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Page Contents: The hard task of seeing through your defenses in psychotherapy.                    

 

I’m on SSDI for the past 5 years and don’t work. . . . I devote about 20 hours a week volunteering with 2 groups that advocate for and work to [deleted for confidentiality], and do grassroots organizing. I also volunteer with . . . a group devoted to promoting non-violent dispute resolution; the peace/anti-war movement. Two weeks ago, my psychologist (PhD) abruptly terminated my therapy with her, telling me at what I thought was to be a regular session that she was terminating immediately. I . . . have seen her for about 13 . . . years. . . . The only explanation given to me re: the reason for termination was that she “couldn’t remain objective” in treating me. She spoke of consulting colleagues (incl.. my psychiatrist), and someone with APA ethics. . . . The specific details of my situation are very, very complex and not easily summarized. . . . I am baffled about what is going on here. I think I’m due a more expansive explanation. . . . It feels so adversarial to me. . . . My faith in the mental health field is gone. I plan on . . . dropping my psychiatrist, stopping my meds, not finding a new therapist. . . . How can this happen this way? Sorry for being so long-winded. I’m in quite bad straits over this issue. Violated, abandoned, confused, angry....terminated.

 
Let’s begin with the end of your message. “How can this happen this way? . . . Violated, abandoned, confused, angry....terminated.” These are profound feelings. And right in the midst of such feelings is the place where psychotherapy should begin, not end.

For most persons, such feelings begin in childhood. And it could be that some form of childhood abuse affected you as well—something irrational and baffling, something that left you feeling, well, violated, abandoned, confused, and angry. And most persons—lacking proper psychotherapy—try to deal with emotions such as these by driving them out of conscious awareness through various psychological defense mechanisms. For example, in your circumstances your wanting to research “termination” is a form of intellectualism. And, like it or not, even social activism is more often than not a psychological defense to get political satisfaction for unconscious emotional hurt. Consciously, you want to end war, and yet unconsciously you are at war with the entire world.

So, if you’re still reading and not fuming at me, I can say that, from what you have described, your psychotherapist has handled the case ethically. Something came up between the two of you that she couldn’t handle objectively, she sought outside consultation, and it was decided that termination was the best recourse. So take it as a blessing. Instead of turning your anger against yourself by stopping medications and feeling victimized by psychotherapy, recognize that feeling “violated, abandoned, confused, angry, and terminated” is the very emotional core of your psychotherapeutic work that, in spite of 13 years of treatment, has been missed all along.

So rather than try to find political satisfaction for your hurt, find a competent psychologist who’s smarter than you are and can see through all your defenses.

 

 


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Raymond Lloyd Richmond, Ph.D.
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