(or 2,700 seconds)
The therapeutic frame. That pillar of the therapeutic relationship draconically enforced by authoritarian therapists and equally loathed by clients everywhere. Or so I thought.
frame (noun, frām) – the setting of boundaries or ground rules for the contractual aspects of therapy. 
The therapeutic frame governs the rules and expectations of therapy: time, place, fee, confidentiality, contact. It is a crucial element for the creation of safety, for both client and therapist.
I spent 4 years in therapy where the frame was decidedly gray. I’ve spent much of the last 9 months having to re-learn how to be in a healthy, boundaried therapeutic relationship. All that time, before, I thought I was fighting against boundaries. Now I see that I was actually reacting to a distinct lack of boundaries. Just as children do better with well-defined boundaries and expectations, so do therapy clients.
The first thing I had to re-learn was the exact length of 45 minutes. My ex-therapist was terrible with time. I mean really truly terrible. She was always running late, which meant that I never actually knew when my session would start. Maybe it would be 5 minutes late or 10 or more. And since I didn’t know when we would start, I never really knew when the session would end either. And then the ex-therapist was so unboundaried with her time that she would routinely let me go over by 5 or 10 or even sometimes 30 minutes or more! I used to interpret this extra time as a sign that she cared about me or that I was special or being pleasing or a “good” client and therefore rewarded with more time together. I would make sure to leave my calendar open for ample time after a scheduled session so that it was never me who had to end an appointment because I needed to get back to the office.
I think about it now and how absurd it was – having to block off nearly 2 hours for what was supposed to be a 45 minute appointment! I see now that the lack of a defined start and end time only contributed to a sense of anxiety and unease, which perpetually kept me on edge. I never knew what to expect week to week.
Now, I know exactly when the office door will open and also exactly when the session will be over. It is 45 minutes each and every week. I don’t have to hold any “buffer” room on my calendar. I know when I have to leave work and when I will return. I think once we “ran over” and went 47 minutes and that felt like such a violation of the therapeutic order!
And while it is much easier to manage my own calendar this way, what helps the most is that I know exactly how much time I get each week. 45 minutes and not a minute more. I know how to pace myself and my narrative in this time. I know how to use it effectively, when to elaborate and embellish a story with details and when to cut to the chase. I know how to give myself time to settle in, but not hold on to what I really need to say. I know not to bring things up too close to the end of a session, thereby leaving me feeling exposed. I know all of this because I know when it will end.
I’ve learned that I can actually make very effective use of 45 minutes. I know how to come in ready to talk, having already thought hard and on my own about what I need and want to say that day. I can even fit everything that happened in the entire month of August – yes, a 42 day break – into a single 45 minute session. Who would have thought?!?
Sometimes we even end a few minutes early and, having felt like I said what I needed to say, I simply leave, and I don’t feel the least bit dismissed or tossed out or short changed. And when a session does come to an end, I get up and walk out. Maybe I need to stop by the bathroom and splash some water on my face, but I never linger more than a few minutes. Whereas before I would need extra time to fall apart and pull myself together, before venturing back out into the world. I knew that it wasn’t “normal” to leave therapy feeling this way, and yet I couldn’t find my way out either.
I used to email the ex-therapist all the time between sessions. Probably way too much. And in some ways I see now that she almost encouraged it. Or at least she never discouraged it. She never told me to stop or asked me to email her less frequently. With the new therapist, there is almost no emailing. She’s not on social media and has only a tiny online footprint. I don’t think she even has a smartphone. And it is liberating. I have no desire to email her between sessions, I don’t spend any time between sessions thinking about her. Sure I think about what I might want to tell her, but I don’t obsess about her. I don’t wonder about what she’s doing or if she’s thinking of me, probably because I know she’s not and that’s just fine. The only time I do email is if I am not able to make a session and want to try to reschedule. She has yet to cancel or reschedule, apart from one planned vacation, so she has never had a reason to email me.
I find that I am much less anxious about therapy when there is no contact between sessions. I know exactly how long until the next session, and yet I don’t find myself doing a mental countdown to the next session, as I used to. I guess I’ve just learned where in my week therapy will fall, and I know it will be there as long as I don’t cancel or have a conflict. I know where it fits into my schedule, my world, my weekly ebb and flow.
The time spent in session is all mine. Surprisingly, I can talk freely and fill the space with my own stories and words. I sometimes have to pause to collect my emotions and find the right words, but the ideas never get stuck in my throat the way they once did. My therapist rarely talks, and when she does it is never about her. She has never once told me a story or shared an anecdote. She is a complete mystery to me. She will answer very direct questions, but only after interrogating me as to my motives for asking in the first place. Mostly she just listens and when she speaks, she does so as a way to validate my feelings and perceptions. I noticed that the first time I met her that we use the same adjectives. She will often say the exact word I am thinking, and it’s how I know that she gets my emotional world. It’s one of the things that I most like about her.
I’m sure that some of this newfound sense of ease in therapy has to do with the simple fact that I will allow myself to be connected to this new therapist, but I will not let myself become attached. I now know that there is a profound difference. That being said, I don’t know that I tell her all that much or let her in very far. But I do know that she needs nothing from me beyond her fee. I pay her and in exchange she offers me a safe space to come once a week and set down my thoughts before a compassionate listener. I don’t see her as a guide or a role model or a longed-for mother figure or the best therapist ever. She’s just someone who can listen. Maybe that’s all I need right now.
I recently re-read some of the emails between me and the ex-therapist that we sent last year, particularly in the space of time between her sabbatical in the spring and her diagnosis in the fall. And it made me cringe because I didn’t recognize myself. The person who wrote those emails is not who I am. I sometimes have an impulse to just delete all of the emails we ever exchanged because the words only fill me with shame and regret. But maybe I need to hang on to them for my own evidence, or until I can make sense of it all. Maybe once I understand the larger narrative and how it fits into my life, I will be able to release those words and let the anger go. And I also try to have some compassion for myself. A very young part of myself was caught in a power dynamic that kept me held hostage by fear and false promises. It turns out that the muddled “boundaries” were just a way to keep me infantilized, small, needy. Instead of being a safety net, they became a trap.
I was a passenger on a high-speed, out-of-control train but I didn’t notice it until it crashed. The journey was too exhilarating, I was too caught up in the ride to notice what I was sacrificing. I have many regrets and have spent a lot of time contemplating the events that transpired. What drew me into this relationship in the first place? Why could I not see the warning signs? Or when I did see signs, why could I not heed them and instead look the other way? Why was it so easy to reconstruct a narrative to fit the relationship? Why couldn’t I see the truth within? Why couldn’t I extricate myself? Why couldn’t I leave of my own accord?
In many ways I am grateful that the train crashed and that I was finally extracted from this relationship, released from some kind of therapeutic Imperius Curse. I wish I had not gotten on the train to begin with, and I am relieved to no longer be a passenger.
What I’ve come to realize is this: my ex-therapist needed me as much as she made me think I needed her. There was a weird co-dependency in our relationship, an enmeshing of our psyches, that was neither healthy nor helpful. I would often tell her that it felt like she was talking to a younger version of herself. There was something in her own past that she was trying to correct through me. Whenever I would mention this sensation, she would never confirm nor deny, but she was clearly not interested in exploring this further. It might have been the only topic where she just would not engage. For a long time, I took her silence to mean that my intuition was way off. But now, looking back, I think I was spot on.
I also always had the sensation that the ex-therapist was going to leave me, despite her promise that: “My door will always be open. Always. As long as I have a door.” I’m sure that if it wasn’t cancer, then something else would have given her cause to end our relationship. In the absence of a well-defined frame, there was nothing to prevent me from becoming “too much.”
In my last contact with the ex-therapist, she said this:
My best comfort is that I do trust that we worked together well and deeply and that we walked together as long as we could, and perhaps even exactly as long as would have been beneficial. I trust that our work started and stopped as it did for a reason- and mostly I have faith in you that you will ultimately be able to use all of it, positive and painful, in service of your growth and healing.
I find this sentiment to be almost callous and to absolve her of any irresponsibility for the ways that I experienced therapy with her and the rupture that followed. I’ve actually stopped trying to salvage anything from our work together because I’ve come to the realization that she probably got more from me than I did from her. And I can’t shake the feeling of being used and discarded. The only thing I hope to take from this experience is an awareness of how I fell into this relationship in the first place, in the hope that I don’t repeat that mistake again in this lifetime. It’s not that I am trying to destroy everything that I had or experienced with the ex-therapist, but I am trying to see it all through a clearer lens.
A reader shared this prediction with me: “Maybe your ex will write to you in five or so months and sort-of, kind-of, not really, but a little bit, in an offhanded way, say she’s sorry.” But really, I need to give up my hope and need for a genuine apology. The ex-therapist doesn’t think she did anything wrong and won’t take any responsibility for how she has hurt me, and others too.
Boundaries, glorious boundaries. We start on time and end on time, 45 minutes later. There is no contact between sessions, no emailing. There are no blogs or tweets to read or social media clues to decipher. I know nothing of her life, so I don’t spend any time wondering about her. I’m not worried about being “too much” or some future catastrophic ending. I let her in just enough, but am also steadfastly guarded of my heart. I spend all 2,700 seconds of each session talking about me. I’ve reclaimed by voice. I’ve taken back my autonomy.
 Langs, R. J. Ground Rules in Psychotherapy and Counselling, Karnac Books, London 1998.