When a Therapist Continues to Mean too Much

512px-Female_spirit_on_a_street

Sometimes your patient cannot get enough of you. He might love you or want friendship. He could wish for continuing advice beyond therapy’s end; or desire you as a stand-in parent available for the long haul. Often he doesn’t understand his motivation. The “draw” of the doctor is felt, but not easily articulated. Perhaps the longing for closeness and security are enough to explain it.*

The preoccupation might take the form of attempting to get a glimpse of him: a pattern of observation from a distance, undetected — as he enters his office, for example.  Checking him out on the internet is another possibility. Perhaps not even that. The simple act of spending more time thinking about your ex-therapist post-counseling than you logged in face-to-face is what I’m talking about.

Is the counselor injured by cyberspace scrutiny or residence in the patient’s head? No. How am I harmed if someone reads a journal article I wrote, watches a speech I gave, views a blog post, or wonders about me? I don’t go sleepless with any fear of privacy invasion. I tremble not because of a potential encounter we might have at Starbucks.

Freud expected his couch-candidates to develop strong feelings about him. He thought these emotions were unconsciously transferred to him from people like mom or dad and therefore called the phenomenon “transference.” By working through the intense attachment to him, Dr. Freud believed the patient would overcome his unresolved early-life injuries. Once accomplished, the therapist again became the shrink, not a stand-in for anyone else. Freud understood it was not he who lived in the mind of his analysand, but an idealized (or diminished) version of himself.

All therapists realize that patients often benefit from closeness. Each of us needs to believe we matter. When such knowledge has been absent, treatment can foster an improved sense of value. The doc’s caring, intelligence, close attention, and understanding help repair earlier relationship injuries. Not surprisingly, a lengthy course of psychotherapy commonly produces at least a bit of attachment to the shrink.

On the other hand, there is a problem if the patient experiences continuing, daily, affect-laden preoccupation with the doc and his life. I’m ruling out the occasional cyber search most of us do. Old friends, lovers, and movie stars are fair game. An impromptu internet investigation is an innocent way to pass a few minutes.

Past counselors can so fill the space in the client’s head as to squeeze out his effort to find satisfying human contact in the non-virtual world. The internet realm is safer and the therapist is “known,” perhaps part of the reason he is chosen over the unreliable community of touchable humanity.

The preoccupation can be excruciating. Yet the sufferer’s relationship history is worse. Thus, the limitations of an out-of-reach therapist are benign in comparison.

It is useful to imagine a shrink as akin to a transitional object for some of his clients. Think of how an inanimate security blanket helps a child soothe himself when his caretaker is absent. Indeed, a counselor might even give a worried adult patient a stuffed animal to help him manage the doctor’s anticipated vacation.

To continue the analogy, the therapist tries to comfort the client and enable his development of emotional self-care skills. The patient will ideally attempt relationships after therapy, but generate these on his own with less sense of either fear or desperate neediness. The goal of psychotherapy is self-sufficiency and “wholeness” for patients, even in those life moments where satisfying intimacy might be absent.

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The problem with an unending preoccupation with the memory of the therapist is, to an extent, not different from the continuing “presence” of a deceased or estranged parent, friend, or lover. Even to the degree that these people played an important role in his life, one must “get over” them and their absence. A mourning process is required, not perpetual attention to a shadow version of them in public space — the footprints they left (or continue to leave) in the real world.

Counselors and patients, from the first day of treatment, need to understand the contact between them will be temporary, however life changing. Many clients, nonetheless, cannot conceive of the extent to which their attachment may intensify. Even were they told in a detailed and emphatic fashion, they would be unconvinced.

Treatment is intended to be a stepping stone to “living,” not a substitute for it. Patients are only fully alive when they’ve taken the hard and courageous learning they wrested from the consulting room on the road. The highway of existence is pothole filled. The journey risks disaster, but offers the possibility of achievement, self-worth, and intimacy not available if you are too focused on a one-sided, unreciprocated experience of watching and longing for what cannot be; and therefore not making the best use of your human qualities in the limited time we have on the planet.

In some sense, all relationships — not just the doctor/patient variety — are temporary. We grow apart, friends move away, death intervenes, and our heart breaks over the losses. This is in our nature, a portion of the human saga. Persistent attachment to a therapist is not the patient’s “fault.” Unfortunately, it can take the form of a ball and chain, restricting his growth. Perhaps a better metaphor is to say the client is haunted by the vaporous remains of a too significant “other.”

Unless he turns to a different counselor, the patient must shed the ghost of his therapist by himself. A warm spot inside for someone who meant much is one thing. An internal cauldron is quite another. You will find no exorcist to make the bubbles disappear.

The first step in solving the problem is to recognize it. Then remember why you sought help in the first place. Surely, it was for reasons other than becoming closer to a professional, reasons you can honor by freeing yourself from the abiding distraction his recollection produces. Next, pursue new activities and connections while simultaneously leaving the therapist’s shadow to mind itself. Grieving is in the mix throughout.

As much heartache as may be involved, the door leading to fresh possibilities requires this challenging set of steps.

But then, you’ve faced obstacles before. Indeed, I’ll bet nothing about your recovery has been easy.

The top image is called Female Spirit on a Street by Bonnybbx. The photo that follows is called Fog-Pocalypse by Zach Dischner. Both are sourced from Wikimedia Commons.

*This post was prompted by reading Staying Connected to My Therapist and Trying to be Kind to Myself.

18 thoughts on “When a Therapist Continues to Mean too Much

  1. “In some sense, all relationships — not just the doctor/patient variety — are temporary. We grow apart, friends move away, death intervenes, and our heart breaks over the losses.”
    ~ So, so true. The only thing permanent is change.

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    • Thank you, Rosaliene. Indeed, I’d go so far as to say that one’s happiness in life is in good part a consequence of how one handles change. Your own history makes you more qualified to comment on this than most.

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  2. This post is really hard to read. I had a psychiatrist in the past who after seeing for five years closed his practice which left me with unresolved issues around our patient/doctor relationship and was on top of my history of unresolved broken attachments. In the seven years after that I only sent him 1 text, l didn’t follow him on the Internet and I did everything I could to get on with my life and become more self sufficient but none of the emotional pain around that relationship deminished, I had another psych after him and tried to resolve it and get over being so dependant in the doctor relationships,to the point I was only seeing him once every six months I was trying to get on with life but the emotional pain never went despite my efforts and I started to get chronically suicidal again so that I had to seek professional help again. Getting over these things and getting on with life doesn’t always happen despite the best efforts. I’m single and live on my own which hasn’t helped and I’ve tried different things to change that to but have ended up in the same situation of being on my own, to the point where I don’t have the answers anymore, it’s hard enough to see that even with the work that I’m doing now with my present psychologist that I’ll be able to get over my past and my chronic PTSD. I manage the attachment to my doc now but I have to allow it to be there, not only for the work we are doing but because the lack of close attachments in my life is to painful to live with. This is a hard one for me Gerald, I can see your point l just hope that one day I can get to my life to a level of deminished pain so that I can finally move on.

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    • Thank you for being so open about this, Claire. I’m sure there are readers who will identify with you. Sometimes there is no easy solution. I will keep a good thought for your ultimate ability to triumph over this.

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  3. I am curious about the therapeutic process. Is the process predictable? By that I mean, I get that each person brings his or her own story and conflicts to the sessions but, assuming a client sticks around to do the work, is there a predictable unfolding of the process? I don’t know if that makes sense but can you, as a therapist, see patterns in a client’s progress? Could you reasonably predict how the work will unfold or is it always a surprise?

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    • It isn’t always a surprise, JT, but it is difficult to predict and you, as the therapist, have limited control. Nor, really, do you want the kind of control that would take the initiative out of your patient’s hands. As to monitoring progress, it helps to keep in mind why the patient came to you and what he hopes for. Some therapists have patients fill out brief questionnaires either weekly or from time-to-time. Others have sessions exclusively designed to ask the client his view of whether he is progressing. It is also possible to give the patient a personality inventory, like the MMPI or the MCMI, at the start of treatment and at a later time to see if these measures reflect change. As time passes the patient may see new challenges and want to address these. For others, once the crisis is over, the emotional and financial cost of continuing to go deeper is not always seen as desirable by them. Thanks, JT, for the excellent question.

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      • Thanks for that response. I guess the therapeutic process is a mirror of life. It twists and turns and sometimes you (both therapist and client) might think you know where it is going but it might go in a different direction. Interesting stuff.

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      • “Interesting stuff” is one of the reasons I kept doing it!

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  4. You know this could have been written just for me. Two years since he moved out of State, 2 years of seeing a wonderful woman therapist and still I sit here crying for the loss. And the constant questions “Did he really care about me as a person or just as a co-pay?” (no matter how well he treated me for the 7 years) and why couldn’t he of considered that he was keeping the “therapeutic distance” (wasn’t that your term?) too “distant” and that being a client with low self esteem and needing a person to show they cared, he could have loosened the boundaries a bit and changed from the “doctor/client” mode to the “equal adult” mode – just for the last appointment or 2. Now I’m left with so many questions – so many regrets – so much loss. Even my present therapist agrees that maybe this was the one thing this “perfect human being” did imperfectly. Thank you so much for your Posts … I look forward to them each weekend and my weekly appointment this morning to share them with Elizabeth. She says she should start following you too!

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    • Ah, Judy — you’ve described the poignancy and distress better than I could. I only wish you didn’t have to feel it. For you and others in this “soup,” I only wish I had a magic wand to wave away your pain.

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  5. What a wonderful post – and one that I need to really allow to challenge and confront me. It would be too easy to say either ‘I used to do this but no longer’ (when Jane my ex-therapist ‘meant too much’), or ‘I may do this now but it’s okay if my therapist means too much right now because it’s early days and the idea is ‘I will get get over it’ ‘ (current therapist). I will continue to think on this and write more later – but right now I wanted to say ‘thank you’, not only for the post, but for the mention of my own. I am very glad to have prompted, in some way, your post and your thoughts on this subject (tickled-pink would be an apt way to put it 🙂 )….

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  6. My approach in therapy has been very different to what I read online of other people’s experiences. In the early days of therapy, I was so envious of these attachments, but on the other hand, it’s a relief not to have this complication on top of everything else. Of course, there is always an underlying fear that I am avoiding and holding back from attachments. Great thought provoking post, Dr G

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  7. Thanks for the article. I am living this exact experience of total preoccupation with my therapist. It’s always nice to remind myself this is a thing and I’m not alone in it. Also very sorry to anyone dealing with this. Coming in to therapy the thought of attaching to my therapist at all never crossed my mind. I don’t think I had ever heard of attachment even, and I imagined therapy would be all about blabbing about my awful childhood. Now 3 years later and all I feel driven to talk about are my feelings for him, because they are all consuming. I’ve come to realize that just being the kind of person I am with my background set me up for this. C-PTSD, strong desire to feel loved, child of drunk and BPD. I’d never experienced anything like the therapy relationship, feeling safe even, he is like a drug. Even though intellectually I understand why I would fall so hard for my therapist, it hasn’t made it much easier. The fact is all people tend to desire partners that meet their needs in some way, and because of my childhood my needs happen to all be met by (decent) therapists and the like. Is it wrong to say that I am in a way permanently broken in this sense? I wonder sometimes, do people ever recover? Falling in love isn’t even thought or emotion related, it is biological isn’t it?

    I talk about it in therapy now, very awkward and bizarre, I kind of like it. Even if you don’t go in as needy and insecure as me it is a seductive relationship, Women especially value emotional intimacy and it is a turn on for most women to feel emotionally close and vulnerable to a man, yet feel completely safe, it is like the ultimate fairy tale really. But knowing any of this doesn’t really change it, at least not yet. I still feel the way I feel. It makes me think in a way that therapy is pretty bizarre. I wonder some times how many other women are in love with my therapist, I’m sure there have been several at least! And it is torturously painful, gut-wrenching, heart-breaking to be feeling heart-broken by someone you meet with weekly and have an otherwise intimate relationship with. It is a mirror of the original trauma really only the therapist is the best possible version of your awful parent and also not your parent and someone you find attractive. Subconsciously (or consciously now since I’m saying it ) I’m demanding he fall in love with me when he’s supposed to limit texts and stay hands off and distant. It is as if I cant stop reliving the terrifying feeling of my childhood.

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    • Thank you for your comment. I think part of what makes this hard to treat is that therapists don’t always know that it is happening, in part because patients don’t always reveal it. Additionally, as you’ve suggested, those who have a long standing absence of affection seem to be especially vulnerable. As to a couple of your questions: “Is it wrong to say that I am in a way permanently broken in this sense? I wonder sometimes, do people ever recover?” I wouldn’t assume you are either permanently broken or outside the bounds of recovery. That said, like all unrequited loves, one needs to grieve them and (eventually) find someone else who will reciprocate your feelings. Best wishes in this difficult situation.

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