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Page Contents: Learning to become vulnerable in psychotherapy and ask for what you need.                    

 

I have been in . . . counseling [about ten months]. I chose it specifically because of the religious sensibilities of my practitioner. He is a psychologist, Ph.D. like yourself. He has, from what I can tell, an excellent reputation and seems very skilled and well-known, with long years of experience. Counseling is done over the phone, e-mail, and by video conference. . . . He lets me e-mail him very frequently, which we both recognize to be less than ideal, but part of the way it has worked out because of the nature of the . . . counseling, and by necessity length of time between sessions. In retrospect, it really isn’t the best arrangement, but it is what I have to work with now. I don’t think either of us realized that I had a lot of deeper issues that I had covered up when we started out, it seemed like a few sessions would get me on track. He has informed me that it is best we cover things in session, not by e-mail, but then he will say, if I need to e-mail him, I can, which, of course I do—all the time! So there is some ambiguity, because, it is amazing for me to be brave enough to e-mail him so often, which is why, I suspect, he allows it, and often responds. I just feel this overwhelming need to maintain a connection with him, and if I can’t, I feel quite desperate and despairing. I’m confused about whether giving in to that impulse to e-mail him is a good thing or a bad thing. I think he wants me to learn how to become vulnerable and ask for what I need, but I can’t really seem to tell how that is supposed to apply to everyday situations.

My question is, how can you tell if what your doctor is doing is appropriate for the counseling, or not, when you are in the middle of a major problem with transference. I have all these fantasies that he will “rescue” me or father me. But how can I trust that he knows what he is doing, when trust itself is the big issue for me? I’m concerned because I can never tell if he is using some kind of smart tricks on me or if I just don’t trust him because now he isn’t as nice to me anymore as he used to be. I used to make great progress, but I hit a wall when I realized I was doing everything for him. . . . I just wanted his approval. I still do. My thinking is all cloudy and confused on him, but for example, I think I got angry at him for what I perceived to be his lack of caring for me or even complete disgust with me, and got brave and showed my anger for the first time asking him why he doesn’t care enough to help me through sessions, and saying that it seems like he can’t wait for me to get out of his hair, to which he responded “I have no need for you to leave counseling. But I can’t help wondering why you persist in torturing yourself with such an incompetent and uncaring counselor as you have now concluded I am?” So, I am confused, because then I felt I had to appease his hurt feelings, even though it is always made clear that I have no effect on him whatsoever, he is here to help me, that he can’t care for me in the way that I “need?” him too, etc. etc. Oh, I am just SO confused, and I want so badly to be able to talk about all this stuff with him in person, but when we have a conference I completely freeze and can no longer speak, can’t remember much of the session, and he refuses to initiate the process by asking me any questions to help me talk or anything like it. He says I have to ask for what I need, but that makes me feel so bad to do, I can’t make myself do it for some reason, even though I have a million things I am dying to try to find out about—I forget them all and can’t even read my list anymore. I’ve asked him to help me stop doing this spacey scared thing, but he won’t, just keeps repeating that I need to help him guide me, which I don’t even understand. How can I tell if what he is doing is the right thing or if it is motivated by his own weird stuff?

 
From what you have told me, I think your psychologist is doing “what is appropriate for the counseling.” You have actually summarized his objective in your own words: “I think he wants me to learn how to become vulnerable and ask for what I need.” In particular, notice how this objective is the opposite of your own psychological defensive tendency to “cover up” things, just as you say you did when you began the treatment. In other words, your psychologist’s objective is to help you overcome the psychological defenses you have acquired from childhood, defenses that serve to protect you from emotional pain.

In this regard, you have the answer to your concern about whether your frequent need to e-mail your psychologist is a good thing or a bad thing. From my professional experience, I have learned that e-mail is an ideal way to cover up emotional conflicts and to present things in a highly controlled manner. The fact that e-mail is fast and socially pervasive only obscures the truth that it is spiritually damaging, at least as compared to speaking directly with someone. In other words, it works for business but it fails miserably for psychotherapy because it maintains the illusion that you are communicating, while, at the same time, it covers up your true feelings—especially spontaneous feelings of anger.

Having understood this, we now have an answer to your “problem with transference.” The real problem here is your inability to express the feelings underlying your anger. You learned as a child that expressing anger would bring punishment—not understanding—from your parents, so you learned to cover it up. That is, you learned to blame yourself for what you didn’t know how to do rather than admit that you felt angry at your parents for not teaching you what you needed to know. And, believe it or not, you are now doing the same thing with your psychologist. You want his help, but because you don’t know how to express your emotional hurt when you feel confused, you cover up the hurt and, turning it all into unconscious anger—and ultimately into a melodrama—you try to convince yourself that you “love” him and that he will rescue you.

  

When your psychologist commented about why you would continue with someone as incompetent and uncaring as you believed him to be, he was making an interpretation about your underlying unconscious masochism. Apparently, that interpretation failed because it needed further explanation, but, instead of asking for that explanation, you went deeper into masochism. In this case, your psychologist made a technical mistake. Still, you can find clear evidence in it that when others fail you, you blame yourself.

  

What you should do, therefore, is gather up all the things you wrote to me about him and tell them to him directly on the phone. (Don’t try this in a video conference because it would be too intense for you. That’s why you acted so “spacey” before: in general, it’s very difficult to express feelings of irritation to someone on whom you depend for protection, and so to attempt this face-to-face, without practice, may feel overwhelming. The telephone offers some anonymity. Alternatively, during a video conference you could ask you psychologist to turn his back while you speak.)

If he responds with criticism, just like your parents did, then you know you can’t trust him. But if he responds by trying to help you understand the meaning of those feelings, then you know you have a competent psychologist. And then, in hearing your concerns, he might adjust his technique to give you some additional help in expressing your inner experiences.

Continuing to speak with your psychologist in this honest manner about any confusing or frustrating thing that happens in the psychotherapy is an “everyday experience.” With enough experiences like this, you will learn the techniques and develop the confidence to ask for what you need from anyone.

 


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Raymond Lloyd Richmond, Ph.D.
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