I feel a deep senes of betrayal and outrage when I reflect that a therapist I went to for 9 months almost ten years ago, the one whom I bonded with the most, didn't share her observations and knowledge with me about the fact that I was presenting as a traumatised patient.
I know she thought I was traumatised because I emailed her about 4 years ago after learning about trauma, asking either to resume sessions with her or for her recommendation of another therapist. I told her I thought I had attachment trauma from my upbringing, and she replied that she agreed with my assessment. That was about 5 years after I first made contact with her. She didn't reveal it when we ended our sessions - we only stopped because she was in training. I never asked for a diagnosis or her thoughts, partly because I struggled with assertive communication at that time, but also because I naively assumed that a therapeutic relationship would naturally include the sharing of important information like that. The lack of transparency astounds me; I feel quite furious sometimes when I think about it. :blowup:
Because I didn't have any clearly defined insight into what my situation was and whether there was a way forward, I stopped therapy about two years after starting with her. I was using a therapist training school to get affordable therapy, so I did have to switch therapists from time to time. Yes, perhaps she was inexperienced; yes, perhaps changing therapists from time to time impacted the relationship and what I got from therapy. But still....! Her decision to withhold her professional assessment of me had a direct impact on the progress I made and the decisions I took. Thank god the feeling that there was something I could learn, something I could do, some answer to my problems kept niggling away at me and kept me searching and eventually led me to finding what narcissism is, what CPTSD is, and other wonderful, helpful resources and communities too. So I'm back on track, but I've lost about five years from simply not being given information that would connect me with appropriate resources. Those were five painful years, too - the trauma was getting worse during that time because I was starting to despair, and I made some really stupid mistakes that have impacted my career. They're recoverable, but I'm definitely worse off and am losing more and more of the precious few remaining years of my youth to recovery. It's not the end of the world; I'm lucky to be alive, and hope to keep learning and growing throughout my life, but it's something that I've lost. Something that was mine, and it's bad enough that my family took years from me; why should authority figures be able to rob me too?
I cannot understand the thinking in the therapy/counselling world that you wouldn't just share information with people. Some therapists do and some don't, but it's such a crapshoot, such a gamble walking into a clinic and hoping you'll get the right therapist, and it's so vulnerable to open up and tell your doubts and trauma again and again.
I imagined that because it was a profession, they had consistent standards. I thought going to a therapist was a bit like going to a GP and receiving either a diagnosis or a referral. Imagine your GP immediately recognising that you probably have diabetes in your first meeting... but not telling you, not calling for bloodwork, just asking you a series of questions about what you eat, how how feel after you eat, trying to guide you to eventually realise for yourself that there's a link between eating sugar and feeling like crap. But you genuinely don't understand, because you've always felt like crap, and your entire family has undiagnosed diabetes and so everyone around you constantly eats sugar and constantly feels like crap, and you've got a brain fog too and you just want to know what's wrong but they won't tell you. Meanwhile, your foot's fallen off and you have developed glaucoma. For f*ck's sake. Why can't they just tell you???!!!!
One of the many reasons I feel angry about this is because of the "take a sh*t or get off the pot" principle - in the time I was working with her, I could have been working with someone else who knew what they were doing. But I earnestly engaged with her, bonded with her, and my experience with her coloured what I thought I could expect from therapy and my understanding of my own situation. It wasn't all bad - it definitely increased my self-compassion and helped me start to be able to examine my own thoughts - but overall it did nothing to reduce the mystery of it all.
I'm also hugely outraged and indignant at what I perceive to be the attitude behind this withholding of information - this idea that I couldn't possibly be capable of understanding my situation; am I not intelligent enough to learn about psychology the way she's learned about psychology? I understand here that I'm doing a bit of a mindreader cognitive distortion and there may be other considerations behind this decision; but I still don't understand why transparency is not the best policy. It's downright Machiavellion. What is with this veil of secrecy?
I don't understand or approve of this unnecessary maintenance of a distinction between the therapist as an authority figure and myself as a patient who must necessarily be kept ignorant except for what understanding I manage to glean for myself. Why? I'm smart. I'm capable. I was being denied a wealth of information that would have given me the understanding that my situation is normal, my responses are normal and healable; that there are words to describe what I'm experiencing, that there's a path to take towards recovery. Why was I denied this? I sought professional help ten years ago. I could have been where I'm at now five years ago. I suffered while I didn't know. I might have even missed the window for having children because of one person's belief that they couldn't just tell me their observations, honestly and directly. A person who I trusted, partly because of our relationship, but partly because of their authority as a therapist.
I understand it's a greater system that's at fault; that CPSTD and trauma, despite being well-researched and written on still hasn't been accepted widely as a diagnosis, that PDs are not taught enough so therapists are not prepared to recognise it and assist their clients in understanding and protecting themselves, etc etc. But still. I'm angry and I feel betrayed, indignant, and belittled. I detest, despise, loathe information being withheld from me and find it patronising and infantilising. Knowledge is power. With knowledge, I am empowered; I am powerful. Without it, I was powerless. I asked for help and was kept powerless in the dark. HOW. DARE. THEY. (Who's they? Her, her supervisor, the clinic, the profession, the medical profession too - I find them quite condescending! the lot of them. Grrrrr!!!) Being withheld information is definitely a trigger for me. It's so pointless and damaging.
I've found some wonderful quotes from Judith Herman (who wrote Trauma and Recovery, which I'm reading now), which support my idea of what trauma recovery and therapy should look like, in this paper she wrote:
https://onlinelibrary.wiley.com/doi/full/10.1046/j.1440-1819.1998.0520s5S145.x
"Trauma robs the victim of a sense of power and control over her own life; therefore, the guiding principle of recovery is to restore power and control to the survivor. She must be the author and arbiter of her own recovery. Others may offer advice, support, assistance, affection, and care, but not cure. Many benevolent and well-intentioned attempts to assist the survivor founder because this fundamental principle of empowerment is not observed. No intervention that takes power away from the survivor can possibly foster her recovery, no matter how much it appears to be in her immediate best interest. Caregivers schooled in a medical model of treatment often have difficulty grasping this fundamental principle and putting it into practice."
...
"If the therapist believes the patient is suffering from a traumatic syndrome, she should share this information fully with the patient. Knowledge is power. The traumatized person is often relieved simply to learn the true name of her condition. By ascertaining her diagnosis, she begins the process of mastery. No longer imprisoned in the wordlessness of the trauma, she discovers that there is a language for her experience. She discovers that she is not alone; others have suffered in similar ways. She discovers further that she is not crazy; the traumatic syndromes are normal human responses to extreme circumstances. And she discovers, finally, that she is not doomed to suffer this condition indefinitely; she can expect to recover, as others have recovered."
(Emphases added in bold are mine.)
It's wonderful to read this and fully agree, this is what I needed. Someone in the field gets it. What's slightly depressing is that her book was printed in 1992 (almost 30 years ago, while I was still being abused) and the above paper was published in 2002 (almost 20 years ago, while I was escaping abuse). The information's out there - why hasn't it trickled down to survivors yet? Why isn't trauma immediately diagnosed, and the first prescription is a reading list of:
-Trauma and Recovery - Judith Herman
-Complex PTSD - From Surviving to Thriving - Pete Walker
-The Body Keeps the Score - Besel van der Kolk (a colleague/collaborator of Herman's)
:Idunno:
I suppose the silver lining here is that it's forced me to realise that I don't need a therapist or a diagnosis to heal; it's not in someone else's hands but in my hands and while there are many wonderful trauma therapists out there and I'm glad others are finding benefit from that, it's quite ok to assess my situation for myself and trust that I've got it right, I'm in control, and I know what to do. So I feel optimistic going forward, and though I could quantify the cost of her decision not to share her professional opinion in actual years of my life lost to CPTSD, I genuinely don't feel the need to dwell on that as I know I can't get it back or get restitution or revenge, and instead I feel excited about my recovery and my future, finally. So that's healthy. :) I just felt I needed to express this sense of betrayal, to get it out, somewhere it might be seen and understood and possibly even be helpful, triggered by reading this wonderful Judith Herman paper this week.
Your insights are very helpful. Thank you for sharing them here. They validate my own journey towards recovering from abuse as I'm sure they do for so many people. I really agree with the part about the therapist always laying the power with the survivor. I can see where therapy could be tough with someone in denial though... like someone who enables but wants help with anxiety or depression. Such a person might not be able to hear these truths... that might have been me twenty years ago...
And yes ever so grateful for the current reality! :)
Hi D,
Thanks for your kind words, I'm glad my rambling is doing some good! It helps me a lot to get my thoughts out in writing.
Yes, I wonder about denial etc too. I was deep in denial - could've gone sour! I might have even left therapy.
Hmmm. Dunno what the best way to share that info is, but I feel sure the right thing is to share it.