This personal story is provided by one of our guest authors, S.T.
My story begins when my life went into a crisis following a number of devastating events that happened within about a year of each other-including the death of my father and a divorce from a ten-year marriage. I ended up in the hospital after I experienced suicidal thoughts and feelings that were unrelenting. I knew that I was reacting from the despair I felt from the loss of loved ones, but I was also aware that there were other factors involved. Although the suicidal thoughts were relatively new I had struggled throughout my life with depression, anxiety, nightmares and a sense of worthlessness. Not long before the crises I had come to understand that the events that transpired in my childhood were still affecting me in my adult life. These events were too upsetting for me to dwell on for any length of time and I attempted to ignore them. After the crises I became flooded with memories from several painful moments in my past making it impossible to push them aside.Prior to the crises I had turned to therapy for help on a number of occasions. When the depression became debilitating I sought the assistance of various therapists. Several medications were prescribed along the way, none of them seemed to help as the symptoms always returned. These experiences with therapists were uneventful in that I would describe them as neither good or bad. I didn’t give the therapy much thought between sessions and even less thought to the therapist. For me, being in therapy was the emotional equivalent to visiting a medical doctor. The only thing that stood out about therapy was my discomfort because I disliked speaking of such personal issues, particularly with a stranger. But that discomfort was about me, not necessarily about what the therapist did or didn‘t do.
After I left the hospital, I decided I would return to therapy and give the process everything I had. I vowed that I would work as hard as I could do find the answers, to understand why I was in so much pain-why I was inundated with suicidal thoughts. I would talk about the subjects that I had ignored in the past and hopefully find a little relief from the despair and anguish. I knew that therapy would be painfully difficult. I knew that it would likely take time before I felt any relief. I did not have a time frame in mind. I did not believe that the therapist would magically fix things and make me happy. I was not looking for perfection or expecting easy answers. I assumed that when I returned to therapy it would continue to be the same sort of experience as it had always been for me. I was wrong.
Over an eight-year span of time I participated in psychotherapy with four therapists, one after the other. Two of the therapists were psychiatrists, two were psychologists. This essay is about the first therapist I met with.
I was referred to Dr. A and the therapy started out in much the same way as my past therapy experiences. In those experiences some of the therapists I had met with asked a lot of questions and the therapy seemed more like a mutual conversation. Other therapists were silent but for a few clarifying questions from time to time. Dr. A fell into the latter category. Dr. A was a psychiatrist who studied and trained at some of the most prestigious institutions in the country. After hearing my reasons for seeking help he strongly recommended that I meet with him as much as possible-as much as I could afford financially. He never discussed a plan or goals for the therapy. This was similar to my past therapy so I didn’t give it much thought. I just continued to show up and talk about the subjects I believed held any relevance in my life. The only clue I had that Dr. A ever regarded what I was saying as important was whether or not he asked a clarifying question. I concentrated on the areas that he seemed to respond to. I continued to report the relentless symptoms, including the suicidal thoughts and feelings, that never seemed to leave me. I made sure to let him know I had never attempted suicide and did not have a history of suicideology until about a year before the crises. He prescribed an anti-depressant but as far as any kind of verbal acknowledgement of what I described he mostly remained mute.
About three months into the therapy Dr. A suggested that I talk with him about how I felt about both him and the therapy. He told me that our relationship was the most important part of the therapy. This was a novel concept to me. I had never heard a therapist refer to the connection as a relationship. Without realizing it, I responded to his words in a powerful and disconcerting way. I was so alone and isolated and mourning the losses of loved ones. Dr. A’s words attached themselves to me, or I to them, and for the first time I thought of my therapist as someone I was in a relationship with. Shortly after this I developed what felt like romantic feelings for Dr. A. I agonized over these feelings. There was nothing exciting or pleasant about them. My initial concern was that, if I told him about my feelings, Dr. A would refer me to a different therapist. Considering all of the issues I needed to focus on I thought the protocol would be to send me to a therapist who would not be a distraction for me. That response made sense to me. Yes, it would hurt me to part with Dr. A but it made sense that my romantic feelings would be considered a detriment to the therapy. That’s how I viewed them. I had no idea what transference was or whether romantic feelings for the therapist were common. I had heard about people falling in love with their therapist, but it wasn’t something I had direct knowledge of so I was completely in the dark. I considered an attempt to bury my feelings and not tell Dr. A but I ultimately decided it might be harmful to the therapy to not be open and truthful. When I divulged my feelings to Dr. A he did not send me away. He encouraged me to speak of all my thoughts, feelings and fantasies about him. Throughout the therapy he repeatedly encouraged me to speak of my feelings, but I was extremely reluctant. I felt ashamed because I knew he was married (he wore a ring) and talking about my feelings only magnified the sadness I felt having formed feelings for a person who could only be with me in a very limited way-and for a limited period of time. Dr. A was simply another eventual loss in my life, a source of sadness.
Another element of the anguish I experienced, as far as my feelings for Dr. A, was the fact that I had no idea how he felt about me-on any level. Particularly after my divorce I felt unattractive and unwanted. I wished to be seen as a viable woman who was worthy of love. I desperately needed to know if Dr. A could see me in such a light. Not to act on it, but just to know that he could see those qualities in me. His reticence to speak of any specific positive feelings for me (even to say that he liked me) eroded my already extremely tenuous sense of self-worth. But what concerned me most of all was my response to everything related to Dr. A. I was terrified by the desperation and the intensity of my feelings. I was overwhelmed with levels of feelings that I had not experienced before. I felt agitated much of the time, feeling as if I was coming out of my skin. And, I began to believe that I could not live without Dr. A. As much as it hurt to be around him I didn’t think I could function without his presence. This made no sense to me particularly because I didn’t know anything about him other than he was a psychiatrist. How could I have such strong feelings for someone I knew so little about? I didn’t have the answer to this question and I started to fear that I was losing my mind.
I attempted on numerous occasions to explain the despair I felt about my feelings for him, and the fears behind their unfamiliar intensity but Dr. A always seemed confused and would only respond by telling me to continue to describe my feelings for him. Dr. A’s confusion and lack of support to help me attempt to deal with what I was experiencing only added to my anxiety and self-doubts.
My primary concern in life was what Dr. A was thinking and feeling. Every session included the hope that Dr. A would finally tell me that he liked me or loved me or tell me that he saw something positive about me. I was constantly hesitant to tell him things that I felt ashamed about, worried that he would see me in a bad light. This concern battled against my commitment to myself to work through all of my issues in an open and honest way. While he eventually told me that he did see positive things about me, he never told me what they were. I prayed that he was telling me the truth, but my plummeting sense of self feared if he honestly did see something positive he would surely tell me what it was.
Although Dr. A remained silent about conveying positive thoughts or feelings he did begin to share the negative side of his experiences with me. After I admitted my feelings for him our relationship moved into a different phase. We both started to respond in an emotionally-charged way at times. Certainly his responses were not as intense as mine-such as tears and the self-hate that often entered the conversation-but his responses did become a part of what transpired in the therapy. I continued to revisit the fact that I had a host of issues and symptoms that I brought to therapy, those issues still prominent and relentless in my daily life. The suicidal thoughts had continued regardless of the anti-depressant he had prescribed in the beginning of the therapy. In one session I again mentioned the hopelessness I was feeling. I was concerned that I seemed unable to articulate the severity of some of my symptoms-he rarely responded to my descriptions. On this particular occasion he decided to question my motivation for talking about the suicidal thoughts. In an agitated voice he said, “I think you’re trying to cause me to feel frustrated and angry. Now you’re going to be on my mind-and I think that’s what you want. I think you want me to admit you to the hospital against your will.” He continued to make these accusations, speaking of his feelings for the remainder of the session. I tried to plead my case, that I was merely describing what I was struggling with, but he insisted that it was my unconscious self that wanted to cause him duress.
This type of dialogue became commonplace between us. No matter how many times I tried to explain what my position was, to express the depth of my pain-not to punish him, he would tell me that it was my unconscious at work. I had no way of debating that sort of interpretation.
I spoke often of the worthlessness I felt that he described only the negative that he saw in me. I asked him why, if he did see positive things about me as he said, did he not ever tell me what they were? He always answered by telling me he thought I needed to intuit his positive feelings. He said he thought that it would be more helpful for me to come to the answers of how he felt on my own, not from words spoken by him. I asked him why he didn’t apply that same idea to the negative thoughts he had about me. With the negative he used several adjectives to make clear what was happening for him and how he thought I was behaving. (Those words included: frustrated, angry, threatened, manipulate, punitive and sabotaging to name a few.) He said he didn’t see those words or his interpretations as negative. When I told him that I believed his choice of words did indicate negative thoughts about me he told me I was simply projecting what I felt about myself onto him. He would not admit and take responsibility for what he said. None of what I thought or felt was acknowledged or considered by him-at least not that he made me aware of. My perceptions and what I knew to be true about myself were always disregarded and dismissed. If I felt badly it was because of me-not from anything he said or did.
He made me responsible for everything that happened between us. I was responsible for making him feel the anger and frustration. It didn’t originate in him. It came from me. He would begin his comment with “I think you want me to feel…” and then would include the negative thought or feeling that was on his mind – “anger“, “frustrated“, “threatened” and so on. I felt and thought two ways about the things Dr. A said. One was to question his accuracy and his motivations. The other was to question mine. This part of me, the self-doubt, was the strongest and although I spoke up often to try to defend myself I folded quickly. In one instance, late in the therapy, I asked him about the meaning of one of his responses and he told me that the therapy wasn’t about what he said and did. He told me he wasn’t analyzing his behavior. Not knowing what else to do, I started to eliminate some of the most critical subjects from our discussions in an effort to keep Dr. A from feeling negatively toward me.
I began a search for information about what was going on with me, with Dr. A and with the therapy relationship-on my own, outside of therapy. It was this research process that started to open my eyes to what was considered helpful in therapy-and what was considered to be potentially damaging. I continued to come across articles and books (written by mental health professionals) that deemed the methods that Dr. A used (not that he explained his methods) with me to be unhelpful, at best. Still, I could not part with him.
Another addition to the levels of pain and anguish I experienced with Dr. A was the realization that he was practicing out of his home. His office had a separate door, but the entrance to his home was only a few feet away. I ran into his pregnant wife, and then later his newborn child, before or after the majority of the sessions. Many times during the sessions, we could hear various sounds emanating from his home as his family went about their daily lives. One of the many issues that I struggled with was the fact that I didn’t have children and had been heartbroken that I would likely never have children considering where my life had taken me. It was jarring and excruciating to see and hear his family. It was in my face constantly yet in the session he was completely closed about himself.
One might legitimately ask why I remained in therapy with Dr. A. The answer is complex. One reason was that despite what happened, despite the fact that it made no sense to me, I felt a connection to him that I was terrified of losing. For the first time in my adult life I was cut off from social contact; I was isolated with the exception of my mother. I was desperate for help. I had all of the same problems as when I started therapy and I often wondered if my extreme reactions with Dr. A were a sign that I would benefit from the therapy at some point. I also wondered if Dr. A was correct and I was just trying to sabotage the therapy or to punish him. And, there were times when I thought I could intuit something going on with Dr. A as far as what he felt for me. At times there was a warmness from him. I also tried to convince myself that his emotional responses, while negative in nature, might come from a place of positive feelings. Unfortunately, I could only guess and, as I told him, when I don’t know I will fill in the blanks with negatives about myself. And there were comments that he made, comments that could be interpreted in different ways, that were provocative and kept me in a constant state of flux. On one occasion I had asked him how he felt about the therapy, a few weeks after he had said he was feeling threatened. I was deeply affected by his comments and wished to fix things so he would no longer feel threatened. He responded, “That’s not what you really want to know, is it. You’re wondering if I have similar feelings for you. You want to know if I think about us being together. If I think about us being married or having children together or having sex together.” At the time he made this comment I had referred to my feelings for him in as limited a way as possible. I referred to them only as “my feelings for you.” I had not given him any details at all. His comments were well beyond what I would have had the nerve to say to him since he was married. I wondered if he was providing information about himself in a self-protective way, by adding “I think you want to know…” On another occasion the conversation started in the same way and for the same reason. He responded, “That’s not what you really want to know. You want to know if I’m going through something too. That I’m also disappointed that we aren’t together.” In another example, I had expressed my desire for him to think of me as more than a patient, more than his job. He responded: “You want to know if I see you as more than a patient and I think you already know the answer to that.“ These comments would usually come after a particularly painful and acrimonious period of time in the relationship and he made several of these types of comments throughout the therapy. I wanted desperately to believe he was imparting information about his feelings for me, but I was unable to hold on to this possibility for very long. I came to refer to these comments, in my mind, as the “hook”. Comments designed to keep me guessing and keep me interested and keep me as a patient. It worked for quite awhile, but I did reach the end of my rope. I decided to leave the therapy.
I remained in therapy with Dr. A for three and a half years. He sat across from me and watched as I deteriorated. No matter what I said to describe my pain he never attempted to alter his methodology or take responsibility for what he brought to the relationship. All of my original issues and symptoms were still with me and just as intense. When I began therapy with Dr. A I feared that I was unlovable, ugly, worthless and that I was what was wrong when things went badly. When I left Dr. A I knew those things were true. I was devastated that I had failed at therapy, that all the pain had been for naught. I was scared of the possibility that leaving him would send me into a final spiral of hopelessness, but I knew that if I remained with him it would destroy me once and for all.