The Absent Therapist

68 Replies

I am not sure if he realises just how much this affects the relationship, not to mentionth3CUJMC8Q the continuity of our sessions. He must know.

In between weekly therapy, I write my way through a “self-therapy” process and I need to trust there is a safety net each week in the shape of a real Therapist. Why is this so difficult to establish?

Paul and I have been meeting for eight months now, but he has cancelled at least five, maybe six, sessions. I did explain after last time how it made me feel, trying not to sound too judgemental, or condescending. thT2GOKY63He didn’t say why he was absent last time, but I barely gave him a chance. I do possess a very selfish approach to therapy.

Some people like to know a little about their Therapist, whereas I would rather not. If Paul is off due to a physical illness, then I would only feel uncomfortable bemoaning about my pitiful life. If he suffers depression, it would only fuel my fears of our sessions making him worse. This is why I prefer to work with a blank canvas because it ensures my freedom to explore whatever I like without worrying about the response.

One of the most difficult things about this saga is that Paul is a wonderful Therapist, whenever he decides to show up, that is. I have met a few over the years and he is one of the best. I probably underestimate the connection we already have and I am free to share anything, without judgement.

The programme comes as a package, comprising weekly individual sessions with Paul and group therapy. Unless I want to leave the programme, it looks like I am stuck with a reasonable group and a Therapist who is possibly a little unreliable.

Nevertheless, the overall therapeutic focus continues to improve life on an almost weekly basis, sometimes I feel like a stranger in my own body. A major hinge of that change comes from interacting with so many amazing people, both on this blog and equally on theirs.

I am doing a blogging 101 course this week and have come to realise just how specialthB5TK4BV9 my blog actually is, not so much the content of posts, but it is more about the community of people who come and go, always so ready to offer advice and comfort, or just a shoulder to moan on.

I want to say thanks to each one of you who make my blog so very special.

68 thoughts on “The Absent Therapist”

      1. Priceless Joy

        I meant, vain, by assuming I was one of them. 😀 I’m sorry about Paul not being there Cat. I remember the disappointment I had when mine did that to me. I’m going to ask you to try and find something positive in it, if you can.

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  2. patternsofsouldevelopment

    Maybe it’s his strategy – I mean, you say he’s so good. And he doesn’t feel like giving you a reason for being absent, which only supports this.

    I dare this speculation only because I know as a fact that, in therapy, it’s not the therapist, it’s YOU! It’s you who eventually need to come to terms with crisis, pain, identity, self-image, etc. He might tell you thousands of times what a wonderful being you are (I’m sure he doesn’t), but you won’t be able to believe him, unles this neautiful flower grew in your own garden. All he can do is occasionally water the seed of your birthing, new soul.

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    1. Cat Post author

      You know, this very thing has been playing through my mind all day. I am aware it’s me who needs to deal with the emotions it evokes, etc, but I’m still not so sure that taking so much time off helps anyone… sort of caught between the two views.

      Thank you for commenting 😉

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      1. Life in a Bind - BPD and me

        I think you’re right about it’s us needing to deal with emotions invoked in us by situations -however, we are in therapy, and I think that that means that we are trying to receive help in knowing how to do that, and in uncovering the reasons/motivations/history behind our reactions and our emotions. So although you may ultimately be ‘doing the dealing’, I think that in the context of therapy, it would be reasonable to bring this up in discussion during a session, and look at the difficulty together, so that Paul can help you process this emotion, just as he helps you process other emotions. The fact that this one is very directly about HIM, shouldn’t make a difference to that (other than perhaps, to make it easier to get at the feelings and what’s going on, as he is directly in front of you!). Does that make sense? If part of your ‘contract’ in this relationship is attendance and timekeeping (which I think it is), then I think it’s reasonable (and right) that this should apply to both parties. Which at the very least means, I think, that you should be able to talk about the absence, even if it doesn’t mean he has to (or can/should) tell you the details about WHY he’s absent…..

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        1. Cat Post author

          You are absolutely right, Paul would be up for discussion about what feelings are coming up, I wouldn’t like him to think I want to know too much. I couldn’t exactly say he talks too much, but he does like interaction and I’d rather not give him any more ammunition 😈

          You make a good point about attendance. If we take more than 4sesionns off, we are frowned upon. Letters get sent and reviews held.

          I have already talked to him about this and it made little difference. I need to think some more about how best to deal with this.

          Thanks for helping me process my woes 😇✌

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          1. Glynis Jolly

            Another thought you might want to entertain is that there’s another client of his in crisis. Of course, he can’t tell you anything about it because of the therapist-client privacy clause.

            Still, patternsofsouldevelopment suggestion does make a lot of sense.

            Ask him about the absences. The discussion may be very enlightening.

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  3. littlevoicetalks

    That would do my nut in. Continuity and trust in the relationship is so important, it comes with consistency and reliability. Also absence can interrupt the therapeutic movement creating a pause in progress and a feeling of maybe ‘where did we leave off?’ and ‘where do we pick up.’

    Hope it’s sorted soon. And thank you for all your care and support also. Blog-ears are very important and yours have been a constant source of comfort and support xx

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    1. Cat Post author

      I felt as though I came to an abrupt halt today, ridiculous, but I suspect it might be something I just need to tolerate, there’s no other option, really.

      Thank you, I love sharing on other people’s blogs, it is all part of our journey…. group therapy online 😉

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  4. ziggy40

    Dear Cat,
    Maybe it’s a lesson in life in a way..i.e nobody is perfect. I had a problem with my T, and we repaired . It helped teach me about resilience. Hope this makes sense…I feel confident to challenge him and built on assertion skills , which are helping in recovery. For a long time he didn’t make one mistake and everyone at my program spoke highly of him , they still do. Then this thing happened and I felt it was scary, but helped me grow..lol
    Love Ziggy

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    1. Cat Post author

      Yes, I think it’s something I just need to accept as part of my journey in therapy and use it to look at the feelings… I could do with learning some resilience.

      Thanks Ziggy 😉

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  5. cardamone5

    Glad to be your friend.

    I am sorry Paul is unreliable, but as we discussed on my blog, a good therapist if hard to find, so if you are benefiting from your sessions, then I say the unreliability is an acceptable bi-product. I am looking for a therapist now. I have a psychiatrist, who oversees my meds, but now I need talk therapy. I hate the search process.

    Fondly,
    Elizabeth

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    1. Cat Post author

      I think you are right Elizabeth, it’s probably better to focus more on the better side, work on the uncertainty it brings.

      Good luck 😊 with the Therapist hunting

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  7. therabbitholez

    The relationship with your therapist is like a fine thread, which each must be careful not to break, your on this journey together and cancellations(might be a good reason for it) can strain or break the thread, he is the one person who you are building trust with whom you tell your inner most thoughts as he guides you to understanding and acceptance.

    Blogging is free therapy, I’m always amazed by what I learn everyday and am constantly even more amazed by the people who take the time to read and comment or just hit the like button, it means you have a voice, and the wonderful discovery that your not alone.

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    1. Cat Post author

      You are right about the therapeutic relationship and it is disappointing, but it might just be something I need to accept, sort of rise above it if I can.

      Thank you for your support, always appreciated 😉

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  8. Life in a Bind - BPD and me

    Thank YOU Cat 🙂 for writing, and for being a part of my blog too – the whole experience wouldn’t be the same without you 🙂
    As for Paul, I am so very very glad you have a connection and you feel so safe with him. It’s been wonderful to hear how things have been developing over the last few months! That’s not to say, however, that the unexplained absences are not a potential problem (in the sense that you are clearly wondering about them and they may be causing you some anxiety and potentially influence how you feel in session). I can see what you mean about wanting Paul to be a ‘blank canvas’ and therefore not wanting to know too much about the absences. Could you perhaps just talk in general terms about the absences, how they make you feel, your desire to not know too much but at the same time to be reassured about the future and about that safety net? Maybe something along the lines of, ‘without necessarily revealing too much about you, can we just agree that we will be open and honest and if there’s something I need to know or should be concerned about, you would tell me?’ Or, would it help if Paul apologised for his absence and then offered to discuss how you felt about it, should you want to? Does he do that already? Perhaps if it is openly acknowledged and spoken about (but in terms of how YOU feel, not what is going on with HIM), it will be easier to see him as more reliable?
    I don’t know if any of that will help, but as a friend of mine with BPD often says, it’s all ‘grist to the mill’ of therapy, and anything, including the ‘context’ (payment, timekeeping, attendance etc) can be extremely illuminating and in some very interesting ways!

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    1. Cat Post author

      It’s always been a pleasure to share on your blog, although I have been a little slow lately.

      I’m not sure how I feel about all this. Of course it is disappointing, but whether it might ruin our relationship remains to be seen. I just can’t believe he is such a good therapist on one hand and so unreliable at the same time. It’s definitely a problem not knowing from one week to the next if I have therapy and it also shortens the 18mth programme. So far I have only 17mth, but if he continued, god only knows how long I will have. That bothers me more than the actual absence.

      I would rather not know his reasons for being off so much. It can’t be good so it is best I don’t know. His apologies make no difference. All I want is his attendance, but I feel doubtful that will ever be consistent. The next best thing is for me to work on the feeling of uncertainty and not getting what I want, which is usually a challenge.

      Of course I will talk to him again next time I see him, but it didn’t make any difference when I told him before. Anyway, the jury is still out on how best to deal with it but thanks so much for your input, it’s always interesting to hear other people point of view. Hope you’re doing well, I will be over to your blog tomorrow. Tonight, it’s bedy bye time. Peace ✌

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  9. Ellen

    I would absolutely HATE this behaviour of the therapist. All my abandonment issues would be triggered. I think you are being amazingly accepting, to tell the truth. I guess, as everyone else said, you can try and talk about it and explore what comes up for you. But…grrr. I would find this very difficult.

    And thank you also. Cute thank you card! 🙂

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    1. Cat Post author

      Thanks Ellen ✌ I think talking about what it brings up rather than what The heck is wrong is the best way forward. It made little difference before so it might be better to try accept…. Mmmm 😎

      Thank you always for your support ✌

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  10. mandy smith

    Sticking with Paul seems to make you stronger, Cat. I would have folded up long ago. Every therapist I’ve gone to has preached never ever missing a session–continuity being critical. Paul, on the other hand, must have some sort of issue–and that is no excuse. He should be upfront so you don’t have to wonder. Then again, you don’t want to know and it does seem to work for you when he is present. In the meantime, you do the work and pissed though you may get at Paul, I can tell you care very much for him, and that is more than I can say for any therapist I’ve ever had. You are welcome, and thank YOU for having such a terrific blog and being open to the likes of me. 😀

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    1. Cat Post author

      Yes, while this is a problem, I wouldn’t like to change him. It’s sometimes difficult to hold his good side and the absence as one. Holding good and bad together is a common problem for people with BPD and I often wonder if they are doing it on purpose. My logical side says the best thing is to ask WTF, why? But, then I would then be stepping over my boundary of not wanting to know anything. He once told me he used to be in therapy, which is something I expect from a Psychotherapist, but when he happened to add what his main issue was in that process, the next time he was giving feedback about something similar in my life, I couldn’t help but wonder if his views were a little prejudiced. You see, Cat has an over-thinking and complicated brain 😛

      As for my virus…. *blushes*… it’s just a touch of man-flu (a minor cold) I think I might survive 😉

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      1. mandy smith

        Haha–man flu. That’s a good one. I’m so glad if that’s *all* it is, and you will be okay. 🙂
        I believe all therapists probably come from a place of having had problems themselves, and that’s how they usually develop an interest in psychology and the desire to help others. I know what you mean–it’s hard to find out that they are human and have the same problems as us. Because I have a *habit* of deflection, I usually end up switching places with them and handing them the tissues. Honest to god, one therapist felt so comfortable being depressed when I was there–once she wrapped up in a blanket and drank a hot milk steamer from Starbucks (because it relaxed her).
        I don’t think you’re over-thinking, Cat. I think we try to protect ourselves from the many way there are to feel abused and abandoned–so analyzing is pretty normal! This is just all my humble opinion 😉

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        1. Cat Post author

          TBH, Mandy, I usually have that kind of effect on people, where they want to give me all their woes and maybe that’s why I avoid Paul’s personal life. Coming from volatile parents, we need to learn to read people, so I feel I have a fair idea what’s going on for him, but I’d rather not know and confirming it would only change the relationship, I think.
          I’m not so sure I’d be happy with a Therapist wrapping up in a blanket 🙂 Did you take her chicken soup?

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  11. Lucky Wreck

    I know I’ve said this before, but I really love that you are writing about these things and sharing them with us so honestly. It’s very inspiring, and I think it instills a sense of hope, at least in me 🙂 Hope that working diligently at something can pay off and help things get better. Thank YOU! 🙂

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    1. Cat Post author

      You can say that a thousand time a week, if you like 😉 It gives me such a buzz to know people get something positive from my blog. This WordPress 101 course is excellent for new and not so new bloggers. If anything, it helped me to see that I may well be doing something right, but this blog would be nothing without people like you

      Thank you for commenting, always appreciated and valued 🙂

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  12. Andie

    This would totally drive me nuts. Have you talked to him about this at all? I think it could be a worthwhile conversation both to assert yourself and to explore the emotion his unreliability evokes.

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  13. N℮üґ☼N☮☂℮ṧ

    If you’re willing to make yourself extremely vulnerable and build trust with a total stranger, then the therapists should keep their end of the commitment. It’s unprofessional. Why not reschedule rather than just cancel?

    I’m happy to be a part of your online community, Cat. Sending you a virtual hug.

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    1. Cat Post author

      Victoria, hi! 😉 Yes, rescheduling would be better, although I do hope they add the 4-5 sessions missed onto the end of my 18mths programme…. somehow, I doubt it, although they would need to do something if this continues.

      I treasure you being part of my community. How are you? I have been popping in and out of your blog looking for the post on child brain development, but I guess that is still a masterpiece in progress!

      Thank you for commenting, Victoria, so much appreciated 🙂

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    1. Cat Post author

      Hi Lisa, and I also appreciate knowing you through blogging. I hope you’re doing okay…. are you? I will be popping over to your blog later…. I’ve been a little behind this week.

      Thank you for commenting, Lisa, you’re a star 🙂

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  16. A Million Thoughts

    hmmm…. I have to say I would also seriously struggle with this unreliable behaviour it would make me think that I wasn’t a priority or even cared about. On a side note Cat I love the fact that we all read each others blogs and are there to support each other, there is nothing like knowing you aren’t alone or that people understand. 🙂

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    1. Cat Post author

      Yes, his absence could be disastrous, but thankfully it doesn’t impact on our relationship too much… it’s just another something I need to work through.

      It is amazing we are like group therapy online. Thank you for commenting, it really helps 🙂

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  17. Ziya Tamesis

    This is a great post on a very important issue. We need our therapists to be reliable and accountable for any breaks in that reliability. I’m very fortunate in that my therapist is reliable, tells me about anticipated absences well in advance, calls to reschedule appointments she needs to cancel, and is willing to meet via Skype if one or both of us can’t come in to her office. She’s also human and make mistakes (such as starting every single session late); being able to relate to her as a fellow imperfect being has been a very important part of my therapy. In fact, some of our most productive sessions have been ones in which she’s made mistakes and I’ve been honest with her about how they impacted me. That has enabled us to work together to make things better, and it’s helped me learn to communicate more effectively with other imperfect people in my life. (It’s also taken me much longer than 18 months to be able to do this.)

    It’s up to you how much you want to know about your therapist (and he will most likely only disclose what he thinks might be helpful to you), but I think it’s very important for you to confront him about this. I’ve been reading a lot about the here-and-now in therapy: the importance of working with the relationships that are present in the therapy room. Addressing issues in your relationship with your therapist directly and honestly is really, really hard, and you have to take it at a pace you feel comfortable with… but it might also be the single most useful thing you do for yourself in therapy. If you think he’s a great therapist you can start with that, emphasizing the importance of continuing the therapeutic relationship and getting the most you can out of therapy. (If I’m reading your post correctly, you might also want to start talking with him about termination, how you feel about it and how you want to handle it in your remaining sessions.) You might want to say something like “Our relationship is very important to me and I want to keep it on the best terms possible, but I also need to talk to you about how your absences are affecting me.” You can talk about your feelings, your ambivalence about his self-disclosure, your concerns (including whether the missed sessions will be rescheduled), what you want the outcome to be, why it’s important to you, etc. It might help to emphasize that you want to collaborate with him to resolve these issues. Even if his behavior doesn’t change, it’s good practice for doing this sort of thing in your other relationships. Heck, if you want you can even tell him that part of why you’re bringing this up is so you can practice communicating more effectively, and ask him for feedback.

    Good luck with whatever you decide to do!

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    1. Cat Post author

      What I love the most about blogging is that whenever I am nearing the end of comments to certain posts, I can often have a slightly different perspective, and your comment draws a nice conclusion to this post.

      It’s often difficult for me to hold opposing views, but with this situation, the good far outweighs any bad, which is his absence. One of my biggest concerns is that it’s only an 18mth programme and already my sessions have been cut down to 17mths by his time off. If he continues, the overall programme could become rather short for me.

      Of course, I can share this with him and will be looking for assurances that any time off will be added onto the end of my programme time. However, being a service, there are other clients in a similar position with him, so I cannot imagine they could delay everyone’s finishing time when there are new people on the waiting list. In some ways, I might need to suck it up, which is a concern if he takes anymore time off. That would then come between us because I would rightly be feeling more and more pissed off.

      It’s strange that he is a good professional Psychotherapist, yet is cancelling so many appointments, it doesn’t seem to make sense. Thank you so much for your very thoughtful and helpful comment

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    2. Cat Post author

      Ps I just wanted to add…. In recent weeks I have become more aware of this client-Therapist relationship and the importance of working with the relationships in the therapy room and this is no more obvious than it is in my group therapy. I was intrigued what book you were reading on the here and now in therapy…

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      1. Ziya Tamesis

        Irvin Yalom, “The Theory and Practice of Group Psychotherapy.” He gets wordy and pretentious at times, but it’s a very informative read (intended for therapists). The appendix gives information about participating in group therapy as a client. I don’t know if he’s written anything on individual therapy and/or geared toward helping clients get the most they can out of therapy, but it’s worth looking into.

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        1. Cat Post author

          I just read two of his books, ‘Psychodynamic counselling in a nutshell’ and ‘Love’s executioner’. I think I’ve seen that book on kindle, thanks

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        2. Life in a Bind - BPD and me

          Ah, it’s always nice to come across another Yalom fan! 🙂 Amazing writing about therapy, I’ve personally found it incredibly helpful in my own therapeutic journey. I would very strongly recommend ‘Love’s executioner’ and ‘The Gift of Therapy’, and his latest book has just been published -I’ve only read one chapter so far, but it seems just as wonderful and has rave reviews. It’s called Creatures of a Day….

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          1. Cat Post author

            I loved the two books you previously recommended, these new ones sounds excellent, I’ll definitely look into them.

            Thanks for commenting 🙂 (& emailing, I was delighted!)

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            1. Lola

              Irvin Yalom is my hero! I had the pleasure of meeting him a few months ago when he was touring for his book “Creatures of a Day.” He is just as humble, open and welcoming a human being as you might imagine. His book, “Existential Psychotherapy,” changed my life in the 1990’s. I was able to share this with him in person. It’s a big fat text book which I have read more than once, and some chapters many times. I think we may have the start an Irvin Yalom fan club here! 🙂

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            2. Cat Post author

              Hi Lola, I loved the two books I read, I’m about to start reading them for a second time…. so cool you actually met him. I do plan on buying those two books you mention. Thanks for commenting, Lola 🙂

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  18. mckarlie

    What was Paul’s response to you raising your feelings? Judging by all your comments and likes and interactions, you don’t need any advice on blogging dearest xo

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    1. Cat Post author

      When I raised the issue before, the first block of three sessions he had off, he did tell me what was wrong, but then I think he realised I really didn’t want to know the ins and outs… he leaves me with little choice but to pry further to try to reach some kind of understanding

      Thanks for your comment, they always help 🙂

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      1. mckarlie

        I don’t envy your situation, after all it’s almost impossible to find a good counselor you click with but the instability in his accountability would feel a bit like disrespect on some level to me. But I think you’re right to stick with it and give it a go, just don’t tolerate anything too unruly, as sometimes believe we aren’t worthy and settle for people crapping on us but you’re awesome sauce and should feel worthy and good 🙂

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        1. Cat Post author

          I said in group today that I was expecting them to add his absent sessions back onto the end of my 18mth programme. He evidently has some kind of issue and because he’s so good in other ways, I can tolerate him being off just as long as it isn’t taking time from my prog. We’ll see what next week brings. Thanks so much 🙂

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          1. mckarlie

            Very thoughtful of you lovely, I have had a very tough week but I’m back on top I just haven’t written about it yet. It was too raw for a couple of days and then I just got a bit distracted with my book lol xo

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            1. Cat Post author

              Sometimes it’s better to take a couple of days before pouring it out in writing. Glad you’re okay.

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  19. Sharon Alison Butt

    I still think they’re playing a little game. It’s like they are deliberately doing unsocial things to make you mad because they WANT you to be and to show it. When we are taken for granted from a very early age, it can instill this ‘it is my fault’ thing in us that makes us accept abuse and other bad behaviour done to us. It seems to me like they are trying to help you find your voice by doing things that are unacceptable. Confrontation is hard for many people but for someone who has been made to supress their anger, it can be almost impossible. I agree with whoever suggested that this could be part of the therapy. If I’m wrong, then they’re just plain rude – him and the one who refused to acknowledge you. I’m going to be positive and opt for the fact that they’re playing games with you to get you to express justified emotion x

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    1. Cat Post author

      I did wonder if it was some kind of tactic, but I’m not sure because he does the same with other clients. Whatever it is, the only way forward is to talk and I’m prepared for that next week, if I get to see him, that is.

      Thank you, Sharon

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  20. Lexy

    I love that you’re writing about this Cat. My experience with therapy has taught me that they really should be available when you need them to be. On the other hand, putting all your confidence in one person could be exactly what he’s trying to avoid, to help you, in his own way. I read a book, granted it’s about anxiety, It’s called “The R.E.B.T. method” and it’s an approach to therapy in which the author talks about how everyone should learn to say “this is what could be negative,” “this is what could be positive” and “this is what it is.” Regardless of what you’re going through, I think the book is wonderful and could be a good read. I definitely love it 🙂

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    1. Cat Post author

      Hi Lexy…Yes, I agree, they should be available when we need it the most, That book sounds very interesting, I have heard a little about REBT method, so I’ll add it to my book list. Thank you so much for commenting 🙂

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  21. manyofus1980

    Cat, I think it must be hard when he’s canceled so much in 8 months. My one piece of advice is tell him how you feel again. Keep telling him if its not sinking in. You need someone reliable! And thanks for coming to our blog and commenting too. We appreciate it very much. XX Carol anne

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    1. Cat Post author

      It is hard. I know he’s back this week, but still not entirely sure my session will go ahead until tomorrow, it’s not acceptable.

      Thank you Carol anne

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  22. Pingback: This is Therapy for You | My Travels with Depression

  23. Rich Devlin

    Regarding “Absent Therapist”: I would be very concerned about a therapist who is unreliable. In my wife’s experience it led to a growing dependency, extreme feelings of lack of control and, in her case, an unravelling into an abusive and sexual therapeutic relationship with one of her “selves”. Therapy 101 teaches that consistency and reliability are cornerstones of this intimate therapeutic relationship. The onus falls on the therapist. You are not asking too much from a professional that they show up and do what they say they are going to do. At its most innocent it is disrespectful and unprofessional and warrants closer scrutiny. At its worst, it is manipulative, destructive and abusive and warrants running away like your hair is on fire. Please be careful.

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    1. Cat Post author

      I have talked to him at length and explained in detail how the absences affect my therapy. He already knew how I would be feeling about it, however, it seems he has had a run of bad luck with sickness. Talking to others who have known him longer, no one knows of him taking time off at other times, so I am happy to give him the benefit of the doubt….for now!

      Thank you for your comment, Rich

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  24. Bynda

    I think much thanks goes to you cat. you have no idea how you help me. I am not on WP regular and it seems les and les all the time. But I always go to you, becaue I know that you will have something that I can relate to and it almost gives me courage to see a therapist..again. I am a work in progress.

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    1. Cat Post author

      Yes, I have noticed you’re posting less… are you okay or just busy doing other writing?

      I am so happy you can relate to some of my posts and I do hope you manage to find a good Therapist.

      Thanking you for such lovely comments 🙂

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      1. Bynda

        I’m ok. thanks for “missing me” lol. I would love to say that I have been busy writing, but I haven’t. I seemed to have run out of steam. I have a severe case of brain fog. lotz of stress and procrastinating. it will get better. 🙂

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