[The ‘reasons’ referred to in the title of this post are described in an excellent post by Dr Stein, reblogged here]

The thing about feeling excluded from your therapist’s life – it’s triggered by the smallest things.

I was usually early for my appointments with my ex-therapist, Jane, and I was used to the feeling of annoyance and jealousy when the client before me walked out of her office, saying ‘goodbye mate’ (‘mate’ – how dare he?!) as he left. On this occasion, though, he had what could have been no more than a ten second conversation with Jane on his way out of the door. I heard her interact with him – she said something kind and empathetic, as you might expect, though I can’t quite remember what.

She started our session in the usual way, asking me how I was and how my week had been. I went to pieces and started sobbing. I couldn’t talk – it physically hurt, right in the pit of my stomach. The emotional pain was intense, but so was the shock, surprise and embarrassment of what I was experiencing. It was the first time I’d had those powerful feelings of exclusion with regard to therapy, which seemed to just rise up instantly the moment I heard that interaction.

It wasn’t long before I had a similar reaction before another session. This time, thankfully, the client who called her ‘mate’ was absent, and Jane and one of the other therapists started talking while waiting for the next ‘therapy hour’ to begin. It was the end of the day, and there were no other clients or counsellors around. The conversation was perfectly innocuous – I don’t think they had met properly before. Jane explained she only worked a few hours a week and they spoke about attending some kind of staff event in the coming weeks. As I listened, the pain mounting, I put my finger against the glowing lightbulb of the reading lamp on the side table in the waiting room, drawing it quickly back when the pain hit, and replacing it with the next finger, and the next in turn.

***

A few weeks ago, my therapist mentioned that she would be out of email contact over the weekend as she would be at a conference. I normally find the gap over the weekend difficult, but this time, knowing where she would be, interacting with lots of other people, powerful feelings of exclusion kicked in and the pain and desperation were intense.

The following week, I arrived early for my appointment, and so I parked my car across the road from my therapist’s house and took out a book to read. Occasionally I glanced in the rear view mirror and stopped short when I suddenly saw her coming out of her gate and start walking in the direction of my car. She passed by, headed for the post-box further down the street, letter in hand. I don’t think she saw me – and I pretended to read, not taking in single word of the paragraph my eyes kept skimming over.

My therapist normally waits for me to start sessions, but this time I felt even more lost and incomprehensible than usual. I started to cry, just feeling like a jumbled mess of emotion. Feeling ridiculous because I was so upset, and because my upset my triggered by the fact that I had seen my therapist outside the context of a session, walking to a post-box to post a letter.

***

‘It’s like the feelings you had last week, when I was away. I’m sending a letter to someone – there are other people in my life’. Posting a letter; chatting with conference delegates; meeting a colleague; talking to a client. In his helpful post about the reasons behind the ‘exclusion’ of clients from therapists’ lives, Dr Stein (a retired psychotherapist), states that it is not unusual for clients to feel jealous of those who claim more of the therapist than they have access to. Yes, I feel jealous. But I feel so, so much more as well. Intense desperation, longing, frustration, helplessness. And pain. So much pain.

I want to scream and cry. I want to claw my way out of my body. I want to try and understand, but also fight desperately against the fact that what might in other circumstances be simple and ordinary human interactions, are completely outside the bounds of the unique (and in this case, uniquely tortuous) nature of the therapeutic relationship. It’s not just those that have more of my therapist that trigger these feelings. What drove my frustration and pain during the time when my therapist was at a conference, was the fact that complete strangers would have the opportunity of spending time with her without the stricture of the clock; engaging her in conversation about topics of mutual interest in which she would talk about herself and her views, as much as they would talk about theirs; asking her questions which she would reply to without holding back or wanting to know why they were asking.

My therapist sometimes speaks, in the context of my high and often unrealistic expectations, of finding meaning in the ordinary, particularly, for example, when it comes to evidence of her caring. But it is precisely the lack of opportunity to be involved in the perfectly ‘ordinary’ aspects of her day to day life that causes me so much pain. Unlike those strangers at the conference, I can’t strike up a conversation in which I ask her how long she’s lived in this city; whether her children are nearby; what type of food she likes or what sorts of things she gets up to at the weekend. I don’t know what her favourite colour is, or if she has one; whether her children grew up in the house in which she’s now living; what book she read last week; or where she goes to church.

I know I can’t be her daughter – however much I might desperately want to be. I know I can’t share in her life in the way a partner might. All of those things cause a great deal of hurt – but it’s difficult to be resentful of those whom she loves, and it’s more difficult to argue against genetics than it is to argue against the boundaries of therapy. But to know that in theory, every other person on this planet apart from me and her other clients (how many, I wonder – another question I cannot have an answer to) has access to her in a way that I can never have – that’s incredibly difficult to deal with and to face full-on. Clients aside, everyone else is a ‘potential’ friend – from the person she meets in a hotel on the other side of the world, to the person who lives in the house next door. They wouldn’t need to worry about asking her whether she actually hates the colour purple – the colour which, for some reason, I have come to associate with her. Clients aside, there is no one else who knows, with absolute certainty, that their relationship with her has a definite end (not related to both parties’ inescapable mortality), after which point further contact will not be possible. She might put her arm around someone she’s known for a few months – but even if I see her twice a week for the next few years, that will never ever happen to me.

***

I don’t understand why this exclusion is so painful – where it comes from, and what it means. I have a feeling it will take some time to get to that. And so in the meantime, I keep trying to hold on to the words my therapist said when we discussed these feelings in session. Rather than focusing on the things that being a client excludes me from, I am trying to remind myself of the things it gives me access to. Although I don’t get to know all of my therapist, what I do see is real. As she said to me, she may only see me for two hours a week, but that is more than she sees her very best friends. And as Dr Stein also mentions in his post, clients experience the individual as ‘therapist’ – an aspect that comparatively few people will come to know. In that capacity, therapists may only give their clients a limited amount of their time, but in that time, they are focused exclusively and intently on their client, giving them their full and undivided attention. Much more than that, giving them their unconditional acceptance, and listening with empathy and without judgment. And even more than  that – sitting with them in all their strong emotions, whatever they may be, holding those feelings and keeping the client safe.

And though I may not be able to talk with my therapist about all the ‘ordinary things’ I want to ask her about – when she does share something about herself with me, it feels very special, and it creates a deeper bond and a sense that she trusts me too. That’s not something that happens simply in ‘ordinary’ conversation. And often when she tells me something about herself, because it’s in the context of a session it may not be something that would come up in casual conversation. It’s a memory about an event or a feeling, it’s an association, it’s a recollection about her own therapy, or about her own children. It feels more intimate, more as if it came from a deeper place. Maybe I do have more of my therapist – more than many, and certainly more than any ‘potential’ friend. Not in terms of volume of information, but in terms of meaningful, important memories and thoughts. Does it feel like enough? No, no of course it doesn’t. I’m not sure anything short of actual kinship would feel like enough, and Dr Stein makes some very good points about why that kind of relationship may start to lose its appeal! But in time, but I hope it will be enough to reduce the pain, frustration and desperation that comes with the feelings of being excluded from my therapist’s life.

I am a ‘therapy-daughter’ – member, by adoption, of a bizarre but special sort of family. All families have their limitations – goodness knows that’s one of the reasons that brings so many of us to therapy in the first place. But the quirky intimacy and joy of this unique relationship is one I wouldn’t be without – and I just have to keep reminding myself of that. Over, and over again.