I know I sort of recently said I'd get around to discussing the roles my therapist plays, at least that I think he does, but a week and a half ago I had a session during which a thing or two he did as well as didn't do, really bothered me, to the point that I woke up in the middle of the night that night and couldn't get back to sleep for hours due to thinking about it, trying to work through it, and trying to figure some things out.
It became clear to me when I woke up later after having fallen back asleep, that maybe I needed to reassess some of my attitudes towards therapy, some of the roles I think he plays or want him to play, and reassess my general orientation towards therapy. I kind of need a paradigm shift, about what I expect and want from therapy, and what I want it to do for me, and whether or not I've been expecting THERAPY to do for me what I should be doing for myself.
At the same time my thoughts get so distorted and tangled sometimes I KNOW I can't always sort them out myself; in fact fairly often I cannot and get stuck. But is helping me see the distortions in my thoughts, and helping me to work inside myself to come up with alternatives to those distortions, ALL my psychologist is there for?
Often, he also reveals observations about my behavior, sometimes connecting things from months or more ago to something I just brought up, and it's sometimes a "lightbulb" moment when he does this. Other times it feels like he is observing, without connecting with what I'm feeling or thinking, when he does this. And so I then feel like he is being, well, cold, almost, or so neutral that it feels like I'm not interacting with a person; like WE aren't interacting at all, but rather that he's just stating his observations without other therapeutic things going on, like empathy and such.
I suppose the nature of observing, and being observed, is that the observer, in order to adequately identify and point out what they are observing, has to hold themselves apart, in some ways, to keep anything emotional or biased from affecting the observation. I think it is that "apartness" that I sense when he's giving me observations that bothers me, a little bit.
He does, though, give empathy when he determines I need it; he gives understanding, he gives patience, and even kindness from time to time. He gives objectiveness (which sometimes promotes that sense of "apartness" in me) and he gives no judgements (most of the time; he's not perfect and when I think he's judged me, I say so and he'll most often explore it with me for a minute and, if he thinks that he did, indeed, judge me, he apologizes for it).
I should say that he strives for objectiveness and lack of judgement; these seem to me to be two of the hardest things to accomplish, especially after you've been working with someone for years and could have some caring about their welfare. He has said, on a couple of occasions, when questioned about it, that he DOES care about his patients; he has said that is an acceptable thing in his work, and a natural thing to happen. It's my opinion that the better therapists (I've only had one, though, so it's a guess) DO care about their patients, on a basic human level. I'd imagine that those who don't would come across as cold all the time.
Even knowing this, I still have times I struggle with feeling less "connected" in our therapeutic relationship. Is connectedness, a feeling of give and take, a feeling of working TOGETHER in therapy, necessary, positive, etc. for the therapeutic relationship? I would suggest that yes they are essential for a good working therapeutic relationship. This does not mean that the times I feel this "apartness" I've described indicate big problems in the therapeutic relationship; it just means that maybe I should note these things to him so he's aware that I feel these things when triggered by specific things during therapy. It does NOT mean that he'll necessarily change his behavior, but I believe it's important to communicate with your therapist if and when you feel like it is more difficult to connect with them, or any other things that trouble me about the relationship at any time.
This makes me wonder, am I after too idealized of a therapeutic relationship? I am thinking right now that I know I tend to idealize people who treat me positively, and so I wonder if this is another attitude about therapy that I need to examine and perhaps change. I do not know that I necessarily idealize the relationship for sure, but this blog post surely gives me THAT impression. I will think some more on it and even talk with my psychologist about it.
There have been occasions I've taken one of my blog posts into therapy, read it, and then discussed it with him, sometimes point by point, and sometimes at the end of the thing. I think this one would be good to bring to therapy this week.
I don't know why it still surprises me after all this years that writing or typing out my thoughts and feelings on a subject will sometimes lead me to new discoveries, unexpected realizations, and even a reassessment of my own behavior or thinking/attitudes on a subject.
A postscript on the Lamictal rash: Well, welts never showed up and it became even more sandpapery feeling, so I was right that it was not the "bad" one that leads to Stevens' Johnson syndrome; on the other hand, I've had it for a week now and taking Benadryl changes it only a little, though I admit most days I've taken it sporadically.
What I do not know is if I should bump up my dose to 250 mg tomorrow as scheduled; the rash appeared the morning after I bumped it to 200; I may be too fearful and cautious, but I will keep it at 200 until I hear back from my psychiatrist via email; I don't think it's urgent enough for a phone call, and it shouldn't hurt me to stay at 200 for a bit longer (I hope!). I guess I fear worse allergic reactions like anaphylactic shock if I bump it up higher, with the rash not responding much to Benadryl.
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