Lost

(or My Therapist Broke Up With Me Via Email)

After 263 sessions, it all ends with an email.

I guess I got my wish after all, my worst fears realized.  I also got the answer to my question: “Can a therapeutic alliance survive cancer?”  Apparently, no.

I think the fairest and most responsible thing I can do is entrust you into the hands of a therapist who has the capacity to supply an appropriate level of care for you. 

This is going to take too long, it’s simply not fair to you, and ultimately even if/when I do “come back” I won’t be able to give you the frequency or regularity of care you deserve. 

I know this email was written from a place of love, but it was actually quite a cruel message to have to read, and process, all alone.  There was a crassness in her tone, her usual supportive empathic voice missing (not necessarily in the above passages, but in the email as a whole).  In the end, it felt like a kindly worded “fuck off,” but a fuck-off nonetheless.

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Manifesto

(or Shout It From the Rooftops!)

I’ve been re-reading old writings and notes and emails, trying to retrace my path of the past few years.  I’m looking for patterns, for what has changed and what hasn’t.  I’m trying to see where I’ve moved forwards or backwards, where I’ve gone in concentric circles, where I’ve stayed in place or just gotten stuck.

In seeing a new temporary-therapist, I’ve had to recover familiar ground and revisit old injuries.  I’ve had to adjust my schedule, contort to fit into a new space, negotiate a fee.  And I’ve had to contend with a whole host of new feelings – ones of loss and rejection and minimization – that caught me off guard.

I’ve had to let this other person into a space that used to only be occupied by me and my therapist.  I’ve had to tell her about our relationship and things that worked well and things that didn’t.  I had to rehash the Impasse, which has always felt like a dark cloud that continued to lurk over me, occasionally unleashing a torrent of anger and rage when I least suspected it.

One of the ways we found our way out of that impasse (although we still sometimes go back in) was by writing a Manifesto.

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Impasse: A Tale in 3 Acts

(or When an Unstoppable Force Meets an Immovable Object)

Prologue: At the heart of every good therapeutic alliance there is an impasse – some insurmountable challenge that must be negotiated between client and therapist before the real work begins.  I know, from my own experience, that being in the depths of an impasse is intolerable.  It takes all the courage and energy you can summon to engage in the battle, to fight the good fight.  I share these stories because it helped me to know how others in my own therapeutic lineage tackled these ruptures, and because I hope my own impasse story gives others hope that there is a way through.  It’s messy and terrifying and may never be fully resolved, but it doesn’t have to spell the end.  It is, in fact, often just the beginning.

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Real

(or Questioning Everything I Once Held to Be True About the Therapeutic Alliance)

“What is REAL?” asked the Rabbit one day, when they were lying side by side near the nursery fender, before Nana came to tidy the room. “Does it mean having things that buzz inside you and a stick-out-handle?”

“Real isn’t how you are made,” said the Skin Horse. “It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real.”

“Does it hurt?” asked the Rabbit.

“Sometimes,” said the Skin Horse, for he was always truthful.

~ Margery Williams, The Velveteen Rabbit

There have been several occasions when I have had to remind my therapist that therapy isn’t real.  She always takes offense at my insistence that therapy is actually an alternate, concocted, manufactured universe that doesn’t even come close to approximating reality.  If all the people in my life were as compassionate and empathic and understanding and able to listen and willing to negotiate and able to engage in conflict and open to change, not to mention be completely focused on me, as my therapist is, then I wouldn’t have a need for therapy!

I know that therapy is meant to be a petri-dish, where you get to test and experiment and fail in safety with a dedicated guide and cheerleader right there by your side.  It’s a chance for a dress-rehearsal, to try things out before you have to do something out there, in the real world.  But it is an artificial construct, with carefully appointed boundaries and roles and responsibilities.  The real world doesn’t work in the same way.  I wish it did, but sadly, it doesn’t.

I also know that what my therapist is really reacting to is my suggestion that the relationship between us isn’t real.  She will counter that the relationship we have is indeed very real, and intimate and loving and supportive and everything you’d hope to find in another person you can relate to.

Sometimes in the past I had allowed myself to believe this, to be pulled into the notion that what we had between us was more than a business transaction.

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