I have been in "treatment" for BPD for almost 2 years now. Treatment is in quotes because I see a case worker once a month because that is all I can afford now. For a long time I felt really... I don't know what you would call it... loyal to her as a patient? And for a while it seemed like I was improving but lately I feel like I am going crazy. Like I have a foot on each side of being insane and ...not I guess. Anyways, because of how little I can see her these sessions are very important to me. She is the only person I can talk to about anything, one of the few people I socialize with. But whenever I go in while in a rut and maybe having a bit of a pity party I feel like she gets upset or something. She acts cold and distant where she is usually understanding and friendly. The first couple times it made me angry but I saw her more often so I had less abandonment issues about it. But lately with how volatile I feel and how little I see her it really sparked a distrust in me of her. I don't know if it's my BPD talking or my rational gut. I don't know what I am paying her for anymore. She wont offer professional suggestions as to how we can make our time more productive and wont give me any idea as to how I am progressing- only "what do you think?". I feel like I can rant in my journal for free! And eventually develop the same results. I am really thinking about stopping therapy but I don't know what effect that will have on me or my future.
I would talk to your therapist about this. Just say you have been feeling this when you meet and when you ask again how you are progressing and she asks “what do you think”, be honest and say you are looking for guidance. I think continuing therapy is important and its so great that you are do what you can afford and steal seeking help. maybe a conversation can help.
I can't really explain why or how but I feel like she responds poorly to any negativity I have. One time I tried to express that I wasn't sure I really needed this or benefited from it and well it became a really tense hour till I changed my tune. Thank you for you advice, it made me realize that I hadn't brought it up so calmly before and that is worth a shot.
sounds like you need a new therapist. my therapist always gave me advice and only asked how i feel a few times. plus i think posting here helps a lot. we know how you feel better than any therapist. im always here if you need to chat.
Really? She never ever gives me advice or opinions even when I've asked for them. Only a, "What do you think you should do?" or encouragement when I've done something well. Just cold silence or change of subject when I am not upset for a valid reason like a death in the family or when I mess up and fight with someone instead of handling it better. Do you have a real therapist or just a case worker filling in?
i had a real thrapist. she always gave me her opinion and encouragement.
Thank you
It's part of the process. Therapists are that way because they want, for the most part, for us to make our own discoveries and figure out stuff on our own. For them, if we make that discovery our self. If it comes from the patient, it's supposed to be more meaningful, stronger, and be of more benefit. That’s what I was told anyway. I came from a family of social workers and got to listen to many hours of their "shop talk" Don't feel bad or strange for wanting more of their input. You are the one that’s paying for the service, and have every right to be assertive in your request and desires as to how your therapy progresses. If after a while you truly feel that their not providing the feedback you need, then shop around for a new one. All therapists are different. Each has their own twist on what format to utilize. I always enjoyed the ones that had a real good sense of humor... cuz life is just way too short...
Thank you so much for your input! It really helps me to put things into a more positive perspective since I was really leaning towards dropping. Next time I see her (in a month) I will definitely (calmly) bring up that I would like/need more input or at least for her to question my motives. I really think that that must be what she is doing- thinking if I come to it myself it will be more meaningful. I can do that for free over the years through heartbreak and living! I wish I could figure out why she gets so cold when I am upset though. Thank you
It's my pleasure.
It took me years to learn and discover that the most important aspect of therapy is that you the patient feel comfortable and trust the one you’re talking with. Therefore, if anything doesn't feel right and ok then it's your responsibility to make that known and if things don’t change you need to politely say I need a referral or need to see another therapist. You should not feel bad or weird, although I know it's awkward, but this is your life and you need things to maybe be handled a little differently. This is all within the boundaries of acceptable behavior and more so your rites as a patient.
And remember... life is short. Peace be with you...O.G.
*takes a deep focusing breath* I will really try to remember your words the next time I see her or deal with someone I suspect is bad for me. This is my life right? Right. lol I always forget that while trying to spare other people's feelings even when they are not providing the service I am paying for. So silly.
First of all, is she your case manager or your therapist? If she is a case manager, she can't give you theraputic advice. You said that was all you could afford so I assume she may be a case manager. Also, I don't know what state you live in or what your insurance coverage may be, but it might be time to make some changes to that so that you can get more/better services. At the least, you can contact the RBHA-regional behavioral health authority- they are the "entity" that oversees behavioral health services for your region-to find out other options available to you.
Have you checked on DBT therapy? This is awesome. You can actually begin doing the DBT on your own but ultimately it's best to have a therapist to go thru it with. Check on line under DBT to get more info and learn how to begin that journey. Also, something that I do that I find effective is EFT; some people call this "tapping" and although it may look ridiculous--it works!
Thanks for the post. You got me qerious, what is EFT? I will check on DBT to see if can help with my issues. Thanks again… Old G.
EFT is emotional freedom technique, almost like an accupressure; check out; www.emofree.com or www.mercola.com. DBT is the recommended therapy for BPD and is VERY helpful.
wow thank you so much Brenda!! That information really answers so many questions for me!!! Yes she is technically a case manager. It has never been a problem because she said she would provide me with therapy sessions but lately I suspect that she actually can't. I am going to start looking into those things right away!
Well, speaking as a previous mental health case manager, it is against the law for her to provide therapy services if she is not a therapist. Glad I could help.
Thank you, I am definitely going to discuss this with her next time I see her. I like to have as full of a picture as I can.
If you wouldn't mind, could you tell me somethings that a mental health case worker does? I just want to know why I was paying to talk to her for and hour once a week and now once a month. I don't feel like there is much of a case to keep unless she is just keeping a record of my progress?
The insurance can determine what services you can get. For example people here in AZ that are on the state insurance (AHCCCS) are qualified for therapy, meds, psychiatrist and case management, transportation etc. Those who have a regular insurance may only qualify for meds and case management. The case managers job is to ensure that your paperwork is kept up to date, that the services you are receiving are working and to help connect you to other services. A case manager, by law, can not do therapy. that's like a nurse doing brain surgery--not gualified and not legal. A case manager can certainly listen and be a sounding board but they can not do/say anything that could be construed as theraputic. Contacting the RBHA may be a good start for you. Definetly discuss your concerns with your case manager too, if you feel comfortable doing that.
Wow. I feel so... so violated right now. I have told her everything. Things I don't know if I can even share here... believing that, idk what I was thinking but at least that she was there to provide some form of therapy since I was told I would be provided with one. I cant remember what she told me but I know I was lead to believe she would provide it. I really really trusted her.
I'd suggest you discuss it with her; get clarification of what her position is there and move forward with the info you have.
I would always make it clear to my clients right from jump that I was not their therapist and explain my job. But I also let them know that I was there to support them and help them any way I could and that if they wanted a licensed therapist I could always assign one to them.