transference and countertransference

I attach hard to therapists. Seriously, suction cup me to your breast hard. Okay, bad choice of words maybe. Or maybe not - attachments are primal. Any therapist I've ever seen is probably cringing at this point. My sincere apologies. When I was younger and was in therapy every week, for years this was my lifeline, the only raft in the sea of suffering. When I was 19, I had some poor therapist I called every day, sometimes more than once. That is the down side for her. I reckon the good side is that my level of self expression at that point was limited to saying "I don't feel good", maybe several times, and then hanging up. My pain when I was a young woman was simply beyond words, and therapy consisted of going to the office, saying hello, talking for 5 minutes, and then sitting in silence for the rest of the hour. I wish I could say that I had reached a zen-like state of wisdom that was beyond words but the truth is I just hurt. And, to any therapist who ever wondered if sitting there with somebody who isn't even talking does any good, you have my undying love and gratitude. Thank you for sitting with me. Thank you for not leaving me alone. Thank you for putting up with self doubt and boredom and all the other things you went through to pull me out of the pit.
It took me years to develop an emotional language. One where I could describe what had happened to me, how it felt, and what I needed.

Now, about what, over 10 years ago now I saw a therapist at Kaiser in Santa Rosa. Really quite fond of the woman. (And now that I live in San Rafael, I have discovered that it does matter which Kaiser you get your psychiatric care from. Huge difference - drive the 50 miles.) Okay, so a year ago I go through a restructure of my Medi-Cal benefits due to having earned income in addition to SSDI. (C'mon people - I'm working eight hours a week at $12.00/hour. C'mon now.) So I get a huge share of cost on my Medi-Cal, go ask Patrick what I should do, and he advised I get Kaiser to handle my Medi-Care, which means switching my psychiatric care from the County Community Mental Health to Kaiser. And I'm "I dunno. Kaiser sucks at urgent psychiatric care". Which he knows - "You use the E.R." Not a good sign when everyone in Marin knows this, but I trust his judgement so I go ahead and make the switch.
Actually, it was a very good move, and improved my access to psychotherapy. I remember telling my private therapist at the time that I was going to move my psychiatric care up to Santa Rosa, and she reminded me that I had said that same thing when I had Kaiser 5 years before. It was time to move.
So, I called up my old psychologist. I still adore the woman - she is stabilizing in a crisis and unfailingly kind. I am happy to be back seeing her, and my impression is the emotion is clearly mutual.

Here is the basic scenario. In between my switching my mental health insurance and the insurance kicking in (a matter of weeks), my life falls apart. Opps. I get turned down for a traineeship at Suicide Prevention, where I have been volunteering for a year. Not only do I get turned down, but I am still working with the people who were offered the position. I'm there every week looking at people, most with less experience and not as far along in coursework, doing something I am not able to do. This is my second year looking for a placement. I am hurt bad. Seriously like artery bleeding, kick to the groin, finger in the blender bad.
Now, I like kung fu movies. There is always a point in the movie where the hero is almost beat beyond the ability to stand, gets up, pulls up one last ounce of strength, and wins the fight. This ain't no kung fu movie. And, I am fighting like hell but just taking a hell of a beating. There is a point in every fight where the kindest a fighter can do for herself is to stay on the floor and let it be over. This may sound like weakness, or resignation, but it is actually incredibly difficult.
So, I walk in after being away for over ten years. I am beat. I am working on accepting that, for now, it is time for me to stay down. I stand up I get hit and I can't seem to cover my head. I'd too frail to take another blow. This is where I am.
And I end up with a very good therapist who happens to be the head of training for the post doc psychology program for Kaiser. She wants to go over what happened, what went wrong, how programs should have run. It is her issue now - it isn't right that I got turned down from some of these places.
Is she right - yup, it's not fair. Right now, there is nothing I can do about the unfairness. The issue for me is letting go and moving on. But, as somebody who recognizes my potential and who likes me, she wants to see me finish my school. We discuss what should have happened, how her program runs, and it is all well and pleasant. But these are her issues.
School is over for me now. I will never be a licensed therapist. My face is on the mat, and I am staying down. And I am on the floor alone...she just can't get down there with me.

This is the sad part. The problem is one of care - she loves me and wants me to be happy. And this has left me holding more pain than I can possibly hold.

This is the minor problem. Now, here is the crux of the matter. She responds very well when I leave a message where I sound clearly distressed. Sometimes I could catch her if I talk to reception when I needed to be out on a Friday afternoon. She is, as I said, unfailingly kind and when she is there she is totally present. But it became apparent fairly early on that she is having the beginnings of cognitive deficits. She forgets. So, in order to get over her threshold, pleas for help need to be extreme.
I first noticed the cognitive deficits when I began and she kept on insisting during the first several sessions that we needed to do the formal intake even though we had done it the first meeting. This happened about three times. Then once she told me that if she didn't call me back to call again to remind her. Finally, in one session I mentioned that she had a poor memory which she summarily denied. So I gave her my "come on now, it's just me here" look. People will tell me anything - swear to god. So she says "you know, you're right. If I talk to someone in the hall and I have to remember to do something they ask I have to go right back to my office immediately so that I don't forget. I have a really hard time like that".
So sad. Then, when I call, if I really sound bad and if she is in that day, she calls back. But, if I sound reasonably stable, I don't get a call back. The woman can prioritize.
But now, about one out of every three calls, the waiting time for a call back is about 50 hours. (Nope, not a typo. Not 5 hours - 50 hours.) The receptionists, when I check to see if she's in, tell me the policy for a call back from a therapist who is in the office is within 48 hours. Do these people not understand a therapeutic relationship? She will frequently call after 8:00 p.m. on Tuesday if I call earlier in the week, or else later on Thursday evenings if I remember right. But, if I feel like I need the contact, I will stay home.
The last time I called her, I left one message on Monday and one on Tuesday. When I checked on Monday reception told me she was in the office. She did call me back Wednesday about noon. Here is the way these interactions in general and this one in particular effect me. I will wait, and not be too worried if she doesn't call back on Monday. There's a freebie there. If I need to talk, I will call again Tuesday. In her regular schedule she is off on Wednesdays. So I will wait all day Tuesday for a call back, knowing that if I miss her it will be Thursday before I get to talk with her.
By this time I have spent most of Monday and Tuesday wanting to be make contact and receive reassurance. I don't remember now what the incident that prompted the call was, but if I called two days in a row it was pretty significant. (At least at the moment.)
I once saw an interview with a surfer talking about trying to go over a 40 foot wave at Mavericks. He talked about how you paddle as hard as you can, trying to get over the crest before the wave breaks. And you're sure you've made it over. Then you feel the ocean pulling you backwards, and you have no control and know that you are going to take a beating. About nine on Tuesday night, I know there is nobody there. The department is closed, she has gone home and is due out tomorrow. I am paddling as fast as I can, and now it's later night and I am being pulled over backwards. There is nothing I can do. The pit of my stomach sinks and I know I am absolutely alone.
Now, when there is an issue, I weigh the gravity of the issue against the thirty percent possibility that I will be pulled over backward by the wave. Unless it is to change an appointment or some other administrative task, I do not call.

I love her and am attached. Knowing that I am cared about fills a huge need. And I have confidence in this woman's ability to handle a suicidal crisis. No question about it. I also know that as far as the day-to-day interactions that make therapy production this is not a good situation. But the heart is there.
As for her, she loves me and wants me to do well. She is also in charge of a program that trains therapists, and sees in me the skills necessary to do this work. She can't just let me go, even though that is what I need to do.
A transference/countertransference dilemma if ever I saw one. Oh the bonds of love and human frailty.