clearer path! This is a much harder situation than if he just wasn’t giving you anything that you need. You mention in the other post that maybe you should only do present day stuff with Ron. Will that satisfy your needs? It sounds to me that the parts really need to connect with someone and feel heard and accepted. I know that for me, that has been a very important part of the healing process.

        Every time I hear someone talk about therapist difficulties, it makes me appreciate my blind luck at finding MB all of those years ago. I was referred to her and in retrospect she can’t quite figure out why I was referred to her specifically, since she had very little Trauma experience at that point. But then I didn’t know that I was dealing with anything more than an acquaintance rape at the time. My symptoms indicated a lot more, but it took me some time to admit to them. I knew nothing about dissociation and probably nothing about PTSD, so I wasn’t about to admit to emotional and body sensation flashbacks when I thought that they made me sound like I was crazy!

        She says that she was already inclined to think in terms of parts, in terms that apply to everyone, and working with me got her interested in dissociation and big T trauma. It was the person who was supervising her who gave her the term dissociation, however, since she hadn’t heard about it at all in her studies or previous work. She saw what was going on, but she didn’t have a name for it. She started reading about it then and once her son was older and it was easier for her to go off to workshops, she went to the experts.

        I stopped doing trauma work with her in 2003 and moved out of town for my husband to go to seminary. She learned an immense amount between then and 2012, when I moved back to the area and started to make the 2 hours each way drive to see her. Doing therapy with her changed a lot and we made some mistakes at first, because of assumptions based on our old work together. However, what we are doing now works so much better for me. She is purposefully doing attachment work, even though she was always inclined towards that style. That has allowed me to develop a much deeper trust in her than ever before, which in itself has been healing and has allowed for much deeper work. She works hard to try to keep me from over engaging in the work and getting my brain revved up into a trauma cycle. She has an understanding of neuroplasticity and is trying to facilitate creating the conditions that will enable my brain to create new connections and patterns. She is willing to try different approaches until we find what works best for me. She uses everything from EMDR to meditation to behavior modification to basic somatic experiencing. The constants are close attention being paid to attachment issues, grounding and symptom management, and IFS.

        Most importantly, our personalities just plain work well together. She is willing and able to provide physical comfort, which turns out to be I valuable for me. She provides the type of calm, warm presence that I need. She says that I help to draw out the characteristics that are so helpful for me. She is entirely genuine and willing to let me see her, not just a therapist facade.

        Sometimes I wish that she was more one way or another, since no therapist can provide everything and be perfect, but over all, I really do consider myself to be very fortunate.

        The reason I included so much about her and our relationship is because I thought that it might be helpful for you to read a description of some of the important characteristics and factors that make me so happy with MB. It might help you think about what would be most important to you, what you can live without with Ron or possibly address with him, and what you might look for, if you decide to explore your options.

        • Ellen said:

          Thanks very much Cat. That is so interesting. I’m glad also that you found MB, or had her dropped in your lap. You deserved this luck. It’s wonderful she went out and got all that extra training / knowledge in order to help you better.

          It does give me a good idea of what i might look for. Though it’s hard to tell at first sometimes, if the person is right. Personality is important. In terms of personality, I like Ron. Just…well, you know.

          I was wondering if MB is a psychologist?


          • Oh, she didn’t get the training just for me. She has made trauma, working with parts, and attachment somewhat her specialty, since starting with me. I just got her started on the road.

            She is a social worker. I wouldn’t limit myself at all by the degree a person has, personally. I think that the degree matters most when someone is a new therapist, but I wouldn’t advise a new therapist for someone with a dissociative disorder. It isn’t fair for either the client or therapist. Maybe if they have really good training specifically in trauma (I’ve heard that buffalo has a good program), they have really good supervision, and their trauma case load will be light to start. Learning how to do both the self care and to be available in the ways a Trauma client needs is very difficult.

            I’ve talked with MB a bit about whether I would ever want to practice and do trauma work. I have inside experience that would be both invaluable and a liability. I both want to and don’t. For now, it is far from possible, though. She says that she knows survivors who make fine therapists, but no one who was traumatized as badly as I was and went on to do trauma work, although she knows of some more famous people who did just that. For now, I will continue writing as my way to some what satisfy my desire to help others.

            • Ellen said:

              Good to hear she is a social worker, and you don’t think the actual degree is an issue, because I just can’t afford psychologists.

              Didn’t know you wish to become a therapist some day. That would be a difficult profession, but some are called to it, and you sure would understand trauma. Myself, I’m just happy I can finally support myself, even if I’m not really making much difference. I’m still taking care of myself which is worthwhile.

              Thanks for explaining. I hope you do practice some day.

  2. Cat said:

    It can’t be easy to fathom projection from gut instinct. It’s perfectly acceptable to feel angry towards Ron for stirring everything up, but you are evidently doubting his ability to deal with trauma and that can’t be good for your therapy. It’s weird, maybe I am arrogant, or something, but I couldn’t care two hoots for Paul’s theories. I work with my theory and maybe I am lucky not to feel challenged by his disagreement. This must be so difficult because Ron means so much in so many different ways, but if you’re not able to process the trauma and have different goals in mind, then maybe you do need to look elsewhere.

    • Ellen said:

      He he. I like how you don’t care two hoots for Paul’s theories. I have to admit, when I first went to therapy about twenty years ago, I also had no idea about theories and didn’t really know there were any. It was all about my feelings I guess. But also, I assumed the therapist knew everything.

      In a way, I might do better if I hadn’t read about dissociation and therapy for trauma. I wouldn’t then know that Ron is doing stuff that is not recommended. The problem with trauma is, you can simply re-traumatize yourself, because trauma is stuck and not processing. That’s what I’m afraid is going on here – a bunch of re-traumatization that isn’t helping me. But at the same time, some good stuff is going on also.

      I currently don’t know what to do for the best, so am sitting tight. When in doubt, breathe, right?

      Thank you Cat.

      • Cat said:

        Trauma was a big one for me and in some ways it still is. I am not sure we ever really get over or heal from the trauma. How can a traumatic event no longer be traumatic to the victim and does reliving it in therapy just call up the same emotions over and over? I am really not sure

        • Ellen said:

          I’m not sure either. 😦

  3. Grainne said:

    I’m not sure how I feel about Ron. I’ve been reading your blog a long while and I’ve never been able to form an opinion on him. I’m sure he’s a decent therapist or you’d not have stayed with him so long but it’s disconcerting the way he deals with some things. Triggering out a child part and leaving you like that…I’m sorry he did that to you. I would be doubting his intentions/training/expertise too. :/

    I hope he answers you soon. It sound like a great idea to explore some other trauma care models with him to find one you agree upon. Xoxo

    • Ellen said:

      Hi Grainne – I think he’s excellent in many ways, I really do. He can relate to you, he’s really insightful with dreams, he’s not defensive, he can be very caring at times. Just…I don’t know about the trauma / parts aspects. It felt kind of crummy when he walked past me stuck at the door. Not that he knew I was stuck exactly. It’s like he’s not realizing the difficulties parts bring to the table.

      He has just answered my email. He says we can talk about it in session – just what I don’t want to do. I don’t want to argue with him about theories. I don’t have the time. Unless he wants to argue after session time, when I’m not paying – I do have time for that. But maybe, somehow, we’ll work out something.

      Thanks Grainne. All the best in your new home also.

  4. Yes, letting you figure out how to get yourself out of a child state in a minute–not more than that–is really unacceptable and then walking past you when you are clearly not in an adult state and doing nothing is also unacceptable. I can see how you are really doubting his competence now. He seems to be in over his head.

    Integration is not an act of will. You don’t become integrated because you decide you want all parts of yourself available to you at all times. You become integrated because you can process the emotions the parts are expressing. His idea that the parts don’t want to integrate is just stupid.

    • Ellen said:

      Yeah, he doesn’t really understand about parts. It’s a painful truth.

      Well – it is stupid. It is a really really really stupid idea. Hearing him say this kind of stuff really bothers me, because he must be making it up on the spot. He blamed the continuing dissociation on child parts not wanting to be part of the larger whole. OMG. This is not even some stupidity the medical establishment spouts, that he at least researched from elsewhere – this must just be his own daydream.

      At the same time, I care about him and am attached to him. He is Mr. Wonderful. What should I do? Rhetorical question. I will be thinking about how to go forward. Sometimes a path does appear, if we are looking.

      Thanks Ashana.

      • Yes, don’t know what to do. The parts are attached to him. He listens to them. Then he blames them for your dissociated state.

        His callousness at the end of the session is troubling. He could take a bit more time–and ought to have–trying to help you get grounded back into the present. Talking to a child part and then just walking on by is callousness. He does care, but there seems to be a limit to it.

        You can always research other therapists while still seeing him. When a good one turns up, you can switch then.

        • Ellen said:

          I actually think he doesn’t realize what’s happening. He really isn’t callous. He may have been eager to start his weekend, but he’s not callous. I think he has a bad theory, and doesn’t really understand about grounding. Plus I think if he sees crying, it’s more obvious to him he needs to help.

          You’re right, I could research. That is not a bad idea, if I can get myself to do that.

          Thanks. Hope your weekend is good.

          • If you’re talking to him in a child voice, I can’t see how he can’t notice. The callousness then would be that he’s not interested enough to pay attention. Care is about paying attention. He shouldn’t need to be hit with a sledgehammer to notice. I’m not saying he doesn’t care, but that it seems to be intermittent or limited in some way I don’t expect to see in a therapist. In a casual acquaintance, yes, but not the therapist who has been seeing you for 4 years.

            • Ellen said:

              It’s true he intermittently kind of flakes out. Yep. Unfortunately.

          • One thought I had about this just now is that you found Ron when you were much more in denial of having parts, so you found a therapist who wasn’t necessarily interested in treating them. It wasn’t of interest to you then, and so that’s not a part of what you got in the therapist package. Now you have come to accept that you have parts, and your needs may be different.

            • Ellen said:

              Yes. Ron actually discovered them. I had no idea whatsoever. All I knew is sometimes I talked in a childish way, and that made problems for me dealing with people. And I thought I had ‘stuck thoughts’, where thoughts went through my mind loudly, so to speak, and always saying the same things. Those were the only clues really. You could have knocked me over with a feather when it seemed to be parts. You still could.

              So yes, I didn’t research for someone who was skilled in dissociation. However, I did kind of ‘ask inside’, without knowing what i was doing, when I was trying to pick a therapist, and he got a stamp of approval that way.

              Things do change.

  5. Andi said:

    I would be very wary of any therapist that didn’t seem invested in ensuring I was grounded and safe before exiting their office. Furthermore, this integration he talks about is confusing. All parts can be available with good internal communication. You don’t need integration for that. I think the separateness comment may be him referring go the parts holding hard to their autonomy – something many in our system do as well. They are afraid of disappearing or being sent away as a means of integration, which is terrifying for them. I say follow your instincts. Shop around and see what’s available and if someone else feels like a better fit.

    • Ellen said:

      Yes, he’s never been too concerned with grounding. As to integration, I know for some who have DID, it’s not a goal they wish to pursue. For me, I am fine with integration as a goal. But yeah, the parts themselves don’t want to ‘die’, but I don’t think that’s what’s preventing integration for me.

      My instincts are mixed. A strong measure of stay put, we love Ron. Mixed with my misgivings. I’ll take it slow and see.

      Thanks for commenting.

      • Andi said:

        Sometimes that’s all you can do. Supporting you no matter what.

  6. Rachel said:

    I felt saddened reading your account of standing at the door, and Ron walking by and not checking in to see how you were feeling. I can feel how isolating and abandoning that might have been. I am sorry the session felt dismissive, and overall awful.
    It is really hard to conceive of leaving a therapist; breaking those bonds and attachment. It is also hard to feel like needs are not getting met. I just want to add that the fact that you are even questioning whether this therapy relationship is working for you, is a sign of self-love and care, and regardless of Ron and what he is/isn’t doing, that is a positive thing you are doing for yourself. xx

    • Ellen said:

      I guess the entire session didn’t feel dismissive actually. Ron isn’t like that – he’s calm and attentive. Just he left me in a really dissociated place, and I think he wouldn’t really do that on purpose. He kind of doesn’t get what dissociation is like.

      It is so hard to think about leaving, except in the moment when I’m hurt and angry. I am very attached to Ron.

      I think it’s positive that I want to ensure no one is being re-traumatized. That level of caring for myself is new. Thanks Rachel. xox.

      • Rachel said:

        I’m sure he wouldn’t do anything harmful on purpose. In the moment, it sure doesn’t feel that way though. I know any time I get upset with my therapist, the feelings are so strong and I think she doesn’t care. But later, can reflect and realize I reacted because of past experiences, and all the positive aspects are not gone. I suppose therapists can’t always do the thing that would feel the best, just as none of us can. I think expressing those hurt feelings is positive though, so I am glad you were able to do that when hurt.

        • Ellen said:

          I expressed it on the blog anyway. Oh yeah, by email also. He ignored that part of the email though. Best to talk in person. Thanks.

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