Dr. Rob Burkham

Wednesday, February 06, 2008
Ellen writes:
I have been seeing a therapist for just a little over a year now. She recently has refused to see me do to a substance abuse issue. I have stopped using the drug that I was abusing but when I told her this she said if that was true then it would be a miracle. The truth is, most of the reason I was able to quit was because of how disappointed I felt she was with me and I don't want to disappoint her. I know it's possible that she doesn't really care either way, I'm just another client, I get that, but I care. She is the first person I have ever been able to talk to about anything that has happened in my life, I usually just pretend my life has been great and people don't have any reason to think otherwise. I feel like losing her is just one more painful thing that I have to deal with on top of everything else. Adding more pain to my life was not my intention when I entered therapy. I feel like she has just dumped me off and I'm not sure what I should do at this point. She did say that if I were to attend an outpatient rehab program that she would consider seeing me again but she also knows very well that I cannot afford it and I cannot get the time off of work that I would need to complete it unless I am willing to lose my job. When I say I can't afford it I really mean it. I don't even have money for gas to drive to work and back right now. I have been walking. She recently told me she thought I had BPD and I know a lot of therapists don't like to work with people with this disorder and I guess part of me is afraid that she might be relieved to have me gone and to not have to deal with me anymore. I feel almost sick that I ever allowed myself to trust her and tell her anything, I feel like I should have known better. People like me have problems trusting other people for a reason, not just because it's a fun little game we like to play with our lives. Finding another therapist is out of the question, I have no desire to go through all of that again and I don't think I would ever be able to trust anyone again anyway. I have been thinking about writing to her to let her know how I feel but I'm not sure if that would be fair for me to do. But, on the other hand, I don't think it was fair for her to ditch me either. Can you please tell me what the best way to handle this situation would be? Part of me feels like I shouldn't waste my time and energy on someone who obviously doesn't care either way but then there is the pain and anger that I feel about the situation. I don't trust myself to know what to do about this or to make the right decision. It doesn't help that there are so many articles and books written for other people to know how to live with or 'deal' with people with BPD. I don't want to hurt anyone and I feel like it is just best for me to keep to myself and not interact with other people at all so that I don't unintentionally hurt them in some way. I'm sorry for rambling, thank you for your time.

Dear Ellen:  Obviously, you are in a very difficult spot.  Your therapist has apparently dismissed your success in getting off the drug you were abusing and is refusing to see you unless you go to an outpatient treatment program, which you cannot afford!  And you say that finding another therapist is 'out of the question.'  So, what options do you have?

One option I would suggest would be to start by writing a letter to your therapist which you would not send.  Write out your thoughts and feelings about her and the work you are trying to do--this can help clarify your own beliefs about your therapy.  A few days after writing this letter, think about whether or not you want to edit that letter into a form that you would actually send to your therapist.  Ask her to reply and ask her if she would consider seeing you again.

If she says 'no' then I would look for another therapist.  I know you say that this is 'out of the question'  but I don't see any other way to get the help you need.  Think about how you need a mature therapist who will accept you as you are and will challenge you to work on yourself but will not try to control you into changing.  I wish this was all easier for you.

Dr. Rob Burkham

Tuesday, February 05, 2008
Sue writes:
My therapist got angry with me recently. It was brief but devastating for me. We have talked about it since and I have learned some important things from it but it still bothers me because it was very painful and makes me feel hesitant about what I say now. Are there times when a therapist's anger is appropriate? Is it part of the process?

Dear Sue:  Generally, therapists need to be accepting and tolerant to do their jobs well so being angry at their clients should not be a big part of the process of healthy therapy.  When a therapist does get angry with a client, they need to talk about it with the client as yours did.  Because it still bothers you and you have lingering fear about opening up, it's important to talk about that as well.  You can learn about your fear of the disapproval of others, particularly authority figures, if you work with your therapist about this.  Keep working!

Dr. Rob Burkham

Sunday, February 03, 2008
B writes:
I am a lesbian working with my therapist concerning abandonment issues, suidice attempts and such. I have developed feelings for my therapist...I fantasize all the time, literally, about her. I understand transference, but this is more than that. I think I am in love with her. What do I do?

Dear B:  It is important to talk to your therapist as clearly and courageously as you can about your feelings.  I imagine this will be very hard for you.  But, if your therapist is good, she will help you through this either by helping you understand and therefore tone down your feelings for your therapist or by helping you move to another therapist who will not be so distracting to your work.  Right now, it's probably very difficult for you to focus on your issues but you can learn alot about yourself and how you attach to people with the help of your therapist and by facing these issues head on.  I wish you all the best.

Dr. Rob Burkham

Friday, February 01, 2008
Growing writes:
I am starting my 3rd year in therapy. It has helped me a lot, but I am determined to continue until I am a stronger, more differentiated person. (Yes, I am reading your book!) I believe I have the mature, differentiated therapist you speak of in your book. One of my biggest sources of pain in therapy has been my feelings of admiration and love for my therapist, knowing the relationship is limited to a professional one only. We have talked about this periodically. My question for you is whether you can clarify for me WHY I feel this way, and how much hope you can give me that there will be a day when I can confidently walk away from this woman who seems like the most wonderful person I have ever known. (As you probably know without my telling you, I grew up with emotionally distant parents.) Secondly, I am very interested in the therapy process and am determined to try to understand as well as possible the therapeutic relationship, which has seemed like such a mystery to me. I read a lot of books on therapy and have often lamented the lack of info for clients, which is why I was very happy to stumble on your website last week and get your book. My therapist seems to prefer not to discuss the 'whys' of the process although she knows I want to know. Do you see this desire for knowledge about the process as something that can undermine my progress? Thank you for the practical, reliable help you offer to those of us in the trenches of the therapeutic process.

Dear Growing:  Thanks for such a well thought out question!  There is alot of good news for you--you are working effectively on yourself and you have an excellent guide in that process.  I'm really glad too that my book is helpful to you. 

Now, for your struggles:  it sounds like you can't imagine one day being without your therapist who is 'the most wonderful person (you) have ever known.'  You feel this way about your therapist partly because she is in fact very helpful to you.  You also feel this way because of your own feelings of inadequacy.  (I'm guessing here but I think this is what is going on.) As you grow up and feel more at peace with and confident in yourself, your therapist will still be an excellent person, but so will you!  You won't need her so much. 

The process of therapy is parallel to the process of growing up as a child and adolescent.  If you have really healthy parents, they help you develop a strong sense of yourself and as you become an adult, you don't need them so much.  They are still great but you are an adult now and don't need them in the same way.

I think you'll do well--just keep on working on growing up!

Dr. Rob Burkham

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