Train Wreck

(or Next Stop: Purple Lake at Love Hall)

I started writing this post several weeks ago and then got distracted by life.  So much so that I had forgotten all about it.  So when I starting writing again and went to save my first draft, not surprisingly using the exact same document name as before, I was startled to get the pop-up warning “The file already exists.”  Really?  It does?  Clearly this is something that my psyche needs to set down.

There’s really no other way to describe it.  The past few months have been a spectacularly catastrophic train wreck.  I wish I could take credit for this adept analogy, but I didn’t come up with it.  Rather it was given to me by one of the therapists whom I consulted with at the beginning of the year.  Despite the multitude of red flags that went up before, during and after our meeting, she did leave me with this one nugget that I’ve turned over in my head many, many times.

My therapist’s life went careening off the rails last fall, and so much damage was left in the wake of that unforeseen disaster.  Every person connected to her was impacted.  The scene of the crash was quite horrific.  The train meant to safely ferry us from here to there, to a destination, was suddenly lying on its side, irrevocably damaged and unable to continue the journey.

Continue reading “Train Wreck”

The Plan

(or How to Call a Minga)

I have something I want to say to all the therapists out there, novice and experienced alike.  Perhaps this message will fall on deaf ears and go unheeded, much less unread.  But I still feel the need to put it out there, just in case someone is listening.

So here’s the thing: you have to have a plan.

I know it’s easier to think that you are the omnipotent being you undoubtedly project onto your clients. But I’m here to remind you that you are not.  And that while you may try to promise your clients (and probably yourself) that “you’re not going anywhere,” life happens and you need a plan for when it all goes careening off the rails.  You are not immune just because you are a therapist.  And I would argue that you have a responsibility, a moral and ethical imperative set higher than many other professions, because of the work that you choose to do.  If this seems like too much to reconcile, I would ask that you give serious thought to your current career path.

I’m not saying that this will be easy (it won’t) or pleasant (it won’t) but it must be done.  Make a plan.  Not a theoretical hypothetical plan.  An actual plan based on real-world scenarios.  What happens if you get sick?  What if the illness forces you to go on short-term disability?  Long-term disability?  What if you need to retire (for whatever reason)?  What if you burnout?  What if your kids get sick or your parents need care?  What happens if you die?  Immediately or after a long illness?

Then what?  You have to think about this.

Continue reading “The Plan”

Observation Room

(or If These Walls Could Talk…)

I wish I had the foresight to start my own photo profile of therapy offices.  But I had no idea on the day I first stepped into a therapist’s office, more than 14 years ago, that it would merely be the first in a long string of such offices.  Sometimes the actual therapy office plays just as an important role as the therapist.  Sometimes it is a treasure-trove of clues, sometimes it is a complete blank slate.  But whatever state it is, it is part of the therapy, and a part of each assessment I’ve made of potential therapists.  Sometimes it’s a conscious reaction to the environment, other times perhaps completely unconscious.  This is what I’ve noticed.

Continue reading “Observation Room”

First Impressions

(or I’m in Therapist Limbo)

Over the last few weeks I’ve been therapist shopping – never an easy or pleasant task.  Many of the therapists I’ve seen have no online presence at all – no website or Psychology Today profile, certainly not a blog or Twitter feed.  So I go into each appointment blind, not sure of what I am going to find, having to rely just on faith of the referrer who provided the name and contact details.  Suffice to say that connection has been elusive.  This is a hard enough task under normal circumstances, made even harder by my particular circumstances.

You see, I don’t even know if I want to be in therapy right now, as much as I might need it.  One therapist remarked to me that I have to find the will to be in therapy, that she couldn’t provide the will for the both of us.  Fair enough – but truthfully I don’t know that I have the will or energy to start this process over again.  I thought I had found the right therapist for me.  I didn’t think I would ever have to start back at the beginning.  I never thought I’d find myself sitting in strange offices across from complete strangers, re-telling my sad little tale.  I thought that part of the therapeutic journey was long behind me.

And although I always feared it, I never fully considered the possibility that my therapist (or I should say ex-therapist?), with whom I had connected and bonded and attached to, would become so ill as to not be able to work anymore or, worse, circumstances would so dramatically change as to preclude us from continuing our work together.

Continue reading “First Impressions”

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.

Continue reading “Lost”

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.

Continue reading “Manifesto”

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.

Continue reading “Impasse: A Tale in 3 Acts”

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.

Continue reading “Real”

Raw

(or In Session, with Cancer)

The long-awaited text had finally arrived.  “Can you do Tues at 1:00?”

The text had been sitting on my phone for more than two hours before I saw it.  I stared at it for several minutes, trying to make sense of what I was reading, trying to get my brain to take in what this really meant.  I checked my calendar, then responded “Sure.”  It was the only answer I could give that captured my mixed-up feelings of anticipation and dread.  I wasn’t feeling a “yes” or “absolutely” or “I’ll be there.”  I definitely wasn’t feeling anything punctuated with an exclamation point.

I had been waiting for weeks for this moment to occur.  Of course I would be happy and relieved to see my therapist, but I was also feeling anxious and sad and scared and overwhelmed.  I hate it that our relationship has to be confined to the four walls of her office.  And that the only way I get to make physical contact with her is in that space.

About 30 minutes before I needed to leave for my session, a headache emerged.  My entire head hurt, as if some invisible and unrelenting force was pushing down squarely on the top of my head, but also down the back near my neck and towards my forehead.  I probably should have taken something before I left my office,  but I was hoping it would pass.  On the subway ride downtown, the pain intensified, my head hurting more with each jerk of the train.  By the time I arrived, I was in full-on headache mode.  Not the best way to arrive at a long over-due therapy session.

Continue reading “Raw”

Left Behind

(with Unfinished Business)

It’s been 15 days (and counting) since I last saw my therapist.  The last time I saw her I was still functioning under the illusion that she and her doctors were working, slowly, methodically, through a long diagnostic process.  Initial signs, along with a family history, pointed to MS, but in order to diagnose, they had to work down the MS rule out list.  There was a long list of possibilities to test for and that would take time to get through.  I did not sense any urgency.  It seemed sensible to remain calm and carry on with these rule-out tests.  Cancer was in the mix, and mentioned, along with the caveat that it seemed unlikely.  At one point, less than a month ago, there was even talk of just needing back surgery, with a mere 10 days to recuperate.

So I wasn’t worried.  And I wasn’t prepared when the very next day, the cancer diagnosis was made.  I had no time to prepare.  I didn’t know we’d be heading into a long, traumatic break.  When she took a 3-week break last spring, we had time to prepare and plan and find ways to explicitly stay connected.  This time, the bottom just fell out.

Continue reading “Left Behind”