What I hear vs What is said: Communication in therapy.

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I’ve been in therapy with my therapist a good long while now; in fact it’s been six years since I first wandered into the rather cold and depressingly decorated consulting room in my local NHS Mental Health Hospital (after a three year wait no less!) to begin a year of psychodynamic psychotherapy…at least I think that’s what we were doing!

Picture a small room with a tiny window at one end, two not particularly comfortable brown chairs (the kind where the back isn’t high enough to lean back comfortably and the sides are so tight that you are forced to keep your feet on the floor – no curling legs up underneath yourself!), a fluorescent strip light in the ceiling a la Girl Interrupted, woodchip wallpaper and durable office-style carpet (again brown) and you’d be in the room.

It was a consulting room like many others in the NHS I guess, nothing homely or that in any way reflects the therapist that works inside it – because many therapists use the room. It was as blank a space as the blank screen that my therapist was to me at that time. I’m not really moaning, though. I will always look back fondly on my Wednesdays in that cold little room in the grey stone building because it was there that I met my  therapist by complete chance.

I could’ve been allocated to anyone in the Psychotherapy Department as a space became available on their caseload but somehow fate decided that she would be my therapist and I am so glad it was her because when I had had a couple of assessment sessions in order to go on the waiting list I hadn’t warmed to the therapist AT ALL. I really didn’t like her and dreaded the thought of having to possibly work with her.

The moment I met my therapist I liked her. In fact looking back over my diary after the first session I wrote ‘Uh oh, I really like this one. She seems really nice’… ha!…wakey wakey attachment issues I knew nothing about at that point!!

Little did I know when we met back in 2012 that (after a too lengthy break – damn Cancer!) I’d now be seeing her privately in her home, in her very lovely consulting room by the sea. It’s a medium sized room but feels homely, with neutral – but not bland- soft furnishings, cream carpet (she must be mad!), a pale blue leather sofa and her IKEA therapist chair (you know the one!), chunky style natural/driftwood wooden furniture, several completely filled bookcases (and not just therapy books), art work and a wooden Buddha watching over proceedings. It’s lovely.

It’s amazing how a nice environment can help make things feel more relaxed. Ok, perhaps ‘relaxed’ isn’t the right word here but I do find that the familiar environment is a place I (mostly!) look forward to spending time each week; it’s a little oasis of calm where I can bring my storm and try and get settled and grounded before venturing back out into the real world. Of course that space, just like the little room in the hospital, would be nothing without the person that sits opposite me from week to week trying to help me navigate my way through my almighty mess.

Yes. I can see how this is getting a bit gushing…but that’s because tonight I am feeling nothing but love for my therapist. I would not, however, have been writing in this way on Wednesday about the therapeutic relationship! I haven’t seen her or communicated with her since our session on Monday and yet how I feel about her, and where the therapy is going, is a world apart from earlier on in the week when I was hurt and raging and devastated and considering terminating… and that is why I have chosen to write this particular post about what I hear in therapy sessions.

I trust my therapist (well the adult part of me does), and for the most part our in session communication goes ok – good even. Of course sometimes she says things that immediately hit a nerve or piss me off, but more often than not sessions go fine. I can see and feel that she is making an effort with me – and frankly I am not easy to work with. My window (letterbox!) of tolerance is minute and I can swing into a dissociation with no warning whatsoever. All through that she is with me and as steady and patient as a….what? Can’t think of a decent simile. She is patient!

Generally I leave therapy feeling ok and sometimes I feel very connected. And yet I keep stumbling over the same issue again and again and that is, as if by clockwork, the moment I leave the room and start driving home, things start to shift and morph into something else – something negative. What was a good session suddenly becomes terrible and I feel like she doesn’t care about me and before too long I’ve had enough of therapy, am angry and want to terminate.

I really feel for a couple of my friends who week-in week-out listen to me rant on about how ‘terrible everything is’ and how ‘I am done with this’ and how ‘unfair it all seems and why can’t she just give me what I need?’ and ‘why doesn’t she show me she cares?’ and they patiently coach me through my fluctuating emotions. It’s hard work being in my head on Tuesday and Wednesday and they must feel so bored by now!

The problem I, like so many of you, have is that is what my therapist says to me in session hits so many different trauma parts: Little Me, Four, Seven, Eleven, The Teen and not just my adult self. Communication, therefore, is really complicated between me and my therapist. She has frequently commented that it is hard to say something that is adequately soothing and talks to all the different parts of me. What the little ones need is very different to the teen and sometimes it is hard for her to know exactly who she should be talking to because I give very little away at times. And we all know that the littlest ones don’t really want to be talked to at all and nothing but physical holding will feel enough for them.

I can hide behind my adult self and she’d be none the wiser that the tiny two year old girl is crying inside. I actually think the coping adult front I bring to session is more damaging than when I shut down in a dissociated silence or the protector parts put things on lockdown. At least when I am like that she knows something is up and can try and connect to whatever part is having a hard time. When I (adult) go in, am articulate and talk about things (but not necessarily the things I really need to talk about) she has no clue that I am not telling her what I need to or that I will leave feeling uncontained and spiral in the week.

I am getting better at telling her how things feel but sometimes it doesn’t go well or sometimes, like last week, I leave what I really need to say to the last minute and we don’t have adequate time to discuss it and then I feel like I am left with loose ends and not quite clear communications. Ugh. Must do better at this.

I doubt you’ll be surprised to hear that I didn’t ask her to sit closer to me or tell her how much her moving closer to me the other week had impacted me – AAAARRRRGGGH! I can’t remember what we actually spoke about during the session, now! It was ‘stuff I needed to talk about’ but it wasn’t #1 on the list stuff that eats away at me!

With ten minutes to go I decided I needed to ask her about wtf was going on with the pebbles:

Why, when we came back from Christmas break, did you say that you felt like I was trying to script what you needed to say in the text messages and yet for such a long time you’ve been asking me what I want you to write on the pebbles? It doesn’t make any sense.’

I mean launching into a discussion about the text communications that caused the rupture and the failing effort at a transitional object with only ten minutes remaining wasn’t exactly a genius plan was it? The thing is, sometimes it takes me that long to build up the courage or feel safe enough to bring these things up – so in some ways it’s better with ten to go than not at all…

We talked a surprising amount and whilst she didn’t say anything explicitly hurtful or unempathic (adult knows this to be the case and can hear it on the recording that that’s not how she is EVER) once I had asked that question I felt a shift in myself. Adult may have appeared to be fronting the show but actually all of a sudden the most vulnerable traumatised parts switched their ears on and were listening intently to everything that was said, analysing every word and subtle nuance, projecting a narrative onto the conversation. Inside was a running monologue: ‘What is she saying? What does she really mean? Does she like me? Does she care? This feels rejecting. No she doesn’t like me. I hate that I need her and love her when she clearly feels nothing…’

I’m struggling to articulate clearly what I want here, but basically the moment I asked the question there was a part of me, if not several, that was automatically searching for confirmation of my deep held belief: she doesn’t care and no one loves me because there is something inherently wrong with me. To be honest no matter what she had have said I doubt I would have heard anything vaguely positive because I am so conditioned to hearing this negative narrative – even when it is nowhere near the case.

My therapist said that she often feels that whilst a part of me wants to be told affirming things and to be loved there is another part that is absolutely terrified of that and wants to run away from it or rubbish and reject it as not being genuine.

Every time she says that it drives me mad inside. Whilst she is right (I recognise this more and more now) it feels really rejecting to the part that does want the affirmation and clear displays of love and care. It feels like she is saying ‘you can’t handle what you want and so I won’t give it to you’. I feel like shouting at her ‘I’m not going to die if you give me more warmth or clear demonstrations of care and maybe if you do it enough I’ll stop doubting you and attacking myself for needing you and convincing myself that you clearly don’t care about me’.

It feels really like a Catch 22 situation. I feel like I need her to be more demonstrative in how she feels towards me and yet she feels like it would send me over the edge if she did. It sends me over the edge as things are so what’s the answer?

We left it that we would work more actively with the pebbles especially as there is the Easter therapy break coming up shortly – nooooooooooo!!!!!!! And so that is a good thing, I guess. I am a bit reluctant about how it’s all going to go. It feels like something simple has become unnecessarily complicated. My therapist said she felt that perhaps I thought she had been too pedantic or pernickety about it but that she wanted it to feel right and genuine. I, of course, heard that as ‘I don’t want to write lies on the stones and therefore have not done it because I don’t want to say anything positive about this relationship when I don’t feel it’.

Anyway, yet again I have navigated my way through the emotional rollercoaster that is the week between sessions. It is Saturday night and I feel quite stable and content in the fact that my therapist is out there, cares about me, and that she will be there on Monday and we can talk – who knows I might tell her all the angst I’ve felt this week about the conversation we had and about the one we didn’t have (proximity).

It’s strange. I always feel quite motivated and able to take these things to session at this point in the week. Monday morning at 10:30….a whole other story!

Ugh!

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Author: rubberbandsandchewinggum

Mid-thirties. Mum of two. Procrastinator. Therapy and mental health blogger.

2 thoughts on “What I hear vs What is said: Communication in therapy.”

  1. This post was really interesting to me, because I definitely feel a similar way often. During session, things will be fine. For me, usually the highest point in my week is the drive home I make myself all sorts of promises for how I will change, but then I get home and the wind comes out of my sails. It’s like I just deflate and start obsessing over little things and start considering cancelling. I’ve never really considered that might be because a different part of me is reacting.

    All the aside, I think it’s great that you brought up what was clearly a difficult conversation, even with only ten minutes to go. At least you brought it up and now it’s out there! I think the therapy room is a great place for her to give you these affirmations and practice hearing how it feels. She can withhold all you want, but like you said it sends you over the edge either way. Why not try the opposite and safely process how it feels in the aftermath in a contained setting? Maybe I’m being idealistic, but this reminds me about what you said in one of your comments to be a few weeks ago about those well worn paths both of our brains take where we just go back to the negative narrative because it’s automatic and it’s what we trust. She could help you forge new paths by learning to hear and accept the positive.

    Ugh, these therapists and their tricky ways. Sometimes I think mine is so wise and other times I think she’s just withholding to be mean! I think that’s my little girl for sure, haha. I hope your session tomorrow goes well! Keep speaking up!

    Like

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