The Abusive Therapeutic Relationship

The comments I received following my post “The absent Therapist” were amazing. IthEHG9H3MM hung onto every single word, as they helped process the disappointment of Paul’s absence, and then reach a nice philosophical conclusion – that the good of our relationship far outweighs the bad and I will be able to talk this through and take something positive from it.

Through the course of today, my views have changed a little, maybe quite radically, and right now, I feel that familiar self-destructive anger surging through my veins. Let me explain…

I was once in an abusive relationship. As anyone who has ever been in this position will testify, we think we love that person with all our heart and want the relationship to work so, so badly, we make allowances and excuses for unacceptable, often humiliating, behaviour. Following an abusive episode, you convince yourself, ‘I’ll forgive him. The next time it happens, you assure yourself again, ‘Och, maybe this will be the last time’ and so it continues, but there never is a “last time.” th (8)

I have been doing a lot of work in therapy in recent months and it feels as though I am consistently moving forward, on a roll. Even the therapeutic relationship with Paul is beginning to show early signs of trust and connection. However, whenever he cancels our sessions every 3-4 weeks, I screech to a rubber-burning halt. Each time he returns, we rekindle the relationship and I pacify myself by saying, ‘Och, maybe this will be the last time’… sound familiar?

Yes, perhaps I am overplaying the title a little, it’s not exactly an abusive relationship, I get that, but if I am giving my 100% to this programme, I need a Therapist who will return that commitment. I can be as understanding and sympathetic to Paul’s plight as I like, and I can make a thousand wishes that maybe ‘this will be the last time’, but I cannot allow this type of scenario to play out in my therapy.

As I’ve said a number of times on this blog, one of the most important aspects of therapy is the relationship between client & Therapist. The way we relate to our therapists is often how we relate to other people. As our relationship changes and grows with the Therapist, so do our relationships with the rest of the world. That is the general theory.

Maybe this is a pivotal moment playing out in the client-Therapist relationship. As IthBX1CQRL7 refuse to accept anything less from Paul, perhaps I will begin to expect more from my relationships with other abusive people in my life.

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42 thoughts on “The Abusive Therapeutic Relationship

  1. Andie

    This is so insightful and important. Whenever we are replaying old dynamics in therapy, there is so much to be learned. You are really embracing that and I know it will pay off for you in the long run. Supporting you!

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  2. bbbr

    Hi Cat,

    You raise some really valid points, here (as ever).

    Having frequently cancelled appointments is really tough to deal with and tbh, I don’t think we could. Ours has cancelled once in a year, but had a phone session later that week.

    The therapeutic relationship is one that should be based on trust. To never be sure if next weeks session will happen (or not) is bound to weaken what trust is there.

    Hopefully you`ll be able to speak with Paul about this, or even show him this post. He needs to know how his absences impact on you and you need to know he gets it and is doing all he can to ensure this pattern doesn’t continue.

    xxx

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    1. Cat Post author

      Yes, I plan to have a good old chat, as difficult as that may be, I can speak my mind. The only time I am sure I have therapy is on the therapy day 12 noon. If they don’t cancel by then, I know for sure I have therapy at 2pm. I can’t work like that, suddenly the light went on and I don’t know how I ever thought I could. I can see the progress, which is a positive.

      Good to hear from you, I have missed you being around. How are you?

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      1. bbbr

        That’s really rough to be on edge like that with not knowing if sessions will happen, but am pleased you`re confident enough to speak your mind.

        Missed being around, too. We`re still alive, which is always a positive I guess. Not on WP much now but can always catch up on twitter.

        xxx

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  3. myspokenheart

    My dear Cat,

    I totally understand your feeling upset with the situation. But I keep hearing the echos from your previous post that Paul is the best therapist you’ve ever worked with, and understanding that you have been diagnosed with BPD I do wonder about the levels of attachment/reliance that may have been placed on this relationship. I know that one of the fundamental issues with BPD is an overwhelming fear of abandonment/need for acceptance. Remember it it is not Paul that has gotten you to where you are now, it is YOU and the relationship that you have allowed to develop. Any experiences of him not being available are going to be tainted by a view of desertion. I am not excusing his absences, what I am doing is suggesting that perhaps the best thing you can do at this stage is to be upfront and honest about how his absences make you feel.

    That way you can make a clear choice about what you would like to see happen and where you would like to take this relationship, based upon his response and your assessment of that response.

    ❤ Andrea

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    1. Cat Post author

      Hi Andrea… I understand what you’re saying, although I’m not too sure how much attachment I feel. I don’t experience attachments in day to day life, so that plays out with Paul. I know I need to hear what he’s saying. Previously, I haven’t wanted to know why he was off, I still don’t. I’m worried his issues might in some way rub off on my own, so I prefer to work with that blank canvas. But, maybe I need to understand it more….we’ll see

      Today, I did realise that I would probably have come just as far with another Therapist. It is me who has done the work and I think I was just ready. I can’t allow this to continue indefinitely, so we’ll see how Paul takes it forward.

      Thank you for your insightful feedback, it helps immensely

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  4. Priceless Joy

    I hope you and Paul will be able to talk to each other about his absences. I don’t want to assume anything and I know you don’t either. Who knows? Maybe he is waiting for you to bring it up so you both can talk about it. I do know how it feels when they cancel on you last minute.

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    1. Cat Post author

      I feel better now after writing that post…lol… nothing like a good old moan! Now, I can put it to the back of my mind until I see him on Weds, if he’s there, that is 🙂 Thank you, Joy

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      1. Priceless Joy

        I’m glad that you feel better now. I know it has always helped me to write it out. I use to write journal after journal. (Before computers). But then, it was different because no one else read my journal, but they do read our blogs. LOL!

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  5. mckarlie

    I’m really glad you came to this conclusion, I didn’t want to tell you that I thought it was unacceptable because me finding something unacceptable doesn’t make it fact but I did think it was potentially reductive to your therapy to have someone who is effectively being unprofessional. The first thing they hammer into us when learning to be a counselor is duty of care, and He is not doing right by you in this regard. I hope it resolves with a positive outcome 🙂

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    1. Cat Post author

      Now I feel confident it will resolve. sometimes I’ve got to write around some kind of circle before I get to the centre. I have prepared myself to talk all this through with him, but it feels kinda good to reach the conclusion, “no more shit from anyone!” Thank you for your very thoughtful support 🙂

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      1. mckarlie

        I’m so glad! You absolutely deserve a consistent reliable counselor, now and again can be forgiven but continuously poor attendance really effects trust and your ability to focus on what you’re meant to be; you. I know myself how incredibly hard and confronting therapy is so I have admiration for anyone who takes it on and especially those who persevere with a positive attitude. All the very best 🙂

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  6. sensuousamberville

    I am on both sides of the fence for this Cat. There are reasons that could possibly call Paul away at the last minute, from health issues to emergencies related to his practice. I don’t know, obviously, anything about his practice, some could perhaps be calling him away. I would hope that what is calling him away last moment is something serious.

    I have been called away often, causing rescheduling. I know this can be upsetting, I explain why to my patients that I disrupted though, what called me away. In my practice emergencies emerge, I am on call at the hospital also, so there are times that I need to visit with someone there. Some things will not keep. I do not take breaking appointments easily, the occasion must be serious. Perhaps Paul senses or maybe you told him that you do not wish to know, as you pointed out in some of your posts. This is ok. Maybe you should talk to him though, about how it is disrupting you. This trust you are building must go both ways, this happens with communication, oh and not scolding please. I think it is very important to talk openly to your therapist, letting things fester is not conducive to the trust building that is so important.

    Are you growling at me now?

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    1. Cat Post author

      Oh no, Amber, I could never growl at you, even if I did disagree. I doubt if Paul’s job is to be on call, but if it is, then he should have made this clear at the start, I would understand, definitely.

      I told him last time how his absence made me feel, his reply was, “I was…em… it was just sickness.” Of course, he probably does realise I do not want to know and this is maybe what is adding fuel to the fire – In many ways, it is forcing me into NEEDING to know to help me understand better.

      I was a bit harsh on my title, but the pivotal moment is not lost on me. Too often, I accept what is unacceptable, for so many different and unhelpful reasons. I find myself saying, “maybe this will be the last,” just like abusive situations in the past. The fact that I no longer feel I can collude with this, I think, is a significant step forward.

      I always treasure your feedback, thank you, Amber

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  7. littlevoicetalks

    Take it to him. There could be a lot of growth on both sides of the room. I love your ability to reflect even though the situation has brought up feelings from the past and has you filled with ‘self-destructive anger.’

    I agree, I think it shows you how far you have come not to tolerate this now within any relationship, especially a therapeutic one.

    Keep us posted. xx

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    1. Cat Post author

      I think you’re right, there will be a lot of growth that comes from both sides of the room. In some ways I am annoyed that I am being forced to deal with problems in the relationship, but on the other hand, this is what therapy is all about. The conclusion of no longer being prepared to tolerate this kind of disregard is a pivotal moment, I think, and I do hope we can grow from it rather than destruct. Thank you for your support 🙂

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  8. janetcate

    You are pretty clear about your thinking. Have you told Paul that the cancellations are too much for you and that they feel like they are part of an abusive relationship? It is just your perspective which is valid. It would be good for him to see how his frequent cancellations are affecting you. Good luck.

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    1. Cat Post author

      Hi Janet, yes, I did tell him how it makes me feel, but I only reached the similarity with abusive relationships last night, but it is a turning point for me, when I am no longer to accept anything less than what I give to the relationship. Thank you, Janet, I will have all this out with him on Weds, I hope we can move forward. Thank you for commenting 🙂

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  9. Glynis Jolly

    You make a good point here, Cat. Reading this post, I see you getting stronger. You’re standing up for yourself. Obviously a good thing. Do what you need to do, Cat. You even have me inspired to stand up stronger for myself.

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    1. Cat Post author

      I think I am getting stronger, Glynis, no longer prepared to accept the sh** and I wonder if they are actually hoping I reach this point. Thank you, Glynis, be strong!

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  10. Janni Styles

    Great that you are standing up for yourself, so healthy. I totally understand therapy changes (whether with one therapist or total changes). After I was first physically assaulted into PTSD, I had no therapist, had to wait a year to see someone, save for a one time intake done by a psychiatrist who could not take any new patients. Feeling lucky to get a trauma counselor, I saw her for a year until the funding ran out. Two years after the assault, I finally got a psychiatrist. Saw him for a year. He just moved to a different city and I am now going to see a new one next week. I really have not been coping well with all the changes, upheavals etc because I need a strong health support team around me and I also have a new family doctor since last August (my old one with me for decades retired due to his own health matters). These people know little of me and it may take years before they do. I don’t like opening up to people I can’t rely on or who may decide to move or change their job or whatever, it’s so hard on me, I go into a downward spiral. Next week am due to see the new psychiatrist for the first time and my nerves are so jacked up, I am having panic attacks already. Hope yours (and mine) both get sorted for the better for both of us. It’s very challenging when you can’t rely on your health care team for whatever reason. Best always wished your way.

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    1. Cat Post author

      I have been through similar changes to get to this point and they are disconcerting, but as you say, it is important to build that support, so great you’re sticking with it. I hope you’re appointment with the new Psychiatrist goes well next week

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  11. Pingback: The Abusive Therapeutic Relationship | Stayingsober

  12. Ellen

    You certainly seem to have struck a chord here, judging by the number of responses. I do support you in raising your concerns with Paul. I think your feelings are completely valid and an important part of the therapy, regardless of the ‘real story’ – the reason Paul is absent so often. This could be a great gateway to discuss similar incidents in your past and present. I found it really instructive and helpful also to realize how my T would react to my anger. I unconsciously expected him to be angry in his turn, or to withdraw. When he welcomed my feelings, I was completely surprised. I also found my feelings changed after I’d expressed them – whatever I was angry about no longer seemed so overwhelming. So go you! Whatever happens should be instructive.

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    1. Cat Post author

      Yes, I agree, regardless of the ‘real story’ I do need to talk frankly. It is already a gateway to so many things, Ellen, and I may even have stumbled upon why I would prefer not to know anything about my T. The thing is, I need to learn to want to know and face whatever fear stands in the way…. not sure f that makes sense.

      The point you make about their response to anger is very valid and is something that has been on my mind today.

      Thanks, Ellen

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  13. mandy smith

    Cat, I’ll be honest, I felt a sense of relief by the time I reached the end of your post and saw that the light had gone on. I’ve felt bad after many of your frustrated-with-Paul posts. I had a hard time supporting your therapy with him. But it is easy to get wrapped up in the excuses when you really like the person and when they ARE there for you, and you get positive things, too. To me, this is not acceptable: “The only time I am sure I have therapy is on the therapy day 12 noon.” It’s the equivalent of saying the only time you can rely on your partner to be there for you is when he “shows up.” And really, I feel a therapist should be almost as important as a partner.

    I think the analogy you so eloquently pointed out, about abuse in relationships, fits this relationship very well. Neglect, inconsideration . . . are all abusive–particularly to a person who is desperate to learn to trust again. I think you hit it on the head in one of your comments–Paul is like an “on-call” therapist. Not on call when you need him, though. Yes he could be getting cancer treatments or some other reason. But when you are kept in the dark, it all becomes more excuses. In the meantime, you risk getting set back. Luckily, you are becoming very strong and recognize that YOU are doing the work in spite of Paul’s neglect. I’m glad you are going to confront him. I hope one way or another, something good comes from it.

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    1. Cat Post author

      Well, if the client-therapist relationship is where real therapy takes place, then I have no choice but to talk frankly. Beyond looking for the practical assurance that his time off doesn’t affect my full 18mth therapy programme, I am willing to work on the relationship issues.

      It’s not lost on me that the relationship issues with Paul are the same as my issues with other people, that’s why I keep him at a distance and don’t want to know why he’s off. Anyway, now I need to ask to help me understand a little better. I can see why he hasn’t offered the information before now – because he knew I didn’t want to know. It seems all so complicated this psychotherapy business, but it works and it will take more than this to put me off.

      Thank you, Mandy, for your support

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      1. mandy smith

        I never even thought about that, Cat, that you’d told him you don’t want to know his business. Maybe he took you quite literally. Yes, by all means, tell him you do want to know some things–wouldn’t it be great if this cleared some things up so you could stay focused on your work? I’m gonna think positive for your next session!

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        1. Cat Post author

          Yer, I might have contributed to the problem, he probably would’ve explained more but I’m guessing he wants me to ask…gulp… something I’m not too keen on doing, but needs must. I just called the service to check he is back this week, hallelujah he is, so roll on Weds to get some of this sh** out my brain! I am exhausted by it. Cheers Mandy! 🙂

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          1. mandy smith

            I get that, Cat. We can wear ourselves out analyzing things and coming up without the answers we need. I hope you’ll get those answers on Wednesday!

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  14. manyofus1980

    Paul is not being respectful towards you. I mean to cancel every 3 to four weeks? Thats showing a real lack of respect towards you, his client. Its got to be frustrating. I hope you’ll be able to figure something out. Your right though, it certainly wont do you any good continuing on that way. XX

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    1. Cat Post author

      It can be rather frustrating, carol Anne, and I do want to see it changing, but I’m sure (hope) I can work it through with the Therapist

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

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