Tuesday, February 17, 2009

An Ending and a Beginning: Termination of a Therapeutic Relationship

I have been quiet for a reason lately. My sessions with Paul became harder and harder for me to do. He pushed me to express anger that I could not express. I did not understand why I couldn't express it. The more he pushed the more I shut down.
Paul is very literal in his interpretation of psychoanalysis. He would not allow me to focus on him in any way. I was not allowed to even look at him. Any reference to his being there evoked the rhetorical question, "Why are you focusing on me, Diane?" Unbeknownst to either of us, I was trying to get at the transference that was building daily in me towards him. By preventing my focus on him, he essentially prevented me from discovering the block I was facing and to do the work I needed to do. He seemed to grow more and more frustrated with my inability to do any real work in his office, and yet, he was the reason I couldn't do it.

As we looked at past situations in my life where I had allowed people to verbally chastise me, I realized that I was allowing the same thing once again but this time in therapy. I knew I had never been able to face the pain of the loss and often accepted the abuse instead of the loss.

In our last session in December, as Paul continued to press me to release the anger I felt, I became fully silent. I knew it was time to sever what was becoming more painful and abusive than helpful. It was time to face the pain of the loss. I emailed Paul and severed my ties with him.

Over the next 5 weeks I read Lang's book on psychoanalysis (a huge book that is force fed to psych students) to try to obtain some understanding of what had happened. As I read I found over and over Lang's reference to resistances of the client and the importance of finding their source.

My resistances had been enormous and Paul's seeking them non-existent. With a little help from my old and faithful therapist, Dan, I unraveled the issue and my transference. I still do not understand how Paul could have missed this.
I despise manipulation, and that hatred formed largely in my relationship with Bob, my first abuser. Paul, unknowingly, tapped into that dynamic. Subconsciously, the more Paul manipulated me to express the anger, the more I dug in my heels. Since the whole issue was subconscious, I could only watch in disbelief as I seemed to be failing at therapy - something unheard of for me. As I realized how thick the transference had been, I began to feel some release as well as some real anger towards Paul's lack of help in the matter.

One instance with Bob, all those years ago, seemed to define it all. In anger I had charged at him, only to be forced face down in the dirt over and over. Subconsciously, I refused to verbally charge at Paul. I had sworn no one would ever have the chance to humiliate me in such a way. I would never give someone that control over me that I gave Bob when I lost my self control and released the anger.
Two weeks ago, I went in to face Paul. While I hoped he would quietly listen and own up to some of his own mistakes and maybe even feel some pain for the humiliated 17 year old, I met a completely different reality. For the first 10 minutes we argued heatedly over my focusing again on him. Since I was past the resistance from the work I had done during the 5 weeks that had passed, I was able to do what Paul had tried to get me to do for months. I stood up to him and forced him to listen to me. At one point I told him he was an idiot! It was not pleasant but I stood my ground well. He finally heard me explain the transference and allowed me to express my frustration in his lack of seeking out the resistance. He refused to apologize with the reason being that was not what happened in therapy - we were not friends and the therapeutic relationship works on a different model - at least his does. I have no doubt had it been Dan, the apology would have come without any big deal and we would have moved on.
I left with Paul's pronouncements that I would never get better if someone gave me the comfort I wanted. Oddly, I got home to two of the most comforting emails I could have received, from two other therapists. They did not seem to agree with his view. One of those therapists is the pastoral counselor I tried to get in to see prior to seeing Paul. He actually refered me to Paul. Stephen read the letter I carried to the session with Paul, just in case I found myself blocked again from speaking my thoughts. Stephen's response was that my letter was a tremendous gift to Paul. My response to Stephen was that Paul didn't see it that way.

Stephen invited me to come and sit down with him when I was ready. He would commit a limited number of sessions to talking with me. I went yesterday. Interestingly one of his comments referred to my blog. He sees my writing here as exposing myself needlessly and possibly causing myself harm. I have not been aware of any hurt but I am giving it some serious thought.

I get few responses via this site though I have readers that I know come here regularly. My intent from the beginning was to give others a chance to see inside of my heart and soul so they knew they were not alone. That was a major fear of mine as I began this journey of healing. I thought I was the only person on this earth who was so screwed up and who felt the confused emotions I felt.
The anonymity of the blog, with the exception of about 5 close friends, seems protective.

I am asking you to reply to me with your thoughts. Is what I share helpful? Do you feel less alone? Is there purpose in it?