At what point does a therapist decide to terminate a client because their relationship has broken down? Over the past three years writing my blog I have received many emails from therapy clients telling me that their therapists terminated them, either for no reason or for a small infraction within the relationship.
Are therapists being over-sensitive or are clients diagnosed with borderline personality disorder unaware of their own personal lack of empathy towards someone who is on their side? Being terminated for relationship issues with the therapist does not make sense to me. The entire reason we are in therapy is because we have huge external relationship problems and this plays out in the therapeutic relationship and the therapist should be aware of this.
But at what point does a therapist say enough is enough? Is it because of transference; counter transference; a therapeutic error; a pissed off punitive therapist; a client with irresolvable attachment issues; a personality clash or the therapist who blames the client? Is it none of the above or all of the above?
As someone diagnosed with Borderline Personality Disorder I can hurt someone’s feelings at a very deep level and think I have only superficially wounded them. I have hurt my therapist on occasion and used her as an “emotional punching bag.”
It appears to be a common pattern, I get upset and accuse her of something and she calls me on it and I get insight and remorse and think, why do I always do these things? At the time I feel I am being reasonable with my demands but on reflection of her point of view I understand where I went wrong and why I went wrong. The “why” is very important is therapy.
I have managed to circumvent this pattern by recognizing my body’s response to what is happening in the present moment. Why do I feel hostile towards her, why do feelings of jealousy and envy surface, why do I feel she is “out to get me,” doesn’t care, thinks I’m a loser or many other hundreds of different erroneous beliefs and schemas that abruptly surface when I am too triggered, hungry, angry, lonely, stressed, frightened, upset or tired?
Because I am used to operating at a very high emotionally hostile level where things I have said are highly inflammatory, outrageously insensitive, stingingly and penetratingly abusive, I assume everyone else can operate at this level as well and get over it the same way I do. After a row I can “forget” hurtful statements I made and others cannot. I have lost friends and family members due to my behaviour.
So I have to be aware that my choice of words, tone, volume and body language dictates my future relationships. I have been told by my therapist, in the past, that I can take her for granted and it is not a nice feeling to receive that sort of assessment of our relationship, true as it might be. I attempt to stay in the present moment so I do not take her for granted.
Therapists are not emotional punching bags. They are professional people who deserve respect for their difficult work. I try hard to say to my therapist that I am feeling out of sorts today and not in a good frame of mind and for some reason it feels like it’s about our relationship. That’s called transference and this tricky, sticky, icky little concept is what gets us Borderliners into enormous strife in session.
A good therapist will know this, and take it into account, but sometimes therapists have feelings as well, hidden unresolved parental issues, or are even undiagnosed Borderliners themselves. And we can press their buttons quite easily. Not all therapists are self-aware, self-insightful or take self-responsibility. It is always a good thing to have had therapy yourself before therapising others, to sort out issues and problems, but not all therapists think they need this.
When I hurt, when I am triggered, I just want to lash out. But I let my body inform my brain of this these days. I work hard at not reacting emotionally, at distress tolerance, at maintaining and enhancing relationships and most of all I try to be mindful and stay in the present moment. Most of the time I do get it right.
Most of the time.
Pictures: http://calmingyourinnerstorm.blogspot.com.au/2011/07/stop-pushing-my-buttons.html, http://www.adfs.alabama.gov/FATM.aspx and http://blog.lib.umn.edu/meyer769/myblog/2011/12/
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Last reviewed: 15 Apr 2012