Termination, Alarms & Gut Instinct – Coping With Disappointment In Therapy

A friend of mine emailed me the other day following a discussion we had had on trusting your gut instinct and what to do when, in therapy, things seem to have reached an impasse, how to know when it is time to call it quits. In the interest of anonymity, I won’t go into detail, but below I’ve reworked some of the thoughts that popped into my head when responding to that email.

Firstly, as always, only the person who is actually in therapy can really make the decision as to when the time is right to move on from therapy (or a specific therapist). To throw a Rogerian thought into the works; each person is the expert on themselves.

That said, going through difficult phases is pretty common in any relationship, and in a therapeutic relationship it’s simply bound to happen. It’s a very special relationship in many ways, one of those ways being that it is a relationship which is constantly scrutinised in the extreme. Therefore it’s natural that difficulties arise.

Have I ever experienced this in my relationship with A.? Absolutely. I see A. twice weekly and talk about really difficult (and sometimes not so difficult) things, and there have absolutely been times when I’ve felt she’s fallen short of what I was hoping for. And it never feels good. It’s aggravating and frustrating – and hopelessly unavoidable.

What I try to keep in mind, however, is that my reaction is a combination of a real genuine disappointment in what I feel she is failing to supply me, and an echo of a deeply buried longing for something which neither she, nor any other therapist, can do; make up for the short-comings of my parents. I know this, but – of course – I still feel let down and disappointed. Sometimes to the point of just wanting to throw the towel in.

But I don’t. Instead, through carrying on talking to her, exploring these emotions, we somehow get through to the other side. No, it doesn’t change the reality of her not meeting my hopes, but it does teach me that not having that ‘want’ met does not mean we can’t work together. That in fact that frustration of ‘not having’ is something I have the strength to cope with. It doesn’t have to floor me, doesn’t have to be the end of everything.

Also, when there are deep underlying trust issues, which there certainly are in my case, it may take many many rounds of experiencing ‘therapist let-down’ for one to be able to accept that this frustration is actually manageable. I’m certainly not there yet. I’m still hitting that same wall at regular and often predictable intervals.

I guess another thing is that when things get difficult in the therapeutic relationship, the relationship feels fragile in exactly the same way it did Back Then with our parents (or carers, or ex-partners), and so it makes sense to respond by feeling “Hey, I better get away from this before it breaks, before my worst fears are realised” because we naturally do not want to re-experience what we went through as children. We don’t want to get anywhere near risking such a re-affirmation taking place. So we panic and get ready to bail.

But, the truth is that walking away before the end of the movie means we also forgo the chance of seeing that this movie may actually have a different ending.

So, while I am pretty prone to tell people to “Trust your instinct” I think it’s also important to look at where that instinct comes from.

Why?

Well, you know when you meet a person or enter into a situation and those warning lights start flashing like mad? Well, they’re called warning lights for a reason; it’s a system that’s there to warn you. And still, it’s also important to recognise that sometimes those lights go off by mistake, because they’ve been set to Super Sensitive based on previous experience. It’s a bit like your car alarm going off at 3 am, because a cat jumped on the bonnet.

The trick (and, incidentally, also the tricky bit) is learning to differentiate between the cat and the burglar; the incorrectly calibrated alarm and the real deal.

Luckily most of us have enough self-awareness to know when the danger is real and when it’s a false alarm, and so we question our reaction before we go out all guns blazing and shoot the poor cat. (Disclaimer: I am in no way advocating the shooting of burglars).

So, while listening to our inner alarm, our gut instinct, is a great tool – we need to remain aware that it has been set up by our previous experience – installed by Inner Child Mechanics – and so, valuable as this alarm is – there is also room for systems failure.

Therefore, in therapy, it is often helpful to stay on until the end of the journey. And, in my experience, the middle of a “period of disappointment” is usually not it.

Finally, if you do decide that terminating therapy IS the right way to go, (because, clearly sometimes that is the case) why not take the opportunity to make it a GOOD ending, in contrast to the bad ones you may have experienced previously in your life? Work slowly towards that ending rather than just quickly cutting off. Long goodbyes are hard, but they’re also full of potential.

I don’t know if any of this makes sense or is in any way helpful to those of you who are still reading this ridiculously drawn-out entry.

But even if I too may disappoint, in my reasoning, or in any other way – maybe it’s another step towards realising that relationships are still worthwhile.

Sometimes as human beings we let each other down. This is reality.
But reality is also that sometimes, every once in a blue moon, if we stick with it, we’ll also come through for one another.

And that has tremendous healing power.

I hope you have a lovely day.

Be good to yourselves,

xx

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Disappointment & Rejection – An Entry About Coping With Negative Experiences

I didn’t have counselling last week as D. was away. It’s been ok, anyway, but it is nice to know that you have that set time that is there just for you to vent whatever you need to vent.

Not only was there no counselling last week, but Dev has been away, also, and is not returning until late on Friday.

So, I’ve been on my own. Which is always a bit of a worry. Not so much because I don’t like being on my own, I actually do, but, well, leaving me on my own with my thoughts for too long can sometimes lead to me getting stuck in a thought pattern which isn’t necessarily healthy for me. I’d say that I have been able to take quite a big step away from becoming directly destructive, but I still, on occasion, end up allowing my thoughts to roam a little too freely. While I was at the women’s crisis centre earlier this year I learned various different distraction techniques, and have become pretty good at using them as my coping strategy when I feel myself slipping. And yet, being on my own – I think it’s a good idea to be aware that I am still recovering from a very severe depression.

The week has actually gone quite well. I’m back to working, which is incredibly exciting, and at the same time very very tiring. It’s amazing how unfit you become, workwise, from being off work for six months. I get home from work and I’m absolutely knackered. Usually I’ll just make myself something nice and easy to eat and stumble into bed, somtimes being able to read for about an hour before falling asleep, but more often not. In fact, yesterday, when I started doing a load of laundry after work, I found myself struggling to stay awake until the cycle had finished. Luckily my friend Bobbi gave me a ring, so she kept me awake, and then I managed to squeeze in another quick call with a friend from back home before dozing off.

Now, I said that the week has gone well, and in general that’s pretty accurate. Having said that, I did have a pretty big downer on Monday. As I’ve told you I had my assessment for psychotherapy a couple of weeks ago. Well, on Monday I was asked to come down to my local community care centre, to meet with S., my care co-ordinator, and Dr J., who I did the assessment with.

Said and done. Come eleven o’clock I rushed from work to make it in time to the meeting at eleven thirty. S. greeted me in the waiting area and lead me to a tiny and very hot room. Dr J. was already there as was some psychiatrist or other from the community care centre. Unlike the last time we met, Dr. J was the one who first spoke. She made a bit of waltzing around before telling me that they had – after careful consideration – reached the conclusion that at this point in time psychotherapy would not be right for me. That, looking at my history, I’m simply too high risk to be put through it. Basically, they felt that therapy might stir up emotions in me that I haven’t got the means to handle.

So, I said exactly what I felt – that it was a huge disappointment and that it felt incredibly unfair that I was being denied the help that I genuinely feel is right for me, and that I can’t prove to them that I am able to handle it, since I won’t be given that opportunity. I also pointed out that I have completely stopped self-harming and that I’m only on a very low dose of anti-depressants, compared to earlier in the year when I was impulsively hurting myself and was taking a very high dose of an SSRI.

Naturally I knew that this would by no means sway the decision that had been made, but I felt it was important to make it clear that I disagreed with it, and that I feel that psychotherapy would be more helpful than harmful to me.

In the meeting it also emerged that Dr J. had not actually talked to D. before making her decision. This feels especially unfair since S. has only been my care co-ordinator for a very short time and we’ve only met three times, and D. actually knows me a lot better, and has also seen for herself how I manage both my counselling and the week between the sessions.

Needless to say I left the meeting feeling pretty downbeat.
I was meant to return to work, but decided in the end that I was too upset and needed time to take this all in.

I went home feeling very tearful and bundled myself into bed, where I reached for the phone and called up the Samaritans’ helpline. I got to talk to this really lovely woman who encouraged me to keep calling back throughout the day and evening to make sure I didn’t lapse too far into my thoughts.

Next I called S. They had said, as the meeting ended, that they’d want to keep in close contact with me to make sure I was able to cope with the disappointment. She told me to come on over to the community care centre again so we could talk face to face.

So, I did. And it was pretty good. I still felt rather low, but it helped to at least be able to talk about how I felt.

I should probably point out here that all of this in itself is pretty solid proof that I’m moving in the right direction. Had this happened earlier in my life, I would without a doubt have felt suicidal, and instead of calling the Samaritans I’d likely have got my razorblades out. And there is absolutely no way that I’d have picked up the phone to S.

Also, I would have shut down emotionally. I would not have allowed myself to stay in the moment for long enough to even identify all the things I was feeling, whereas now I was able to tell S. exactly how I was feeling and pinpoint that it was without doubt the feeling of being rejected that I struggled the most with.

I made it through the rest of the day and evening by calling a number of different helplines and talking to my sister. I never felt that I was in any real danger of becoming physically or mentally destructive, but I did make a conscious decision to not hold back on the way I was feeling, but explore it and express it as best I could and to be aware of any drastic changes in the intensity of my emotions.

And when morning came round I was ready to go to work.

This is not to say that I’m not still very disappointed – I most definitely am – but at the same time I want to make sure that I properly acknowledge the fact that I found a way to manage this let down that was positive and will hopefully eventually prove to the powers that be that I am capable of controlling my negative impulses.

I’m not sure what will happen next, and that does worry me. A lot. A few of my friends have suggested that I go to a private therapist, but in all fairness, I think that looking at my papers they would also make the decision that I’m too high-risk and would likely be unwilling to take me on.

Unless you actually know me you probably wouldn’t be able to see how far I’ve come and how radically my view on life has changed. Looking at the papers it will probably look like We’ve been here before – she says she’s better and then she crashes.I guess I can’t really blame them for thinking that, but it’s enormously frustrating to feel so ready to start working on my issues and at the same time be denied a safe place to do it.

I think that is the main problem for me at the moment; I feel ready to talk about my experiences – I can feel it wanting to bubble out of me – but I have nowhere to put it all..

Still, at least I have learned something from all of this:
I’ve come damn far from where I started out!

xx