****This post talks about therapy burn-out and possible termination and serious ruptures. If this triggers you or frightens you, please consider before reading.*****
I feel like it’s really important to document this period of time that is filled with so much heartache and hardship. To write about this massive rupture in my therapy and hope it has a happy ending.
But I’m not holding out too much hope for happy endings, if I’m honest.
Right now we are dealing with a burnt-out therapist and a burnt-out client. A terrible combination. A dangerous combination.
I could go into great detail about what’s been happening lately, but I’m not sure how useful that is? And I think people reading would find themselves just as confused and tangled up in the details and the who’s right and who’s wrong as I am.
What I can say is this. Things have been pretty shitty for months now. I have been continually triggered by Sienna’s lack of availability and the feeling that she’s psychologically not as there for me anymore. I’ve sensed it for a very long time, yet Sienna didn’t and denied it. Until recently.
The once sturdy foundations of my relationship with her have been decimated. I haven’t felt contained or safe for a long time. And it feels like the more my fears and needs intensify, the more Sienna backs further way. My therapy, that room has become a battleground, a weekly implement of torture. Things have soured so much.
And you might wonder what kept me turning up, if it was so bad? I’ll tell you. Hope. Hope kept me turning up. The terror and confusion and isolation and abandonment and rejection I was feeling in between sessions was so encompassing, so painful that I’d turn up to sessions with desperate hope that she might just say the right thing, do the right thing to take away all this pain and fear. But all that happened every single session was that I was triggered and then fell into emotional flashbacks that would last days and weeks. I desperately wanted to leave therapy and never return. I desperately needed to take a break from it, yet the nature of my disorganised attachment to Sienna made it impossible to leave her. Terrified to let go. Terrified to lose sight of her. Terrified to feel the longing and missing her, terrified she wouldn’t be there when I got back. So I clung on with a vice-like grip. Like my life depended on it.
Last Monday (2nd October), it all exploded. I had a sick bug and couldn’t make my session. I text Sienna to tell her I wouldn’t be in. I said we could reschedule for another day or we could do a phone session at my normal time instead. She opted for the phone session.
I knew something wasn’t right when she didn’t pick up immediately. She’s never late for my sessions. She sent me a text to say she’d be a couple of minutes. I felt a sick feeling in my body. I knew this was a symptom of something bigger. Lately things just haven’t felt good. I haven’t felt like she is really there anymore. It’s lots of little things that seem innocuous, yet are signposts to something else going on. Simple things like, normally she’d walk me out her room at the end of a session, right out into the foyer to the stairwell. It was nice because it almost felt like she didn’t want me to go or she wanted to see me safely out the door, it felt caring. But she hasn’t done it for a while. I’m not sure when she stopped, but very often she’s left me just outside of her office door and disappeared back inside.
She’s finished sessions pretty much on the dot and very occasionally a couple of minutes early.
There’s lots of tiny signs that just sort of build up a picture. And it just feels bad.
Anyway, she finally called me.
I don’t want to publicize what happened next, I feel like I have to protect my therapist. And it just doesn’t feel right to tell the world exactly what happened or why when it’s something she isn’t proud of herself.
But she basically ended the call within 2 minutes. She was angry and upset with me, she sounded close to tears and she just wanted away from me I think. She basically hung up on me.
I sat in pure shock. I couldn’t believe what had just happened, yet strangely even though I was shocked, I’m not sure I was all that surprised.
I felt scared. But the biggest thing I felt was huge compassion for her. She’d literally just crashed and burned right in front of me. I knew she wasn’t in a good place. I knew this was very out of character for her and I knew once she’d calmed down that she’d be really hard on herself.
Surprisingly I wasn’t so much bothered about the incident but more concerned about what it meant for us. What it meant about us? I knew things were bad. I knew this incident was really bad.
A bit later on she text me to apologise for what happened and to say that she had contacted her supervisors for emergency supervision. And that she needed to take the rest of the week to herself and wouldn’t be available. The word burn-out was used.
I know burn out is bad. I know some people don’t come back from burnout.
That night, I just sat shocked. Terrified for me and concerned for her. It looked like I was losing my therapist. I’d broken another therapist. Once again, no matter how hard I had tried, I had managed to find myself probably terminated.
In the middle of the night, I sat in my living room just sobbing my heart out. Feeling utterly insane and broken and terrified that no one will ever be able to help me. That I’ll be stuck with this pain for the rest of my life. I felt completely alone. I felt rejected and abandoned and confused.
Something in me just broke. I needed help. ASAP. I text my mum and my brother at 2am, hoping someone would be awake. Obviously they were sleeping but they replied in the morning. And by 9:30am, my mum was here. And everything flooded out of me. I told her a lot of what’s going on.
I don’t know if it was sheer stress, or the bug I had but I couldn’t eat or drink without wanting to be sick. I felt starving yet couldn’t put anything in my mouth.
My mother came the next day too. And my brother visited. My husband has been absolutely fantastic. And every-time I slip back into the past and start feeling terrified about abandonment, he is able to hug me and remind me where I belong; with him and my pets and my house. And somehow that would bring me out the terror place.
But last week was absolutely horrific. I know I keep using that word, but it isn’t hyperbole, I mean it, it’s been horrific. It has tested me to the absolute limit. It has taken me to the outer edges of my sanity.
Sienna did text me on the Wednesday to reassure me that I wasn’t terminated. But other than that she couldn’t say what was going to happen next. She wanted me to come to my session on Monday.
But that didn’t help me. I needed to know what I was going into on Monday. I knew as my fear built up that I was not going to go to that session. I couldn’t face going in and sitting in front of her for bad news.
I didn’t reply to her text. I wasn’t sure if she’d want me to. But by Saturday, I needed to know what she wanted to say to me on the Monday. I explained that I needed to know because I was feeling very vulnerable and I’d rather get bad news via text while I’m at home supported by family.
She text me to explain that she’d undertaken some supervision to support her. That ethically she couldn’t work with her private clients until she knew she was safe to do so. That her confidence had taken a big knock and that she’s in need of a break to regroup.
Things looked black.
I already gathered she’d be taking at least the next few weeks off. And part of me was relieved, because I too need a break. Things haven’t been good with us for a long time and I think that none of us can see the wood from the trees right now. But overshadowing my relief was sadness and fear that my therapy was over.
I asked Sienna if she had 5 minutes to chat? To my surprise she agreed.
We ended up chatting for 40 minutes. It was a truthful and heartfelt conversation. She’d taken the week off and was already feeling better. She sounded more like her.
We both took stock of what was happening. I knew that she just had no more capacity to hold my therapy by herself. The level of the work is such that we now need to get me more support outside of sessions because she can’t do it anymore. She said even though I am one client, it’s like holding 6 or more different clients all with trauma because of the parts. That she never knows which one is going to turn up. And she never feels fully off duty because she’s always wondering when the next text is coming in.
I don’t think this burn-out is all about me. She did say there’s all elements in her life adding to this feeling of burn-out. And I think one of the big issues is perhaps she’s not taking big enough chunks of time off. Normally she just takes a week here or there.
I felt reassured after the conversation we had. She still wants to work with me, that was never disputed in her eyes but she needs to be careful of her work load and I need to get more help for in between sessions. I acknowledge this, but I really don’t know where that help is going to come from.
I did go to my session this Monday. It was hard. I still feel all the pain of Sienna’s lack of capacity for me. I feel fear of what will happen with my therapy. I honestly don’t know if I can bear having no contact outside of sessions with her, after having had her be such a solid presence in my life for 18 months plus. I don’t know how to do the triggering work IN session and then go out into the wilderness and have no one to support me with everything that therapy kicks up.
I keep trying to remind myself that nothing has changed except outside contact. My sessions are still the same and our check-ins will still happen on a Friday morning. I am trying to keep myself based in reality, that it can be okay. But I frequently find myself slipping into lack of hope and fear and abandonment.
I don’t think Sienna and I are out of the woods yet. Not by a long shot.
I don’t know that we will survive this rupture. I am not sure I can accept the changes.
I can tell you that I want us to survive it. I can tell you that I have faith in her still – although it has been knocked quite a bit.
She is taking next week off as a break I think. And I am glad. I need this break. And I may extend it to longer than a week. I do think that maybe we need some distance from each other to really let the dust settle, for us to each find clarity and I need to find some stable ground, because all therapy is doing right now is triggering me for weeks on end and it is beyond agony.
If we can pull this off, if we can get through this massive rupture and come out the other-side, then I think we will both have learnt some valuable lessons. And I think our relationship with strengthen and deepen.
She feels like such a solid and real part of my life. I can’t imagine her not in it. Ever.
Yet, it remains to be seen if I can tolerate the changes. I reckon a lot of trust has been lost. I know somewhere I feel very angry with her. And I don’t know how I’ll be able to trust her with anything anymore. How can I trust that she’s pacing herself? How can I trust she won’t burn out again?
I flip between doubt that we’ll get through this, and thinking we should just give up now. I literally have no idea what’s for the best.
So, for now I’m doing nothing but taking a break. Gaining some distance from it and hopefully get a clearer perspective.
But it’s not easy. I am permanently hurting. I can’t get a minute’s space from the pain I feel. It consumes me.
I am dealing with that by sleeping a lot… but even then my dreams torment me. Sienna, once a figure of comfort and safety in my dreams has become mean and persecutory and that makes me so sad.
I am meditating. I am taking anti-depressants – waiting for them to kick in. I take a Valium when I just need rest from the pain. I am waiting to see a community mental health team next Monday to see what they can offer me (probably nothing). And I am constantly coaching myself, to staying in the present, to not let myself slip down into the regressed terror of the child parts who are just bereft right now.
Real damage has been done in this rupture. I am not sure we’re coming back from it. All I know is we are trying our best. We both want to come back from it. We are both committed to my therapy for the long-term. And it’s her commitment and care for me that is keeping me in therapy right now.
I feel like there’s so many ways we work really well together. I have her love and care and huge commitment to me and that in itself is worth its weight in gold.
Whether it is enough, remains to be seen.