I remember a friend telling me years ago how much it annoyed her when people regarded therapy as a bit of ‘tea and sympathy’, and had little appreciation of the immense effort of mind, body and soul that it takes to do therapy, and to keep going. I still find myself a little shocked and irritated on the odd occasion when my husband almost seems to put therapy on a par with ‘a night out’, or implies that it is fun or enjoyable. It can be fun, and it’s true that I look forward to going. But as with the ‘tea and sympathy’ remark, I think his words betray a deep lack of understanding (which to be fair, I have felt unable or unwilling to address) of how gruelling that therapy hour can be, and how much hard work is involved.
My friend’s descriptions, and the short courses of CBT I had had in the past, meant that when I started psychotherapy in 2013, I knew that I wasn’t in for a walk in the park and that there was a long, tough road ahead. But I still had no idea how the open-ended ‘talking cure’ actually worked –how long the process could be or how intense and all-consuming it could become. I remember reading ‘Get me out of here: My recovery from Borderline Personality Disorder’ by Rachel Reiland, just after receiving my diagnosis in early 2013, and wondering how on earth anyone could have three psychotherapy sessions a week. Surely no one but those in the worst difficulties imaginable (and I have no idea who I thought those individuals might be) would need three sessions a week!
And yet here I am, recently having moved from two to three sessions per week of psychoanalytic psychotherapy. I have joked with myself that this ‘worrying trend’ will not continue: in my first year with my current therapist I had one session a week; in my second year I had two; and now, in my third, I am up to three. Unlike the move from one to two sessions, this one was suggested by me, and the decision felt nowhere near as obvious. It was patently clear after a few months with my therapist, that one session a week was not enough – the gap between sessions was simply too long and too disruptive to the work, which felt very unconnected from week to week. Two sessions worked much better and my second year in therapy was a revelation, in so many ways.
Nervous though I still was of change, when something is working and is productive, you end up wanting more – or at least, I did. It felt as though we had a huge amount to cover; my two sessions were quite close together and the long gap over the weekend felt very hard to get through; my trust had deepened, the relationship had become stronger, and it felt as though we were making really valuable progress. All of which prompted me to make the suggestion of a third session, in the full knowledge that what might actually lie behind the request, might simply be my intense attachment to my therapist and the desire to see her for an extra hour a week. Because when it comes to my emotional connection to her, any amount of time with her, would never be long enough.
As soon as the suggestion went from being just a possibility to being an agreed upon course of action, I started to get cold feet. It wasn’t about the time constraints or the finances, all of which had taken a lot of thought and working out; it was about the feelings that suddenly arose in me in connection with that ‘extra session’. It very much started to feel like an ‘extra’ – like an unnecessary indulgence. I didn’t really need it; there were so many others who were ‘worse off’; it didn’t feel right that I should give the impression things were ‘that bad’ that I needed three sessions of therapy a week. We trialled a third session a couple of times over the summer and each time, as I approached my therapist’s front door, I had a huge sense of not being worthy of that extra time; a feeling that I really shouldn’t be there, and that I wasn’t really wanted. Once I was in session I felt as though I was depriving potential clients of a valuable morning slot; and that I was depriving her of an interesting new client. Instead, she had to put up with ‘more of the same’ from me. I was afraid of her getting bored, and of her getting resentful. I was afraid that as she hadn’t suggested it herself, that she didn’t really think that I should have a third session.
I brought those feelings up with her – it was hard to avoid, as they left me in tears right at the start of those trial sessions. We talked about where those feelings might have come from, and why I felt that my needs were less important than those of other ‘potential clients’; and about why I often felt as though I ‘forced myself’ upon people and that my presence was unwanted. She told me that there was not another client waiting for that slot; that it was free, that she had genuinely offered it, and that I should accept what it was that I wanted and was being offered, without feeling bad about it, or giving myself a hard time. Thinking about it now, perhaps this was another example of my putting a course of action into a ‘moral category’ where it did not belong (as described in my recent post ‘Staying connected to my therapist – and trying to be kind to myself‘). This allowed me to ‘legitimately’ beat myself up about the decision I had made and even gave grounds for backtracking upon it, both of which were easier options than dealing head-on with my feelings of being unwanted.
I remember from my early reading on psychotherapy, being struck by the idea that a client’s feelings about the practical arrangements governing therapy – time, place, payment – can often provide valuable therapeutic material. I have certainly noticed how the practical differences in my third session have triggered feelings that were not as present before. My other two sessions are at the end of a day: I turn up having had a busy time at work, with my ‘work persona’ still in place. That persona takes a little time to fall away, and when I get home it doesn’t have to be ‘put on’ again; I can process therapy, and then go to bed. My therapist too, can put her ‘work self’ aside once she has seen me on those days.
In contrast, my third session is at the start of the working day for both of us – following a spare hour or so afterwards in which to ‘process’, I have to get to work and be productive, however challenging or distressing that session might have been. And my therapist has other clients to see. Which, I am slightly ashamed to say, has given rise to strong feelings of ‘sibling rivalry’ with regards to her other clients. I have felt distress and resentment after that third session: because while I struggle to focus and to put aside my post-therapy feelings, and while I feel very alone with those emotions; she ‘gets on with her day’ and not just that – at some point, even if I am still in her thoughts, she has to physically evict me from them, in order to ensure that her focus is completely and utterly on someone else. I always knew, of course, that that is what she does for every client – and I am grateful for it, because she does it for me, too. But it feels completely different when you know that that eviction will be happening imminently, and you start to imagine the faces and the stories of those who are responsible for it. It has been another illustration of the lesson that, just as with a mother’s care and attention, hers isn’t finite and carved up into an increasingly smaller number of slices, depending on the number of clients she sees. Her other clients aren’t a threat to me – however impossible it can feel to accept that truth.
Having said all of that, and difficult though it still feels to accept that I have a right to that third session, I think that it is already proving helpful, and that in itself is frightening. Frightening, because if therapy progresses more quickly, the end of therapy will come sooner and that is an eventuality that I still cannot bear to think about. Twice now, that extra session has allowed a topic that came into play at the start of the week, to conclude or resolve in a way that simply would not have been possible in just two sessions. I asked my therapist what would have happened if we hadn’t had that third session, to which she replied: “It would have taken longer”. But how much longer, I wonder? It’s not simply that the discussion would have been postponed until the following week. Depending on what else happened during the gap over the weekend; how my thoughts or feelings changed; and how long it took to ‘peel back’ the layers of the working day and my working self – it might have been quite some time before we reached the same point. The third session follows quickly on from the second, and no time is wasted ‘changing gear’ from the day – it feels as though my emotions are more readily accessible. I think that, as well as the additional time, makes it possible to get to the heart of things and to start challenging and changing, much more quickly.
Changing gear in therapy is always difficult, and that third session has really brought home to me again, how emotionally and physically exhausting therapy can be. That gruelling hour I referred to at the start of this post can leave me feeling wiped out for days, and it’s also having a temporary impact on the way I’m processing therapy, and how this comes out in my writing. There was a similar effect last year – looking back, I wrote slightly fewer posts in September 2014 as I adjusted to the move from one to two sessions a week. Right now, I cannot even begin to see how to write about some of things I have been exploring in therapy over the last few weeks. As my therapist has said, a number of markers have been put down – issues which are not ‘done with’, but which have been brought to a helpful conclusion for now, to be visited again later. And when that happened I felt I really needed to take a breath – to leave the subject while it either lies dormant for a while or is worked on subconsciously. In the past, the material of therapy used to occupy a very large part of my thinking space in between sessions, and that came out in my blog posts which themselves were part of the processing. Over the last couple of weeks I have hardly thought about the material of therapy in between sessions, and I haven’t yet felt able to write about it.
I know that that will change – and there is so much I eventually want and need to write about, that has happened over the last few weeks. Some very important work has been done and I have come to a number of valuable realisations. I feel as though I have crested wave after wave of a therapy storm, and those waves are still coming. In the meantime, for those who may not have experienced therapy, but who want to know a little of what that can feel like, I can do no better than refer you to a couple of excellent posts by psychotherapists who, having been in both the client’s and the therapist’s chair, can attest to the fact that what it takes to weather that storm and to stick it out, is courage – with not a cup of tea in sight, for it wouldn’t survive those rolling seas. And as is beautifully described in this post by Dr Gerald Stein, what you reap is what you sow – therapy doesn’t just take courage, it fosters it. It enables you not just to take the road less traveled, but eventually to be the road less traveled – a more authentic version of yourself.
October 19, 2015 at 1:24 am
I’m at 3x a week as well. It’s not perfect but it does help me feel more contained and less anxious, which in turn allows is go do more work. It can be intimidating and downright exhausting at times. I struggle to find balance. Wishing you the best.
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October 19, 2015 at 7:53 pm
Thank you – same here 🙂 I think it reduces my anxiety too, particularly over the weekend break. And yes, it is IMMENSELY exhausting! I still find it hard to believe just how physically exhausting that therapy hour can be!
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October 19, 2015 at 2:19 am
I kind of envy you the three sessions, or even the two. Until early this summer, I only got to see E. every two weeks, and it felt like such a long time between sessions that I kept losing momentum. I think that is part of the reason I didn’t make much progress for a long time. Now I see her once a week, but even that sometimes feels like it is spaced too far apart. There are days I feel like I spend a third of the session catching her up on what happened over the past week. Her sessions are only 45 minutes, so I often feel I have to leave right as we’re getting to the core of something important. I’m not sure what to do about this though. Even if she had another slot available (she does some weeks but not all), each session costs me $67 after insurance, so it’s a lot to add additional sessions. I wonder if it would help to go to someone else in my insurance network (which would cost me just $10 per session) but I have known her for such a long time, she knows my history, and I trust her.
It sounds as if that third session makes a big difference for you, and I can see why it would. You can dive deeply into something, process it for a day or two, and then carrying that processing right away back into the next session. With sessions a week apart, new life events are often distracting and pull e in different directions from one session to another. But a question: do you feel like three sessions a week could promote an over-attachment? I worry even now about relying on her so much…
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October 19, 2015 at 7:55 pm
Thank you SO much for your comment, which I really appreciate – I want to reply in more detail but can’t do so right now, so just wanted to say THANK YOU and I will come back to this within the next couple of days! x
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October 19, 2015 at 8:06 am
Hi Life In A Bind. Your blog post illustrates so clearly both the process and challenges in therapy.These two things cannot be separated from one another. Entering into therapy (let alone increasing sessions per week) does bring up one’s internal “stuff” that can then be thought about in the room – felt and processed. Congratulations on persevering in your therapeutic journey! I hope you can share your post with your therapist and that you can reflect on it together. Keep up the good work! Warm regards, F.
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October 19, 2015 at 8:01 pm
Thank you so much – I really appreciate you reading and taking the time to comment, and I’m definitely grateful for the ‘congratulations’ 🙂 I have shared my posts with my therapist since almost the very beginning of me starting my blog -she has seen this post and hopefully we will talk about it more soon. It’s interesting – my thoughts about sharing blog posts with her can sometimes be a barometer of how things are going. If I am reluctant to share a post with her, it leads me to wonder why, and to talk about it with her. I’m also conscious of not wanting to communicate with her via blog post – so I don’t tend to write about something significant until I have had the chance to at least mention it to her, so that we do our major communicating in session, rather than remotely. Thank you again for your comment – I am always glad to have ‘the therapist’s perspective’ 🙂
October 23, 2015 at 2:55 am
I see my analyst five days a week, and I see a “supportive” analyst on Saturdays because I have such a difficult time with the loss of connection over the weekend. It is still not enough, but it is what it is.
I also plan to never be done with analysis. My analyst says that lots of people are in it forever, and I plan to be such a person. One never stops growing or learning. It sounds like you’re doing great!
October 26, 2015 at 10:17 pm
Wow – that sounds like ‘traditional’ Freudian analysis, is that the case? I’m in awe at the mental/emotional strength (and physical resilience as well!) that that must take. I am sorry you are finding the gaps very difficult and it’s not enough, but glad you have the support that you do. I can completely understand the desire to make this a lifelong endeavour! If my therapist were the same age as me, I think I would be saying exactly the same thing 🙂 But the thought of ending with her, and of forming an attachment to anyone else, at the moment is impossible….If you are happy to do so, would you say a bit more about how this analysis works? Is it traditional ‘on the couch’ work, and how does this function in practice? I have often wondered about trying it as my therapist has a couch in her room, though we have always used chairs instead, and I get the impression she seldom does ‘couch work/traditional analysis’ anymore….thank you for reading and commenting!
October 30, 2015 at 4:43 pm
It’s actually not Freudian, it’s Modern Psychoanalysis (looking up Hyman Spotnitz is a great place to start if you want to learn more). Five times/week isn’t a requirement of modern analysis but it’s important for me in order to keep the connection. It is the most intense, intimate experience I have ever had. Analysis is fascinating.
My analyst would happily let me lie on the couch but the idea makes me nervous. It feels very exposing and somewhat sexual to me. I’ve never done it. I’ve heard that it can make free association more productive as it can remove the pressure of looking at the analyst while talking. (You should ask your therapist about it – she has a couch for some reason!) Instead, my analyst and I sit on the floor next to each other, with our arms touching. Lately we’ve been sitting with a blanket across our laps. Occasionally she will hold my hand. It’s very warm and wonderful and really helps me relax enough to feel a connection and talk. It took a lot of convincing, though, to get her to try it this way. She was very hesitant (“That is not how analysis is done.”), and I brought in a lot of research on oxytocin and physical contact in analysis in order to support my position. But, I knew what I needed in order to be productive and I think she picked up on that. We’ve been sitting together for about five months and it’s been working very well.
The focus of my analysis is on the relationship – how to be in one that is healthy and mutually respectful, how to ask for what I need and how to get my needs met by someone besides just my analyst, and working through the transferences. It is chaotic and messy and often overwhelming; it took awhile for both of us to find our footing. My analyst had never worked with someone five days a week, sat on the floor, etc. It is also very, very lovely.
My analyst is 61 and I am 26. Though she says she never plans on retiring, the reality is that one day she will have to stop working, either due to old age or death. I will, at some point, need to enter into another analytic relationship. I plan on being an analyst so it will be important for me to stay in analysis. The thought of losing my analyst, though, is incomprehensible.
I love your blog! It’s nice to read about someone with similar experiences (I, too, “have” BPD, and often find myself in binds, and lost a therapist I felt very close with and am still dealing with that loss). I’m happy to chat about therapy anytime; it’s my favourite topic! 🙂
Hope you are well.
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October 30, 2015 at 5:10 pm
Oh wow….will reply more later but is there any chance you could email me that research or point me to the Web links ? I think there is zero chance of changing my therapists mind on this one, but it sounds fascinating and I’d love to read about it. I do also have lots of questions! But more about that later 🙂
November 1, 2015 at 6:36 pm
Sure! I’m a firm believer in the idea that touch in therapy, while not for everyone, could do many people a lot of good. So, I’m always happy to help where I can 🙂
I should mention that after I first asked my analyst to sit with me and she said no, I accidentally stumbled across alexithymia, which I found to strongly match my experience. Alexithymia is basically a lesser ability to know what one is feeling. My research into that showed that increased oxytocin is helpful in the “treatment” of alexithymia (excuse the quotation marks; I hate labels and diagnoses and such). My argument for contact in my analysis became even stronger with the idea that oxytocin is released in this way.
I emailed a bunch of therapists/analysts who had written about this topic as I was looking to make my case as strong as possible. I’ll include their suggestions as well. So, I’ll just give you what I have – some are more alexithymia related and some are just touch in therapy.
Hope this helps! Happy to answer any questions 🙂
Click to access Breckenridge-K-2000-Physical-Touch-in-Psychoanalysis-A-Closet-Phenomenon-Psychoanal.-Inq-202-20..pdf
Click to access In%20search%20of.pdf
Fosshage, J. (2000)
The meanings of touch in psychoanalysis: A time for reassessment.
Psychoanalytic Inquiry. Vol. 20, 1: 21-43
Speaking of feelings: Affect, language, and psychoanalysis. Published in Psychoanalytic Dialogues 8: 685-705, 1998
Whew! I also have some articles I can send via email if this isn’t enough information, haha.
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November 2, 2015 at 9:52 pm
Wow – thank you SO much for all of this! There is enough to keep me busy for a year 🙂 Honestly, I envy what you have, even though I would not in a million years want to have a different therapist to the one I have developed this relationship with, even if another therapist was prepared to use touch. There are so many times when I feel absolutely desperate for touch – when it feels so important. At this moment, and for the last few years, touch has been primarily a negative thing for me (or, at best, a neutral thing). And though my therapist can show me a ‘different way’ when it comes to acceptance and other things that I may have missed out on in the past, she cannot help me to re-experience touch in a positive way, if touch in therapy is prohibited. And that feels like such a problem sometimes. But at the same time we _have_ developed an amazing trusting andr close relationship and she _is_ really really helping me and I _am_ making progress. And I absolutely take her point that touch may be what the child desires (or even what the adult desires), but touch is always more complicated for adults.
Thank you so much for offering to answer questions – and I hope it’s okay if I continue to take you up on the offer in future! I guess I have one key question right now, connected to my post https://lifeinabind.com/2015/08/08/sexual-feelings-for-your-therapist-and-what-they-can-tell-you/ . One of my difficulties is that my thoughts feel very real, even if the thoughts themselves are very unlikely to come ever come true and may not even want them to come true. When I think of the possibility of say, being hugged by my therapist, or of holding hands, in my head I imagine that I would find it hard to resist the temptation to push boundaries with that touch. Part of me knows that in real life a hug is a hug and I would not try and push it to anything else -that the thought is unsafe and shocking and in ‘real life’ that is not what I actually want, despite whatever ‘fantasies’ I might have on occasion. But because I have the thought, the possibility feels real and likely, as opposed to being just a thought. I guess my question is, are your feelings for your therapist ‘complicated’ and multi-faceted, and do you see them in different ways on different occasions, and if so, how do you manage to maintain safe touch in that context? Does it ever become frustrating or tempting to push boundaries?
Please don’t worry if you’d rather not share all of this stuff, or if you’d prefer, please do feel free to email me! I really appreciate your comments and the information you sent, and your experience sounds awesome. I think it’s great that you know that this is what you want to do long-term as well – I know that I would never ever make a therapist, but I have the greatest admiration for therapists – I think it takes some very special qualities to be able to do the job 🙂
November 2, 2015 at 9:59 pm
Therapy is my favourite subject as well 🙂 And my therapist is a very similar age to yours, though I am a little older than you 😉 Like you, the thought of losing my therapist just does not bear thinking about and is immensely distressing. I know she will retire within ten years – probably sooner than that. I also know that she will move to another area when that happens, and finding that out a few weeks absolutely threw me into a complete state and was shocking to me. The thought of her house being occupied by someone else; of not being able to go by her house and know she is there; of having a great deal of distance between us – the thought is horrific. And of course I started to think about ‘other endings’ too – at some point she will die. That in itself is absolutely horrible, but the idea that if she dies elsewhere I won’t be able to ‘visit’ where she is….that was very upsetting as well.
I have heard the same things about lying on the couch, and I do hope to try it someday, if only to see what it is like! I have briefly discussed it with her before – i think we have felt it wouldn’t be a good idea (up to this point) as although it can make free association easier, you also can’t maintain eye contact and you can feel more ‘cut off’ from the therapist. And given abandonment fears and my need for connection, it didn’t seem wise to try and situation in which those feelings might be exacerbated. But now I feel more trusting and secure, I think I would like to try it at some stage 🙂
Your therapy environment sounds immensely warm and wonderful -I am really happy that it is working out so wonderfully for you 🙂 x
November 6, 2015 at 5:15 am
You are very welcome!
I totally hear what your therapist is saying. Touch is complicated, even when it’s incredibly natural and simple. Tonight my analyst sat with her arm around me and it was wonderful, and then the session was over and I had to leave and go home. It will never fill the hole from childhood, no matter how much I get. I think, like you said, it is most important to have a meaningful relationship, because it is in the space which the therapist and the client create that change occurs.
To answer your question (requires some background):
I have a history of sexual abuse, and in my family of origin it was unconsciously communicated that it was shameful to have a body, to physically exist, because bodies are only for sex and sex is bad. Touch was seen as sexual so there was very little of it outside of the abuse.
My previous therapist was very affectionate and that is how I grew to be aware of the lack of touch in my life. Before that, touch was incredibly awkward for me and I kind of looked at it with disdain. But then my first therapist decided I “needed some mothering”, zipped up my coat, and I was high on touch. I grew to love her in a maternal way (nothing sexual ever happened) and even though our relationship started to get very rocky, I could never imagine leaving her. I knew that she was in over her head with me, but the touch was too important to lose. Eventually things got so bad that she dragged me around a room and pinned me in a corner when she thought I was suicidal. I had bruises from our squabble and I worked up the courage to leave a few months later. She had been so kind to my body, but ended up hurting it.
Okay, so my analyst – initially I was very wary of her. On our second interview session, I asked if she would try to have sex with me if I decided to lie on the couch. I was sure that no one would ever touch me safely again, that my first therapist had been my one and only chance.
I wasn’t too concerned about erotic feelings. I did once have an overwhelming urge to kiss my first therapist, which I’ve never discussed. Once recently with my analyst, I felt so moved by how much I loved her that I felt that a kiss should follow our hug. I haven’t told her, but I think for me it’s from my history (what isn’t?!), that I grew up thinking that sex is the only way is the only way to be physically intimate with another and when I love someone, I’m supposed to be sexual with them. Logically I know this us not the case and the feeling passed as quickly as it came. My analyst did ask once if I had any sexual feelings about sitting together. I said no, and she said it was okay if I ever did, that she wouldn’t freak out and we would just talk about them and not act.
So, my feelings for her were initially complicated in a different way – I was worried she would hurt my body like so many other people had, and then I was desperate for her to touch me and she wouldn’t, which brought up feelings around my mother. Now she does touch me, but she’s mentioned that she isn’t a naturally physically intimate person, so I often want more than I’m brave enough to ask her for, because I desperately want to preserve the relationship and I don’t want to drive her away with my neediness. And more than anything, I want to go to her house and curl up in her bed with her and sleep. It is frustrating that I can’t get what I want/need. The feeling toward her is always maternal and that is how I interpret her touch.
I absolutely, 100% trust my analyst to not cross a sexual boundary. I have spent many hours in her office alone with her, and if she wanted to do something, she could have.
Hopefully that answers your question! Happy to provide clarification. Honestly, you seem like you’d make an excellent therapist. You have a lot of curiosity and insight.
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November 11, 2015 at 9:19 pm
Thank you SO much for such a comprehensive reply and for being so open about your own past circumstances….I’m so sorry for everything you’ve been through, and that your previous therapy relationship was one in which touch ended up being used in a way that hurt you….and I’m so glad things are so different with your current therapist. I think I worry much more than I need to about the potential for more erotic feelings – I think that if it came to it, and those feelings arose in the context of a hug for example, like you, they would be fairly fleeting. If I was in a ‘flirty mood’ to start with, it probably wouldn’t be a situation in which it would be wise to hug in any case! 🙂
I’m sorry to take up your time with follow-up questions – but if you didn’t mind…! I’m just wondering how you got to that place of her changing her approach…..I’m not actively trying to change my therapist’s mind, as it were, but I do feel that by talking about it (which I have started to do), I need to keep checking ‘where we are’ with that conversation. Have ‘the rules’ changed? Are they still the same? It’s almost as if, having started to talk about it, I don’t really know what to do with the material……how long did it take (weeks, months?) to have these conversations, and did you have to be very explicit about what was or was not ‘allowed’ and what the new boundaries of your relationship were? Or was it much more organic and spontaneous – did you just find yourselves in situations where touch happened? Do you always have to ask, or does she initiate it? How do you know if she will respond positively to something you might do, or _did_ you know, in the beginning? Or do you always ‘ask permission’ first, as it were? Sorry if these seem really silly questions – I tend to be quite ‘rule driven’ because I’m so worried about putting a foot wrong, and I also like to reduce uncertainty and know where I stand!
I’d make a terrible therapist 🙂 I think I would probably fall for my clients and have terrible boundaries – or at least, I would if I tried to do that sort of work now! But I guess by the time I get much further with my own therapy, the idea is things will have changed 🙂
November 14, 2015 at 11:57 pm
Thank YOU for letting me talk about this! It’s really enjoyable.
Obviously I don’t know you but I think you’re right, erotic feelings – though very real – are maybe not so worrisome. They are feelings like any other, and they warrant a good discussion. They don’t require action, and it seems to me that you have enough awareness that should the feelings arise, it’s likely you would be able to prevent any action from occurring.
So, as I said earlier, my analyst was absolutely against touch in analysis. The feelings of rejection and abandonment from my mom were so strong that I had literal freak outs when my analyst would say no. I mean, full on meltdowns, hyperventilating, dissociations, you name it. When I left my therapist, I thought I was ready to give up the physical contact – boy, was I wrong! And now I was in a situation: stay with my analyst and accept her position, stay with my analyst and hope that she changed her mind, go back to my therapist, or go find someone completely new.
So, there was a lot of discussion. A lot. I brought in all of my research. We talked theory. We talked about needs. She said that I might not deal with the feelings of abandonment if I didn’t face them in my therapy. I countered that obviously she wasn’t going to sexually abuse me, and I wasn’t going to have to relive that to process it, so why did I have to relive something else that was traumatic? Lots and lots of discussion.
Of course, she consulted with other analysts, which I fully encouraged. Her supervisor was supportive of my position, someone else was completely against it, and a third person was on the fence. The person who was against it suggested analytic reading material for me which ended up pissing me off. It was all about how talking in analysis is important, etc., etc. I said that of course I wanted to talk – that was what the touch was going to help with! Without touch, it felt like a very formal business meeting or an interview, and I didn’t see how I would be able to work productively in that mode. (The guy’s literature also pointed me to alexithymia, so I admit there was some benefit.)
My analyst continued to say no and so we tried to come up with ways to eliminate the formal feeling. We started by sitting across from one another on the floor. It didn’t really help and it was even more frustrating. With our legs extended, we could have touched each other’s foot and that was not allowed. It was just… haha, I don’t know. I had to be very patient. Looking back, it set a very good foundation for our ability to discuss our relationship.
Anyway, my analyst held firm and while she was very compassionate and kind about the pain I was experiencing, I told her that I didn’t know if I was going to be able to stay if we weren’t able to touch. She understood and said that while it could happen down the road, it wasn’t going to happen now.
So it was really the alexithymia that did it, I think, plus our many, many sessions of discussion. As I mentioned before, in my research I found that alexithymia responds to oxytocin, and oxytocin is obviously released when there is human contact. After that, things kind of changed and we eventually sat down together to write a contract. It was supposed to be a trial and if it didn’t go well, my analyst said she might have to refer me on to someone else. It was kind of a scary leap but I didn’t know where else to go with it. The contract stated that we had discussed and researched the topic. It said that we would sit together on the floor in order to help me talk and for a therapeutic alliance to form. Either party could terminate at any time. As touch in therapy can be taken as sexual, and given my history, it was very, very important to me that our arrangement was not kept secret. And of course it wouldn’t be, as my analyst discussed my case with her supervisor, but I wanted it in writing. And my husband was made aware of the situation. I just wanted people to know so it wasn’t this “dirty secret”, even if it wasn’t dirty. Touch in analysis is obviously not common. My other big concern was that we had been dealing with this issue for so long and it had been so stressful that I was unsure of whether or not I would be able to work with my analyst based on the fact that I had had to struggle so much to get her to try what I knew I needed.
Haha, sorry this is getting so long!
So, we signed the contract and then we sat together and it was weird at first. And there was a lot of stuff to work out, like when I wanted to hug her and she wasn’t comfortable with it, or how I felt she was distancing herself from me if we were sitting very close but not actually touching – you know, just, I don’t know. Details and such. And you mentioned checking in – we did A LOT of that. I would ask her how she felt, she would ask me how I felt. She would see if the contact was too much, not enough? I was worried about forcing her to do something physically that she wasn’t comfortable with (because it made me feel like I was being abusive in some way), and to this day I ask her at the beginning of every session if I may sit next to her. We’ve been sitting together for about five months now and it really is working beautifully, but we talk about it now and then. I always want to make sure she is comfortable. Additionally, she has gotten to know me in that way and has held my hand or put her arm around me a few times when our discussion has gotten particularly difficult. And I always, always get a hug on Fridays before the weekend.
So, I think it’s good to keep talking because you might have feelings about something initially and then your feelings can change or evolve, and same with your therapist. It’s a good rule for any relationship, I think, whether there is touch or not. Checking in with a person you’re in relationship with is a great resource because it helps you to know what’s going on.
I think it took about 4-6 weeks of constant discussion (and I was doing 5x/week analysis) for my analyst to feel comfortable trying it. It felt like a very, very long time.
As far as boundaries, my analyst said she wouldn’t want anyone to sit in her lap or anything, and that was fine with me. I’ve mentioned how I’ve wanted a hug or something and she’s been hesitant, as she was raised in a way where you don’t just hug people you don’t know well. In the past month or so she has seemed to be more comfortable with hugs and I’m taking it as a sign that she has come to know me better. There are still the rules of the contract but they don’t really feel like rules, they feel like a very clear understanding of what each other is comfortable with and a mutual respect to uphold those standards as to keep the relationship respectful. I would never want to make her uncomfortable, nor would she want to do that to me. It’s just kind of… easy, now, I guess.
As you can probably surmise, touch absolutely did not come about organically, at least in the beginning. Every now and then my analyst will reach out to me when she knows I need it, and that has been really nice. But at first it was awkward and a little forced. She knew that I knew what I needed but felt out of her element and it was a navigation on both of our parts. It’s always difficult for me to ask for something because of my worry of making her uncomfortable and being too needy. Like I have this fantasy that some Monday (maybe this Monday!) I will go in her office and sit down next to her and ask her if we can hug under the blanket for a few minutes so I can just BE with her, because weekends are so difficult. But I have yet to work up the courage to ask for that.
Your questions aren’t at all silly, and I hope I didn’t repeat myself too much or just go on in a verbose way. I really like your questions because it helps me to reflect on what we’ve been through and, as I said before, talking about therapy is my favourite subject! I told my analyst that if this works out, she should publish an article. I think it’s kind of a unique way of working and it has definitely helped me and if it could help someone else, then all the better.
This is kind of a weird offer and I don’t know how you or your therapist would feel about it, or my analyst, but if you ever did get to the point where you wanted to try any of this and your therapist was looking to do a consult, I’m happy to ask my analyst to share her experience with your therapist. I’m not sure if she’d do it, but she might.
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November 12, 2015 at 9:12 pm
No problem with answering additional questions. Rules are very important around issues like this, I think. They help to keep everyone safe. My analyst and I actually wrote up a contract before any touching occurred. This, I think, was really to protect her if things took a turn for the worst and I wanted to sue or something (which I would never do. I could have sued my first therapist and decided against it – but that’s another story!)
Anyway, I will happily answer your questions in more detail. I will get to them this weekend.
Hope you are well!
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July 5, 2016 at 12:35 pm
Wow, both the post and the comments (I always read all the comments on your posts as well) are very interesting. I currently only see my therapist once a week, even though she wants us to have two sessions, but I unfortunately can’t afford it at this stage. I’m hoping I’ll be able to sometime in the near future though. Once a week certainly isn’t enough and it’s torture having to wait 6+ days between sessions. Even though my therapist occasionally sends me messages to let me know she’s thinking of me.
I’m super jealous of the whole touching in therapy discussed in the comments, lol.
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July 22, 2016 at 10:24 pm
I hope that you are able to find a way to have a couple of sessions a week, at some stage – I think many people are fine with one, but it sounds as though both you and your therapist are on the same page about sensing another session would be useful…..Personally I have found that although more sessions is exhausting, it really has enabled us to do more and for more progress to be made. It’s not just the amount of material you have time for, but the fact you’re not spending time ‘getting reacquainted’ or ‘peeling back the layers’ each time, before you can delve deeper. Some people are able to dive straight in, but it often takes me a long time to get round to talking about what I want to talk about, and to establish ‘reconnection’ with my therapist after the weekend. My therapist has spoken about it almost as though you start to develop a skin or ‘crust’ in between sessions, and the longer the gap, the thicker this gets and the more there is to dig through at the next session, before getting beneath it. Having more sessions means both that there’s more time to do the breaking through, but also less ‘crust’ to break through as it’s had less time to grow! If that makes any sense at all! As for touch….it’s taken me a LONG time to become more accepting of the fact that this is out of bounds in my therapy, and for me not to feel resentful or incredibly sad about that. I used to feel ashamed and resentful talking about it, but I’m now able to do that openly and honestly, without feeling like I’m asking for anything, but just telling her how I feel. And strangely, that in itself has really helped – so even though I can’t have the hugs, I have the experience of being able to talk about it openly and comfortably, and have her really acknowledge and see and understand that need for hugs, and validate it, even though she can’t actually give those hugs, physically. The ’emotional holding’ is becoming more real, and that’s lovely….(but I’m still a teeny bit jealous of not having the actual hugs themselves 🙂 )…
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July 25, 2016 at 5:58 am
I’ll definitely switch it up to two sessions a week as soon as I can afford it. Therapy is the one thing that I’ll give up all luxuries for, in order to squeeze in another session, lol. The nice thing about my therapist is that she has this way to break down my strongest walls within a few minutes of our session, and make me feel connected and cared for again. Maybe it’s because it’s still only been 4 months that I’ve been seeing her, the “honeymoon stage”, haha! Only time will tell I guess. What your therapist says makes a ton of sense. Thanks for making the time to reply to me. 🙂 ❤
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November 2, 2016 at 1:18 pm
So glad I found your blog. I was searching for BPD as that’s what I’m self-diagnosing. I’ve been in psychotherapy for nearly two years and just today added a third session a week. We called it turning the heat up after a dream I had a few weeks ago. Curious and anxious what will happen and oh, the guilt… You exactly describe my thoughts in this and so many other posts! Thank you for writing.
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November 11, 2016 at 10:44 pm
Thank YOU for reading, and for your comment! I hope the third session is working out well and you’re gradually adjusting to the new pace….