A lot of this from my own personal experience of a number of therapeutic environments from the sublime to the ridiculous. My personal (least) favourite as some will know was the therapist with two cheap plastic office chairs in a stiflingly hot room with no curtains above a busy high street. Needless to say, two sessions and I was out of there.

So why is it not a given that the physical therapeutic environment must be as comfortable as the emotional one?

It is of course a given that human beings like to feel safe and comfortable. This is why the majority of us spend time and money making our homes comfortable with decoration, art, books - whatever makes us happy and feel safe. So why should this be any different in the therapist's room, especially when we are deliberately putting ourselves into an intrinsically uncomfortable position?

Ok, we cannot choose the decor, nor would we expect to, but I know from personal experience that sometimes the physical environment of the therapy room is the last thing therapists think of and unfortunately can end up being a deal-breaker in the relationship.

It is a question of our basic needs - enter Mr Maslow and his very clever hierarchy.

We can clearly see that physical comfort is central to human psychological motivation so why is it overlooked so often in therapy?

Most of the emphasis in psychotherapeutic training is on the interpersonal relationship and the words exchanged. This makes sense given that, assuming the physical environment and chemistry between client and therapist is conducive, the majority of the work will be verbal. However I can't help but feel that sometimes this initial (and to me) obvious need is overlooked.

Nor is it good for the work that then takes place within the dyad.

The effect of client physical discomfort on the work
Not all clients will be self-aware or brave enough to question the therapeutic environment. It can simply be a subconscious feeling of discomfort that the client cannot quite define and if the therapist has not taken the time to address the environmental issues practically then there is little chance that he/she is going to be aware of the emotional impact on the client.

Therapists spend so much time monitoring client's body language for information and insight but if this is all skewed by the patient’s discomfort in the room then how can any accurate interpretations be made or any informed decisions guide the therapy?

This discomfort can also lead to miscommunication and frustration on both sides as the therapy fails to progress. The sense of security in the relationship (on both sides) cannot be assured if the physical environment is not conducive to the basic comfort needs of the client.

The roots of physical comfort
As a child, interaction with the physical environment is as important with our interaction with people - more so for some children who find the interaction with significant figures in their early lives inconsistent or traumatic. This means that physical objects, sensations, and places for example become invested with additional emotional meaning and memories can be triggered by certain kinds of environment.

We know how important the environment is in child therapy - why is this forgotten when it comes to dealing with adults?

Especially when so much of the material we address involves our primary experiences?

The needs of traumatised clients
What about those dealing with specific traumas such as PTSD where so many physical things and situations can "trigger" further traumatic experiences, panic attacks etc? If PTSD clients have a tendency to run from uncomfortable situations and therapists are not giving enough care to the physical environment then it is unlikely that the therapy or the relationship will "stick".

Realistic expectations
Of course there are practical concerns that effect the physical environment - the therapist's own financial resources, location of office, furnishings, building renovations, the city digging up the road outside etc but there are simple ways to make the environment not only private and safe but of more importantly comfortable for the client.

Conclusion
I would say that there needs to be a greater awareness, certainly at the early stages of therapy, of how some clients experience the physical environment. Some people, after all are more cerebral; some more tactile. An awareness of the client's physical needs through effort on both sides, well communicated and discussed can prevent unnecessary ruptures and difficulties from occurring in the relationship.

I am not suggesting that this needs to be a major area of discussion and certainly not of conflict but merely that it is an area of opportunity to discover the significance of the environment to that particular client and also make small changes, as reasonable, to add to the comfort of the client which can only deepen the trust within the relationship.

Of course there can be feelings of client discomfort in the warmest, most comfortable therapeutic environment however it is less likely to be *traumatic or create barriers and resistance between therapist and client when these issues are anticipated and discussed as early as possible in the relationship.




See also
List of all posts
Building trust - the collaborative relationship
How insecure attachment effects the therapeutic relationship
Rights and responsibilities in therapy
Emotional “resistance” - building trust with extremely defensive clients
The mind-body connection in therapy
Special moments in therapy
Introductions

- Roger Ebert

(H/T Decrepit Old Fool)

I can find no info about the scientific merit or validity of this "test" so don't take it too seriously, but it might be of interest to anyone wanting to learn more about their attachment style, particularly within the context of the therapeutic relationship which I have talked about a little before.

*** Here is the link to the test.

And here are a couple of relevant previous posts:
Article: The origins of Attachment Theory
How insecure attachment effects the therapeutic relationship


See also:
The weirdest relationship you’ll ever have
How parental narcissism effects attachment
Why do narcissists have children?
Maintaining your sense of self in therapy - for clients
Expressing negative transference
Giving it time…
List of all posts
Introductions

We have no control over the world.

Things are ever-changing. The pace is way too fast for you to attach yourself to anything. Not a sign. Not a pole. Not a plant. Not even an entire building. Everything around me is going to change or is in the process of changing as I type these very words. This means nothing is for certain: Not objects, and not people.

Attachment

I (and maybe you as well) need to get away from the attachment game. I am very guilty of it. I get too attached to the siliest of things, like my phone, or my shoes..And though I have been in the long circle of materialistic refusal I find myself stuck on materialistic things. As an excuse I believe that sometimes the materials are more than just materials, they are also special emotionally.. Like knowing that she slept on these sheets and having it difficult to wash them. Or knowing that she chose this tissue box and therefore not being able to throw it.

Detachment

But I surprise myself.. I never knew I had the will and strength to detach myself from someone I held dear to me once. But I have. It was like throwing out of your system a piece of yourself, or one of your organs. But it happened, and I was so unaware of its process.

And..

I have lost my confidence in men. As friends, and as lovers. They have no capacity for long term. They have no capacity for attachment. You need to be ever-changing to keep a man at bay, and many women are so. But I can't be. I am steady. I don't change easily.
So for one, I can get attached to myself safely without worry.

The researchers, led by Yale Child Study Center Assistant Professor James Swain, M.D., recruited two groups of parents from postpartum wards. One group of 12 mothers had cesarean sections and the other delivered naturally (vaginally). All women were interviewed and given brain scans two to three weeks after giving birth. During the brain scans, parents listened to recordings of their own baby's cry during the discomfort of a diaper change. The researchers then conducted interviews to assess the mothers' mood as well as their thoughts and parenting.

The team found that compared to mothers who delivered by cesarean section, those who delivered vaginally had greater activity in certain brain regions in response to their own baby's cry as measured by fMRI. These brain areas included cortical regions that regulate emotions and empathy, as well as deeper brain structures that contribute to motivation, and habitual thoughts and behaviors. The responses to their own baby's cry in some of these regions varied according to mood and anxiety. [Emphasis added]

Reference:

• Swain, J. E. E., Tasgin, E., Mayes, L. C. C., Feldman, R., Constable, T. R., and Leckman, J. F. F. (2008). Maternal brain response to own baby-cry is affected by cesarean section delivery. Journal of Child Psychology and Psychiatry. (Abstract)

This morning I was reading an article on Questia (amazing website, saving my already creaking book cases from further distress). The article is from the Annals of the American Psychotherapy Association and is entitled "Intimacy: The Key to a Healthy Relationship" (full reference below).

The article raises a number of significant points about intimacy in the relationship between two people - mostly emotional - and some of the prerequisites for the creation of an intimate relationship. This got me thinking about how this can fit with the therapeutic relationship which is of course far from "normal".

I read in psychotherapy texts, blogs, forums, articles and journals constantly about the need for creating intimacy within the dyad (emotional intimacy - and always platonic, of course) in order to build trust, a stronger more effective therapeutic relationship, access more challenging material etc. But if we apply the rules of this article then this is simply impossible.

I'm going to look at some of the key points of the article that really struck me but with the therapeutic relationship in mind.

The first point the article made that struck me was the need for equality in any relationship for emotional intimacy to take place. The article says that, for example, you cannot say that a person and their dog are emotionally intimate because one simply cannot know the other on an intimate, equal emotional level.

The article states that for intimacy to be created, "both partners give each other the opportunity to see what is inside the other."

Er.... no.

The therapeutic relationship this is not.

Well, not unless you are working with a therapist who has no concept of boundaries and the therapeutic frame and spends at least half of the time talking about themselves in which case frankly you are working with the wrong therapist.

We are never going to be emotionally close to our therapist in the way this article suggests. We are never going to know their innermost thoughts, fears, hopes, dreams and all the stuff that we share in an emotionally intimate relationship with a person in the real word - so how on earth can we create "intimacy" in therapy?

And is the kind of intimacy we are therefore creating truly helpful to our personal development? Sure, they know everything about us - but this article suggests that this is simply not enough.

Another section of the article says that "Another important aspect of an intimate relationship is each partner's capacity to be in touch with his or her own feelings.”

Surely this is what we are in therapy to learn - not what we already know.

Is this author then saying we can learn intimacy by the end of the relationship..? And if we can only reach that level of intimacy when we actually lose the relationship, then what message is this sending to us...?

Next up - "Insofar as partners [...] lack honest self-disclosure, their relationship is less intimate. To the extent that one party feels the need to constantly monitor the relationship, thus inhibiting the self-direction of the other partner, intimacy is decreased. "

Well this explains how obsessed we become about our therapist's every reaction - we are looking for the intimacy that cannot be achieved. I imagine that this is where a lot of insecure attachment issues get raised.

And finally, the article says that intimacy is about "Enjoying being together without being dependent on each other”.

The issue of reciprocity notwithstanding, surely we are supposed to become dependent on our therapist to a certain extent in order to build trust and examine attachment issues when there are breaks in therapy, work through transference etc? So are dependence and intimacy mutually exclusive?

Conclusion/Confusion:
Is emotional intimacy something we really are meant to feel or learn with our therapist? Or is it just a misuse of the word in this context? And if so, why is an article targeting psychotherapists seeming to suggest that emotional intimacy with a client can never be achieved when it is something all the other texts actively promote for the success of the work?

Surely we're meant to be in therapy to learn suitable skills for dealing with the world and improving our relationships outside of therapy by working things through with the therapist - but how do we not end up learning an extraordinarily dysfunctional concept of intimacy?

Help me out here people.


REFERENCE:
Article Title: Intimacy: The Key to a Healthy Relationship. Contributors: Will Mosier - author. Journal Title: Annals of the American Psychotherapy Association. Volume: 9. Issue: 1. Publication Year: 2006. Page Number: 34+. COPYRIGHT 2006 American Psychotherapy Association; COPYRIGHT 2006 Gale Group


See also
List of all posts
Building trust - the collaborative relationship
How insecure attachment effects the therapeutic relationship
Rights and responsibilities in therapy
Emotional “resistance” - building trust with extremely defensive clients
The mind-body connection in therapy
Special moments in therapy
Introductions

In one week, I had two people use Facebook as a symbolic gesture that they did not want me to be apart of their cyberworlds anymore for whatever reasons.

The deletion of me, a "friend".

The deletions made me consider the definition of friendship and how Facebook is changing that definition.

Friendship on Facebook is categorised into two distinct groups: the friend (accept) and the non-friend (ignore or delete). In the real world, there many scales of friendship. Relationships are never static. They waver -- sometimes two people are close, sometimes they are distant.

I actually considered the deletees to be flesh-and-blood friends. True, at times, there were tensions. Nevertheless, when people are befriending people online they barely know, I was put into their non-friend category.

It made me question my attachment to people and, subsequently, my psychological attachments to places.

Here are my scattered thoughts.

Attachment to people:

My Facebook friends list includes people from primary school, high school, clubs and people I met while overseas, people I would, in reality, have grown apart from. But I now I roughly know, or can know, the goings-on of their day-to-day lives.

Attachment to communities:

Do I really need to know what is happening in the lives of people I will never see in the physical world again? Today, virtually my entire high school year is connected through Facebook -- an attachment to a community that ended eight years ago with graduation.

Attachment to places:

Being in another country, Facebook has become a useful to stay in touch with close friends back home and a way of finding out what events are going on in my new hood. But this means psychologically I have never left home. In the physical world, I ride on the back of ojeks and eat tempe, yet in the cyber-world I am still at home, chatting to my close circle about relationship problems and checking out the photos of the parties I have missed.

And yet, I am still addicted.

Dear bank account owner,

Funds wired into your account are stolen from innocent account holders through Identity Theft. Please check your account statement (the statement is attached to this letter) and contact your bank account manager.

Federal Deposit Insurance Corporation

POP QUIZ: What's wrong with this picture? (multiple choice)
a: It came on a Sunday, and the Gov't doesn't work on Sundays.
b: There's no such thing as "innocent" account holders.
c: dot exe's are "executables" (aka "scripts" and "programs") and make things happen on machines.. maybe bad things.

Answer: C

Folks, this is a really old attack method, and it preys upon the fact that users are unobservant (won't notice the .exe) and uneducated (don't know what a .exe is).

Sadly, those two facts really don't change. And so someone is trying this old trick again. The attachment "statement.exe" is a "downloader virus".
Open the attachment and be "pwn3d".

Today's free link(s):
* Top 10 things you should do to your computer–updated
* Internet and System Security - Common Sense Tips

Copyright 2007-8 © Tech Paul. All rights reserved. post to jaanix

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No matter what our specific diagnonsense the experience of therapy has a profound effect not just on us and not just for 50 minutes a week but on how we relate to everyone in our lives on the days in between sessions and particularly when we have breaks in therapy that can leave us feeling even more unstable and vulnerable.

The good times
When we first start therapy there is often a "honeymoon period" where things suddenly seem to get better for a while. We might even think we are "cured" after as little as four sessions and think it's time to stop. If we do, then there can often be a quick return to previous patterns of thought and behaviour and if we continue then things often get a lot more confusing before they start to get better.

There are of course good times throughout therapy - nothing is all bad after all.

I for one have noticed improvement in many small ways but mostly through the reactions of my friends and family and particularly my partner who has to put up with the bad times as well as the good. Their support during the bad times is what keeps us going in therapy but their recognition of the good times and the work we are doing is what keeps us going through the bad times!

The bad times
The bad times are, well, mostly bad. There are times when we want to be as far away from everything and everyone as possible (especially therapists). There are times when any kind of close or emotionally intimate contact with anyone - even those we love - can be almost unbearable. There are times when we just have to be alone.

This doesn't mean it is easy for those around us. Any long-suffering therapy widows will know that from time to time their partner curls up emotionally and physically and just has to be left alone until they are ready to talk about it either with them or their therapist.

It must be so hard to be on the other side of the therapeutic relationship. At least our therapists are trained to deal with us pushing them away - our friends and family are not.

It must also be really hard to be witness to an intimate relationship that you can have no part of. Sure, if we decide to we can share every detail of the therapy session with our other half but I for one do not and I know I'm not alone in this. So do we just hope that our partner will cope with this and not see it as rejection or exclusion? Do we tell them things we can tell "no one" to make them feel involved? Do we hope they understand what we need and what we can and cannot say? And if we as clients have doubts about the competence and commitment of our therapist from time to time - how on earth must our significant others feel? (Mrs BTC sometimes wishes to kill Goodtherapist).

The sometimes
I think that therapy is cyclical. I go through good periods where I make progress and bad periods when I get stuck and very bad periods where I feel like quitting. Throughout all of these times I am lucky enough to have good people around me to help me hold it all together. But I still feel sorry for them and sometimes feel an overwhelming sense of guilt at my need to exclude them from this area of my life. I am however, very very grateful. :)

See also:
Introductions
Link to all posts
The mind-body connection in therapy
Client self-disclosure
Therapist self-disclosure
Maintaining your sense of self in therapy - for clients
Expressing negative transference
Giving it time…
Client survey - results
Longer breaks in therapy
When therapy causes more problems than it solves
Writing and therapy

The attachments are little things they attach to my teeth to help the aligners move my teeth. I only have five, three on the top left side, and two on the bottom, one on each side. My braces have indentations (is that a word?) that the attachments fit into.

When we got home yesterday, I had to take my braces out to eat, and what do you know? One of my little attachments came off my teeth! It actually stuck in the little indentation in my braces. So, of course, Mom had to call the dentist and they told us to come back again today. The dentist put a new little attachment on my tooth, and it only took about 5 minutes or less!
I've taken my braces off several times now already and all the attachments have stayed on so far! :D

The braces are a tad bit harder to get on and off now with the attachments, but it's getting a bit easier since the aligners are loosening up since my teeth are shifting. The pain isn't as bad today as it was yesterday, and I'm sure glad of that! :)

She has an Abeka book for reading called Tip Toes, and since Mom had used Abeka on us for those first grades, I have the same books! So I can sit over in my 'Teacher's Chair' ( :) ), and make sure she is saying the words correctly and stuff.

She did really good this evening! I had her write four sentences and we completed her Tip Toes book. Having her in the barn is better, because she can focus on her work instead of trying to look out my bedroom door all the time to see where Mom is! ;)

To find and retrieve full text:

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3.      EndNote begins searching for and downloading full text for the selected references.

During the searching and downloading process, the selected references appear in a temporary Full Text group. When the operation is completed, the Full Text group includes only those references to which EndNote added either a full text file attachment or a URL. When you close the library, the temporary Full Text group is removed.

Full text downloading happens in the background, which may affect the performance of other operations.

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You can cancel the Find Full Text operation at any time by clicking Stop full text download in the status line at the bottom of the window. Full text that has been retrieved until that point is already saved in the library.

I will be referring to the narcissist as "he" throughout for no other reason than personal experience and bias. ;)


Following on from a previous rant about narcissistic parents, a subject quite.. ahem.. close to my heart, I thought I’d have a little ponder on why narcissists have kids in the first place? What do they think they are going to get from their children and what is it that they don't get which makes them act the way they do?

The need for Narcissistic supply
Narcissists are entirely focussed on how the world perceives them. They have an overwhelming need to be approved of by everyone - to have a constant source of narcissistic supply. This is why they need others around them and need to be in relationships. Ultimately of course they will destroy those relationships as the narcissistic need can never be satisfied - anyone who loves and approves of them, basically, must be an idiot who is only worthy of distain.

The requirements of society
Being seen to conform to society’s expectations is often part of the narcissistic framework. Appearing to have a stable relationship is key to private and public recognition. Having children is part of this status, whether they actually want them or not. If they don't want them, this of course throws up a whole new set of issues for all involved, especially the children.

Living vicariously through their children
Irrespective of whether the child is wanted or not, the children of narcissists can never live up to the parent's expectations and will always be disapproved of no matter what they achieve, simply for not actually being an extension of the narcissist.

The child is driven by the narcissistic parent to succeed at all costs - and the goal posts of what success means are changed on a daily and sometimes hourly basis. This external drive becomes a compulsive need within - and internal drive within the child/adolescent/young adult over time as I said before resulting in either another narcissist or a totally undermined human being with little or no self-esteem.

If the child succeeds it is a reflection on the narcissist, if it fails it is a reflection on the child. If the child, becoming an adult, goes beyond the achievements of the narcissistic parent then there is a whole new world of hurt and rejection waiting for them as the narcissist will reject the child for outshining them and will always continue to criticise and undermine their achievements so that they are never a real threat to the narcissist's sense of self.

Having someone to control
One of the features of a narcissistic marriage - which I witnessed first-hand as a child - is that the narcissist needs to have all the control. This can often be done in quite subtle and manipulative ways. He often turns his spouse into a co-narcissist (think an alcoholic with an enabling spouse) which only supports his need for and frustration at not getting narcissistic supply. Because of this the other parent, where present, will rarely be able to support the child's needs, focusing almost entirely on pacifying the narcissist.

By controlling his spouse or partner as well as his children the narcissist is able, in theory, to control his environment and protect himself from realising his own inadequacies. Unfortunately, this is not an environment in which a child can develop a functioning sense of self or gain any confidence in its own abilities to think, feel or make its own decisions in life without the approval of others.

Re-enacting their own attachment experiences
One final aspect of this which becomes apparent as we step away from the personal experience of the narcissistic parent and try to take a more objective view, is that the narcissist is created by his own narcissistic/co-narcissistic parents. His own attachment experience is projected directly on to his own children. He uses the child to vent the pain of his own early experiences and frustrated needs thus perpetuating the cycle unless, sooner or later, that child ends up in therapy and with a good therapist, can begin to break the cycle.


See also:
Introductions
Link to all posts
How parental narcissism effects attachment
How insecure attachment effects the therapeutic relationship
Manipulating the countertransference - how narcissistic clients destroy their own therapy
The narcissist in therapy
List of all posts

It is a software feature. It is a wonderful add on to the latest version of iTunes and the iPhone software.

the Genius button. I love it.

I love being able to plug in my headphones, pick a song to match whatever mood I am in and get 25 of its friends to listen to on the way home. I love hearing songs I haven't heard in forever. The Genius button really does help me to rediscover my music.

I just love it. There, confession is good for the soul.

I'm going to be doing some collaborations with other clients over the next few weeks to get a more balanced view of negative transference in and of itself which may be of use/interest to anyone who reads this blog but for now it's just me expounding some random thoughts.

I've talked before about transference in general, the complexities and dangers of erotic transference and a little about idealising and devaluing the therapist. Here I am looking at ways we can handle negative transference and negative feelings towards our therapist in general so that they don’t destroy us and our therapy.

As has been mentioned on this site and across the web as well as in the psychotherapy literature, transference occurs inside and outside therapy. Every relationship we ever have has some elements that come from previous experiences that influence and sometimes direct the ways we respond to significant people in our lives for example, we often overreact at our spouse's "criticism" because of how we were criticised by narcissistic parents (**sheepishly raises hand**).

What we learn in our relationships outside therapy is that our perceptions of other people's intentions are often wrong. We learn this through communication - often in the form of arguments - where feelings are expressed (not always in an ideal way) but where once the anger is out, communication often takes place and disputes are hopefully (eventually) resolved.

I think the problem with therapy is that it’s a similar kind of relationship to the one described above but with that fundamental imbalance of power. We know what the rules of engagement are with this professional who is trying to help us - we feel they have more power, are more deserving of respect and we cannot (really) lash out at them with a crazed accusatory diatribe as we may with our partner or close friends. Of course, reacting in this way in either relationship is not ideal but in real life it's just often what happens before real communication can take place and conflict is resolved.

So what happens if we cannot vent these feelings and get to the stage where we can talk through our anger and frustration at the other's behaviour?

Welcome to therapy. You are now stuck in negative transference. The 8th circle of hell.

So your therapist says or does something that triggers something. Some kind of resentment, embarrassment, memory, feeling of inadequacy or whatnot and you cannot react immediately saying "you b@stard how dare you say that to me you know how that makes me feel it's just like when my mother used to..." so you say nothing. You let it sit and stew until it becomes something foul and corrosive sitting in the bottom of your stomach.

Take it from me - this is not ideal. You cannot push down negative transference forever. It will come back to bite you on the @ss. You cannot build a positive working alliance with a therapist when you are suppressing negative feelings. It will undermine the therapy to the point that no positive feelings - transference or otherwise - can exist and you will just walk (or run) away from therapy.

So what do I do smarty-pants?
I have no fancy advice, no magic formula. Just get it out. It's scary and embarrassing and it'll make you wish the couch would swallow you up but the whole point of therapy is that you don't have to handle it all alone any more.

Tell them, write to them, email them - whatever you need just get it out and make it something they have to take partial responsibility for. I know, I know, that we have to take responsibility for our own feelings and that technically someone else cannot "make" you feel a certain way (you do it to yourself by how you internalise their words and actions yada yada yada) but we are meant to be working with the therapist to learn how to do this.

Therapists are there to help us unlearn all these negative and dysfunctional reactions and they can't do this if we keep it all inside.


See also
Introductions
Link to all posts
A brief introduction to transference
The weirdest relationship you’ll ever have
Miscommunication in therapy
Building trust - the collaborative relationship
NY Times article & the importance of “fit”
The client experience of therapy
How insecure attachment effects the therapeutic relationship
How parental narcissism effects attachment
The intelligent client (soapbox moment)
Talking about the tricky stuff - being honest with your therapist
Resistance is (not) futile
About erotic transference - #2 - acting on erotic transference/countertransference
About erotic transference - #1 - Falling in love with the therapist
Getting “stuck” in therapy
Acting-out in therapy - boundaries, communication and resistance
Rights and responsibilities in therapy
Emotional “resistance” - building trust with extremely defensive clients
Writing and therapy
Couchside manner - how clients respond to (perceived) criticism
For Therapists: 10 ways to increase the client’s motivation in therapy
The four horsemen of the (therapeutic) apocalypse
Idealising the therapist
The dangers of devaluing the therapist
Giving it time…

So here's my thinking:

There are many aspects to any relationship or friendship that is going to last for the long haul - whether this is a romantic relationship or a working and helping alliance. These have been talked about before on this blog but here are the main ones that MUST be built for the work to succeed:

* Trust
* Intimacy (emotional not physical!)
* Understanding
* Communication
* Boundaries (on both sides)

All of these must be well enough developed to remove any remnants of resistance. I don't mean forever as ruptures and miscommunications will always occur but I mean removing them enough for some consistency in the work and stability in the relationship to build up.

When does this trust get built?
Talking to friends who have been in therapy for more than 2-3 years with the same therapist, I get the impression that one reaches a stage where the relationship becomes pretty stable - otherwise it ends well before this 3 year watershed. During the first 6-12 months though it certainly seems to be a rollercoaster of emotions for most clients - myself included.

Presenting conditions notwithstanding, the first year at least seems to bring up varying amounts of transference which needs to be worked through with the therapist before any lasting trust and mutual understanding can be reached. This is a huge investment in time (for both sides of the dyad), emotional effort and of course money so I can see how difficult it must be for clients who begin to experience ruptures and serious miscommunications at the laters stages of therapy. After only 4 months the idea of switching therapist was almost physically exhausting to me!

Why do we seem to want more from our therapists than we get?
I think that during the most intense stages of transference, (again I'm going to propose that these manifest in the first 12 months) we seem to want more from our therapists than they are able to give. Sometimes more of their time, sometimes a sense of need for physical contact and often we cannot even put this into words but we feel they are just not "there" for us as we need them to be. So where does this come from?

I would suggest that this is the result of "normal" relationship development being magnified to the extreme in the therapeutic environment. As I've discussed before erotic transference is often connected to confusion around the patterns of building intimacy in a relationship - which need to translate in to the therapeutic relationship but of course without any of the sexual or physical elements being acted on.

So in this case, we are experiencing a new, intense form of "friendship". We are suddenly extremely intimate with someone and have an overwhelming set of feelings towards them and yet we receive nothing from them in return - no information about themselves and seemingly no emotional response to us as individuals. It's as if the time it takes to form an intimate relationship is compressed into an extremely short period of time - and we're the only one in the dyad experiencing it.

My theory (or is that "hope"?) is that when we get to the 2-3 year mark, the space-time continuum expands, contracts, does whatever else it needs to do and levels out - the therapist catches up with us as they finally begin to understand us at the deepest level and the work can finally begin in earnest and with a consistency rarely seen at the beginning of this emotionally chaotic relationship.

Still, all this is just my quasi-intellectual guesswork - I'll let you know when I've been doing this for 3 years!

See also
Introductions
Link to all posts
How insecure attachment effects the therapeutic relationship
The role of the therapist’s experience
The four horsemen of the (therapeutic) apocalypse
Longer breaks in therapy
When therapy causes more problems than it solves
Emotional “resistance” - building trust with extremely defensive clients

We first started recording five months ago. The project drug out. I noticed this person had a poor work ethic and was a slacker. Rather than thinking I would be better served to move on, I tricked myself into becoming a supporter, encourager, and motivator for the engineer.

Big mistake! The signs were there, but I did not listen. I gave up a part of myself that was, in many ways, a caregiver.

Then, after all the signs, and the time of this project dragging on, the moment came when I was blamed for the engineer's lack of faith in the project. What! Me? How could I mess it up? I'm not the slacker. I'm the one who's focused.

Then after some thought, I realized I took on a parenting role in our relationship. No wonder the engineer blamed me! I set myself up for it.

Lesson learned! The signs were there and I didn't listen to them. Once again, intuition, wise friends, and my significant other were right. They told me I would be better served by moving on.

What I'll do in the future is to make the situation less about me. I'll pay attention to how my ego and insecurities are self-sabotaging me. I'll trust the opinions of my loved ones.

Upon reflection, I was pretty attached to making everything right. I wanted to be liked. I put the engineers needs in front of my own. And most importantly, I resisted my intuition (UGH! That's the one that feels most important!)

I was afraid to let go.

I'm told that's difficult for Pisces to do, but it doesn't matter. It's a lesson learned and a good one indeed.

And if you're wondering about the guided meditation CD... I got right on it! Since I had to start over from scratch, I booked audio recording time and did many other things to catch myself up. I'm quite proud of how I'm handling the letting go and moving on :)

Reid
www.manifestcreations.net

Most importantly this release fixes the problem of messages being received by Enterprise Outlook as text attachments to blank messages. It also has some enhancements to the validation logic for SMTP that should make SMTP sending more reliable under higher latency situations.

• Fixes problem with the added text in forwarded and reply messages being shown as text attachments to a blank message by enterprise Exchange servers and other legacy email tools.
• Properly handles attachments when forwarding/replying to messages
• Fixed problem with image attachments not being displayed on api 4.1 version
• Fixes problem resulting in time and date being shown as 00:00
• Fixes problem with delete lists not being persisted between sessions - messages deleted on the handheld are no longer re-downloaded after restarting tiggit mail.
• Fixes problems with sub-folders not being replicated
• Adds hot-key functionality to folder screen - I to set folder for download and P to show folder properties
• Waits for response 354 to DATA command within SMTP send

It's something that people, especially those with attachment or abandonment issues tend to do in lots of relationships - if it goes wrong it’s the other person’s fault they are stupid/incompetent/heartless/cruel etc. Personally, it’s something I need to be aware of not so much in my relationship with my therapist who has proven her own worth and competence but more when I hear about other clients experience of therapy.

Could it be transference?
My own experiences with past therapists have included some who were competent, some vaguely competent and some who should perhaps consider a change in career. I am aware that this colours my reaction to other clients' tales of their therapists, particularly when things go wrong. This is one of the reasons I try so hard to present as balanced a view as possible on this blog whilst still offering fellow clients as much information and reassurance as I can.

Ok enough about me, let's talk therapists.

Resentment and rupture
It's too easy to build up resentment towards this person who gets so close to our vulnerabilities and most intimate feelings and secrets. Unless miscommunications are dealt with as quickly as possible clients can find themselves blaming the therapist for all sorts of misdemeanours that, although often valid, could also be the product of negative transference and can lead to various types of acting-out or resistance and all of this destroys the therapy as much as over-valuing them does.

As I said before, it’s all about finding a balance. I know as well as anyone how hard it is to keep a level head in therapy. Intense emotions are flowing around all the issues and material we are dealing with as well as this new and unusual relationship with the therapist.

Inevitably, this all combines to make it incredibly hard to see straight sometimes. However, it is essential that at least when we are in a lucid state we establish a permanent, realistic conception of the therapist that has at least a passing resemblance to reality. This way, when we are faced with crises, we have a reference point for our feelings about this person.

If we can say - ok, he's made me angry this week but in general I know him to be kind, empathic and patient even though he sometimes seems to torture me with silence . And he makes mistakes, because he's not a god but he is at least willing to talk them through with me and will recognise when he is in the wrong and apologise for it because he really is just trying to help.


See also
Introductions
Link to all posts
The weirdest relationship you’ll ever have
Why your therapist is not your friend
Boundary issues
Rationalising the therapeutic experience
Miscommunication in therapy
The therapeutic use of silence
Why questioning isn’t interrogation
The client experience of therapy
NY Times article & the importance of “fit”
Building trust - the collaborative relationship
Talking about the tricky stuff - being honest with your therapist
The “irrational contract” as an expression of transference
Rational vs emotional - two sides of the same relationship
Rights and responsibilities in therapy

win yu go we not see yu long time and yu gon go way far far far you go so long
"k" sho us on calindr that a long tim we think
us not tawk you much but we see you and we like you
you give us stuffi dog
that is nise
we don want you go
we not tawk much cuz we not spose to
but we ther sumtime and but we not want tawk cuz
us tawk to other t an her not want us
and if we tawk you maybe make us goway to
not want us tawk
cuz thats bad us be ther we think
if we tawk you will say pur yur feet on the flor and yuou will want us go way
thats wat we think
so we just not tawk
but we will miss you
not want you go

us

January 15, 2008

Joy*,

I only got 3 hours sleep last night and I can't sleep again. I can't stop thinking abowt yu leeving. i don want you go don want you to don want you leeve me and be far far far way. scared you go away.

Im sorry Im sorry Im sorry

Somebody has to speak for all us I guess because molly..........well, that's her crying. But all of us are worried about you being gone. None of us want you to go but then we do because we want you to have fun vacation and wee don't want to be bad and pitch a fit but we are trying we are trying not to cry because we know we are too big to cry I think and that's silly but we don't wan you to leave.like you close to us we'r afraid you will be so far so long we will not "feel" you anymore. and you be gone and us will be empty and alone not have anybody close to us.I know it doesn't make any sense.........it makes no sense what so ever but lots us are afraid.....cuz we think we got something good and somebody care and kind to us............not want to lose that........what if you come back different?they sayt????Like othr therpist she came back things wer difrent and we dont want anything to change at all not one bit at all. Im sorry if your not having a easy time reading this nbut we gots lots us typing and talking at the sdame time big ones little one and lots us aNnd thats we not can sleep but we try that medicine again but this time not a whole one cuz just half was ok but not the whole thing that was bad bad and but we gotta sleep...

you like us? You not leave? Like leave leave an not com bak??? you will come back and you will still lioke us and you will be happy to go on vacashunm but also happy to see us when you get back??? YOu not be different when you come back.??promise? and I dont want to feel feel far from you. when some peepl go way they lose feelings for peepl and come back like stranger and dont be frends anymore. i doint want you to leeve.........I dont

I'm going to miss you so much...............so so so much. but i try real hard to be just fine while your gone and i try to make us both proud ok but I will miss you so much it gonna hurt in my hart. like tears........tears on my pillow.........and my teddy bear...............but you come back?we can see you the first day you work when you come back and the last day you work befor you leev? dont want to let go............sometimes you let go you lose people.............but the counselor within says sometimes you don't let go, you lose peeple. I just want to close my eyes and zoom through time and make it be when you come back cuz I just dont' even wabnt to face it at all. Want to just skip it and like it never happened and time leap.........not gonna happin.......i know I feelllllllllll I know I feel now...............but these feelings are sad and scary.cuz i have to let go and trust that you will come back and be the same and trust that I can be ok and scary scary scery.

i better go before the ambien kicks in and I opass out at the keyboard.

im going to miss you
its hard to let go
you no that?????

Half a month you be gone...15 days!!!!!!

you have fun seeing the ocean and being warm and we freeze up here.

we will be ok?? You think??? I think so, but we will miss you so much. so very much..........

You will be ok, but the hard part is that you might not realize that til I am back .I know it's hard. I can only be me, and I will do my best to come back, because that is who I am and what I do.
Joy

January 15, 2008 (Later that day)

I guess, I'm not really worried that you will not return.....When I think about it and really look inside......I'm afraid of losing the comfy attached feeling I have. I don't want that to go away. I guess I fear.......detachment. I like being "close" with you because you are so safe and caring. I do love you lots (albeit a selfish childlike love ) but I don't want to separate emotionally from you. I'm comfy in my safe spot with you.

Do you have other clients who are stressing over you leaving? Of course I could just be the most vocal one.....(lol)

I know you'll be back, but I wanted you to know that's what worries me. When Karen*(previous T that didn't work out for us-not her real name) left, I forgot what she looked like. I lost that image I had in my mind.

But when she came back things were so different. I don't want things to change between you and me. I like being snuggly attached not want detach......

*Not our therapist's real name.

voices voices voices..........
they say we need our little "Joy* fix" for a sec., OK?

want hugs......... 

You know, we are so just like a toddler. We keep having to come back and "touch" base. Then we are happy and we can go off and "play" again. Then....we gotta come back, and repeat, repeat, repeat.

Actually we do feel somewhat "little" right now. We are in that "in danger of switching" state. That zone of....ooooooooooo........how could I describe it.......You know on TV when a person "bonks" their head, and then they show their vision and it's like a double image sort of blurry together and separating and blurring together and separating??? Like that!!!! But we don't "see" it, we feel it....and hear it inside too.

I gotta get up and cook dinner. That will be grounding enough to keep me out of the zone, but for now....yeah we got littles around and they say hi hi hi hi hi to you and send a wave and a hug and a snuggle and a "we happy"

wave 

.........and we happy

"K" and the little ones..............

*Not my therapist's real name.

***(We are such goobers!!! See post on Attachment and the Therapeutic Relationship.)

This message is for all of us. All who breathe, all who feel, all who need food, sleep, shelter and security. All of us who survive on this planet called Earth, which is a small part of this galaxy, which is again part of the Universe where millions of other galaxies and many trillions of similar planets exist, all of us who are born and are told that we would be dead sooner or later. There is enough evidence around to prove these basic facts, isn't it?

First of all my question is do we know who we are. Do we know what are we here for? Do we know what the purpose of our life is? Do we know what are we supposed to do? One thing one want to make clear is that this is not again a philosophical business. This is truth and we all know it. Most of us agree that life is all about money, food, sex, shelter and security. Are we aware that there is more to life than craving for money, desires and competition?  Do we ever try to find out more from life? Yes there are many people living here who are doing more than the four basic requirements mentioned before. But is it enough? We have great musicians, fighters, artists, sportsmen, speakers and many more of such great gems who dazzle our world. Yes, they are the crown. But is it enough? Can't we move further? Does life end here? 

We all know what business goes around in the world. We are confined with our desires, our mind. We do what we are taught and we do not ever dare to think more than that, because of fear; fear of losing our identity, or fear from powerful people governing this world. We all know that we are going to die, because we have seen it going that way with other people. That is something which creates agony within us. Then there is fear of emotions, we are humans. We have feelings and emotions. We cry, we laugh, we love, we hate, and we do all what is not mechanical. We agree that emotions are one important aspect where we could be distinguished from machines, robots and computers. I did not say trees, animals and birds because they too have emotions. They do feel anger, hatred, love and attachment too, although they are not human beings. They feel the love, they feel the agony. 

We are all living a mundane life no better than trees, animals and birds. It is actually worse. I can prove it is worse. Then we have mind, the desires and thoughts. Mind is something what rules most part of our lives, we human beings have multiple minds. Mind is nothing but ego, the self. It is what creates thoughts, it is what creates desires, it is energy behind all our sins and achievements. Yes, achievements too. Mind is a blind jockey which keeps whipping us all the time and creates desires and then provides energy to fulfil them. I said blind because it is biased. It cannot differentiate between truth and erroneous. It makes us keep running in this blind race where nobody wins. People seem to win or loose, but actually nothing is ever lost or won. 

It is here, survives eternally. Remember wise people have said, "Energy can neither be created nor be destroyed, but can only be converted from one form to another". We seem to own a lot of things. We own our house, our cars, our machines, our clothes, don't we? What is going to happen to all these possessions of yours when you die or when you don't exist? Somebody else will take over them. It becomes the property of somebody else. He is ruling it now; temporary dictatorship. When he dies, somebody else will take care. The cycle goes on and on, endlessly. The things survive, eternally, in one form or the other. Physical attributes change. They say, it all existed as a gigantic mass of energy. They there was the biggest collision in the history of Earth - Big Bang. That created universe, galaxies, stars and planets. Energy always exists. It can never be destroyed. You can climb the biggest mountains, swim through the Atlantic, conquer the stars, or dig out the deepest mines, it's all the same. Physical aspects are different, energy is always present. 

I am writing all this to trigger an inquiry within you, within me. Let us all inquire. Let us learn to inquire. Inquiring is not just probing or getting answers to your routine questions. Inquiring is deeper. Inquiring is more subtle. Inquire means to explore, to find out, to dig deeper; to find more meaning to all of this. 

Can we begin with the ground level? Can we again start with a zero? Why zero because all of your intellectual oceans, hills and valleys are made up of virtual sand, which blows away even with the smallest jerk of wind and which is an effort of the society at large, for their own benefits. Society has created your mind or rather nurtured it. They have taught you what was needed for you to serve them. They can't teach you more. Don't expect miracles from them. You will have to work on it yourselves. Your perverted and crippled mind is the gift or rather by product of the education provided to you by the society. A crowd can never be intelligent. Intellect, freedom and bliss are individual's aspects. An individual can be happy, or sad, or intelligent or idiot, or free or enslaved; crowd can never be. Society is a crowd. 

Remember nobody will do a favour. They cannot, they have their own self. They have to feed their desires; they do need their bread and butter. As long as you are helpful to them in one or the other means, they will help you. Lets us reclaim this fake business. You only can find answers to your questions. Nobody else can. I am a human being. I am weak, I have fear of death and I have desires. I have feelings. I am not god. I am a simple man like you all or rather weak. I am not able to understand all this matter. 

Gods are the nothing but our desires aggregated in larger masses. We create gods when we want. We ask them to fulfil our desires. We visit churches, temples and mosques only when we have something to ask for, but that is human nature. We are born with a self, an ego, a mind which makes you run all the time. You are not able to take a halt. Stop for a second and think. What if you fulfil all your desires of power, money, luxury, lust? Won't more of them arise when earlier ones have been accomplished? Does this business ever stop? It never stops. We continue to crave for desires. We go on and on. We never stop, because, if we stop for a second, we might start thinking what is all this nonsense. God has become a business. Temples and churches are biggest of shopping malls where gaining, loosing, negotiating and all that business goes on. We buy gods in rupees and dollars, if not, then in golds and silvers. We promise him to pay if he fulfils what we want. Is this the god we pray, is this the god we trust? 

Motion keeps us afresh with our desires and senses. That's why we keep running all the time. You know that stagnant water becomes useless. Mind is the same. If you stop for minute, you tend to think, what the hell is going on? And mind stops to work. Mind moves every inch to make you run again, in this endless world of thoughts, desires and needs. 

I am not against the mind; I am neither against desires, nor materialistic demands. I am an inquirer. I want to inquire, I want to find out. I have all these possessions. I love, I cry, I feel for other people, I have fear of death. I am not against this world. I cannot be. This is the only place we have, this is the only time we have got and this is the only life you are gifted. Let us all inquire, inquire within you, inquire the nature, inquire the trees, and inquire the world around, what is missing. Despite of all what we have there is something important missing, something substantial. We miss happiness and we miss freedom. We miss ourselves. We do not want to be machines, do we? Then let us all explore all the seen and the unseen. Let us find more out of it and then this all will start making sense. Even if you die within your process of exploration and inquiry, trust me, you would not go to hell, if there exists one! 

~Student of life, an Inquirer