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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by Dinah on January 29, 2003, at 9:08:05
OK, the main reason I always want to have two therepists is to dilute the dependence. My therapist isn't the most stable guy in the world, job wise. And my worry that he'll choose a different career path isn't unfounded.
But after seven years, there is also the curiosity that other therapists might have different things to offer. I feel like I've gotten as much as I can from my therapist in certain areas, although he is very good at and continues to help me substantially in others. I don't want to leave him, not at all! Because I'm not sure that other therapists could offer the same things he does.
My idea would be to see each every other session, which would still put each at once every two weeks, not an unusual therapeutic schedule by any means. In fact, when I was on more meds, that was my schedule at times.
I signed a contract when I signed on with this therapist that I wouldn't see others without terminating him first. And in discussing the option with him, he said he would stick to that contract. And in researching the issue, I see that it is pretty standard.
But my question is why? Why is it discouraged? What are the down sides to it? Has anyone done it? It's not like I married the guy. And I don't want to "cheat", I just want an "open therapy".
Posted by mair on January 29, 2003, at 11:08:04
In reply to Why can't you see more than one therapist at once?, posted by Dinah on January 29, 2003, at 9:08:05
Dinah
I was in this situation for awhile and would never do this again.
For a time I had a therapist (therapist #1) who was also my pdoc. His approach to therapy was pretty traditional. At some point he recommended that I see a woman in his practice for CBT. I think he also thought that I would have an easier time talking with her about certain gender-based issues. I had been seeing therapist #1 2x per week and when I added this other therapist (#2), I saw each of them 1x week.
I really found it to be more confusing than helpful because the lines between what each would cover were not clearly enough delineated. I never quite knew what issues I should raise with one and not with the other or with both.
Things got to be really bad when my pdoc (therapist #1) left on a several-months long sabbatical which happened (very coincidentally) to coincide with a period of time when the practice was breaking up, not at all amicably. My newer therapist (#2) was going to go off with the splinter group. At around the same time I was feeling pretty equivocal about therapy anyway and was talking alot about this to therapist #2 while therapist #1 was away. I think I was also looking for some validation of all of the work I had done with pdoc/therapist #1 and I wasn't getting that from therapist #2. I started to feel like I was in the middle of this break up, and I also didn't get the sense that they were communicating particularly well with regard to my case. (therapist #1 was in regular phone contact with therapist #2 while he (#1) was away). I also felt very torn about what I should do after the split. I liked therapist #2, but I also felt this huge sense of loyalty to therapist #1 and felt that I'd hurt his feelings if I terminated with him in favor of therapist #2. The ugly upshot of this was that I got pretty angry with both of them and terminated therapy altogether. I never saw therapist #2 after she left that practice. Therapist #1 continued to be my pdoc and I would sort of drift in and out of therapy with him on a periodic as needed basis. I never felt that same level of commitment to longer term therapy with him and our relationship, I thought, clearly had suffered. It probably didn't help that I never really worked out the anger with either one of them. After a couple of years of being in therapy limbo, I realized that I really needed to be seeing someone again on a more regular basis. It was then that I hooked up with my current therapist.I really think for this to work you need 2 therapists who are both committed to making this work for you and you need some very clear boundaries about what gets addressed when and with whom. You could end up spending all of your time in therapy talking to therapist #1 about therapist #2 and vice versa.
Mair
PS: I should explain that neither therapist dragged me into their dispute - alot of what I knew was intuitive. Also, I had a friend in this same practice who was part of the splinter group. She was quite circumspect with me but open enough for me to figure out that there were alot of bad feelings between the splinter group and therapist #1.
Posted by jane d on January 29, 2003, at 11:11:28
In reply to Why can't you see more than one therapist at once?, posted by Dinah on January 29, 2003, at 9:08:05
Dinah,
I posted a somewhat related link below because I didn't want to risk diverting responses on your question which I think is incredibly important.I have no theoretical knowledge in this area (as you well know) but I am always suspicious of someone that does not allow you to check their work. Second opinions are standard in other areas of medicine. Why should this be different? Or, and I know this is a little too harsh, I think of the companies that require key personnel to take vacations so that if they've been dipping into the till someone else will have a chance to find out.
Jane
Posted by Dinah on January 29, 2003, at 11:43:35
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by mair on January 29, 2003, at 11:08:04
Thanks, Mair, for the detailed response from someone who's been there. I guess I do understand that there could be pitfalls. I *never* would want to go to someone connected with my therapist. The pdoc and psychologist that are loosely affiliated with him were awful, and I don't trust his taste in colleagues at all. But even without that, I do see your point about spending all session talking one about the other.
I guess I just get frustrated sometimes when I bring up an issue like abandonment fears, and get the same answer I've gotten before, from a CBT standpoint, that hasn't really proved helpful in the past. But our relationship is great and I've come so far with him in other issues, and still feel that I have things I can productively work on with him. And of course, he's terrific at supportive therapy.
But I also know that a lot of this is coming from fears of intimacy.
I really do appreciate your insight as someone who's been there.
Dinah
Posted by Dinah on January 29, 2003, at 11:48:17
In reply to Re: Why can't you see more than one therapist at once?, posted by jane d on January 29, 2003, at 11:11:28
LOL. Well, sometimes when I add up the therapy bills, I do feel a bit ummm.... well.
I don't think he'd have a problem with a second opinion. And he's said that if I want a particular thing that he doesn't offer, like EMDR or hypnosis, he'd refer me to a colleague that does for just that. But I don't know... I'm not sure that a different modality is what I'm looking for, maybe just a different viewpoint. Or confirmation that there are no answers or anything anyone can do to help me with certain things.
Sigh. Seven year itch?
Posted by mair on January 29, 2003, at 12:29:11
In reply to Re: Why can't you see more than one therapist at once? » jane d, posted by Dinah on January 29, 2003, at 11:48:17
Dinah - there are a couple of things I wanted to add both to my earlier post and also in response to your post to Jane.
First, although it may have been relevant that my 2 therapists were affiliated, I actually think of more relevance is whether these are therapists who are willing to work out any issues you have with regard to them or the therapy they are offering. I carried around alot of anger and no small amount of confusion that never got flushed out or addressed. I felt uncomfortable raising some of these issues and so I didn't. My current therapist is absolutely relentless in her insistence that I raise issues I have with her or with the process of therapy. If I don't raise them, she does. So for me anyway, she is a better fit certainly in this one respect.
Also, how much of this is really about equivocal feelings you might be having about your own therapist and are afraid to raise with him directly for fear of his abandonment? When I decided I wanted to go back into therapy, I had to figure out how to do that without hurting Therapist #1 who was still my pdoc. I was still pretty concerned about hurting his feelings and yet I really didn't want to start up with him again. The way I dealt with that was to tell him that I wanted some therapy that was far more directed and of shorter duration. I knew that wasn't his strong suit. He recommended my current therapist who did try some CBT with me. It became pretty clear to her fairly quickly that CBT wasn't in and of itself, going to work for me. I always sort of felt like I came to her under false pretenses or something even though when I started with her I thought what I needed was just some basic stress management.
Is it possible that your ongoing fears of impending abandonment are a real barrier to making any further progress with this therapist? I don't think there's anything unique or wrong with your desire for therapeutic stability. It's one thing to have these fears, it's another matter altogether to have them intrude on and impede, in a significant way, the therapeutic process.
I was always greatful to Therapist #1 for helping me out so much when I first got sick. However, I think my overarching sense of loyalty AND my discomfort and reluctance to address relationship and therapy issues directly with him caused me to stick with him probably longer than I should have.
Mair
Posted by Dinah on January 29, 2003, at 17:47:24
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by mair on January 29, 2003, at 12:29:11
I have no doubt that that is a part of the problem. It's not that I'm afraid to bring it up with him. We do discuss it.
But lately there has been a definite sense of deja vu with our interactions. I'm sure that's perfectly normal after almost eight years. But I don't want to move on from him, and I won't. Hence the perhaps less than brilliant two therapist idea. :) More likely than not, I'd discover that the new therapist didn't have any more wisdom to offer than he does, no new insights, no new techniques.
And I tie my hands by being completely unwilling to leave him. Oh well, boredom can be a problem in any relationship from time to time. And there is a lot to be said for comfort and familiarity.
Posted by noa on January 29, 2003, at 19:51:40
In reply to Re: Why can't you see more than one therapist at once? » mair, posted by Dinah on January 29, 2003, at 17:47:24
I think you should get a second opinion if you are curious about whether you'd be happy with someone else. I don't know, but having 2 therapists at the same time sounds confusing and anxiety provoking to me!
Posted by Tabitha on January 29, 2003, at 22:48:25
In reply to Why can't you see more than one therapist at once?, posted by Dinah on January 29, 2003, at 9:08:05
There's an episode of Sex and the City where Sandford tells Carrie he sees three therapists: one for when he wants to be coddled, one for when he wants tough love, and one for when he just wants to look at a really beautiful man.
Posted by Dinah on January 30, 2003, at 0:15:23
In reply to Re: Why can't you see more than one therapist at once?, posted by noa on January 29, 2003, at 19:51:40
Hmmm. It sounds as if it isn't a very good idea.
I'm sort of relieved that it isn't just my therapist that thinks so. Because I was a bit bewildered by his objections. (OK, it made me feel like a rebellious teen.) But if it's backed up with good reasons, that's different.
And he did say that if I wanted something he didn't offer, like EMDR or hypnosis, he wouldn't mind my seeing a specialist. Of course, he wants to refer me to someone he knows, and I question his taste in colleagues.
Posted by Dinah on January 30, 2003, at 0:18:08
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by Tabitha on January 29, 2003, at 22:48:25
Ooh, Ooh!!! I want to look at a beautiful man too!
They should make them put their photos in the paper. Wanted: Harrison Ford lookalike therapist.
I've got the caring nurturer. I don't want tough love. But....
Posted by Dinah on January 30, 2003, at 0:18:51
In reply to Re: Why can't you see more than one therapist at once?, posted by Dinah on January 30, 2003, at 0:18:08
Posted by judy1 on January 30, 2003, at 17:30:27
In reply to Re: Why can't you see more than one therapist at once?, posted by Dinah on January 30, 2003, at 0:18:08
Hi Dinah,
That's kind of the situation I'm in- my pdoc does therapy (1 hour sessions) and my therapist (psychologist) also has 1 hour sessions. At times I do complain about one to the other, but not too often- and I think that's the only downside. My reasons are one is male and the other female and I get a different perspective (and maybe some parenting- who knows?) But if my main issue was abandonment (and it is a big issue for me too), I wouldn't see a back-up, I would try to work hard on that issue with your regular therapist. good luck-judy
Posted by JenR on February 2, 2003, at 21:33:02
In reply to Why can't you see more than one therapist at once?, posted by Dinah on January 29, 2003, at 9:08:05
I think the theoretical reason would be that you would be diluting the transference. All feelings you have toward the therapist are generally considered transference, and addressing them in that relationship is supposed to be what helps you figure out your issues and change things beyond the therapy room. So if you were rotating therapists, when the pressure builds with one, you get to escape the issue by going to the other, instead of dealing with it. I think it might get a little confusing too, in terms of who you told what to. And if you get different reactions from them, that will be confusing too.
Personally, I had a great thing going with my first therapist, then it fell apart. This second one is better in what he was lacking, yet she is lacking in some things he had. Sometimes I wish I could combine the best of both. Which I guess would mean seeking out a third, but I don't have the energy for that.
Anyway, if you have concerns with the current one, I'd deal with that as intensively as you can, for your own good and for what you can learn about yourself from it.
Posted by Dinah on February 3, 2003, at 22:04:30
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by judy1 on January 30, 2003, at 17:30:27
Funny you should mention that, Judy. Abandonment is one of my main issues, and the reason for this question really. A while back we had discussed directly guiding the therapy towards my fears of abandonment, and ways to help me deal with that.
I reminded him of it the session before I posted this question. And really got the feeling that he had no more idea than I did of how he might help me or what to do. He mentioned some things that were really common sense, and that I'm positive he's mentioned before. But I got the feeling that we were equally at sea as to where to go from here.
I have zero desire to leave this therapist. In many ways he does what I need him to do. But in a few ways I feel I need to move forward. I certainly have mentioned it to him, in as non threatening and non judgemental manner as I could. But I think a second viewpoint, not for just a one shot consultation, but on a longer term basis, might be helpful.
It doesn't really matter, of course. I agreed not to see someone else while seeing this guy. And I'm not going to go back on my agreement, and he won't give me permission to do so. And since I'm not going to quit seeing him, I can't see someone else either.
I was just wondering if there was good reason for the prohibition, and I see there is.
I'll be ok with it. And I guess it really isn't all that unusual after seven years to wonder what else is out there.
Posted by Dinah on February 3, 2003, at 22:12:06
In reply to Re: Why can't you see more than one therapist at once?, posted by JenR on February 2, 2003, at 21:33:02
> So if you were rotating therapists, when the pressure builds with one, you get to escape the issue by going to the other, instead of dealing with it.
Ooh, that sounds like a good thing. :)
Seriously, you raise good points. And I know that part of my problem is fear of overdependence on him. I suppose if I could work to the point where I wasn't terrified of abandonment and didn't feel dependent, that would be the best thing.
And one thing I did to evaluate his competence was to read very intensively in the last little while books and articles written by "experts" in the areas that I need help with. And honestly I wasn't tremendously impressed with their techniques over my therapist's. In fact some of them seem downright, well, odd. So unless I can have Steven Levenkron *as he describes himself in his books* I think I'm just as well off with this guy. I think it's better to have someone who admits he doesn't have all the answers rather than someone who thinks he does, but is wrong.
So I'm feeling a bit better about the whole thing. And I explored what else was out there without ever leaving my therapist's couch, so to speak.
Posted by noa on February 5, 2003, at 5:25:02
In reply to Re: Why can't you see more than one therapist at once? » JenR, posted by Dinah on February 3, 2003, at 22:12:06
Dinah, when I read books by expert therapists, I always feel a little wary of just how neat and tidy their treatments work out. It seems that a lot of times, they pull composites together, and concentrate anecdotes, etc. I have doubts about how often things really go the way they are described. I do believe that the anecdotes are true, but that the overall progression of the treatment they describe is not really as smooth and successful as they describe it--ie, there are great moments in therapy, I'm sure, but I also think that these are probably interspersed among all the lousy moments and periods of "stuckness", you know--the more boring, muddling through not feeling like much progress happens phases.
My therapist has also acknowledged he doesn't always know what is going on with me, or how to get me unstuck, etc., but I really get a sense of confidence from him that he will work through it with me and explore until we figure it out. I find that much more honest than the super-confident authors (imo, Yalom, author of "Love's Executioner" is a good example, and maybe Virginia Axline, author of "Dibs in Search of Self").
I also think it is probably common for us to wish that our therapists would have "the answer", or some magical power to find THE thing that will cure us. We have so much doubt in ourselves and the world, why wouldn't we want to turn to someone who knew exactly how to make things better, right?
When I first started therapy (different therapist) at age 22, I had a slightly paranoid idea that my therapist knew what the key things were that I had to uncover, but that because therapy was a process of SELF-discovery, he was making me find it myself. But I was convinced he was withholding the info from me. I think this is partly based on my conception of therapy, which was at that time based on books--both fiction and non-fiction, and movies. In books and movies (especially of the era preceding my initiation of therapy), psychiatrists and psychologists were so all-knowing and able to quickly diagnose and then succinctly explain a person's problem in pat, reductionist, self-assured terms, usually of a Freudian nature, in a way that described the person as their problem and did not (I realized later on) really acknowledge the complexity of the individual.
Interestingly, later that year--ie, the first year I was ever in therapy--Judith Rosten's book, "August" came out (sorry--no good link came up from Amazon). In some ways, this book kind of broke out of the pattern I was talking about, but it also sticks to the idea that one clear early life experience can explain all of the patients problems. She portrayed the main psychiatrist as a real person with plenty of problems and self-doubts. And, the patient's pervious psychiatrist is portrayed as having major countertransference and boundary problems. Also, we saw in that book, from the point of view of the main psychiatrist character, how arrogant some of the other psychiatrists could be. On the other hand, the book is essentially a mystery to uncover "the" event (in this case a traumatic one) that led to the patient's psychiatric problems, with neat clues, and all. It kind of made me think that there must have been a key event for me, and I just needed to find it and then I would get better (like the character of the patient).
Posted by Dinah on February 5, 2003, at 16:46:05
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by noa on February 5, 2003, at 5:25:02
You're right of course. Yalom rates right up there with Levenkron for looking great in print. :)
I don't think I'm asking for a magic solution. I think the problem may be more what Mair and others were talking about. After seven years, and resolving most of the push/pull intimacy and trust issues, in the absence of a crisis therapy can be a bit boring. I'd like to be a bit more proactive in the therapeutic work when I'm feeling good - push a bit more. Sometimes it seems like we're chatting. And I don't think I'm avoiding anything. When I ask about working on something, his answers aren't all that groundbreaking. Mostly stuff we've done before.
I think it's mostly seven year itch, when familiarity breeds a bit of boredom. Perhaps there is a stage past this. We'll see, I guess. There is a lot of change in the works in the therapeutic situation. Maybe that will shake things up a bit and get us past this stage.
Posted by noa on February 5, 2003, at 19:28:11
In reply to Re: Why can't you see more than one therapist at once? » Dinah, posted by noa on February 5, 2003, at 5:25:02
"August"
by Judith Rossner(I had written Rosten).I still can't get the amazon link to work, though.
BTW, I think where it used to be psychoanalytic POV's that dominated the "know it all, cure it all" literature, now a lot is CBT. The books that fall into this too neat and tidy for real life category are kind of like contestants on "Name That Tune" show----"I can cure that disorder in 4 sessions!"
--not with people like me you can't!
Posted by noa on February 5, 2003, at 19:29:17
In reply to Re: Corrected book info, posted by noa on February 5, 2003, at 19:28:11
> I still can't get the amazon link to work, though.
Well, I take that back--it worked, even though the links it listed in the confirmation were altogether different!
Posted by noa on February 7, 2003, at 11:50:53
In reply to Re: Corrected book info, posted by noa on February 5, 2003, at 19:28:11
August link comes up with "Cyberlaw" book. ???? I've inquired on PBA.
Posted by Jonathan on February 8, 2003, at 0:44:15
In reply to Re: link did not work correctly afterall, posted by noa on February 7, 2003, at 11:50:53
http://www.dr-bob.org/babble/admin/20021128/msgs/9114.html explains why this works.
Posted by noa on February 8, 2003, at 11:22:21
In reply to Problem solved » noa, posted by Jonathan on February 8, 2003, at 0:44:15
Posted by kyp on March 6, 2003, at 11:00:25
In reply to Re: Why can't you see more than one therapist at once? » noa, posted by Dinah on February 5, 2003, at 16:46:05
I thought the point concerning transference was a valid observation.
I personally see two therapist and it works out great. They both know that I do and do not "keep up to date" with the other. I get different topics covered in different "styles". One Ph.D is very objective in the therapy and private about her own life and directs me to self discovery. She is fantastic in my theraputic process of what I need in my life. I discuss my personal, hidden, secret thoughtlife that I wonder many times if it borders the "crazy" point.
The other Ph.D is more is more personable and shares her life experiences. With her, I discuss my parenting and marriage skills. She knows my family through counseling which is helpful for her to know what I am talking about. We are very in touch, creatively and through art. I don't get confused between the focus of each one. Even though my thought life overlaps the practical daily living skills, it does not cause any problem. I gain from one, what the other one is unable to give. Both psychologist are excellent and experienced. They are firm in boundaries which I am able to respect without even realizing what they are. I trust both of them a lot to keep our relationships professional and theraputic for me. All of the therapy is about me learning about me and me getting what I need from it, for me.
I realize this is an older topic, but I just saw the site after a long break and thought this was something I could add to.
Posted by Dinah on March 6, 2003, at 12:00:16
In reply to Re: Why can't you see more than one therapist at once?, posted by kyp on March 6, 2003, at 11:00:25
What you describe is exactly what I'd like to experience. A different viewpoint. I think my therapist is great in certain areas, weak in others, and while leaving him is not an option (I can't give up that source of safety), I'd just like a bit more balance.
But he won't accept that, so I guess I have to live with it. What can't be cured must be endured and all that stuff.
Thanks for your input. And welcome back.
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