To my analyst, the closest thing I have to a mom: Happy Mother’s Day.

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Another fantastic post from the author of Life In A Bind, and another I could have written myself! I am in the middle of literally begging my mother to go to therapy with me, because I can no longer bear the way our relationship is conducted. And yet, my mother is resisting in every way possible, which of course stirs up feelings similar to those mentioned in this post. And, of course, I am in the middle of a rupture with my analyst: I am supposed to strictly adhere to the relationship in the way she wants it, or I’m out, just like my mother. Thank you so much to the author for writing encouraging words at the end, that as much as we wish they were, our therapists are not our mothers, and because of that we have the opportunity for something different with them. We just can’t let the transference get the better of the relationship.

Life in a Bind - BPD and me

Part I – Estranged families

It is Mother’s Day in the UK on Sunday 6 March. I’m looking forward to celebrating it with my own children, but am aware of the desire to ignore and minimise it as much as possible, when it comes to my own mother. We have never celebrated it in a major way – and for years I sent a card but nothing else. As with so much when it comes to my relationship with my mother, I was worried about expectations and the possibility of ‘give an inch, take a mile’. Should she, did she, expect a present? And if I gave her one, one year, would she expect one the next? And if she did, was that a problem?

The problem is that my desire to give, is absent. Over the last few years I have started sending her flowers on Mother’s Day, but…

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It has been five months since I’ve posted. Motherhood keeps me busy! Also, analysis five days a week is incredibly complex and so hard to encapsulate and put into words, especially while one is in the thick of it.

But, I am grateful to the author of lifeinabind for bringing up the topic of touch in therapy. It has long, long been a source of both pain and pleasure for me, and I think it should be something that is considered as part of talk therapy far more than it actually is.

I don’t have time to explain or write a full post, but I will edit and take some of my comments that I wrote on lifeinabind’s post to explain my experiences and thoughts on touch in analysis (wow! This ended up being very long!). Also, for anyone who is interested, I will include the list of research articles I found helpful for convincing my analyst to allow touch in our work. (For the most part, it is working wonderfully.)

I feel very passionately about this issue, and I’m happy to answer any questions in the comments!

“I see my analyst five days a week, and I see a “supportive” analyst on Saturdays because I have such a difficult time with the loss of connection over the weekend. It is still not enough, but it is what it is.
I also plan to never be done with analysis. My analyst says that lots of people are in it forever, and I plan to be such a person. One never stops growing or learning.

It’s actually not Freudian, it’s Modern Psychoanalysis (looking up Hyman Spotnitz is a great place to start if you want to learn more). Five times/week isn’t a requirement of modern analysis but it’s important for me in order to keep the connection. It is the most intense, intimate experience I have ever had. Analysis is fascinating.

My analyst would happily let me lie on the couch but the idea makes me nervous. It feels very exposing and somewhat sexual to me. I’ve never done it. I’ve heard that it can make free association more productive as it can remove the pressure of looking at the analyst while talking. Instead, my analyst and I sit on the floor next to each other, with our arms touching. Lately we’ve been sitting with a blanket across our laps. Occasionally she will hold my hand. It’s very warm and wonderful and really helps me relax enough to feel a connection and talk. It took a lot of convincing, though, to get her to try it this way. She was very hesitant (“That is not how analysis is done.”), and I brought in a lot of research on oxytocin and physical contact in analysis in order to support my position. But, I knew what I needed in order to be productive and I think she picked up on that. We’ve been sitting together for about five months [ETA: now eight months] and it’s been working very well.

The focus of my analysis is on the relationship – how to be in one that is healthy and mutually respectful, how to ask for what I need and how to get my needs met by someone besides just my analyst, and working through the transferences. It is chaotic and messy and often overwhelming; it took awhile for both of us to find our footing. My analyst had never worked with someone five days a week, sat on the floor, etc. It is also very, very lovely.

My analyst is 61 and I am 26. Though she says she never plans on retiring, the reality is that one day she will have to stop working, either due to old age or death. I will, at some point, need to enter into another analytic relationship. I plan on being an analyst so it will be important for me to stay in analysis. The thought of losing my analyst, though, is incomprehensible.

I’m a firm believer in the idea that touch in therapy, while not for everyone, could do many people a lot of good.

I should mention that after I first asked my analyst to sit with me and she said no, I accidentally stumbled across alexithymia, which I found to strongly match my experience. Alexithymia is basically a lesser ability to know what one is feeling. My research into that showed that increased oxytocin is helpful in the “treatment” of alexithymia (excuse the quotation marks; I hate labels and diagnoses and such). My argument for contact in my analysis became even stronger with the idea that oxytocin is released in this way.

I emailed a bunch of therapists/analysts who had written about this topic as I was looking to make my case as strong as possible.

Touch is complicated, even when it’s incredibly natural and simple. Tonight my analyst sat with her arm around me and it was wonderful, and then the session was over and I had to leave and go home. It will never fill the hole from childhood, no matter how much I get. I think it is most important to have a meaningful relationship, because it is in the space which the therapist and the client create that change occurs.

(Some background):
I have a history of sexual abuse, and in my family of origin it was unconsciously communicated that it was shameful to have a body, to physically exist, because bodies are only for sex and sex is bad. Touch was seen as sexual so there was very little of it outside of the abuse.

My previous therapist was very affectionate and that is how I grew to be aware of the lack of touch in my life. Before that, touch was incredibly awkward for me and I kind of looked at it with disdain. But then my first therapist decided I “needed some mothering”, zipped up my coat, and I was high on touch. I grew to love her in a maternal way (nothing sexual ever happened) and even though our relationship started to get very rocky, I could never imagine leaving her. I knew that she was in over her head with me, but the touch was too important to lose. Eventually things got so bad that she dragged me around a room and pinned me in a corner when she thought I was suicidal. I had bruises from our squabble and I worked up the courage to leave a few months later. She had been so kind to my body, but ended up hurting it.

Okay, so my analyst – initially I was very wary of her. On our second interview session, I asked if she would try to have sex with me if I decided to lie on the couch. I was sure that no one would ever touch me safely again, that my first therapist had been my one and only chance.

I wasn’t too concerned about erotic feelings. I did once have an overwhelming urge to kiss my first therapist, which I’ve never discussed. Once recently with my analyst, I felt so moved by how much I loved her that I felt that a kiss should follow our hug. I haven’t told her, but I think for me it’s from my history (what isn’t?!), that I grew up thinking that sex is the only way is the only way to be physically intimate with another and when I love someone, I’m supposed to be sexual with them. Logically I know this is not the case and the feeling passed as quickly as it came. My analyst did ask once if I had any sexual feelings about sitting together. I said no, and she said it was okay if I ever did, that she wouldn’t freak out and we would just talk about them and not act.

So, my feelings for her were initially complicated in a different way – I was worried she would hurt my body like so many other people had, and then I was desperate for her to touch me and she wouldn’t, which brought up feelings around my mother. Now she does touch me, but she’s mentioned that she isn’t a naturally physically intimate person, so I often want more than I’m brave enough to ask her for, because I desperately want to preserve the relationship and I don’t want to drive her away with my neediness. And more than anything, I want to go to her house and curl up in her bed with her and sleep. It is frustrating that I can’t get what I want/need. The feeling toward her is always maternal and that is how I interpret her touch.

I absolutely, 100% trust my analyst to not cross a sexual boundary. I have spent many hours in her office alone with her, and if she wanted to do something, she could have.

Erotic feelings – though very real – are maybe not so worrisome. They are feelings like any other, and they warrant a good discussion. They don’t require action, and should the feelings arise, it’s likely one would be able to prevent any action from occurring.

So, as I said earlier, my analyst was absolutely against touch in analysis. The feelings of rejection and abandonment from my mom were so strong that I had literal freak outs when my analyst would say no. I mean, full on meltdowns, hyperventilating, dissociations, you name it. When I left my therapist, I thought I was ready to give up the physical contact – boy, was I wrong! And now I was in a situation: stay with my analyst and accept her position, stay with my analyst and hope that she changed her mind, go back to my therapist, or go find someone completely new.

So, there was a lot of discussion. A lot. I brought in all of my research. We talked theory. We talked about needs. She said that I might not deal with the feelings of abandonment if I didn’t face them in my therapy. I countered that obviously she wasn’t going to sexually abuse me, and I wasn’t going to have to relive that to process it, so why did I have to relive something else that was traumatic? Lots and lots of discussion.

Of course, she consulted with other analysts, which I fully encouraged. Her supervisor was supportive of my position, someone else was completely against it, and a third person was on the fence. The person who was against it suggested analytic reading material for me which ended up pissing me off. It was all about how talking in analysis is important, etc., etc. I said that of course I wanted to talk – that was what the touch was going to help with! Without touch, it felt like a very formal business meeting or an interview, and I didn’t see how I would be able to work productively in that mode. (The guy’s literature also pointed me to alexithymia, so I admit there was some benefit.)

My analyst continued to say no and so we tried to come up with ways to eliminate the formal feeling. We started by sitting across from one another on the floor. It didn’t really help and it was even more frustrating. With our legs extended, we could have touched each other’s foot and that was not allowed. It was just… haha, I don’t know. I had to be very patient. Looking back, it set a very good foundation for our ability to discuss our relationship.

Anyway, my analyst held firm and while she was very compassionate and kind about the pain I was experiencing, I told her that I didn’t know if I was going to be able to stay if we weren’t able to touch. She understood and said that while it could happen down the road, it wasn’t going to happen now.

So it was really the alexithymia that did it, I think, plus our many, many sessions of discussion. As I mentioned before, in my research I found that alexithymia responds to oxytocin, and oxytocin is obviously released when there is human contact. After that, things kind of changed and we eventually sat down together to write a contract. It was supposed to be a trial and if it didn’t go well, my analyst said she might have to refer me on to someone else. It was kind of a scary leap but I didn’t know where else to go with it. The contract stated that we had discussed and researched the topic. It said that we would sit together on the floor in order to help me talk and for a therapeutic alliance to form. Either party could terminate at any time. As touch in therapy can be taken as sexual, and given my history, it was very, very important to me that our arrangement was not kept secret. And of course it wouldn’t be, as my analyst discussed my case with her supervisor, but I wanted it in writing. And my husband was made aware of the situation. I just wanted people to know so it wasn’t this “dirty secret”, even if it wasn’t dirty. Touch in analysis is obviously not common. My other big concern was that we had been dealing with this issue for so long and it had been so stressful that I was unsure of whether or not I would be able to work with my analyst based on the fact that I had had to struggle so much to get her to try what I knew I needed.

So, we signed the contract and then we sat together and it was weird at first. And there was a lot of stuff to work out, like when I wanted to hug her and she wasn’t comfortable with it, or how I felt she was distancing herself from me if we were sitting very close but not actually touching – you know, just, I don’t know. Details and such. We did A LOT of checking in. I would ask her how she felt, she would ask me how I felt. She would see if the contact was too much, not enough? I was worried about forcing her to do something physically that she wasn’t comfortable with (because it made me feel like I was being abusive in some way), and to this day I ask her at the beginning of every session if I may sit next to her. We’ve been sitting together for about eight months now and it really is working beautifully, but we talk about it now and then. I always want to make sure she is comfortable. Additionally, she has gotten to know me in that way and has held my hand or put her arm around me a few times when our discussion has gotten particularly difficult. And I always, always get a hug on Fridays before the weekend.

So, I think it’s good to keep talking because one might have feelings about something initially and then one’s feelings can change or evolve, and same with the therapist. It’s a good rule for any relationship, I think, whether there is touch or not. Checking in with a person you’re in relationship with is a great resource because it helps you to know what’s going on.

I think it took about 4-6 weeks of constant discussion (and I was doing 5x/week analysis) for my analyst to feel comfortable trying it. It felt like a very, very long time.

As far as boundaries, my analyst said she wouldn’t want anyone to sit in her lap or anything, and that was fine with me. I’ve mentioned how I’ve wanted a hug or something and she’s been hesitant, as she was raised in a way where you don’t just hug people you don’t know well. In the past month or so she has seemed to be more comfortable with hugs and I’m taking it as a sign that she has come to know me better. There are still the rules of the contract but they don’t really feel like rules, they feel like a very clear understanding of what each other is comfortable with and a mutual respect to uphold those standards as to keep the relationship respectful. I would never want to make her uncomfortable, nor would she want to do that to me. It’s just kind of… easy, now, I guess.

As can probably be surmised, touch absolutely did not come about organically, at least in the beginning. Every now and then my analyst will reach out to me when she knows I need it, and that has been really nice. But at first it was awkward and a little forced. She knew that I knew what I needed but felt out of her element and it was a navigation on both of our parts. It’s always difficult for me to ask for something because of my worry of making her uncomfortable and being too needy. Like I have this fantasy that some Monday I will go in her office and sit down next to her and ask her if we can hug under the blanket for a few minutes so I can just BE with her, because weekends are so difficult. But I have yet to work up the courage to ask for that.

I told my analyst that if this works out, she should publish an article. I think it’s kind of a unique way of working and it has definitely helped me and if it could help someone else, then all the better.

https://books.google.com/books?id=Pp-ajrfMDOwC&pg=PA327&lpg=PA327&dq=physical+touch+in+psychoanalysis&source=bl&ots=EQmQA1aygB&sig=GqcymLanAX2CWrGpJohL4mAW098&hl=en&sa=X&ei=t9ttVZL-AYjQtQXhi4G4Ag&ved=0CC4Q6AEwAg#v=onepage&q&f=false

http://icpla.edu/wp-content/uploads/2012/09/Breckenridge-K-2000-Physical-Touch-in-Psychoanalysis-A-Closet-Phenomenon-Psychoanal.-Inq-202-20.pdf

http://www.cbpc.org.uk/TouchInPsychotherapy.htm

http://www.zurinstitute.com/touchintherapy.html

http://www.psychotherapyexcellence.com/read/read-listing/2012/november/touch

http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&uid=2001-16100-003

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832802/

http://www.psychoanalysis.ugent.be/pages/nl/artikels/artikels%20Stijn%20Vanheule/In%20search%20of.pdf

http://www.academia.edu/1080285/Affectionate_experience_mediates_the_effects_of_alexithymia_on_mental_health_and_interpersonal_relationships

http://www.cbpc.org.uk/TouchInPsychotherapy.htm

Fosshage, J. (2000)
The meanings of touch in psychoanalysis: A time for reassessment.
Psychoanalytic Inquiry. Vol. 20, 1: 21-43

Speaking of feelings: Affect, language, and psychoanalysis. Published in Psychoanalytic Dialogues 8: 685-705, 1998

http://apa.sagepub.com/content/61/1/99

 

Induction and transference in psychoanalysis: the unconscious is fascinating!

My analyst is trained in modern psychoanalysis, which is very similar to traditional analysis, or what you think of when you think of Freud. But this guy, Hyman Spotnitz, came along and basically said he thought everyone could be analyzed, even schizophrenics, whereas Freud did not think analysis was applicable to everyone. Spotnitz’s basic goal was to get the client to “say everything”. (This is part of the reason my analyst is so awesome – I can email her ’til her inbox won’t hold anymore and she’s cool with it, because I am putting thoughts and feelings into words – discharging energy in a productive way.)

Anyway, my analyst knows that I want to be an analyst (I think she may be a little put off by this idea, but perhaps that is transference), and so she is letting me borrow her analyst books. The first one she gave me is Modern Psychoanalysis of the Schizophrenic Patient by Spotnitz, also known as “The Red Book”. I’d been reading along, googling the many things I don’t understand, writing my analyst emails about this theory or that technique. Then I came across what felt like a recipe for a “cooperative analysand”, as Spotnitz called it. It felt so creepy and manipulative. And then I thought, why not my analyst? If she was trained in this discipline, isn’t she also playing mind games with me? What the fuck is this analysis shit, anyway?

What it came down to was transference. With a history of stalking and sexual abuse from my grandfather, I was assuming my analyst had creepy attributes and was trying to manipulate me into doing what she wanted. It kind of blew up in our relationship but we were eventually able to identify that what was going on was actually transference. My analyst isn’t being, and has never been, inappropriate with me. And now we’re both aware that if those feelings surface again, we will know what we’re dealing with.

Transference is an interesting phenomenon, certainly, but I find induction to be even more fascinating. Induction is a big part of modern analysis because the analyst is trained to use the emotions induced in them by the client as a tool to understand the client’s life as well as for interventions. I’m not quite sure how it works, and it seems a little weird, but my analyst said she’s seen it a million times, and it’s really the result of the unconscious. Small things like body language and probably mirror neurons conjure up countertransference feelings in the analyst. If the analyst is well-trained, he or she will identify that they are being induced and will use that as part of their work with the client.

I recently went away for a long weekend to attend a wedding out of state, meaning that I wasn’t physically with my analyst on Thursday or Friday. We did talk on the phone, but the feeling of connection was weak at best. After all, I sit next to her every session, so this change was pretty drastic for me. Then, of course, we did not talk at all on the weekend, and I started shutting down. I stopped feeling, which was great, and I emailed my analyst and said that maybe I shouldn’t be doing therapy – I was doing fine without it.

What I really wanted, though, was more connection. I walked into her office on Monday desperately wanting a hug, but not being aware of it. Growing up in a household where hugs were pretty much unacceptable, not being able to shake off my need for connection, and not understanding what I was feeling or what was going on, I was stuck. I wouldn’t sit next to my analyst, I was frozen on the floor – and she played right into it. The more I wanted connection but stopped myself from seeking it, the more distant my analyst became. I worked up the courage to sit next to her, and she was emotionally distant. She was completely unlike herself. It was a mess.

This went on for a few more days until I understood what had actually happened. After telling my analyst, she informed me that she was likely induced to be my mother. My mom is awkward around physical contact and I spent much of my childhood wishing for connection. Instead, I received the message that this desire was unacceptable. This same scenario was reenacted with my analyst, because I induced her to behave the way in which my mom did. Weird? Yeah. And really hard to sort out. Both the client and the analyst have to be aware of what’s going on and willing to work things through – I definitely considered leaving the relationship. But! It’s important to trust the process. The unconscious is fascinating.

I have yet to experience erotic transference with my analyst (I’m waiting for it!) – but here is a fantastic post on the subject that I will be sure to reference when the time comes.

Life in a Bind - BPD and me

Tonight is the night. I have been meaning to write this post since last November – so it’s only taken me nine months!
I finally decided I had to write it because of a comment I read on an amazing post called ‘Erotic transference‘ by Attachment Girl (AG) on ‘Tales of a Boundary Ninja‘. The individual making the comment thanked AG for the post, and said that it was a “great public service for people like me to learn from“. This immediately reminded me of the start I had already made, many months ago, on this post. I began like this:

I can’t quite believe I’m writing this post. I think the only way I can convince myself to do it is if I see it as some form of ‘public service’. So often I come across forum posts or bloggers who talk about…

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Touch in therapy is uncommon. Touch in psychoanalysis is rare, and rarer still is it discussed. But, it has had a profound impact on my analysis and I feel that it is important to talk about.

My analyst has been sitting with me for five weeks. We sit on the floor, backs up against the dead-cow couch, side by side, arms touching. Since it is summer, I sometimes have the privilege of directly feeling her skin, if she is wearing short sleeves. I always wear short sleeves.

We sit like that the entire session. I always ask before sitting on the floor – I do not want to violate her space. I can usually tell what kind of mood she’s in from our close proximity. When I get upset with her, I move away slightly. On a few occasions, I have become so exhausted from the material that I have laid my head on her shoulder. We have hugged twice. She has held me, and put her head against my own. I usually keep my hair down so I can hide behind it, eyes closed, so I can feel her. Feeling her allows me to not feel like a helium balloon, looking down on the world below and wondering how to get back. Touching her is so basic and primitive, and also provides so much depth and richness, that I have difficulty articulating the effect it is having. Or maybe that’s just the goddamn alexithymia.

I have a difficult time with the fact that we do it, though. While there is nothing sexual about it and it is not a secret – my husband knows, my analyst’s supervisor knows – it feels slightly taboo. Part of this may be because touch in psychoanalysis, especially in this manner, would probably have Freud rolling over in his grave. But I think the biggest reason for me is because we did not touch each other in my family.

It was always the message from my parents that bodies are dirty, in a sexual way, no matter what you do with them. Of course, you can engage in varying degrees of disgustingness – sex is dirtier than everything, probably except for masturbation, but breastfeeding, childbirth, puberty, hugging, and sharing food off of your plate are all dirty. Yet, as I’m discovering with my daughter, safe, non-sexual touch can be a wonderful way to connect and has all sorts of physical and psychological benefits. There is nothing like kissing the smooth skin of a baby’s belly, or smelling the back of their neck, or tracing their tiny shoulder blades.

So, even though I know, intellectually, that touch with my analyst is also safe and non-sexual and feels good and it is okay to feel good that way, it still feels… clandestine. As I explained to my analyst, it is like your parents not letting you eat dinner and then sneaking to the refrigerator when they’re sleeping. There’s nothing wrong with eating, but it feels like you’re doing something bad, anyway. My analyst didn’t miss a beat. “You’re starving,” she said.

Analysis is interesting, intense, intimate.

My analyst is really good. Her interpretations are accurate, but it’s about more than the interpretations. She is present with me. She is thinking about what I’m thinking about. When she makes mistakes, she apologizes and learns from them, and moves on. When I make mistakes, I apologize, learn, and move on. In just four months, we have a good relationship.

Of course, it is important to be honest, but I’m seeing just how important that is. It really goes a long way in moving the analysis. And when I am honest, there is no judgment on her part.

I’ve learned a lot in a few short months. My mother was constantly over- or under-stimulating, so I engage in self-destructive behaviours to recreate that inner state – it’s all I’ve known. Thankfully, my analyst listened to what I needed and agreed to sit next to me during our sessions. Her physical presence keeps me calm, which is something I don’t experience outside of her office. I’m able to tolerate more difficult topics and more boring sessions without feeling like I need to run to the bathroom and hurt myself.

Also, my analyst identified how my parents’ harmful patterns are now seeping into my daughter’s life. Thankfully, my daughter remains unaware of these influences, but it is important to me that they are stopped before she becomes affected by them. It sounds like it’s time that I put in some firm boundaries. It’s a scary prospect because it means my parents will likely end up hurt, and I might feel them pull back from me. But my daughter’s wellbeing must come first. There is no option, there.

There is still a lot of work to be done. Alexithymia is a bitch. It is often difficult for me to know how to think or feel or act in many situations because I was never taught how. But I have a lot of faith in my analyst and in the process of the analytic relationship. There is movement.