I wrote this after therapy today:
“I feel so shit after therapy and fucking angry at her for how she approached our session.
Just before our session I received an email from [my old therapist who I worked with in treatment in Boston]. The email triggered my ‘attachment’-based sensitivity on an emotional, mental and physiological level: I felt angry, upset, confused, happy, sad, nostalgic, shaky, you name it…
So, I planned to speak to my therapist about it immediately because I felt paralysed within the ‘Emotion Mind’ state I was in.
As I sat down at the start of my session, my therapist asked what I wanted to put on the agenda for the day and so I told her I wanted to speak about the email. She asked to see my Diary Card and noted that my food had been a bit off key recently, and claimed that we needed to add that to the agenda too. I said I didn’t feel I would be very effective in talking about eating-disorder-related issues due to the fact that I felt so stuck in Emotion Mind and couldn’t think straight on much else. I said that it would be helpful for me to process why I felt so knocked by the email, and what was going on for me in that instant internally instead.
However, she said that according to the DBT hierarchy in which target behaviours are approached in therapy, we needed to start by addressing the behavioural aspects, i.e. my recent food difficulties, first.
Even though I was struggling so much to stay present – and despite feeling many many emotions in (direct and indirect) response to the email and subsequent ache of Boston-related nostalgia I was experiencing – she pretty much refused to let me talk to her about it.
I know it’s a DBT ‘rule’ but it felt incredibly invalidating and somehow spiteful – like she was doing it on purpose and was trying to provoke me. Maybe this is my paranoia, but even so, I didn’t feel it was the most effective approach she could have taken considering how non-responsive I was.
I was so anxious and angry throughout the remainder of the session and felt pretty vacant and disconnected from both my therapist and the content we were talking about. I was lower than I’ve ever been in therapy with her and rather tearful (because when I’m angry I tend to hold it in until I get so upset and blocked up that I cry). Ultimately, I felt unseen and unheard by her – two things one should never be ‘made’ to feel by their therapist. All I wanted to do was explore the feelings and cognitions that had arisen for me in response to the email, and I really don’t feel as though that was too much to ask. Especially considering it would be a very appropriate thing to talk about in a bloody THERAPY session with a THERAPIST who specializes in BPD, including attachment, rejection, and pretty much everything I was struggling with in that moment.
I rarely feel able to express my anger in the moments I am feeling it, and it usually comes out sideways like it did today through my refusal to engage effectively in our session and the many ‘I don’t know’s and ‘Mmhmm’s I graced her with. However I am going to tell her later how angry I feel about how our session panned out, and explain why, and see what she has to say about it all. I feel like it is so obvious that she probably knows anyway, and if she doesn’t, well… she really should.”
Around 8 hours later, and having calmed down, I called my therapist to explain to her what had been going on for me during our session.
This is what I wrote to my friend when explaining how WELL the honest phone conversation went, and how effective it was for me:
“Well I tried to very quickly tell her that a) I had been feeling angry earlier and b) why I had been feeling that way – because I knew if I lingered or paused I would never muster the strength to be able to say it!
She explained that she knew I was getting increasingly frustrated through observing my body language, physical anxiety, lack of eye-contact and overall tension. She explained her rationale behind not engaging in the process of exploring the email from W which in my Emotion Mind state I was so desperate to wallow in and fixate on. She explained that if she had ‘given in’ to my Emotion Mind cravings it wouldn’t have been effective of her as a DBT therapist.
She told me that she wants to encourage me in general to take responsibility to communicate to her when I’m feeling angry, that it’s not her job to draw it out of me – and that if she did she would only be enabling the less able less empowered parts of me. She said that instead she wanted to give me the chance to take ownership and responsibility for both my feelings and the act of expressing them to her, and that she was waiting to hear about my anger from me and not the other way around.
Because she was really validating on the phone I felt a lot better and actually empowered by the end, especially because it’s rare for me to be able to Directly Communicate so effectively! And especially so with anger!
Also I explained the “winning or losing” cognitive distortion I have – that basically I feel weak and like I’ve “lost” the imaginary battle if I admit I’m angry with someone, and that then the other person “wins” and I spiral into a place of shame and self-judgement. Whereas what I did today in my session was the opposite: I played the ‘if I don’t let it impact me and act blasé or non responsive externally, then I don’t have to feel vulnerable’ card. Emotionally this enabled me to checkout, disengage, and be like “Well fuck you then I’m outta here!”
I even explained that I was waiting for her to acknowledge/ realise what was going on for me – that I was testing her, because I wanted her to SEE me without me having to put it out there myself, which we agreed was basically me setting her up to fail. She wasn’t prepared to enable that within me or turn herself into my ‘rescuer’, which I actually understand and appreciate in hindsight. Ultimately, she explained that her job isn’t to make me feel better but to enable ME to help MYSELF feel better.”
I really valued the conversation we had and surprise surprise – I don’t hate her any more! In fact I am really quite pleased with the outcome of our chat, and was beaming with love for her when we hung up after the phone call in the evening.