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Page Contents: What to do when you start to believe that your psychotherapist does not really care about you.                    


Suddenly I have this tense and anxious feeling and I just dont want to go to my psychotherapist. I have mentioned it to her. I’ve been with her for nearly three years (one year privately), and had a very good relationship with her but of late I “tell myself” perhaps even convince myself that she is just doing a “job,” does not really care about me, and from my obessional feeling for therapy and therapist I’ve moved to the other extreme and don’t know why.

I know I’ve come a long way but still have a long way to go and can’t imagine why I’m feeling anxious, stressed about our meetings. Knowing myself and my self destructive moods I feel I am capable of kicking out at the whole world both bad and good (therapy being the good). I only manage to bring these feelings at the last 5 mins. of our session.

I’ve never held back any information in the past but I find extremely difficult to talk to my therapist that of late I feel very upset about her other patients and just don’t want to become one of her list of other patients. A month or so ago she added another chair in her consulting room and since then I have this feeling of a third person sitting in the room and many time I feel like addressing this third person and not her.

Because of my split treatment with [my psychotherapist] and [my psychiatrist] (I am on lithium because of bi-polar disorder) I mentioned this to [my psychiatrist] which of course I know I should bring out with [my psychotherapist] and could not help feeling like the child running from one parent to the other.

I then told her that I the client felt so horrible and ungrateful because [my psychotherapist] has always been there for me, phone calls, meetings, etc., all of a sudden I’ve built up this defense wall with all sorts of negative feelings which are not even rational but are affecting me and the therapy and I DON’T UNDERSTAND WHY.

Your problem begins with the fact that you’re not running between two parents, you’re running between two mothers.

Now, this may not sound politically correct, but “always being there for you,” “phone calls,” and “meetings” are nurturing functions. This is the role of a mother who takes care of your needs. In contrast, a father “comes between” the child and the mother—to separate the child from total emotional absorbtion in the mother—and leads the child out into the world so as to teach the child how the world functions culturally and intellectually and how the child can function independently in the world.

Good psychotherapy, therefore, involves both mothering and fathering. We’ve already seen what the mothering function is. So what is the fathering function of psychotherapy? Well, it’s the ability to recognize the “third person” in the consulting room. It’s the ability to recognize that all personal identity is the product of external, arbitrary, social constructs. It’s the ability to work therapeutically with the unconscious.

And you encounter the unconscious in psychotherapy when you are forced to admit, “I don’t understand.” Call it the moment of truth.

So what is the truth you are being called to encounter now? Well, after three years of “a very good relationship” with your psychotherapist, you now have to encounter the ugly, dark side of all relationships. You have to recognize that intense negative feelings, such as hurt and anger and resentment, exist in you right beside the good feelings. These negative feelings aren’t just unique to you, but they are in everyone; in fact, they’re a large part of human psychology. So it is necessary to take responsibility for managing these feelings consciously, rather than letting them smoulder in the depths of the unconscious.

Of course you don’t like feeling horrible and ungrateful—after all, who does?—but that is exactly where the next phase of your treatment is going, if it is to go anywhere productive. In short, you have to experience the flip-side of “love.” You have to realize how much you “hate” your psychotherapist, even though it doesn’t seem rational. You hate her in just the same way you hated your mother yet couldn’t express it.

The best thing you can do, then, is to start speaking about all this in your psychotherapy, in the presence of that dreaded “third person.” Through the guidance of your psychotherapist, tell her what your difficulties are and begin learning to express all that hurt and anger about unfulfilled needs from the past, when you were just another needy child on your mother’s list. Otherwise, you will spend the rest of your life running from the truth, and going nowhere.


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Raymond Lloyd Richmond, Ph.D.
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A Guide to Psychology and its Practice



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