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Choosing A Therapist & Emotions

Choosing A Therapist & My Raging Emotions

"That is what learning is. You suddenly understand something 
you've understood all your life, but in a new way."  -Doris Lessing

December 6, 2000 

Hello Dr. Irene!!

Thank you for your wonderful site.  It has been incredibly helpful to me.  I've been eagerly reading everything, checking the boards, and went to the bookstore and bought a bunch of new books.  Your sensitivity and awareness and your very practical down-to-earth remarks are eye-opening.  I feel like I 'see' something new about myself every time I read another board.  Great! Because no matter how much help and support you get, in the end, you are the only one who can know what is best for you and you are the only one who has the ability to make your changes! Thank you so much for your time and energy on these very difficult but very important issues. Thank you for using the material. 

Phew!  I did want to get that out, this site feels like such a lifesaver to me. So, on to my question:

My question is about finding therapists and support groups and trying to understand the role they play in my healing. 

I am 39, female, and have been  verbally/ emotionally/ sexually/ physically abused from childhood on. Ouchhh... I've been married twice, and have a current boyfriend. All my relationships have been abusive in one way or another. Not surprising. Abuse is all you "know;" all that is familiar to you, like it or not. Fortunately I have no children, haven’t screwed any kids up yet!  I am finally becoming much more aware of my part in the abuse – my feelings of inadequacy, fear, etc. Excellent! Self awareness is KEY. Without non-judgmental (i.e., non-guilting, non-self bashing, etc.) self awareness, you are not in a position to intelligently assess what stuff you may need to change in order for your life to work better.

It is time for me to get off this roller coaster and I'm looking for a therapist.  What is the role of the therapist vs. the support group vs. family, friends, vs. my own personal support for me?  Should the therapist be the one I use to just 'get to work', that is, keep the emotional expressions to a minimum and just work on the structure of my beliefs and thoughts and then use the support group for SOME of these raging emotions (I've been in group therapy and al-anon in the past and there is only so much time and space for everyone - and I appreciate that) and family and friends, and my own alone time for the rest? 

Your questions are multiple and none are cut and dry. Different therapists have different ways of handling the same problem. I am a cognitive therapist and I am clearly biased in that direction. I would encourage you to look at your thinking and would encourage you to learn to impose impulse control over the raging emotions. I would certainly encourage validation and your attendance at support groups, though your goal would not be to vent your rage. This would not be helpful to you though it may feel good momentarily. If you are in the destructive habit of expressing runaway emotion, you need to learn emotional modulation.

A therapist from a different orientation may or may not agree. Many clinicians believe it is healthy for you to "let out" your emotions or to "ventilate." This position is some variation of Freud's basic hydraulic model whereby emotions are "stored up" until they find an escape outlet. There is absolutely no support for this position in any of the social learning research that I am familiar with. Personally, I find this approach destructive.  

Nevertheless, many therapists practice a "ventilation" model and their clients seem to benefit. I think you begin to get the idea why choosing your therapist is probably the first step you will want to take. Let your therapist be your guide and help you allocate your time.

Right now the feelings are starting to really come up very strong - rage, fear, and incredible pain.  I've been in a major depression and unable to work full time for several months.  I need to get back on my feet and work again - but I dread it. Of course you do. One day at a time, one foot in front of the other. I feel like these repressed emotions that are starting to come up are the immediate problem, and I want to be able to spend more time on them with a therapist - for now - but the therapists seem to just want to concentrate on my thoughts and beliefs. They concentrate on your thoughts and beliefs because your thoughts and beliefs create your emotions!  So I end up feeling more depressed and ignored. Ouchhh! In other words, I feel like I want to be HEARD and VALIDATED and I want more of that from the therapists. Then tell them just that! (Hey, I've heard it from my clients - and listened!) I know I need to change my thoughts and beliefs, I need help with that, too, but the validation feels much more important right now. Then certainly get some validation!  Please never forget validation is a necessary step rather than an end point. Don't  get stuck lamenting your woes or venting your anger endlessly. 

Am I asking too much of them? No. You are the cunsumer. You choose the consultant you hire. Perhaps you simply haven't met a therapist you really connected with yet. Maybe you haven't clearly communicated your concern to your therapist(s). Were you working with beginning therapists? Newbies tend to get stuck in theory rather than use themselves as an instrument to help you. Maybe you would respond better to a psychodynamically oriented therapist who practices more of a hydrolic model. Or, a client-centered therapist  who makes it their primary business to meet you exactly where you are now. Different strokes for different folks, you know. You are dealing with at least two distinct variables: therapist personality and therapist orientation. I think "clicking" with the provider is probably most important for you right now. That is probably not a good question to ask, since I'm trying to keep this email very short, you may not have enough info about me to answer that.  I guess it was a good question.

A better question just might be more like, what is the healthy balance between dealing with the thoughts and beliefs vs. dealing with the emotions themselves within the support structure of therapist, support group, friends, family and self?  Or is there no single answer and it really is an individual thing? All of the above.

First of all, whatever you do has to feel OK to you. Otherwise you won't do it. So, start by finding a therapist who is willing to meet you where you want to begin. A sensitive, experienced clinician, cognitive or otherwise, will.  Cognitive therapy can be very emotional! If your therapist continues to push thoughts and beliefs when you are someplace else, go someplace else.  Therapy is more art than science.

When you have been with numerous therapists and none meet you emotionally, ask what they think the problem is. As an abuse victim, you may be afraid to trust anybody!  Or, perhaps your expectations of others are unrealistic. Ask, listen carefully and take it from there. For many reasons some people won't feel OK with any therapist  - unless they stick with this person long enough to get through their trepidation.  

On dealing with emotions: There are wonderful support groups like ALANON, which you're already attended, and Emotions Anonymous, both  12-Step sister groups to AA. The role of the support group is to show you that you are not alone and to help de-shame your experience. You learn coping strategies, share war stories and  validate and support each other.  A support group whether live, email, or otherwise is a valuable recovery resource.

The role of friends and family is to love you. Often they do more than that either because they can't help but try to help you or because you push them to help you. The problem with family is that they're human and can only take so much, do so much. They care too much and their feelings of love, guilt, obligation, frustration, anger, etc. can get in the way. Same thing with friends. In your case, recovery from prolonged depression, people who care about you are likely to feel frustrated and powerless in their inability to help you feel better. 

A trained professional is in the best position to guide you through recovery, and support groups are there for you when your therapist or loved ones are not available.

Thank you so very much for your time and concern. 

Char

Thank you Char. Good luck to you.  Dr. Irene