Dr. Rob Burkham

Friday, September 14, 2007
Morgan writes:
I've been in therapy for over a year with an excellent therapist. She has helped me quite a bit. My therapist has strict boundaries and will not share anything about herself with me. She is single, that is all I know about her. In my pursuit of wanting to know about her, I searched the internet and learned more than I wanted to know. I saw her picture on a dating site in a seductive pose. I feel as if I have corrupted our therapy relationship. I cannot bring myself to tell her what I have done. I've lost respect for her and myself. I can hardly look at her in therapy. Should I just quietly leave her and find another therapist?

Dear Morgan:

This is a tough spot you've gotten yourself into.  The good news is that you have been helped alot by your therapy and you've apparently developed a good working relationship over the past year.  However, you are facing a serious rupture in the therapy relationship.  One of your choices is of course to end therapy and find another therapist without talking to your therapist about this issue.  If you had been seeing this therapist for only a brief time, this would make the most sense.  But you've worked with her for a year and things have gone well.

Your other choice is to talk with your therapist openly about what you have found out and see if the two of you can heal the relationship and get back on track or if the relationship is unworkable.  This choice is more difficult but it does hold some significant rewards whether you keep working together or not: you will be working on some difficult issues inside yourself and empowering yourself to figure out if this relationship will work or not.

Obviously, I can't make this choice for you.  It's a difficult situation, to be sure.  I wish you all the best.

Dr. Rob Burkham

Friday, September 14, 2007
michele writes:
I have recently started therapy for issues relating to the here and now and to the abuse i recieved as a child. I am finding it extremly hard and sometimes it feels as though something within me stops me from talking, i get ever so uncomfortable as whatever it is thats happening stops me in mid flow of the conversation. I have only been for 4 sessions and the therapist seems nice and open. The last two sessions i have been late but not due to fault of my own, the client before me runs over time. I am not quite sure how i feel about it, and feel as if i am squashed in between the two clients. The therapist always asks me if i will be back and because i am the way i am, i worry that maybe i am in the way and that maybe she doesnt want me to come back. I am also struggling between the sessions, i am very deressed at the moment and finding things hard. I have no one i can talk to between the sessions. Is it normal to feel bad between the sessions and can you please suggest what i can do, as i am finding daily life such a task. thank you

Dear Michele:

You raise three important issues with your questions.  One is feeling that your therapist may not want you to come back.  I would bet that your feelings of rejection which you developed early in your life being played out in therapy.  I would bet your therapist is not trying to push you out of therapy but is wanting to make sure that you want to come back.  She may sense your hesitancy and difficulty expressing yourself.  Another issue is your therapist's previous sessions running over time.  I would talk to her about this--you are paying for and have a right to your time.  When I run over time, I try to make sure that the next client gets their full time--50 minutes in my practice.  It would be hard for you to talk to your therapist about this but it is both important and empowering to do so.

Which brings me to issue number 2: your difficulty talking in therapy.  You obviously have some painful feelings which are brought up in your sessions and it natural for some clients to 'shut down' during a session.  It's important to tell your therapist that this is what happens to you and, if she is worth her salt, she will accept this as natural and help you overcome it.

Issue number 3 is you feeling bad between sessions.  It seems that you are facing head-on some very painful experiences from your past.  It is natural to feel distressed about these because, although they have been there for years, you may not have faced their powerful impact on yourself before.  Again, talk to your therapist about these feelings and she should be able to help.  It would be great if you could find someone to talk to between sessions who would help easy your pain.  Sometimes, doing some simple things that you enjoy can help--it reminds you that there are good things in life.

Keep working and I wish you all the best.

Dr. Rob Burkham

Sunday, September 09, 2007
Question writes:
I have been working with a LCSW who my husband brought me to see, requesting I have individual therapy, as I have a court order for 'individual therapy'.My therapist, however, has preferred for my husband to attend all my sessions. My court ordered therapy is due to a misdomeaner charge. I am in mental health court due to having a diagnosis for Dissociative Identity Disorder, not due to any charge for use of illicit drugs, violence, etc. For some reason I feel uneasy, because my therapist does not focus on couple issues, only my issues, and having my husband present makes it more difficult for me to talk openly with my therapist. Do most people do individual therapy alone with their therapist? Or is individual therapy something ones does with a spouse present to hear and contribute about the individual in question? I thought individual therapy was something that was primarily limited to an individual working with a therapist alone, when only the individual issues are being discussed? What are the boundaries for individual therapy? How does individual therapy differ from couples therapy? And when does individual therapy become couples therapy? What are the boundary differences between individual and couples therapy, in regards to who attends? I am confused and don't feel very safe in this situation, but my husband likes to attend and give his input and listen in to what is said, and seems somewhat offended by my desire for privacy? Are my feelings pathological or is this situation not atypical?

Dear Question:

You have asked a great series of questions which are complicated and illustrate many of the struggles that people have in therapy.  You are stuck in a 'therapy triangle' which is the title and the subject of my book.  You, your therapist, and your husband are forming an emotional triangle which appears to be preventing you from getting anything out of therapy. 

Here's how this works: you feel ganged up on by the two of them--it's two against one and so you feel you cannot talk openly, you don't feel safe, and they are both focusiong on you as the problem.  You feel cornered and a truly helpful therapeutic relationship cannot exist in such a situation.  You won't be able to work on yourself because you won't feel free to be yourself and say what's really on your mind.

Your feelings are not pathological--they reflect the unhelpful situation you are in.  I do have some recommendations for you which I'm guessing will be very difficult for you to carry out.  You would need to talk to your therapist and to your husband about what you are feeling and that you need a place where you feel safe and not pressured so that you can use therapy to get better.  They are both likely to resist this.  If you don't feel your therapist will provide a safe place for you to work, I would find another therapist of your own choosing.  I would explain to your husband that you cannot get better in the current therapy set up and that you need to make a change.  Making these moves will be difficult for you but can end up empowering you to get the help you need.

I'd like to hear how this works out for you!

Dr. Rob Burkham

Tuesday, August 28, 2007
Theresa writes:
I think I have a dissociative disorder. Is dissociation a choice? How do I stop doing this when I'm usually unaware of when it is happening? How can others help me?

Dear Theresa:  Dissociation is not a choice.  It happens automatically and almost always without the person knowing that it is happening.  It is generally developed as a way to mentally escape highly traumatic abuse and it can be a way of coping with the ongoing pain of remembering or reliving that abuse.  In order to not use dissociation so much, you most likely need a caring, non-judgemental, and knowledgeable therapist who can help you understand and get more peace about the trauma which underlies your tendency to dissociate.  This is not an easy process and will take some time even with the best of therapists.  I wish you the best of luck in the process of healing!

Dr. Rob Burkham

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