There is a dark side to therapy that nobody wants to talk about; even therapists, especially therapists. It’s a Catch-22 where emotionally-promiscuous clients quickly fall into dependency with their therapists and problems occur when dependency, instead of the original problem, becomes the main issue. Weaning yourself off your substitute mother/therapist can be like trying to forcibly remove a security blanket from a two-year-old or an attempt to separate the ingredients of a corrupt Hollandaise sauce after the egg has curdled.
Michael G. Conner, Psy.D, author of the internet article, Transference: Are You a Biological Time Machine? gripes that “Transference is really difficult to recognize, deal with and understand, but it is incredibly interesting. I tend to avoid people who are “oozing” with transference potential.” His attitude is not uncommon as Borderline Personality disordered clients, seen by many as the cane-toads of Therapy World, tend to “ooze” transference. Seen in another light - dramatic, intense, super-heated, fierce and impassioned, but controlled and regulated thoughts, feelings and behaviours where you have easy access to powerful emotions can be an amazingly vital and life-giving source of art; think Sylvia Plath, Vincent Van Gogh, Brian Wilson, Patrick Swayze, Marilyn Monroe or Heath Ledger.
Borderlines in therapy are hard work, and their recovery never follows the straight, narrow and linear path from problem to solution in twelve Medicare-covered insurance appointments that the Australian government would like us to believe. It took me fourteen years to learn that the Art of Borderline is in mindfulness, not madness. It’s in the knowing, harnessing, concentrating, focusing and sitting in the moment long enough to capture, guide and mold the lingering essence of the raging storm into something creative and constructive. Overweened therapy is not part of this process. When an emotionally intense person gets hooked on therapy, it’s hard to give up that dependency and become your own person; you just want to get legally adopted by your therapist and walk together hand in hand towards the quintessential sunset. So while those emotions don’t just disappear overnight, they do have to go somewhere else.
Here are ten methods I have found helpful.
1. The Perfect Person.
Your therapist is not perfect. But just because she doesn’t remember the name of your favourite teddy-bear when you were six years old doesn’t mean she doesn’t care for you during the therapy hour or even sometimes outside it. Like electricians living in houses with blown light globes, non-working ovens, and live wires hanging out of random walls, dentists with cavity-ridden children or psychologists with badly behaved teenagers (actually they are the worst) and nurses who hate looking after sick family members; your therapist, when she leaves her office for the night does not want to deal with her family, her friends or anyone else’s problems, let alone your extra-curricular 3am emails, phone calls or text-messages. She just wants to chill out with a bottle of wine in front of Desperate Housewives or South Park like everyone else and have a long hard bitch about her day.
2. Literal -v- Symbolic
Therapy is role-playing. Your beloved therapist is role-playing your symbolic mother. She is not your biological one. This is a phenomenon I’ve had trouble coming to terms with. Therapists get quite frightened and tend to mutter the “T” word (termination) ominously when this happens. I get angry when she is not available 24/7 but I do have to remember I am not two-years-old and pre-verbal. I am a grown-up woman who can look after herself and her family.
3. Exorcise dependency needs from your therapist.
And I mean that in the nicest possible way. Ritualize the exorcism if you like. Light a scented candle to symbolize the removal of dependency and transference needs, at the same time building up and retaining the not-so-subtle nuances of the nature, spirit and intense oxygen-giving, red-cell life-blood of being that was once you and her merged in a symbolic relationship, and use that intensity in other areas of your life. Internalize the lessons learned, re-experience the warm, rich, acute brain feelings of those aha moments. Un-enmeshing and un-entwining, but remembering with loving/kindness takes time, patience, motivation and practice. Instead of thinking what my therapist would do in a certain situation, I think what I would do, with the knowledge and power I now possess, thanks to her tender care and kindness.
4. The Internalized Therapist.
I have to remember always what I have learned, in a healthy, healing, mindful manner. That is the embodiment of good emotional-regulation. Sitting in those brain-storm moments of overwhelming feelings, working out what they are, where they came from and finally realizing I do not have to act on them. I can have Grace on one shoulder and Dignity on the other and my Internalized Therapist sitting, Buddha-like, in the middle coalescing and fusing with my highest chakras, harmonizing with what I have learned from her to make me who I am today. I know, in that respect, she will always be with me.
5. Move On.
When you feel as though you have learned everything about yourself and you are wondering if you are just seeing your therapist for coffee and a chat, it’s time to reassess why you are still going to see him/her. Are there issues you have not dealt with or do you just enjoy a loving, motherly chat? I had to sweep aside with an iron broom the self-deception, repression and ultimate denial as to my reasons for still ringing up and booking those appointments. I sometimes forget I am well now.
6. Keep yourself busy.
Plan your day as best you can. I hate routines and boundaries but they work when I adhere to them. I learned that in a psychiatric hospital. Physical, emotional, mental and spiritual busyness can keep your mind off the fact that therapy is no longer available. When I’m at work I’m finally me, without the lingering therapy-ghost hanging around Drop Dead Fred style. There are plenty of times I no longer feel umbilically attached to someone who is not a huge part of my daily physical life now.
7. Replace therapy with something you love.
I love writing, it gets me into the zone, a space where I can recreate myself, discover my potential and create a vibrant headspace where I fully believe I am ok and fit into the cogs and wheels of a rapidly spinning world. Some people knit, garden, paint, crotchet, make china dolls, play guitar, cook new food recipes, fly model airplanes, get a dog or a cat to pour their love onto (just don’t call it by your therapist’s name). It doesn’t matter what you do as long as it gets you “into the zone” where your mind slows down to a set-point where some form of balance, rationality and stability kicks in. Sometimes for me, cleaning the bathroom and toilet calms me down.
8. Enlighten yourself with education, intellectualism and rationalism.
You don’t need to enroll in a psychology degree to educate yourself on the role the amygdala and hippocampus play in your Post Traumatic Stress Disorder or permanent hyper-vigilant state. Google search for insightful articles on anything psychologically related, although I guess if you are reading this you have already discovered the power of the internet. Anger, rage and hostility are the biological reactions where stress incites our amygdala to produce copious amounts of cortisol, the stress hormone which can cause us Borderlines to go postal. Falling Down, anyone? I have an overactive amygdala which means when someone gets in my face or thwarts my goal, I channel bunny-boiler Glenn Close and think my head is about to explode. Learn about your brain, educate yourself in alternative behaviours other than smashing a cup or a plate on the floor and watching and feeling the subsequent dissociated, unflinching nothingness as the shattered rippling effect of china shards fly all over the place; followed by a feeling of high justification. I was always mindful enough to use the cheap china. I never once smashed a piece of Wedgwood or Royal Doulton.
9. Forgive yourself for having extremely harsh and protracted emotions.
This is a tough one, especially if you set high standards for yourself. It wouldn’t occur to you to need to forgive yourself for diabetes, kidney cancer, a stroke, a heart attack or a broken leg. So forgive and be kind to yourself for having a biological pre-disposition towards unholy emotions but know that there is something you can do about it.
10. Cold Turkey.
When all else fails there’s cold turkey. Hot turkey is something I have once a year at Christmas - hot, smelly, dry, and stringy and for some reason has a most repressive and foreboding taste. So you can imagine what cold turkey tastes like. But sometimes it can be a most palatable dish when the alternative is to mainline that infected needle of endless therapy and wait for that warm, nurturing but ultimately self-destructive rush to kick in.
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From Psych Central's World of Psychology blog:
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You make a metaphor of transference being like the omnipresent/dependent two-year old. And yet you then talk about tumultuous trasferential feelings being unending. My experience has been that these feelings, very much like those of the two-year old, if allowed to be experienced, honored and taken seriously, mature and are transformed into a much broader and healthier dependency, which can then lead to a termination of the therapeutic relationship. For those who have been deeply wounded early in life, these feelings take sometimes many years to transform. I look forward to the time when Borderline PD is accepted for what it is: Complex PTSD.
Sonia, You raise a good point by observing that transference dependency may feel like a “dark” and unexpected side to therapy. However, some of your “keep-a-stiff-upper-lip” advice runs completely counter to much of what I’ve been taught. Transference is not something to be brushed under the carpet, but, rather, it is often the very site where the core of the patient’s problems are expressed. Not that it is good to dwell on your transference issues, but the idea of “keeping busy” in order to distract oneself seems just as dangerous. I agree with Claudia. If the transference dependency isn’t resolved, the therapy isn’t over.
I can’t think of more destructive means to go than cold turkey.
I view too strong of an attachment as analagous to taking benzodiazepines. Quit taking them all at once and you have seizures– tapering is the key, the means for slowly ending dependency and giving a person the opportunity to walk away free.
Hi Tec,
I’ve had many emails from people who have had no choice but to go through cold turkey as their therapist or the company they work for has abruptly terminated their therapy. Their stories is what prompted me to write this article.
There is also the other side of the coin where privately paying clients can get hooked on endless open-ended therapy even when their main problems are resolved. Even if they’ve done the weaning process they still simply don’t know how to separate without anxiety from their therapist. It’s been compared to the insecurity of teenagers leaving home, they are more than ready but still need to be pushed out of the nest in order to fly.
Claudia, There can still be dependency issues after the transference has been resolved. Transference resolution doesn’t mean an end to those tumultuous feelings, it just means you are more aware of where your intense feelings are coming from and no longer have to act on them. But if you are still dependent on your therapist post-transference, it is a problem and needs to be dealt with. I’m talking about a relatively minor proportion of clients but they always seem to fall into the BPD category.
Yes, BPD is a form of PTSD with a side-dish of hypervigilance. I’ve also heard these clients can be high functioning, motivated and although a challenge to deal with, are not always treated with disdain, in fact some of them elicit strong positive counter-transference feelings.
Have you read Nancy McWilliams case study of Donna in her book, “Psychoanalytic Psychotherapy.” It is a warm moving account that mirrors the mother/child relationship.
There can be still be loads of dependency issues post transference resolution. My article is to highlight ways of dealing with those intense feelings post transference awareness and stuck in present high dependency needs.
TAR, I’m British by birth and live in Australia. When you have completed therapy, where transference issues are out in the open and dealt with, a stiff upper lip can be a life-saver, especially in a work situation. That means feeling the feelings but not acting on them, it doesn’t mean repressing them out of awareness.
Regards to all, Sonia
I am your article and found it humorous and light. I laughed to myself as I read it because I can relate. Do I take it as the LAW…no. But I appreciate that you have taken the time to relate to people who face transference and dependency issues with their therapist. This is a very difficult issue to deal with, and can be scary, frustrating and confusing. But humor helps when we are trying to figure stuff out. I loved the way you used your vocab skills to put this piece together. Thanks for sharing and shedding some light on such a tender subject. Peace
Thank you for this article, especially #9.
What a wonderful article! And I laughed at seeing myself over and over. I am not sure I have finished learning enough to live comfortably, but I do know I HATE the dependency which just happens! and my dread of this dependency and apparent inability to control it, my dread of angry transference issues which never seem to get resolved over the years with many different therapists, is now pushing me out the door after decades. I still have pervasive anxiety which physically hurts, and reoccurring deep depression, but I now have many good days when my dissociation covers the pain of my symptoms, and I have accepted this is how it will be until I depart this earth. I think we not only have to accept that the therapist is not “perfect”, but we also have to accept that life is full of pain and adjustment, life is one challenge after another and if we are to grow and learn from our experience here, then we have to face and walk through these challenges, no matter how scary.
I guess I just don’t understand why this stuff is supposed to be funny. I’m at a loss with that one. Love is sacred to me so I just don’t get it. My feelings have always felt like a beautiful gift that should be held and cherished. They are a sign of my potential. I’ve been out of therapy for more than 9 months and still adore my therapist and miss him.
I also have a very strong distaste for the idea that therapy is all about role-playing. It sure felt like a genuine relationship to me. I never ever got mother vibes from him. Protective “Big Brother” types of feelings? Well, yes. If anything, my feelings for him are maternal…on my end.
I guess my point being that everyone’s experience in therapy will be their own and they have to find what best fits them in order to heal. I can’t understand how caring for another person (even when that person is my therapist) can be bad for me. Obviously I’m not dependent on him. Maybe I was for a time, but I would not have viewed that as a negative thing back then. I’m still feeling great. The love that I feel for him is really about me. He just brought it out in me.
I know I should probably refrain from reading articles like this as it is difficult for me to not take it as my feelings (or anyone like me that has had a similar experience) are being made fun of and laughed at. They are ultimately sweet and caring and really represent the best of me. The gift he gave to me was in showing me what I have to offer. Sure there is some transference involved here, but there are also 2 human beings who cared for one another as well. You can’t categorize that.
All of this is my personal opinion and meant to be said in a respectful manner.
Thank you Sonia for a very thought provoking article. It doesn’t really always matter how ‘correct’ an author is in any/every way and form there is, but more so, how stimulating the article in stirring one’s brain, and feelings.
And that you have surely done here beautifully.
So many thoughts come to my mind, I need to make a choice about what points I want to most comment on.
First, an easy one.
Claudia Behr says: ‘I look forward to the time when Borderline PD is accepted for what it is: Complex PTSD.’
I never thought about Borderline PD in those terms but am very intrigues with your definition, and think it’s great and has so much truth to it. Thank You!
I am also thinking that time limited therapy is not always only a negative but has a lot of positives. And I don’t mean twelve sessions. but there is something comforting about knowing that you have maybe 30 sessions, and that’s it, because it makes some really work harder, as you want to get it all in. Then, the time limit could be reassuring and work like a container. Open ended therapy is very difficult to tolerate, I think.
Then, the therapist him/herself has a huge amount of power to make a difference as it relates to not only ‘normal transference’, but helping prevent ‘pathological transference’ and ‘dependency.’ (I mean the stuff that is unbearable to the patient)
She/he can do that by being more real, and in the presence, and by volunteering to share some of who they are as people, avoiding the ‘blank screen’. Giving real answers, and saying what they think.
I remember my first visit with a psychiatrist who did psychodynamic therapy, and the initial interview.
He was asking me about my father, and I told him that my father really did not live with us, although my parents were not divorced. So the psychiatrist responds by saying this: “You believe that your father did not live with you?”
I was speechless, and said nothing but I thought to myself: ” No, I don’t believe that my father did not live with us, I know my father did not, so what’s the deal here you idiot?” More honestly, his response set the ground for me falling into his view of me that I was some sick idiot who wouldn’t know .
Last, as I am getting really tired, is this, and it’s not a theoretical point even if it may sound like one.
When people do such things as cut themselves, they do so usually for more than one reason. i.e. to get out of a painful state of emotion, or to ‘feel’ when you are numb and feeling ‘nothing’. The cutting may be as a result of something like a feeling, or it may be in prevention of feelings to come. It may get you to do something that you were not able to do before.
(I am not even going to bother with the ‘attention seeking’ one as I find it way too stupid to even consider)
But here is a serious one. This dependency is horrible for the patient, and it is especially horrible for a patient who had made it his/her life goal to never become dependent on another, and/or never to need anything, or be a burden. So, when this happens it leads to total self hatred.
Cutting yourself when dealing with such therapy dependence for such a person, and especially if they do not want to be labeled Borderline, they may and do use ‘cutting’, and not only always the slight superficial cutting, but serious cutting, to cut the dependency to the therapist.
And Sonia, since I am feeling both insecure and vulnerable today, i would really like it if you said if no more than a couple of words about my comment, like just acknowledged it?
Thanks,
KATRIN (not edited)
Thank you Katrin
Katrin, I can relate to everything you have said.
Thank you for saying it all so well.
This article is quite patronizing and dismissive of the complicated therapy relationship. Therapists create the dependency then run a mile when it becomes an issue. Don’t hide behind your “education” and get real with what is a huge issue for many people in therapy. If dependency is an issue its the therapists fault for fostering such dependence. And the person who wrote the first comment, no offence but BPD is not anything like complex ptsd.
You are awesome! I relate to everything you are saying.
I just wish my therapist didn;t take some of my comments so personally..Although, the Transference got out of control..so I guess termination was the only option…with no open door ever to return or check in,,,and that has almost killed me.
It sounds to me like your therapist really missed out on this with you. Unless, of course, the therapist feels he/she is being threatened in some way. The best way to deal with transference issues is to to explore and understand them. Your transference within that relationship is like a blueprint of sorts. It is a wealth of information about you…what motivates you, what you need and desire within relationships, what you need to work on within relationships and it basically tells you a whole lot about who you are. I can’t imagine being left to hold all of that and to have to do it alone. It must have been agonizing to have all of this happen with a “no open-door” policy for returning. I’m very sorry to hear this happened to you. It seems like a missed opportunity to learn a great deal about yourself.
Well I’ve got to say that many years of dependency on my therapist, I am sorry I went down this path.
The only resolution now for me is cold turkey. I am not going to be torn apart for months over weaning this relationship. I just haven’t picked the day yet that I am leaving.
I pushed for a more real relationship and got it. Now I’m suffering for it. When I move on he’ll be glad and won’t flinch. Me? The suffering will last forever.
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