Challenging a Beloved Therapist: A Catalyst to Growth

• A Break in Need of Repair
• Healing through Empathic Attunement
• Confrontation Revelation, and Repair
• Incremental Progress, Monumental Change

A Break in Need of Repair

“I’ll wear a mask, unless you take a COVID test!” This was the message that I emailed Jeffery, my therapist of 29 years. It was a few days after he returned from a vacation that entailed a long airplane flight. My appointment was the following day.

“Wear a mask,” came Jeffery’s reply. He said he didn’t want to “stick something up my nose,” and was sure he didn’t have COVID because he was masked the entire flight. 

I was startled. His annoyed tone was out of character. I was also surprised to find I wasn’t devastated. In the early years of our work together, I’d been 100% emotionally dependent on him, a child beneath my grownup facade, and the thought that he might be annoyed would have been the end of my world. Now, I knew this was a temporary disconnect, one that could be repaired if we discussed it.

“Let’s do a phone session,” I emailed back. I was at risk for lung infections because of a health condition. Also, I would feel more secure on my own turf if the discussion proved difficult.

When we Facetimed, I saw that Jeffery was home, not in his office. Though dressed in his usual button-down shirt, he was stuffy and hoarse and looked as if he should have been in bed. But he was back to his usual cordial stance.

“Do you have COVID?” I asked.

“Just a cold. I don’t have any fever.”

By then it was common knowledge that fever wasn’t the gold standard for making a COVID diagnosis. I didn’t pursue the repair. He obviously wasn’t ready. I was glad to see him — he’d been away six weeks — but the session was superficial, not emotionally satisfying.

Before our next appointment, Jeffery texted that we should do another phone session, because he had COVID. Again, I was surprised at myself, this time for not wanting to say, “I told you so.” I understood that he could be wonderful 98% of the time and not wonderful 2% of the time.

When we spoke, I tried again for the repair, explaining that I was afraid of getting sick. He said he thought I was telling him what to do, but once he understood why, he was OK with it.

I saw that Jeffery was trying to be conciliatory, but it didn’t make sense. He’d known for a long time that I was afraid of getting sick, in part because I dreaded needing someone to care for me. We had been working on that in sessions. Also, he had never before gotten annoyed when I told him what would make me feel safe, even if he chose not to comply. Most likely, my COVID test request had triggered something in him that had nothing to do with me.   

I grew up in a home that didn’t model the best way to resolve conflict. If my father was displeased at something my brother or I did, he flew into a rage that involved prolonged and intense yelling, often accompanied by physical punishment. If he was displeased with something my mother did or opinions she had, he just yelled. She would answer softly, almost meekly, then later do as she pleased. If he found out, there would be more yelling. Early on, I learned not to rock the boat, a skill that traveled with me to adulthood. I was afraid that people would stop liking me if they became annoyed or angry, so I did everything I could to keep the peace. Now I was stymied.

It was rare that Jeffery let his own issues interfere with our work. In 29 years, that had happened only four other times, the last more than a decade earlier. This was by far the least consequential, but it was the first since I felt like a grownup through and through. I knew that before a meaningful discussion could begin, I would have to wait until he was ready to acknowledge what happened. If this was anything like the other times, that could take months. In the past, I would have discarded the 98% while I waited, just because I wasn’t happy with the 2%. It was a testament to our work together that I didn’t do that now. But gray was a lot harder to navigate than all black or all white.

Healing through Empathic Attunement

At 51, when I began seeing Jeffery, I had already spent 35 years in the mental health system. I’d been hospitalized three times with a misdiagnosis of schizophrenia, lived in a halfway house for a year, and had seen six therapists, each for several years. Though high-functioning at two jobs — weekdays as an I.T. systems analyst, weekends as a librarian — inside I was in emotional pain so great it felt like organ failure.

Relief came only through escape to an imaginary world I called the Atmosphere, where kindly invisible people, more emotionally reliable than real people, understood all my feelings and thoughts. That, and the knowledge that I always had an out: I could kill myself. The one place in the non-Atmosphere world where I was relatively comfortable was at work. I worked seven days a week — to stay alive and to pay for therapy.

Five years earlier, at 46, I learned I had what was then called multiple personality disorder (MPD) and has since been renamed dissociative identity disorder (DID). I was shocked that such a sensational-sounding diagnosis could apply to me. At the same time, I was relieved to finally have a plausible explanation for so much of my past: feeling not real, watching myself from outside myself, talking to faces in the mirror who were not me, functioning on a high level at work yet feeling psychotic outside of work. The diagnosis let me know I was not an alien species. I had a condition documented in clinical literature, said to have been caused by ongoing childhood trauma. That part fit, too.

It was one thing to have a diagnosis, another to find a clinician skilled in treating multiplicity. It would be another five years before I found Jeffery, recommended by a member of the dissociative disorders support group I had begun attending.

Jeffery soon realized that the Atmosphere, which was more real to me than the real world, had developed in response to early attachment trauma. The Atmosphere had been helpful when I was a child, providing the emotional connection I wasn’t getting from my parents, but when I became an adult, it got in the way of my having meaningful relationships with real people. Jeffery believed the Atmosphere had to be dismantled before healing of the multiplicity could take place. His theory, unbeknownst to me until years later, was that I needed to have an Atmosphere-like experience — perfect and unbroken attunement — with a real person: himself. I would then transfer my attachment from the Atmosphere to him, and eventually to other real people.

Over many years, with infinite patience and kindness, Jeffery saw me through the stages babies and toddlers go through when attaching to their caregivers. I may have been in an adult body, but parts of me who were very young still had to learn things as basic as object constancy — that people and things exist even when you can’t see them. Jeffery understood that to my magical way of thinking, I had two versions of him. In-person Jeffery waved goodbye to me at the end of each session, then froze, hand in the air, and stayed that way until I returned. The moment I walked out of his office, Atmosphere Jeffery materialized and remained with me 24/7, knowing everything I thought and felt and did until the start of my next session when in-person Jeffery would be right where I had left him.

In that way, he was with me continuously. Whenever something happened to let me know this was not so (his socks were another color, or he’d gotten a haircut, or worse, I saw the patient before me leave), I would berate him for his betrayal and call him a “deceiter.” He would explain that he hadn’t abandoned me, that I was always in his heart, even if he wasn’t physically with me. His words would soothe me — until the next time.

What went on in any given session depended on which of my parts was “out” (present). There was a sliver of me who was grownup, in particular an administrative part I called AlmostVivian. She kept me functioning in the world but had no depth. The more three-dimensional, feeling parts of me were largely children. These “littles,” who were causing most of the chaos and pain inside me, saw that Jeffery was a safe person, and they gradually began revealing themselves to him. Sometimes the only way I could communicate was by talking in nonsense syllables or writing backward on a piece of paper he had to hold up to the light to read. Other times, a feeling was too big to fit inside me, and I screamed, or hid behind a chair, or wordlessly locked eyes with him in an attempt to connect. And sometimes, ashamed to be visible, I could talk only in the dark, so he turned out the light.

At the start of a session, Jeffery would wait to see where I chose to sit. If it was a chair, he sat in a chair, too. If it was the floor, he would sit on the floor with me. If I was unable to talk, he and I might draw a picture together, taking turns adding a squiggle or something representational, like an eye or a bird. Sometimes we passed a computer back and forth, typing to each other in conversation. I likened our sessions to emotional surgery, where Jeffery dug deep but never more than I let him know I could tolerate. We would both make sure to leave enough time at the end to sew me up, so I could go out into the world and live my life until our next session. The sewing-up routine came to include having toast together, my ultimate comfort food. As we ate, chatting about seemingly mundane things, I would slip in something about my itinerary. “Before I go to work tomorrow, I have to take my mother to the dentist.” Atmosphere-Jeffery always knew where I was. I needed in-person Jeffery to know, too.

There were many bumps along the way, but the more I got from Jeffery what I had previously gotten only from the Atmosphere — feeling seen, acknowledged, understood, and cared about — the more I began connecting on a deeper level with outside people. My cubicle-mate at my I.T. job said, “You seem different lately. More sparkly.” My sister-in-law said, “It’s much easier to talk to you now. You’re more connected.” In my writing workshop, instead of hurrying out as soon as class was over, I began lingering to chat.

It took years, but I finally did “lose” the Atmosphere, and with it, the Atmosphere version of Jeffery. Concurrently, my internal parts were becoming more conscious of one another. While these developments were ultimately positive, adjusting to a new mental map of who I was and how I related to other people was not easy. For a few years, I felt lost from Jeffery, even when he was sitting across from me. A children’s book, Farfallina and Marcel, helped. I kept a copy in Jeffery’s office, and we often closed the session by reading it together. It’s the story of the friendship between a caterpillar and a gosling. One day, the caterpillar says she doesn’t feel well and climbs a tree. The gosling waits below, but the caterpillar doesn’t come down. A long time later, when the gosling has become a goose, he meets a butterfly. As they talk, they find out they each feel bad because they each lost a friend. A while after that, they realize they are the friends they thought they had lost. They look different, but they’re still the same inside.

Confrontation Revelation, and Repair

Jeffery had been my sherpa through decades of monumental changes that literally gave me back my life. Now we were having a tiff about something as trivial as a COVID test. At least I thought we were. From his point of view, the air had been cleared as soon as he understood I was simply telling him what would make me feel safe. I loved this man and wanted everything to be OK between us, so I did my best to ignore the elephant and go on as we had before. But six months later, when he was scheduled to take another trip — brief, but it involved a long flight — the elephant was still there.

“I don’t suppose you want to take a test when you get back, so let’s plan on a phone session,” I said, hoping to start a discussion.

“It’s not going to happen,” he said, smiling as if at a shared joke.

I smiled back, but inside I felt a great loss. The one person who had completely seen and understood me no longer did.

When Jeffery returned, I decided to confront him. I told him again that saying he didn’t want to stick something up his nose had been hostile. He could have just said he wasn’t comfortable taking a test. I repeated that this issue had more to do with him than me. He said he saw it differently. He had always shielded me from things that annoyed him. Now he was allowing himself to be more spontaneous. Then he clarified. During a session, he always saw my point of view, but outside of a session, he felt freer to let his annoyance show.

This initiated a new worry. How many other things had I done over the years that annoyed him? I asked for a list. All he could think of was something from two decades earlier, during the period when I could talk only in the dark. If my session was in the daytime, he had to hang blackout curtains, then take them down when I left.  

In our next meeting, I realized it was up to me to get the discussion back on track. I told Jeffery I had been caught in his forcefield, so I’d gone along with his explanations, but they didn’t make sense. His response: “Just because I disagree with you, that’s a forcefield?” This, too, was out of character. I said I didn’t want to know exactly what sticking something up his nose meant to him. I just wanted him to know that whatever it was had more to do with him than me.

There was silence for several long minutes, during which Jeffery’s eyes went up diagonally, the way they did when he was thinking through a complicated issue. At last, he looked at me and said humbly, “You’re right. There is something. I didn’t know it until now. Thank you.”

This was huge, but I didn’t stop. I brought up what he said about being annoyed outside of a session but not during a session. I told him that was hard to deal with. I needed to know he was a consistent person. Jeffery agreed he shouldn’t have said that. “It was mean and not true. I was just rationalizing my behavior.” That might be, I said, but it still hurt. He nodded his acknowledgment, holding my eyes.

We talked about it for a few weeks. I told Jeffery he was so near perfect that it was hard to know when it was legitimate to call him on something, especially when he kept insisting on his point of view. He admitted he didn’t like to think he had faults as a therapist, so he didn’t see when his own issues got in the way. Then he told me a little about his childhood, no details, but enough to let me know that what occurred between us most assuredly had nothing to do with me. I felt a surge of gratitude to him for his honesty. This couldn’t have been easy. But the elephant was gone.  

Incremental Progress, Monumental Change

At first, I was just glad to have my therapist back. But within months I found myself acting differently outside the therapy room. I had always been surface-friendly with everyone, easy to be around. I rarely became involved in deep discussions because I rarely had strong opinions. Whenever I did have one, if it was contrary to someone else’s point of view, I soon came to feel the other person was right. Now I was finding myself less inclined to remain safely on the sidelines, more willing to take cautious risks and become involved.

Shortly after the air cleared between Jeffery and me, I was asked to become co-chair of an organization I belonged to. While I liked the group and its mission, the thought of having to run meetings where there were sometimes opposing viewpoints — and hurt feelings — was daunting. I declined, explaining my reluctance to the person trying to recruit me. “But you’re so good at handling that kind of thing,” she said. I knew I was, but it was a skill that came with a toll. I was constantly vigilant in my interactions, never fully relaxed. Still, when she continued trying to convince me, I was flattered. She was someone I respected. After a month, during which I thought long and hard, I accepted, having decided it would be good for me to step out of my comfort zone. 

Of all the changes I went through since the start of my therapy with Jeffery, none had announced itself with an ah-ha! moment worthy of documenting in a progress note. Change was so incremental, like the slow movement of tectonic plates, that I never noticed it until a seemingly minor incident, like the COVID-test brouhaha, let me see how far I had come.

It has been said that in psychotherapy, in addition to whatever expertise the therapist has or what their approach is, it’s the relationship that heals. Jeffery was a safe person for me to challenge, and I had become strong enough to trust my instinct that something about his protestations didn’t ring true. While he didn’t agree with me at first, he didn’t try to crush me but allowed a discussion. I saw that we both wanted to reconcile and were negotiating in good faith. Ultimately, the fact that he was big enough to step back and take an honest look at himself, despite his discomfiture, was healing for me.

In my new role as co-chair, I have already been challenged by several disagreements. Each time, I’m initially sorry I accepted the post, but after the issue is resolved, I feel good. When I was on the sidelines, I never took a stand or tried to shape an outcome for fear of upsetting someone. Being involved is more difficult, but also more gratifying. It’s as if I had been snacking before and have only now sat down to a satisfying meal.

At 81, I am still becoming. 

©2024, Psychotherapy.net