Is she going to refer me out? hi all, I apologize for the long question, but Ive been hanging on by a thread and just please go easy on me. recently my therapist told me that in her 11 years of practice I am the worst case she's ever seen. my mental illness consumes my mornings, afternoons, and nights. she has really been pushing me to consider long term treatment, and despite my never ending suicidal ideation she leaves the decision up to me. I have done short term psychiatric stays, and I seem to come out in the same mental state. I've grown so attached to her. I'm terrified she will drop me, I feel like she's all I have left in my life and I recognize that that is unhealthy. She checks on me daily, phone calls, text messages and I've grown to feel so guilty. Like I'm a huge burden in her life.
I guess I'm wondering what you would do with a client like me..
It does sound like you’ve had some very challenging struggles, and I’m sorry to hear that you’ve been going through so much.
I only know what your question says and I’m missing a lot of context, but it does sound like this therapist has gotten sucked into something with you that’s not at this time therapeutic.
She’s clearly gone far beyond what a therapeutic relationship typically entails to reach out to you daily.
That’s not in and of itself a bad thing. The therapeutic frame can involve a wide variety of conditions and daily contact could be one of them. If you two had talked about this daily texting and phone calling and agreed together it’s what was needed for a time, then it would be fine to continue and you would not feel guilty… or if you did, you would simply talk it over in therapy and work through those feelings.
I’m guessing that things drifted into daily contact based on her fears, though, and that what’s at play now is some kind of enactment of your own trauma dynamics.
It also seems that whatever she’s afraid of for you has not gotten any better, and now she’s feeling frustrated as a result, and her saying you’re the worst case she’s ever seen is an expression of her frustration. Again… she’s focused on her feelings, not yours.
So… for this therapy situation to actually be therapeutic for you, as in it helps you heal, not simply plays into your particular mental health dynamics, your best bet is to bring up the dynamics of your therapeutic relationship themselves and step outside them and talk about them. You are the therapy client and it shouldn’t be on you to lead this process. A good therapist should understand how to do this. However, it will likely be on you to bring up that there’s a problem to alert her of the situation. The idea of bringing this up may feel overwhelming to you and the answer to that is for you to share exactly what you’re feeling when you bring it up. You can preface the conversation with something like “I have this concern but I feel afraid to bring it up because (insert perception of reason if you have one or just share the feelings). Hopefully the therapist will respond in a nondefensive way and a few really great conversations can get your therapy back on track, and you two can make an intentional decision about a level of in between session contact that works for both of you. If she gets defensive and/or blames you for stuff and persists in that state, then you’re going to have to seek out a new therapy situation, as hard as it is.
My point in all this is that regardless of the severity of your own issues, a huge part of your problem is that the therapy you’re in has lost its effectiveness and that is likely contributing to your symptoms getting worse, not improving, etc. If you and your therapist can get the therapy back on track, then your symptoms should begin improving and you two can assess how that’s going and if you need some additional support.
A good therapy situation is generally a better option than inpatient treatment… based on my own experiences. So… I would focus on securing a good therapy situation, first by bringing up your concerns with this therapist, and if that doesn’t work, seeking out a new therapist who can stay focused on you and your feelings and is able to properly contain her own feelings. In either outcome, your responsibility as the client is to be very honest about your feelings and experience right now, and it’s your therapist’s job to help you explore and work through all your feelings and in the process help you reach a level of emotional regulation that allows you to navigate your life’s challenges and improve your life overall.
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