Attachment Theory and the Healing Psychotherapy Relationship

In the first part of this series, I discussed Allan Schore’s video about early neurological damage resulting from failures in the attachment relationship between mother and baby. In the second part, I used Schore’s research to help explain why our defense mechanisms are so tenacious, and why authentic change is difficult and rare. I’d now like to conclude with my personal, somewhat idiosyncratic view on how real change occurs, how that early damage can to some degree be healed, and what conditions are necessary to do so. I don’t have the science to back it up; all I can offer is my experience, both as a client on the couch for 14 years, and in working with my own clients for the last three decades.

My thesis is simple: if failures in early attachment damage the brain as it develops, the way to repair that damage (to the extent possible) is through another “attachment” relationship that somewhat resembles but also differs in major ways from that early bond: the psychotherapy relationship. I suppose I mean that in therapy, something like a “corrective emotional experience” occurs, as long as we don’t idealize that experience and we understand that therapy doesn’t fully correct for all those early emotional failures. The corrective emotional experience in therapy is not a replacement for a mother who truly loved and cared for you. It’s the closest to such an experience that many people ever get but it’s a distant “second best.”

Broadly speaking, there are several different aspects to the successful (and healing) psychotherapy relationship. The first of these involves the therapist’s ability to enter into the client’s emotional world, bear with the pain and confusion long enough to make sense of it, and then to present his or her insights in such a way that the client feels understood. That one sentence condenses many elements. To begin with, you need a therapist who can tolerate a wide range of emotions, who isn’t afraid of anger, envy or hatred, and who can bear with the client’s often profound pain.

Especially in working with serious difficulties such as borderline personality disorder, the therapist needs the emotional/psychological strength to bear with and not feel overwhelmed by a significant amount of terror, rage and overall chaos. The therapist must have had extensive psychotherapy him- or herself. Then the therapist needs the skills necessary to understand what it all means and to communicate it. Those skills come from good training, supervision and years of experience as a therapist. I understood quite a lot when I was 30 but I when I made my interpretations, I often came across a bit stilted; I was trying too hard to maintain that ideal psychoanalytic posture, and rather than feeling understood, my clients sometimes felt “analyzed”. It took me a while to learn how to speak in a more empathic way.

Empathy (and not sympathy) lies at the heart of the healing interpretation (see my post on empathy vs sympathy to understand the difference). I’ve always been good at detecting unconscious rage and envy; it was years before I developed an emotional appreciation for just how agonizing those feelings can be. Especially as the transference develops, you can find yourself the target of painfully destructive attacks, enraged and unjust accusations, possessive angry “love”, etc. In the heat of the moment when we’re under siege, it can be difficult to recall just how agonizingly painful it is for the client to feel that way. If the therapist can’t bear those feelings within him- or herself, it will be hard to make the client feel understood, safe and accepted. But if we are able to bear with those painful emotions and offer to our clients empathic insights, we will gradually — bit by bit, over time — help them learn to tolerate those feelings in themselves.

In this way, the therapist provides a kind emotional support analogous to what a good mother provides. As I discussed in an earlier post about the development of mind and meaning, it is the mother’s role to accept the infant’s projected feelings — all the terror, anger, etc. that it doesn’t understand and can’t tolerate. In a “good enough” attachment relationship, the mother responds appropriately to those projections and thereby helps her baby learn how to bear them. In Schore’s terms, the brain then develops more or less “normally”, making many complex neural interconnections and building structure so that the child grows a capacity to understand and contain its own experience. Years later, a therapist can try to make up for a failed attachment relationship. He or she can bear with a client’s projections, try to understand what they mean and respond appropriately. Bit by bit, over time, we can help our clients develop the mental capacity to understand and bear with their own experience. It’s not the same as having had a good enough mother. It won’t restore the brains of our clients to some pre-damage state, but it can make a very large difference.

Most of my colleagues would probably agree with what I’ve had to say so far. This view is based upon the psychoanalytic theory I read during my training, the excellent supervision I received and my years on the couch with an analyst who never shrank from my pain, rage and envy, who had a profound ability to bear with me through my depression. Without his help, I never would have developed the mind and emotional capacity I have today. I was extremely fortunate to have found him when I did; I’d never be where I am today without his help. I know he cared deeply about my welfare and gave emotionally to me in ways that meant a lot to him, too. It was within the context of this relationship — this new attachment relationship — that the healing occurred.

Where I think I might diverge a bit from my colleagues — at least in what we’re willing to discuss in public — is that the truly healing relationship involves a kind of love and commitment on both sides. When I accept a new client, especially someone with grave difficulties, I take it seriously; the relationship may last for many years and the emotional demands will be large. If our work “takes hold,” my clients will attach to me in powerful ways. While the psychotherapy relationship means something different for each of the participants — it is, to a significant degree, about the client’s life and not mine — we both must care about it. And over time, we will come to love each other. It scares me to put those words down — I feel extremely vulnerable saying it.

While it’s not the same thing as the love between mother and baby, though it can never replace what was lacking, it is important and powerful. I would say that in many ways, it is this love that offers the greatest chance for healing. The brain may not have developed normally because the child lacked what it needed at a critical period, but love and understanding within a later therapy relationship can do quite a lot to repair the damage. Maybe my clients and I will never be “native speakers”, as it were, because, as infants, we didn’t get what we needed, but that doesn’t mean we can’t become proficient at the language.

Merry Christmas, everyone!

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

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218 Responses to Attachment Theory and the Healing Psychotherapy Relationship

  1. Evan says:

    Hi Joseph,

    This comment is from reflecting on the experience of the ‘transference’ of someone I love.

    My problem is that it sounds sensible to say that the therapeutic experience isn’t and can’t be the child-maternal experience. This is rational and sensible. BUT it is not the rational and sensible part of us with which the transference has to do. It is the childlike.

    In the usual therapeutic situation (the therapist’s office for one hour) there is a conflict for the client. My way of saying it would be something like: “Please open up all you childlike dependencies and overwhelming experiences; OK the hours up now. See you next week.” In other words I think that working with the transference in this situation is extremely likely to be re-traumatising.

    I think this is a pretty awful experience for the client. My guess is that there are better ways.

    • Joseph Burgo, Ph.D. says:

      I can’t speak for other people and therapists, but in my experience, the process of learning to bear those childlike dependencies over time is a major part of growth. While it is surely difficult and painful, it’s not traumatic. It’s also important to remember that the client isn’t an actual child, however childlike he or she may feel. My clients would tell you that it’s difficult and painful at first, but deeply gratifying in the longer term.

      This type of work is exacting and time-consuming, I know, and not for everyone; if you find a better way — a treatment form that can effect the same kind of change as I’m describing — let me know.

      • samsara says:

        Oh my goodness I am so attached to my therapist,infact Im in love with her and even have dreams of kissing her and have all sorts of fantasies,talk about frustrating!!
        The hardest part is, I’m a lesbian and so is she which really makes no difference because she is my therapist and thank goodness for me, one of those good ones who would never cross any boundary as I sure as hell am trying to get her too!! I can’t stand it when she goes on holiday or if even dares to hint at changing or cancelling an appointment and I have this fascination for her breasts,I wish she would wear more revealing tops!
        She knows that I am attracted to her but I haven’t told her this kind of detail,should I or would this be inappropriate and unnecessary and get this, although I am probably coming across as very childish I am actually in my 40′s and suspect that I am borderline but one of those ones that is too ashamed to show it.This is a painful and frustrating process yet at the same time I am finding it challenging,interesting and exciting and can sense that my life may be improving, just a little unsure what I need to be telling her.
        I really really love this site or blog or whatever it is called and sorry if I have butted in like this,Thanks!

        • Joseph Burgo, Ph.D. says:

          You should definitely talk to her about these feelings. It sounds to me as if the “transference” is well underway; this relationship and the ways you feel about her are an avenue for working out your issues. I suspect that all this sexual attraction masks some deeply needy, “baby” feelings of dependence, where what you really want is to be a baby at her mommy’s breast.

      • LSS says:

        Not traumatic?!? For whom? If whatever somebody feels when they begin to trust someone else and get close to them, God forbid get ‘attached’ to them…invokes all of the full blown terror of what childhood was like (um…traumatic)….then does it not stand to reason that this awful experience would indeed be traumatic? We’re the one who would have to be at the utter mercy of the person sitting across from us when we’re the one who needs their help. We’re the ones who swore we would NEVER be in the place of needing something from somebody so much that we’d ever fall for the illusion of the warm and fuzzy. And that is exactly what it is in this ‘therapeutic relationship’ stuff…an illusion, a role play on a stage. A relationship is a two way street not an entirely one sided need/take. Even what occurs between newborn and mother is not exactly a ‘relationship’. And besides, we’re not an infant. I’m a full grown adult who can’t afford to walk through life preoccupied with her ‘needs’, casting away the very defenses that allowed us to survive, so that I can swap them out for some temporary feel good. It’s thoroughly unbecoming us to be seeking out and gravitating to the next person within proximity who claims to offer some symbolic binkie to soothe us. I don’t need a mom, or a dad. I need a counselor…i.e. one who counsels…and isn’t one of the very first definitions of the word counsel…..’to give advice’? I went to counseling for tips, advice, information. Not for somebody to knock all my defenses down (which are there for a very good reason), get me to feel all attached, open the floodgates and depths of ‘feelings’ and traumatic things that I obviously can’t endure or I wouldn’t have stuffed them and split and shattered into however many pieces to begin with. Suddenly becoming aware of the fact that you’re out to sea, can’t swim any more by yourself, and your options are narrowed down to: sink…or grab on to the person hollering ‘trust me’ IS traumatic! Feeling the vulnerability and dependency that got me here in the first place IS traumatic and against absolutely everything in me. It evokes terror and panic, excruciating weakness, shame, and emotional nakedness. So, like I said when it was first revealed to me that I was IN some relationship, whether I had sought it or not: I can’t do this! So I hope Evan is right and there’s some other possible angle, else I’m scre….um….toast.

        • GYC says:

          Wow, LSS… You couldn’t have articulated my heart more clearly. Thank you for sharing.

          • Wobbles says:

            Mine either. I so struggle with ideas on attachment and transference; realness and authenticity; trust and dependency; survival, coping skills and judgements based on punitive ideas that reinforce what’s wrong with me me ( like splitting , projection, perception.)
            I am losing faith in the value of transference and healing because some how in that 1 session per week, that unravels so much, I have to still function in real life; with the responsibilities that follow. How fair is it to place a client in a place where you are retraumatised and left largely alone to piece together conflicts of lost opportunities and heartache in all those hours away from the therapy relationship. Me. who is so drawn and comforted / tortured by my experiences of NOThaving good enough parents which left my experience as all I had; made to reexperience a close to replicatable but unreal relationship with a therapist who is not available to sit with that pain, loss and desperation outside that 50 mins.
            I really care about the relationship with my therapist but I think the dysfunction that sits in her need to use transferece is destroying that relationship at the same time. It’s what was said in the article. I feel analyzed; not part of any shared journey.

        • Thank you Joseph for this site I am so grateful to you and to everyone who posts. I would like to say I have experienced that healing, empathetic and respectful ‘love’ in therapy and I find it allows a safe place for the exploration and making sense of feelings in a less traumatic way, providing a buffer, a sense of well being and a more nuanced approach to life. A number of sessions a week are helpful in bringing about very subtle changes which allow for a more normal life. Cheers

  2. Sonjia pridham says:

    Hi , and MERRY CHRISTMAS TO YOU. I posted you last article on a site for BPD. There are many on the page who post really anguished posts and i can feel their pain. I thought that the last article helped to recognize that actual damage is done to a person and it could help someone stop beating themselves up for their dysfunction.
    This article provides hope that people can recover. I am going to post this article as well and maybe it can give some hope to some who feel they can’t bear their lives.

  3. Stephanie says:

    I’m a therapist myself and I couldn’t agree more. You’re brave to say what no one dares say: after years and years of sharing the real-world, real-time pain of a client’s innermost struggles, real love develops. Without the love, truly transformative therapy cannot occur; it’s not a true “attachment” relationship. In many client-therapist relationships, narcissism poses as “love” which leads to all sorts of boundary violations, sexualizations, etc. that give real love a bad name. Let’s make the distinction. Love is good; narcissism is not. Cheers to you for being brave enough to speak the truth, and Merry Christmas to you, too!

    • Joseph Burgo, Ph.D. says:

      I agree about the narcissism, and I suppose you’re right, it’s not a true “attachment” relationship in the primary sense. But it’s certainly related.

  4. Gil says:

    Joseph,
    I suspect writing this took some effort and time and I thank you for that. I appreciate your clear and concise writing style.
    For me their is no doubt that real/true human intimacy, as you described, can bring about real healing. It does not make damage from the past vanish but it does allow transformation to occur. I would say the healing is from new growth that allows for different options going forward.
    I also agree with Evan’s comment about, “working with the transference in this situation is extremely likely to be re-traumatising”. It certainly was part of my story. It felt like I was going in day after day to therapy just to re-traumatize myself. Slowly that began to change as I came to understand my deep pain in new ways and I built capacities for containing those pains. Until then it was a necessary re-traumatizing process. I do not imagine there is any real way around that, as this process involves opening up to the pain that has been overridden. And, possibly overridden for many decades of time.
    My biggest obstacle was my not allowing for the true intimacy to occur. Because of such poor early life attachment it was extremely difficult for me to get to the point of allowing even a minimum amount of healthy attachment with an other (i.e., therapist) to occur.
    I will close with repeating that true intimacy is the healing principle. And, as we are in the time of year that celebrates true intimacy with loved ones I wish you and your readers much joy and healing with your loved ones over this holiday period.

    • Joseph Burgo, Ph.D. says:

      Gil, I think you and Evan mean something different by the word “traumatizing”. Evan means something destructive, to be avoided; you mean something that’s excruciating and extremely difficult to bear but worth going through.

      • Anonymous says:

        Joseph,
        You may be right on with the distinction you made about Evan’s and my sharing. At the same time, I know in my own therapy, for a period of time, it was very difficult to make and/or understand such a distinction. I think one has to learn this distinction over time through experience within the therapeutic relationship.
        I am glad you shared your thought about this distinction as it has helped me to be clearer about it for myself.

      • sarah says:

        agree with your sentiments gil, im not sure there is any way around it, i read John Bradshaw stuff and his saying is “the only way out is through” and i happen to believe that the rewards are in the darkness!

        another saying is “keep looking at the bandaged place, that is where the light enters”

        its a painful process that im in the midst of but already i can see little chinks of beautiful light in the form of healing, that i never thought i would see, it gives me the courage to keep going forward,

        Anyone ever watch the ~Bafta awarded film “touching the void” or read the book, true story of a badly injured climber’s agonizing efforts to get to base camp whilst left for dead in a black seemingly bottomeless ravine on a south american mountain range and in pain to the point of hallucinating. sooooo metaphorically reminiscent of this healing journey i reckon! but he got back to base camp even though he had crawled face first through the litrine on the way ! happy christmas!!

  5. Julie says:

    Once again, thank you for a great post. As someone who has had – over many years – three rewarding relationships with good therapists, I can say that it was clear they loved me and that, through their professional standards, they contained and expressed that love appropriately – through sustained attention and appropriate response.

    It’s been a long time, and two of them have died, but I love each of them still. Thanks for leading me to spend some time this morning reflecting on those good women.

    And merry Christmas to you, too.

  6. Anneka says:

    I have followed your blog for a while, with great interest, but have not commented until now. I so appreciate this post and what you say about the fear involved in writing those words.

    I wonder if you’re familiar with Deborah Lott’s book In Session.

    Just yesterday I had the last session before the holiday break with a teen I’ve been working with, quite intensely, for a couple of years. As we stood up to say goodbye, she handed me a small bag and said, “For the holiday …”
    I accepted it with thanks. I know the general rule about gifts; I also know that she likely doesn’t know it, that to have rejected this bag at that moment without explanation would have been very hurtful to her, and — well, there are many reasons for why it felt OK to me right then. After she left, I opened the bag and saw that it was a cookie — not a Christmas-themed cookie, as I thought on first glance, but a big heart. It’s hard to convey, here, how moved I was by that wordless expression of how she feels and what we have done.

    Of course there is love in the therapy relationship. Thank you for being one of the people who will say it, and beautifully.

    • Joseph Burgo, Ph.D. says:

      Anneka, I have also accepted gifts at Christmas; I don’t think there can be a hard-and-fast rule. If it’s a genuine expression of love and gratitude, as was the case with your client, it would be cruel to reject it, don’t you think?

      • Anneka says:

        Absolutely. I had no dilemma about it. My mentioning the rule at all in my comment was probably just a nod to the possibility that some readers might question it.

  7. sarah says:

    like this post, more hopeful, which i think is realistic as there are so many people out there that have acheived what they were told they would never acheive cos all the science was against them,

    but they chose to disbelieve that “credible” stuff and acheived the “impossible” and “crazy” like walk again or create boxes in hands that talk to another box in another hand on the other side of the world!!

    i just think that to say things too definitely can limit possibilities and i refuse to let that happen,

    BUT i love what you say about the therapeutic relationship.

    My therapist trained in psychodynamic but has over years moved to bring in more humanistic into her work which i am grateful for and i think its a more honest way of working because whats wrong with having warm feelings of love for another human being even in the therapeutic environment, (obviously boundaried in action etc)

    i do admin work for a low cost therapy center that has diff discipline trainees there and the psycho dynamic trainees really struggle to keep their clients their turn over is huge and i really feel that the human side is lacking when they follow the blank screen to the letter,

    a very happy christmas to you and other commentors who i have benefitted fromtheir words, grateful for your posts through the year,

    • Joseph Burgo, Ph.D. says:

      Thanks, Sarah. I think many people (including me, at first) misunderstand what it means to be a blank screen. It doesn’t mean being remote and stiff; it means keeping your boundaries, not disclosing a lot of information about yourself, and not stepping in to reassure your client when difficult feelings start to emerge. I find that even if you’re (relatively) warm and approachable, you still leave plenty of room for the transference (and the negative one, too) to develop.

      • Leah says:

        I wonder what you mean about not reassuring clients when difficult feelings emerge?

        My therapist will tell me it’s ok to cry when I do, or to let it all out. She will offer to help contain all my feelings that seem so hard to bear, telling me therapy is the safe place for them and she will help me hold onto them. She will say she is sorry when I recount something painful.

        I appreciate those gestures that help me feel less alone, like she is a caring witness to my struggle.

        Do you believe that to be counterproductive, or perhaps I am missing nuance in your comment?

        Thank you.

        -Leah

  8. Stephanie says:

    Well, it’s a good point that narcissism and love are related, and I probably wasn’t clear in my comment above. What I meant is that I believe psychotherapy which includes real love–a bond of love *earned* by both client and therapist through”blood, sweat and tears”– *is* a real and true attachment relationship. Without that kind of love, it can’t be true attachment.

    Maybe in a way, the narcissistic element of love is something like the “unearned love,” a sort of gushing good feeling of mutual admiration that sometimes leads to boundary violations by the therapist. In my experience as a professional, though, it feels as if mention of *any* kind of love between client and therapist is immediately suspect and perceived as “co-dependent” or representative of some other kind of narcissistic mishap caused by the therapist. No one (besides you) makes this really important distinction. I’m not sure if I’m articulating this well.

    • Joseph Burgo, Ph.D. says:

      Oh, I see — I misunderstood. Thanks for clarifying … and yes, you articulated it very well. I agree with what you’re saying about the mutual admiration society that sometimes passes for genuine, hard-earned attachment. It’s both narcissistic and sentimental, and I’ll bet it develops in those therapeutic relationships that never go near hatred or envy, that have never gone through the very difficult period when those feelings come into the transference. The love, as you say, has to be earned.

      • Alyssa says:

        This is helpful to read. I spilled my guts and tears immediately in therapy. My therapist was empathic and caring. By the fifth session a part of me wanted him to love me with the force of 10,000 suns and a part of me knew he never would. So I froze him out, and then I started verbally attacking him with criticisms.
        Now I am analyzing that; how I feel inferior to him, hate him, etc. All along I’ve been sad about not being able to recapture the initial positive relationship.
        After reading this essay, I realize that I am in the process of building a “genuine, hard-earned attachment”.
        Good things may be in my future.

        • Joseph Burgo, Ph.D. says:

          They may very well be! Hang in there. I will say that one thing that’s difficult to accept (and I’ve been on both sides of the issue) is that your therapist will probably matter more to you than vice versa, even if he cares deeply about you. The therapy is about YOUR life, after all, and not his. I sometimes think it’s like what babies might feel — that mommy is the center of their universe, then there’s the dawning realization that there are other people in mommy’s life — daddy, other siblings, friends, maybe a career.

          • Alyssa says:

            He has said that exact thing to me.
            I am in the process of accepting and mourning what this therapeutic relationship ISN’T (which is what that baby wants), and I can’t be completely open to what caring he DOES have to offer until I’m done.

  9. Anastasia says:

    Hello Joseph,

    it has been several months I kept following your blog, and the last post moved me enough to resolve myself to write here (sorry for my unperfect English!). I just wanted to thank you for all your insightful thoughts you are sharing with such a wonderful generosity!
    Your reflection on love and loving patients joins my ideas (it’s quite a theory because I still in training and should see my first client this year!) about how the love and friendship are the real hope for change. May be, in a way, the kind of love every good therapist develop for his patients, is a very personal affair…
    Thank you very much again
    and Happy Christmas!

    • Joseph Burgo, Ph.D. says:

      Good luck with your first clients! It’s a big step and (at least for me) very anxiety-producing. Merry Christmas to you, too!

  10. Sheila says:

    Dear Joseph: Thank you for this post and the entire series on Attachment Theory. Very powerful. Very clear. Very needed. In reading these particular posts, I dropped into greater acceptance of the reality of my limitations and opened to the opportunities within them. I feel more peace from this. It helps me to care for myself when I read what you write. Thank you and Merry Christmas to you also!

  11. Maryann says:

    Thanks so much for this. My current therapist would wholeheartedly and unabashedly agree with what you’ve written. And I am in a much better place for it!

    Thanks again, and Happy Holidays

  12. Stephanie says:

    Exactly, on all counts!

  13. Anna says:

    I hope I’m not the last commenter on your blog as it’s an essentially very gloomy comment. I am a brave person and I do want to heal, however I do not think – I’m quite certain – that I will ever be able to enter into a relationship of the depth you describe here with a therapist. I realize that my life is limited in all sorts of ways by my childhood experiences, yet because of the depths of betrayal and agony suffered I feel sure I couldn’t ever open myself up to another person, especially not a therapist who could leave me. I often, often read comments by other survivors such as those posted above, about the traumatic/ painful process of experiencing childish needs etc in therapy and how much they valued this in the end, that ‘the only way was through’ etc, but I just know I couldn’t do it.

    • Joseph Burgo, Ph.D. says:

      Dear Anna, one doesn’t enter into a therapeutic relationship of the type I’m describing right away; it takes a long time to develop — sometimes a VERY long time, when the person is as frightened and traumatized as you seem to be. In my experience, if people can’t bear the process, they’ll defend against it, keep the therapist at bay, etc. until they develop enough trust to put their toes in the water.

      • sarah says:

        Hi, ive been in therapy for several years and its only been this year that i started to really get honest and start to trust, its been one long journey for me and i still struggle but please dont give up, keep having a go

        i sometimes say to myself whats worse, trusting and getting hurt or never trusting and feeling empty and lonely all my life,

        and sometimes after years of feeling empty and cold inside i now feel like taking the risk more,

        yes its scary and a frightening path but i really believe its better than staying lonely.

        start from where you are, do what you can today, dont make it a massive undertaking, small steps

        xx

    • Gil says:

      Hi Anna,

      I have often though I could not do it. And, on many times I have not done it. For me the trick was / is to just keep trying to do what I can without concern about any ultimate end goal – to take tiny little steps forward never knowing if I can go one more step. If I focused on “getting through it” I would be scared away and I think many people would also be. Some sessions are just about me talking about I cannot go on with it anymore. These actually help me keep on with it. :-)

      Gil

      • Anna says:

        Thanks for both replies to what I posted. I have come to realize that my father was truly a psychopath, he was involved in highly organised paedophilia and, I believe, associated with murders. Yet he maintained, and does maintain, a valued pastoral role in society and is often spoken of highly. I have other reasons not to trust (emotional abandonment by my mother, very negative experiences of past therapists), but it’s my father who remains the stumbling block to my engaging in therapy, because I always think the therapist could be just like my father, pretending and then waiting to hurt me in any way possible. The standard tactics of therapists that teach you that you are no longer a powerless child do not cut it, because my father abused adults horrifically too, as psychopaths do. Two therapists have now told me they are not sure I will ever overcome the depth of my mistrust in order for therapy to be able to help me, and that leaves me feeling incredibly bleak and also – oddly, I know – just about as isolated as a psychopath must feel. I do not want to be feeling like this.

        • Joseph Burgo, Ph.D. says:

          Dear Anna, the additional problem, as I see it, is that there are so few professionals who are actually “trustworthy” in the sense you mean it — emotionally able and psychologically developed enough to bear with a client exploring the kind of horror you’ve experienced. I totally understand your reticence. I hope you will eventually find someone you can trust. They’re out there. Personally, I don’t like the therapists telling you that you may never be able to overcome your depth of mistrust. But then, despite the sometimes “negative” subjects that I write about, I’m an extremely optimistic person when it comes to the human capacity to grow.

  14. TheTaxi Dog says:

    First, an introduction.

    I’m a 67 year old, retired MFT, who was in the day, a leader in the mental health counselor movement. I retired as the result of a severe stroke that left me paralyzed and aphasic. Much less of either than in 2002 when this all happened. As you’ll notice, I’m communicating pretty well now. Still, the mental effort to write intelligently is often exhausting.

    I blog at http://taxi-dog.com. At first I was embarrassed by my writing and took on a “pen name” as “The Taxi Dog”. All is explained inside, if you’re interested. Its an affectation, of course, but it helps me express myself.

    I came to your website wanting to make a comment on your thinking on “What is Tx actually worth” in your July posting. But your comment widget must have been broken. I thought, How go you [or I] justify your fees? Much to my dismay, its only an academic question for me now.

    Still, another blogger and I have been having a “conversation” through our blogs. I’m a free market conservative; he’s a “Progressive”. I blog to him cartoons from “Town Hall”. He blogs his cartoons from our usual suspects. Its a good natured rivalry so far.

    I wanted to tell him what I believe. That “Helping People” is all good, but I’m entitled to brioche once in a while. But more than that, the free market describes the real world as it actually works. Not some pie-in-the-sky utopia where love conquers all. I’d read Milton Friedman, but I now I can hardly read the scribbles on my own blog! After writing this I’ll need a long nap.

    Do you, as a successful, intellectually aware, practitioner have a political philosophy that guides you? Is it something you feel comfortable sharing? No one TALKS anymore. People just scream at each other. Both the pot AND the kettle are black. Its important for side to practice “mindfulness’, if you will.

    If you don’t respond, no harm, no foul! My closest friend didn’t speak to me for two years when I told him about MY politics, so I have a lot of nerve asking as much from you, n’est pas?

    Anyway, I appreciate your blogging. You’re intellectually honest, I’m sure, and it must reflect your personal honesty as well. I look forward to your response.

    • Joseph Burgo, Ph.D. says:

      Hi, I’m sorry for not writing back soon. I’ve been off for most of the week.

      While I nearly always determine my vote based on “social issues”, I am also a free-market conservative. If there were a viable Libertarian Party I’d cast my vote for its candidate, or if the Republic Party really were the party of small-government (that is, if they really did believe in staying out of your business and not dictating what you can do with your body, your sex life and your marriage), I might have more sympathy with Republicans. My belief is that most people confuse the idea of social responsibility with government. While I believe we, as a society, have a responsibility to help the less fortunate, it doesn’t follow that a government program is the best way to do so. I also believe that governments (i.e., monopolies) are highly inefficient because they don’t have to compete … but I’m sure that all these ideas are familiar to you.

      Regarding the fee, I do believe that the free market should determine the value of my services. At the same time, my personal sense of responsibility to the less fortunate people who need my help leads me to make adjustments — I could charge a lot more than I do. But that is my personal and entirely free choice. I’m not compelled by any law or program to do so, and I would never fault anyone for doing otherwise. I’m free and my clients are free to enter into and continue this relationship as long as we agree that it’s worthwhile for both of us.

  15. another anna says:

    (i’ve only recently returned to your site as i was a victim of that vicious trojan horse virus)
    … your articles are such a valued resource for me and i thank you for sharing your experience… i was very moved by anna’s comment above and just wanted to say how much i agree with the VERY long time the process takes ~ i endured 6 years with a therapist who only enhanced my deep shame & pain, but now, 11 years into therapy with a woman i’ve learnt to TRUST and LOVE, i feel i am just beginning the healing process… it’s not grammatical error when i use the lower case for first person yet anna, prior to therapy i would not have even been able to post a comment, so PLEASE put your toes in!

  16. Inked Rev says:

    I read and enjoy your blog often, but rarely comment. This series has really resonated with me as a parish pastor and therapy-goer. It’s not done yet, but be watching for a response within the next two or three days over at my blog – inkedrev.wordpress.com.
    Thanks for all your work for this blog!

    -The inked Reverend

  17. Hi, I have been reading for a while but this is the first time I have commented. I cannot say thank you enough for posting this. I am a long term therapy patient who managed to do what I wouild consider a significant amount of healing with my second therapist. So much so that about 15 months ago, I decied to stop going regularly (my therapis is available by phone or email and I schedule appointments as needed which has turned out to be anywhere from four weeks to four months). His identifying my disorganized attachment proved to be both the key to my understanding myself and the soure of believing I could heal.

    My therapist had extremely clear boundaries while still managing to be emotionally accessible and highly empathetic. He understood my need to experience a reliable dependence for a short time in order to complete the developmental steps I had missed as a child. (I was sexually and physically abused by my father). My therapist helped me heal in ways I did not believe possible. It is exactly as you say, I will always carry some of the effect of what happened but now at least I have learned to experience my feelings, gained a sense of worth (which occasionally crashes and dies but not for long) and am living so much more fully than I have eeven been capable.

    The most important and most healing part of my relationship with my therapist was his acceptance of and acknowedgement of exactly what he was to me. He did not dodge the reality that he is of incredible importance in my life, while also being clear about the bounded nature of our relationship. We discussed how the relationship was more important to me, closer to the center of who I am, than it was for him. I struggled so long in my insecurity and fear, to believe it was a real relationship, that he really cared about me. He was amazingly patient and beautifully non-defensive. I threw so much misplaced anger, hatred and fear his way, along with way too idealized an image of him for a very long time. He remained rock steady through it all, until eventually I came to see both him and myself as normal human beings. Learning to move closer to him, and finding it safe to let someone know me on such an intimate level has taught me to move closer in all my relationships.

    So it was incredibly moving to me to read what your wrote from your side of the couch. My therapist and I would speak of love and the healing to be found in a loving relationship but he never, nor should he have, said he loved me. But I left him certain that there was a very real love between us . But to be honest, I have those days when I can question it (for someone with my background, the inherent ambiguity of the therapeutic relationship makes it easy for doubts to creep in). To hear you acknowledge the depth and the love you experienced as a therapist (while acknowledging the asymmetry) was just a wonderful thing to read. Thank you for being vulnerable enough to risk sharing that.

    Peace, AG

    • Joseph Burgo, Ph.D. says:

      You are very fortunate to have had such a good therapist. In my experience, it’s not all that common to be able to remain clear on the boundaries while communicating real concern, genuine caring. Of course, the success of your work also has a lot to do with your willingness to face the pain and your holding on for dear life to someone who — in the middle of all the anger and projections — you somehow knew was a good person. So often, I think of the expression “cleave unto” — it sounds so biblical, and yet it’s what I think needs to happen for therapy to succeed. The client needs to cleave unto her therapist (attach to him or her) and feel real concern in return.

    • Anonymous says:

      Why shouldn’t he have said he loved you?

      • Joseph Burgo, Ph.D. says:

        Probably it was outside of his notions of his professional role.

        • Actually, I had such an interesting reaction to reading this article that I ended up taking it into my therapist. My first reaction was what I wrote above, that it was very reassuring to read and made me happy to believe. But then it started to not feel so good, so I went back to see my therapist and discuss it. Proved to be a very intense session in which I discovered some rather interesting deep seated beliefs about what happens when you’re loved. His reason for not saying “I love you” came up during the discussion (in which he clearly expressed that he found what was written very true and acknowledged that there is love in the relationship) and he said that the difficult thing about saying it is that it’s hard to know what it means to the person hearing it and what is meant by the person saying it. In no other way did he shy away from the subject or the relationship so I have no complaints. Joseph is quite correct, I am extremely fortunate to have a therapist like him.

          • Joseph Burgo, Ph.D. says:

            Another sign that you’ve got a good therapist — he didn’t shy away or get defensive about the issue and really went into it with you. Thanks for letting me know what happened.

  18. Alyssa says:

    Why does it scare you to put those words down?
    And thank you for doing it, they feel true and good.

    • Joseph Burgo, Ph.D. says:

      Just ’cause it’s not considered terribly “professional” in my field.

      • Alyssa says:

        Thanks for being “unprofessional”. Reading that made a big difference for me. Just to read the truth. I’ve read so much and I finally a therapist telling the truth about the most important part of my sitting in that room.

  19. Alyssa says:

    I’ve been fighting the cleaving thing really hard, for multiple reasons, which all boil down to…you’re going to hurt me if I do that.
    But reading that sentence tonight, “…we will come to love each other.”
    It’s true. I do love him. I’ve cleaved.
    I guess I’ll let him see that a little. I’ve been hiding it.

    • Joseph Burgo, Ph.D. says:

      i understand it’s not easy; but by pretending otherwise, you haven’t actually changed anything, have you?

      • Alyssa says:

        I have shame, rage and sadness about wanting him to care so much more than he does. He’s an empathic person and I feel that during sessions, but I’m not on his mind when I’m not there, he’s not going to miss me when I terminate. Ultimately, I still feel alone and lonely, even though I know he cares.

        • Joseph Burgo, Ph.D. says:

          Yes. The fact is that your therapy is all about “you” and your life, needs, feelings, etc. and not his, so you’re right, he’s not thinking about you in the way you are thinking about him. But I doubt very much that he won’t miss you when you terminate.

  20. Mike says:

    Thanks for the post, and the comments / dialogue that followed

    I am in the early days of training as a psychodynamic counsellor (and so am also in once a week therapy at present, maybe more later) and struggling to understand the meaning of therapy and the therapeutic relationship. I am at the “everything is confused”stage, maybe it passes?

    • Joseph Burgo, Ph.D. says:

      Yes, it passes. I think the way to get beyond the confusion is to stick with a good therapist for a long time. My own personal therapy, along with supervision, is where I learned almost everything. Very little from books. And of course I’ve learned a lot from my clients over the years.

  21. Mike says:

    So how do I know if my therapist is a good therapist for me?

    • Joseph Burgo, Ph.D. says:

      I say to my own clients that in time, they will know for themselves if the therapy is of value to them. Usually, it’s clear very quickly whether or not it’s a good fit. Sometimes the inability to value the therapist is one of the main issues, which can complicates things, but usually, a client can tell. If you’ve been going longer than a few months and you’re not feeling that you receive something of value, that should give you pause.

  22. Tom says:

    I have just started to read your blog today. I had grown up in a family where my parents were deeply in hate. Father not around and mother berating him whether he was there or not. They took 12 yrs to divorce. Among many other indignities that I internalized, unaware as shame.
    Until I was 29 I was in survival mode – more accurately protecting the shame, the person within me, from discovery by people who would get to close to that which I thought I was. The shame was unconscious at one level but real in my reaction to it. I guarded that interior by becoming the castle guards, by weaving webs of my life (exaggerated) for other peoples consumption and adulation. I was extremely active sexually. Short intense relations that were distant emotionally so as to protect (semi-unconsciously) myself from the other discovering that “real person” that I thought I was. I had no clue who I was, I had been a guard all my life and knew nothing about what I guarded – In fact I was terrified of what I might find. Through a rather short term therapy – and mainly because of the hurt I had caused myself and others (my view) I crashed to a point of bottom. In therapy I knew I had to go to the dark place, I knew I was following the proper path when I felt I was most scared of going forward – most terrified – I was feeling and looking into my abyss,the darkness, the unknown that I had guarded but never turned around to see. At times I literally felt that I would die were I to move forward but I compelled myself to move, compelled myself too not distract myself away from that direction. At times again, I was certain that I would wake-up years from the then now – institutionalized – but I pushed forward. I had pushed through my soul and found I was a good person. I had found that I did not need to crawl through the corridors between my emotions. I found that my emotions were opened up to me – that I could be who I was and operate from me. I faced as many of the people I could find and told them of my deceptions, antics, self delusion and hurts and lies I had done to them. I found the doorway leading from the corridors between my emotions and, found that my emotions were vast spaces of great beauty – even the culturally frowned upon emotions. I am aware of how easily one can open a door back into those corridors but, now find them to be inhospitable, something known and disliked instead of something unknown and without alternative. With this ‘catharsis’ come a sadness and realization that many people do still stay in the corridors between their emotions – some see through clearer glass than others but have yet to find their doors into the vast spaces of emotion.

    Just wanted to thank you and your profession for work that can make profound differences in peoples lives.

  23. Tom says:

    In addition to my comments above. I am looking for some council. I have been married to a diagnosed narcissist – not my diagnosis but a professional. I can tell you from personal experience that my past and the shame it produced fits nicely (negatively) with narcissismand my retrograding back into my corridors. The defenses my wife uses triggers my defenses which, from very young, was to crawl into my shell – those corridors. Instead of my recognizing early, I gave her leeway to trample me – one small step at a time. She has abused my friends, her friends and family to the point that they wish not to see her. We were blindsided by a teenager who plowed into our car after failing to stop at his light – on our wedding night. The accident has left my wife with fibromyalgia – at least that is the thinking. Her narcissism was evident before our wedding and, we had sought therapy before and after that day. She will not go anymore nor was consistent at the time. _ My point is that I am left as caretaker and whipping boy with a sense of duty and empathy that made me ignore myself while failing myself and letting myself retreat one abuse at a time. Again I find myself at bottom – and feel it will not be long to have myself back again. It is that when a person goes for help and feels substantially healthy again, it may be worth noting that even though that person is self actualized they remain at higher risk to retrograde than ‘normal’. I do not think that normal in the psychiatric field means ‘majority’ but, rather, ‘ideal’.

    • Joseph Burgo, Ph.D. says:

      Tom, I’m not sure what the counsel is that you’re seeking. I agree with what you say, that even with therapy and growth, one always has certain weak spots and tendencies. From my point of view, if your wife truly is a narcissist, then you are feeling a kind of sympathy and not empathy for her (I talk about the difference between sympathy vs. empathy in an earlier post). You have likely been coerced into feeling that sympathy as she uses her so-called fibromyalgia to manipulate you. (Has this condition been diagnosed or is it just what she calls it in order to justify her need to be taken care of?) Your own basic shame plays well into her defensive structure, as I discussed in my earlier post on winners and losers. It sounds to me as if you two are colluding in some way, about your inferiority and unworthiness, and you probably need to get out of this relationship.

  24. Looveey says:

    Dear Joseph
    Thankyou for sharing not only your views but your own experiences around therapy. It helps me to reflect on my own experiences and I have a new found appreciation for the difficult work done in therapy.

    I had a bit of a realization reading your post that the unconcious expectations I have had of therapy is to ‘survive’ my therapist. My first psychiatrist told me that he was the definition of a narcissist (and he was right) and that i would be cured when I could deal with him. That definition of course played into my beliefs and reflected the ease at which I attach to narcissists simply to feel safe rather than feel genuine love.

    I also think I have an unhelpful attachment to my second pscyhiatrist. He is a compassionate man but we are both traumatized (as a medical condition was misdiagnosed as psychiatric and the drugs he prescribed caused delirium). Your post helped me to understand that if part of his role is to bear my pain that he cannot do this whilst he is bearing his own. I think that is hard to accept – but I do think that is the truth of the situation.

    • Joseph Burgo, Ph.D. says:

      I’m sorry to hear that. Is it possible that he can be in pain AND bear your pain, too? Or do you really feel he’s overwhelmed by his own pain?

      • Loveey says:

        I have sat with this question. He has told me he is trying to protect himself. He has told me he is worried about medical negligence. He has told me he tries not to talk about my trauma. I think I should believe him. I feel sad because I don’t feel this way but I respect his right to his feelings. It is difficult.

        • Joseph Burgo, Ph.D. says:

          I can understand his feelings, but I have some doubts as to his ability to help you. How can he do so if he’s avoiding your trauma and won’t bring up certain subjects for fear of a malpractice lawsuit?

  25. Alyssa says:

    I am in therapy and I have a caring therapist.
    I feel the benefits of that, and also the periodic realization that paying someone to care about me sucks.
    Sometimes his caring just feels good, and the payment aspect isn’t in my mind, but every once in a while the reality that I’m paying him for it really hurts.

  26. Holly says:

    I have a deep attachment to my analyst and oscillate between feeling that he really cares for/loves me vs I’m just another patient of his. I became angry with him today when his reply to my “I guess I expect a lot from you” was “It makes sense that you would expect a a lot in a deep relationship (like ours)” . I was feeling at that moment the lack of bidirectionality in our relationship and did not think that he really felt the “depth” of the dyad on his side. I felt keenly then the “as if” nature of the analytic set-up and the inordinate amount of love and emotional investment the analysand places onto this relationship . I told him petulantly that our dyad is like an edifice which I build, with walls only on my side; on his, there is nothing.
    Perhaps, I have been unfair to him, and maybe this is just one of those ebbs and flows in feelings that I will have again and again in the relationship, the mercurial nature of the transference.

    • Joseph Burgo, Ph.D. says:

      Here’s how I think about it. Of course your therapy means more to you than it does to him — after all, the therapy is all about you and your life, not his. That’s not to say he doesn’t care about you. I also think that what you’re going through is part of the “infantile” transference, if will — the point where babies “wake up” to the fact that their mother may be the center of their own universe, but mommy has whole life that doesn’t include the baby — a husband, friends, maybe other children … a whole lifetime that preceded the baby’s arrival. I remember going through that it my own analysis and it’s not a pleasant experience. But eventually, you “grow up”; your analyst will always be important to you, but when you feel less dependent upon him because you’ve gotten what you needed, the relationship won’t seem so lopsided.

  27. Honestly, I have never known someone who could manage to remain so non-defensive (He’s been a wonderful model for me in my other relationships). I have no doubt that my therapist has a calling for this work. If you’re interested (and have the time, I’m fairly long winded :) ) I actually wrote about the whole thing on my blog. I did quote an excerpt from this post but made sure I linked back here. :)

    I really do appreciate that you wrote about this, since it triggered my going even deeper into my healing.

  28. No Name says:

    I have been dealing with depression for 20 years. Been on Prozak, Paxil and now Zoloft. I don’t feel I’ve made much progress as I’ve spent over $10,000 on medication, counseling and psychiatric visits. My issues contributed to a divorce and now I see my kids 1/2 the time and feel lonelier than ever. I feel that my relationship with my kids has given me some emotional strength, as I had no father and a limited relationship with my mom growing up. Some kind of emotional issue runs in my mom’s side of the family, and at this point I don’t think I’ll ever be well. I eat excessively to feel better. I feel there is too much going on – maybe some attachment, depresssion and/or self-esteem issues all rolled into one. Searching the web for answers, dealing with ‘live’ people unfortunately has had me coming up empty for a very long time. I feel good for the hour I am there – but nothing stopping me from downing 6 ice creams at 9pm every night. I hope someone listening has some possible answers. Thx.

    • Joseph Burgo, Ph.D. says:

      There aren’t any “answers”, I’m sorry to say. The “answers” you’ve been turning to — ice cream, medication, etc. — haven’t helped, either. It’s too bad your therapy hasn’t been more useful to you, because I think that’s the best way to get some kind of meaningful relief.

  29. Alyssa says:

    I wrote a post up there thanking you for writing “and over time we will come to love each other” because I felt this is what has happened in my own therapy.
    Today I told my therapist that I have felt confused, because his very expressive empathy makes me feel personally loved, and I don’t think he loves me.
    He agreed. He apologized that his way of doing therapy made me feel this way, and said he is careful to do it differently now.
    I also said that he had used the word “love” and that confused me.
    He said once that “when I try to love and value you, you push me away.”
    Everytime he used the word “love” my heart jumped, hoping he loved me.
    He apologized for using the word “love”, too.
    I thought he was going to say that he had some kind of therapist love for me, but instead he just agreed that he didn’t love me and apologized for confusing me.
    I guess I was wrong when I wrote to you that “we will come to love each other” was my experience in therapy. My therapist doesn’t love me.
    I’m sad, really sad.
    Do you have any thoughts? Thank you.

    • Joseph Burgo, Ph.D. says:

      Sorry for the delay. I think that the way he phrased his remarks to you is odd. I don’t see that a therapist tries to “love and value” a client, or that it’s the main job to be done. It just happens. I might say to a client that he or she pushes me away whenever I try to “get closer” or “make contact”, but that feels quite different from what your therapist said.

  30. Alyssa says:

    It might be because I first said, in a blaming tone (because I have blamed my therapist for my feelings of being unlovable) “I feel like I have no value in relation to a man.”
    And then he said, “When I try to love and value you, you push me away.”
    He has often said I put him in “a bind” because I push him away.
    He tells me that only a very small percentage of what he has to offer gets through.
    I asked him what he has to offer, and he said, “My presence, my empathy…”
    Does the added information make a difference, or does it still seem odd?

    • Joseph Burgo, Ph.D. says:

      I guess it makes a little more sense now, but it still seems odd to me to speak of “trying to love” a client.

  31. Alyssa says:

    I thought that over time, we had come to love each other. My therapist is so empathic and compassionate that I felt loved, and loving of him. It turns out, he doesn’t love me.
    I told him that it felt like he loved me, and he shook his head no.
    I told him I didn’t mean “in love” , I meant just person-to-person, platonic love.
    He kept looking sad and shaking his head.
    I asked him to come right out then, and say, “I don’t love you.”
    He said he didn’t feel comfortable saying that because I had been rejected so much as a child.
    He said, “I don’t want to reject you” and “I’ll tell you what I do feel” and then he said he feels compassion and empathy, and anger and sometimes rage towards the people who abused me in my childhood.
    I feel very sad that we have not “come to love each other.”
    Turns out it’s just me, who grew to love him (I’ve been in therapy with him for a year).
    I was thinking of you, Dr. Burgo, and I told him that I think some therapists do grow to love their clients. He didn’t say anything.
    Will you please give me some feedback, Dr. Burgo?
    I feel pretty sad.

    • Joseph Burgo, Ph.D. says:

      I’m sorry, Alyssa. For me as a therapist, the kind of love we mean would take much longer than a year to develop. It comes from having been through so much with a client in his or her life, the experience of knowing one another “for years.” I would also be uncomfortable myself if a client of one year asked me if I loved her. It would be very difficult to answer in a way that was honest but not hurtful — as your therapist was clearly trying to do. But he obviously feels concern and cares for you; maybe you’re expecting too much too soon.

  32. Alyssa says:

    I just want to add this comment to my March 29th post (above),
    It may seem like the March 29th post is a reiteration my March 19th post, but I brought up the issue (again) in therapy today of my therapist not feeling love for me, because I’m still wrestling with it.

  33. Alyssa says:

    That was a very helpful answer, actually. I feel a lot better-thank you!

  34. sam says:

    This article was resonant with me. I am four years from retirement and braver in my humanity with clients now. I was extremely touched when you said how vulnerable you felt talking of love. But i get what you mean. Love is an all encompassing word for the compassion, respect and admiration which i nurture as a therapeutic relationship evolves with another person. Thankyou.

    • Joseph Burgo, Ph.D. says:

      That’s helpful. “Love” can mean so many different things and thus becomes a little fuzzy as a concept, but describing the specific aspects of the relationship between therapist and client makes it much clearer. Thanks.

  35. E says:

    Hi Dr. I am mom of 2 very young children and have diagnosed post partum depression, which has brought up a lot of pain from an unresolved incident in my past in which I was sexually assaulted by a coworker. I finally am seeing someone now to deal with all my issues and even though it is very early in our relationship, I felt like I attached to him somewhat quickly. I told him in our second session about the assault and after asked him for a hug which he gave me. In the following session he talked about it and said we would try a handshake and see how I did and told me what I really needed was a hug from me. I made a joke and I asked if I could have a hug until I got to the point when I could hug myself and he gave me a hug. I decided going forward I would only ask if I really needed one but then at the end of the next session he just offered me a hug so I figured it wasn’t an issue. The hugs were reassuring after telling someone for the first time these awful things and made me feel safe and willing to open up. We missed a few sessions since he was away/sick and then the first thing he brought up in yesterday’s session was that he would no longer hug me or touch me in any way ever (he also moved back from the other couch to his chair across the room). I felt really rejected and abandoned and hurt and asked him what I did wrong. (I cried through the entire session). He insisted it’s just his policy and that he should have told me from the beginning but saw that I was suffering and made an exception to his policy. I thought that would have been understandable if in the last session he hadn’t OFFERED me a hug. He says with my “past” he has to really establish firm boundaries, but I am not a typical assault case where I want space. I need comfort to open up. My parents weren’t very affectionate and so I know I seek it from others and he probably recognizes that. He may be correct in his approach but I felt like he handled it poorly going from giving me hugs for weeks to saying that no matter how upset I get going forward he will never touch me. It would have been better if he just said in general we weren’t going to do that instead of making a hard fast rule. It makes me feel alone and like I could never open up and even has me considering quitting. I know I have to get help but I don’t know if I can get past this with him. I didn’t say anything about quitting but he asked me a bunch of times if I was going to come back which made me wonder if he really wanted me to. He said he’s not rejecting me and invites me to continue working with him but it seemed like he figured I was going to quit. I really felt so safe with him and now I feel like I just see him my allotted 45 mins a week, pay my copay and go. How can I open up like that? Is there something wrong with me?

    • Joseph Burgo, Ph.D. says:

      You’re right, he definitely handled the situation badly. It’s the kind of thing we therapists do from time to time. If you’re unprepared for a client to ask you for a hug at the end of the second session, you might be thrown off balance and not know how to respond in the moment. At this distance, without actually being involved, I can tell you that he should have said that he wasn’t sure whether a hug was the very best thing, given what you’d told him, and that maybe you should discuss it more in the next session. He did tell you this later, but not until after he’d already been hugging you, which understandably makes you feel rejected. I think the error was his and he has recognized it. Whether you can get past this is another issue. Keep talking to him about how you feel and if you don’t reach some place of acceptance then move on.

  36. E says:

    Thank you Dr. Burgo for your response. It was helpful to hear your perspective. I am going to go back this week and try my hardest to work through this with him. I’m just hoping you can help me with one more thing. I definitely believe in order to trust someone and be willing to open up to them and eventually heal, I would have to develop a strong attachment and respect for my therapist. And even though the relationship is by nature really one sided I would at least have to feel like we’re getting to know each other and that he cares about me. So it’s not even so much the actual no touching rule so much as the abrupt 180 degree change which leaves me wondering what happened to change things so drastically. (And if I did something wrong.) And leaves me wondering what will happen the next time I let my guard down and am vulnerable. I felt so much empathy and understanding from him which was leading me to begin to trust and hopefully eventually open up to him. He just seemed so much colder this last session with the outlining of the new boundaries. I don’t really understand why my “past” puts me in a textbook category that would make me have to be treated according to some rules rather than establishing a trusting relationship on our own as we were.

    • Joseph Burgo, Ph.D. says:

      All I can say is that you need to have a frank discussion with him about the changes. He should be able to explain this to your satisfaction. In my view, you’re not in a special category; I don’t believe that hugging and physical comfort have a place in psychotherapy, for all sorts of complicating reasons.

  37. In pain says:

    I find your posts about transference very interesting and honest. I have had “erotic” transference issues with my therapist since about 5 months into therapy. It has been two years now. I am seeing him for severe depression and have a history of trauma and neglect as a child/teenager.

    The transference has always felt very awkward, but it’s presence was not a constant source of pain. In the last few months my depression has gotten worse (for a bunch of reasons independent of him and therapy) but I also find myself longing for him between sessions. I imagine a sexual relationship not a “real” one. I am married, have been for almost 20 years and have no desire to leave him. The rational part of me knows my feelings aren’t “real” but rather a part of the therapy but another part of me believes that my feelings are real.

    My depression has gotten worse and I recently quit seeing him. I’m hoping the pain of wanting him will go away if I don’t see him every week. I miss him terribly. I want him to love me like I love him. I would even be happy to know that I am more than just a person he sees for an hour each week (Ie that he really cares about me and thinks about me outside of session – not obsessively like I do but on occasion). Sometimes I wonder if quitting or talking about quitting (which I’ve done in the past) is my way of testing his commitment to me. A test to see if he really cares Why does this relationship bring out such difficult child like feelings and can they be avoided?

    Thanks for your insight

    • Joseph Burgo, Ph.D. says:

      Maybe I’m wrong, but I’m under the impression that your therapist doesn’t work with the transference. I mean, talking about your relationship with him as a primary subject of the therapy. This sounds strange to people who’ve never experienced it, but you need to talk about and explore all these feelings you have about him during a session, not break off therapy in order to avoid the feelings or hoping for some sign that he actually cares about you. The transference is not an awkward artifact of therapy that needs to be gotten over; it needs to be explored as a way to understand yourself.

      • Anonymous says:

        Thanks for your response – I didn’t clarify in my original post that he does know about my feelings and has for over a year and a half. We do talk about it, off and on, but it is definitely not the primary subject of the therapy (although that’s all I think about these days). I wonder how I know whether the discussion we’ve had about the transference is helpful or whether there is “more” to discuss. Therapy is really hard work! But I guess you know that!

        • Joseph Burgo, Ph.D. says:

          I can’t tell if this is a duplicate comment, but the transference relationship is full of distortions, fantasies and defenses — it’s not simply this weird thing that happens and gets in the way of treatment. You need to understand it as a tool for insight and growth. One small example: the erotic transference often thrives on an unconscious fantasy that, if only the client could have sex with the therapist, it would be magical and curative, making the long, hard work of therapy (and the painful dependency that comes up) unnecessary.

  38. InPain says:

    Thanks for your response. I forgot to add in my last comment that we have talked about it. He has known about it since it started. We talk about it on and off depending on what is going on for me aned how brave I am to bring the subject up. It is not, however, the primary subject of our therapy. Does it really need to be? Is that why I’m not working through it? We have talked about it many times, but I find after those occasions I feel both incredibly embarrased and more needy then ever. That’s why I stopped – because it seems like it just keeps getting worse, not better. Maybe we didn’t do “enough” work on it?

    • Joseph Burgo, Ph.D. says:

      Yes, it does need to become a focus in order to work it through. I have invariably found that the erotic transference is a defense against something else; if you take it at face value and hope it will pass or fade away, you’re not addressing what’s underneath.

  39. In pain says:

    Thanks for your response. I’ve tried thinking of what the transference could be a defense to buy am coming up empty. There is also very little information out there about transfefence, and erotic in particular, so I appreciate your feedback.

    Thanks

  40. Faiya says:

    I enjoyed this article. My therapist speaks of love many times during ruptures or my fear. It has been profoundly healing.

  41. JMW says:

    Dr. Burgo,

    I stumbled on this blog recently and have found it compelling both personally and professionally. Thank you for your honesty. You connect with people’s pain and shame in a way that both validates and dignifies their efforts to find health and peace. This kind of approach should be the norm for mental health professionals; unfortuneately it is not.

    I am 50-ish, and a therapist working in a crisis center with with survivors of recent sexual assault. I began my career relatively late in life, but it is something I have wanted to do for a very long time. The treatment principals you describe here are ones that I believe in and aspire to in my work. So glad I found you!

    I’m also a survivor: severe and prolonged sexual abuse in my home, from @ age 3 to age 11. As soon as I was safely out of that environment I sought treatment and spent the next 30 (and counting) years working toward recovery and peace. I feel strongly that the failure of early attachment was at the core of my difficulties (the sexual maltreatment, bad as it was, secondary), but it took a very long time to understand this concept and how integral it was to the profound shame that seemed woven into the fabric of my being. For years I avoided mirrors because I could only see filth, and the pain of that was intolerable. Therapy posed the same kind of challenge: while I desperately needed and wanted to connect with a trusted other, such connections felt like looking in the mirror and having to face all that filth…the more I tried to connect to people, the more exposed I felt. Hard to hide from yourself…. I found a therapist who was able to enter into my pain, be with me in it, and demonstrate in a very meaningful way that it really was possible to look at it, speak about it and ultimately make peace with it.

    My recovery has taught me that, as you have said, understanding and tolerating a new kind of attachment is hard, hard work that requires dedication on the part of both therapist and client. Nothing easy about it, but it is possible and the rewards are immeasurable. And not just for the client. Such an experience, shared by two people, would be impossible without love. I just believe that. I have learned that love has many facets and comes in all shapes and sizes. It doesn’t really matter what it looks like or even how it’s expressed. Love is love. It wasn’t till I just let it be–stopped trying to understand the nature of it–that the wounds started to heal.

    Thanks for this blog. I think you are helping a lot of people.

    JMW

    • Joseph Burgo, Ph.D. says:

      And thank you for taking the time to write such a lengthy, heart-felt response. I think it’s hard for most people to understand that sexual abuse might not be the very worst thing that can happen to you, but I think I understand what you mean. Maybe the sexual abuse is just a symptom of something much deeper. I also agree with what you say about love coming in different shapes and sizes. Just because I charge for my services doesn’t mean that I don’t come to feel a kind of love for my clients over time. A lot of people have an idealized view of love — like, if I really loved my clients, I wouldn’t charge them.

  42. Lisa says:

    I think I would become physically sick if a therapist talked about “love.” I’ve had therapists compliment me and that just makes my head spin. I’ve had both genders of therapists and all I can feel is hate. There are times that I feel admiration for their experience or training and the insight they provide. I see therapists, psychiatrists, etc. more as a thing maybe. Maybe that’s cruel to say.

    • Joseph Burgo, Ph.D. says:

      It’s not cruel to say, but it speaks to your issues. The prospect of needing or depending upon a therapist must be so frightening that you have to push them away. I suspect that your hate is defensive — a big strong feeling, to ward off the fear of being small, needy and dependent.

  43. Molly says:

    I have recently started reading your site, I am 10 weeks into psychotherapy and find what you have to say makes so much clear to me. I was hoping you could help me solve a dilemma with my therapist. He is a trainee and will be moving onto a new training rotation in six months time. I have attachment problems and am having severe fear of rejection in the transference. I think I see him as the parents that abandoned me. Should I get out now, or wait to see if things get better before the “deadline”, I am not sure I can get over the fear of him leaving me, when obviously I know he will be moving on.

    • Joseph Burgo, Ph.D. says:

      That is a very tough one. Have you talked to him about how you feel? In general, I think it’s not such a good idea (especially if you have attachment problems) to begin treatment knowing your therapist won’t be around for long. Maybe he could help transition you to someone who will be more stable, but I don’t think you should just bail without talking to him about it.

  44. KAprilRain says:

    Dr. Burgo,

    Thanks for being so up front and communicating the essentially healing part of therapy which is the attachment relationship and love. This time around I have just started my 4th year of therapy. What has helped me so much is that my therapist is so real. He sometimes shares things he has struggled with, and that has made all the difference for me. He normalizes my feelings, listens, cares, and is there for me. He told me a long time ago that he has made a commitment to this work of therapy with me, and that he’s not going anywhere. Therapy has been a lot of hard work filled with fear, love, hate, projections, denial, grief, dissociation, and many other difficult thoughts and emotions. It has been incredibly painful dealing with childhood abuse and realizing that the one person who was in your life to provide nurture, support, and love, ended up abusing you. It is surreal sometimes. My therapist and I have struggled, cried, argued, endured silence, depression, mistrust, hopelessness, incidious fear, and anguish that hurts to the core. Through these experiences we have developed a relationship and a closeness that defies the reality of my background. He has really never been a blank screen. I don’t think I would have been able to continue if he was because my mind would have done all sorts of things with that ambiguity. Yesterday, out of the blue he asked me if I knew he cared about me to which I replied, yes, and I think that is a major reason why I am healing. Right after that he asked me if I knew that he loved me, and I replied, yes, and I think that is a major reason for my healing. I remember asking him a long time ago how he felt about me to which he replied I care about you as a client. I’m not sure I understand why it’s so imortant for me to know that my therapist cares about me, all I can share is that knowing that he really does care about me and loves me has been a springboard for my healing. I never thought I would ever trust him. It took almost 3 years for that to truly happen, and then some. Sometimes that incidious fear rears its ugly head and the mistrust reappears for a moment or two. But it is because we have this realtionship and a commitment to work together along with deep feelings for each other (agape type love), and a history of struggle that healing is possible, at least from my experience and perspective. Thank you for having the courage to take a risk and share that an important part of the psychotherapy relationship is love. I have visited your site many times the past few months. I find your articles both informative and healing at the same time. Thank you so much.

    • Joseph Burgo, Ph.D. says:

      You’re welcome. It’s nice to hear from someone who has such a strong, positive relationship with her therapist. So often lately, it seems like I’ve been hearing just the opposite.

  45. another childhood..... says:

    thank you for your time
    this will be very disorganized…so I apologize first
    Therapy makes me feel so uncomfortable even though I like my therapist
    He keeps himself very distant….boundries or his own agenda, I’m not sure
    I dont want to trust him…because I feel I will be jumping in at the deep end ;
    my therapist might watch but not catch my fall
    I dissociate often – he gives me space
    I am very scared..because the relationship feels so fake
    I want to take this seriously…but I cant seem to let go

    • Joseph Burgo, Ph.D. says:

      Holding the boundaries and remaining distant aren’t necessarily the same thing. I’m not sure how long you’ve been in therapy, but I find that trust isn’t something that comes easily or quickly. You might just need more time.

  46. anon says:

    Thank you for time and detail you put into this blog – it sheds insight into the therapy process for me and I am sure many others.
    What are your thoughts on hugging clients? Not as a routine gesture -but perhaps only when there is significant emotion or pain for the client. I have had moments where I felt very vulnerable and exposed and the therapist has expressed that it would be ‘very natural to hug/hold” me but can not because of boundaries. She often says that sometimes it feels as if it is the “boundaries” that are the aritficial part of this relationship.
    It has come up in discussion a few times – and I hate ever feeling the need for that hug – knowing I will not get it. Yet sometimes I think it would be so helpful.
    Where should the boundaries lie for things like hugs? And if is confined to limited/specific scenarios what are the risks or downsides?
    Thank you again for this important forum.

    • Joseph Burgo, Ph.D. says:

      I think it’s up to every therapist to set those boundaries in a way that feels appropriate for him- or herself. For me, I rarely hug clients, and I never do it in order to offer comfort. I think it can easily be misinterpreted. Hugs and physical comfort are what friends and family offer; for me, it’s important to remember that I am neither one of those, even if the relationship feels very close.

      • Lee says:

        What if your client has no family or friends? Hugs are far more healing than words…

        • Joseph Burgo, Ph.D. says:

          I’m sorry, that sounds sentimental to me. I don’t agree that hugs are more healing than true understanding.

          • Lee says:

            I meant it in the sense that on a given day that I have been hugged, that chemical cocktail is more powerful than was said-initially. The state of being understood does indeed come later. But come it does. Having touch deprivation may be the issue. Just my experience…
            Lee

  47. TMP says:

    Hi Dr. Burgo,

    I’m an MA Counseling student and just finished up a course on psychoanalytic play therapy for children. Fascinating! I love the counseling profession, however, sometimes, the coursework is completely disconcerting. I spend hours trying to self-analyze my deficits and perceived weaknesses through the scope of XYZ lens or ABC theory. Of course, it always comes back to my mother.

    When I was born (1979), she was in her mid-20s and married, with an 18-month old son already. Less than three months after that, she was pregnant again. My younger brother had major social and behavioral issues (would probably have been called ADHD), and demanded so much of my parents time and attention, not to mention that for much of my infancy, my mother was pregnant and also running after a toddler. So, if being the middle child wasn’t rough enough, I always felt ‘sandwiched’ between my siblings. When I was six, she had another child. I don’t recall ever getting any personalized attention from my mom. I know my sister did, and it seems like both of my brothers probably did too – one was 18 months when I was born, and the other was the baby for another 5 years. I have no memory of ever playing with her or being comforted by her. Sorry for the sob story! It’s something I really need to untangle the more I think about it.

    I’m reading more and more about attachment disorders and wonder if this is why I have so much resentment and pent-up frustration about my family situation, especially with my mom. I don’t feel connected to any of them in particular, yet for the most part, they seem to have a close bond without me. The effect this has had on me throughout many important times in my life is obvious. I’m the most independent in the family, and have lived most of my adult life pretty far away from everyone else. I’ve read about some of the adult traits of failure to attach, and see myself in some (not all) of those traits. I struggled through defining my personal identity, “reinventing” myself several times in my adolescence and 20s – most of which were pretty lonesome as far as my family of origin goes. And, I’m still trying to figure out how to stabilize and validate my own emotions.

    Your blog came across in a search, so I thought I’d ask if you can recommend a specific assessment or diagnostic tool I can research that would tell me, as an adult, if my intuition is correct – that my mother and I failed to bond when I was an infant. I’m curious, just for my own sake, if this can even be determined or not. I haven’t quite mustered up the courage to just ask my mom about when I was an infant yet! I’m afraid of what the answer might be… so I best be prepared to have that discussion when the time comes. I probably need therapy.

    A good friend of mine says, “Part of a mother’s job is to make us crazy.” I hadn’t wanted to believe it… Yet, after a year of graduate school in Counseling, I think I finally understand.

    Thanks for any help. Hope your weekend is full of life,
    T.M.

    • Joseph Burgo, Ph.D. says:

      I don’t know of any such assessment tools. It seems to me that you already know something went amiss. I agree that you probably need therapy, but only because I believe that in-depth, long-term therapy is the most crucial part of a therapist’s training.

  48. Lee says:

    Dear Dr. Burgo,
    First let me commend you on this website! I don’t know where you find the time or energy, but to say it is appreciated is an understatement! You are a wellspring of humaneness!
    I wonder if I could pick your brain about my situation.
    I had a lovely child hood with two of the kindest parents one could have. All my attachements were solid. I considered myself incredibly fortunate.
    Until my mother passed away at age 6 and my father at age 7.5. I also had a solid attachment with my uncle and grandmother who looked after me post their deaths. My grandmother passed away 6 months after my mother did. But I thrived regardless. My grandmother’s death prompted the intervention of social services who saw fit to take me away from my uncle ( an upstanding and much respected university professor) whom they felt was a danger to me because he ws gay. ( We adored the ground each other walked on and the powers that be jumped to some erroneous and harmful conclusions.) I was susequently adopted by a couple with two childtren of their own days before my 9th birthday.
    My experience with them was 9 years of neglect and verbal abuse daily. They were the antithesis of my birth parents! Stockholm Sydrome set in along with a high degree of confusion. Who was I? The good daughter or the devil’s spawn? They were clearly not able to parent me in a healthy manner. They simply did not possess the skills required. To make life more difficult, I went from being an only child to middle postition, with the elder sibling being of the of the same sex. Luckily for me, the verbal abuse and neglect ended when my step-father died when I was 19 and my step-mother when I was 23. Clearly loss is a big part of my makeup. I have been diagnosed with “Borderline ‘Light”. I would have thought C-PTSD would be more apt. Given that up to middle childhood my attachments were stable and nurturing, why would I have insecure attachments as an adult? It is almost as if the subsequent years wiped out the intial ones! How can that be?
    Forty plus years later (and therapy since I was 20) I am still trying to untangle one complicated personality that has yet to have a healthy relationship. ( I still have more issues than Reader’s Digest!)
    Can you shed some light on this for me? Any insights would be most appreciated! I thank you in advance for your efforts !
    Best Regards,
    Lee

    • Joseph Burgo, Ph.D. says:

      I would think that the death of two beloved parents at such an early age, despite the strong attachments, would traumatize anyone. It would shake the very core of your faith in attachment and cause you to doubt the permanence of all your future relationships. Years of abuse on top of that might very well have undone the good you experienced in your early childhood. And to think it all might have been different if the social services people had been more enlightened! I’m sorry.

  49. Sally says:

    Thank you so much or sharing your thoughts and insights with us. I was doing some internet searching on being “fired” by a therapist and one thing led to another until I came upon your blog. After spending 1 1/2 years in therapy with what I considered to be a wonderfully caring, empathetic, insightful, and helpful counselor I am afraid that I have worn my therapist out. She has suggested that I see a psychiatrist. These last three weeks have been horribly painful as I have come to realize that I probably became too attached and dependent on her…and now that the therapeutic relationship is over I feel very sad that it has ended this way. I really admired and looked up to her. Now I’m just hurt and angry with myself for allowing myself to become so attached, although I would never have been receptive to any of her help had I not opened my heart and mind to her. I guess that’s the nature of the beast…

    So, now, I am scheduled to see a psychiatrist and will have to do psychotherapy with her and her counselor in her office…and I doubt very much that I will be able to open up and talk about all of this painful stuff AGAIN. It was hard the first time…and that was after several months of getting comfortable with the other counselor. I’m not sure I want to risk all of the emotional discomfort again…especially if this therapeutic relationship is bound to end someday, too.

    So my question is this: Is there any way to remain detached and “matter of fact” while still receiving the guidance and help I need?

    • Joseph Burgo, Ph.D. says:

      I consider what your therapist did to be incredibly unprofessional and insensitive. What probably happened is that she didn’t have the kind of training and personal therapy that would enable her to understand your dependency feelings; she probably felt overwhelmed by them. I’m so sorry. But I don’t think you will be able to get what you need if you remain detached. You will probably need to test your new therapist to see whether he or she has what it takes to do the job this time around.

      • Sally says:

        Thanks for your reply. I decided that I should let her know how disappointed I was in the way that we ended, and she admitted that she didn’t realize that I was becoming emotionally dependent. She was appreciative that I called to let her know how I felt about our last session, and offered me an opportunity to come in and discuss it, or even to continue working together with safeguards in place. It may just be me, but I feel very self conscious and embarrassed about all of this…so I doubt that I will ever feel comfortable with her again. I will do the best I can with the next one…and will make sure that we set up the appropriate boundaries, etc. It will be easier knowing what to expect this time.

  50. Sonya says:

    Thank you for posting this article.

    I recently went back to my first therapist who I was very attached to and the feelings of being attached is the hardest part of therapy. Because I was so attached before I dreaded going back to therapy as I find it to be extremely painful. Hopefully I will come out the other side sooner than later.

    There is an end in sight when it comes to attachment – right?

    • Joseph Burgo, Ph.D. says:

      Yes, there is. The point is to become dependent long enough to get what you need and then to move towards independence. Which isn’t to say that you won’t miss your therapist when it’s over.

  51. Kennedy says:

    I read this article, (and linked my therapist) and asked my therapist specifically about her opinion on love within the therapeutic relationship- if she ever reached that point with her clients in her practice.

    Her response was, “I don’t feel like talking about my clients or how I feel about them.”

    This answer kind of threw me off. Was I out of line for asking the question?

    • Joseph Burgo, Ph.D. says:

      You’re never out of line in asking a question, but it sounds as if your therapist felt it wouldn’t be helpful to answer it. She might have felt it would be confusing, or maybe she felt it wasn’t the right time in your therapy to address that issue.

  52. joyce says:

    I am just beginning to acknowledge the realtionship that I have with my therapist. Two of them actually. For months I would fall apart after a session not understanding why. I now understand that I am experiencing such fear about the closeness we have. It is a very boundaried relationship but very deep nontheless. Much like the one I did not get as a child. Feels a lot like I have found a missing piece of myself. Safety, love and acceptance. It is so scary to be so vulnerale but so healing.

    • Joseph Burgo, Ph.D. says:

      I’ve heard so many awful stories, it’s nice to hear about a positive (albeit scary) attachment relationship with your therapist. Courage! It’s worth hanging in there.

  53. Emily says:

    I feel like I can’t stay in therapy because of my intense bond with my therapist. I always want more from her. I think that my therapist has tried to be generous but I never feel like it is enough. I have seen her for 5 years and feel like I have gotten a lot out of our work but I don’t know if I can continue to feel so unfulfilled. I constantly find myself having trouble separating at the end of sessions, I think about her constantly, and wish we had more of a “real” relationship. Do you think that there is a way for me to feel more comfortable & satisfied in the therapy relationship? At times I have felt like I am “in love” with her which is strange since I am married. I do not currently feel that I am in love with her but maybe too deeply moved by her having a presence in my life. Any thoughts would be appreciated.

    • Joseph Burgo, Ph.D. says:

      Do you talk about these feelings with your therapist? I would think it would need to be worked through in the “transference” since it should be a focus of the work, rather than an uncomfortable by-product.

  54. Emily says:

    I have talked about feeling too attached to her and that I have trouble separating at the end of the session. Since I have been seeing her for 5 years it seems striking to me that I have not mastered this yet. She said this was interesting. What direction could I go in from here?

    • Joseph Burgo, Ph.D. says:

      Keep talking about it. It’s up to your therapist to understand and help you deal with those feelings.

  55. Sara says:

    My therapist recently dumped me.
    I asked him periodically if he wanted me to continue being his client and he reassured me that he did every time.
    He often said, “I don’t feel effective” or “I wasn’t trained for this” and similar things that made me feel he didn’t want to continue with my therapy.

    I wanted him to love me like a baby wants her parents’ love.
    Because he didn’t love me I criticized him, was cold, rejecting (just basically a lot of fun to be around).
    He kept telling me that I didn’t allow him to be caring, and that my criticizing made him stay in ‘a safe place’.
    Two weeks ago I told him that I had felt like ending therapy the previous week, but I had changed my mind.
    He said, “You want to end therapy?” and he started ending it, he recommended next steps, offered a referral, summarized our work…
    I was confused, but went along because I slipped back into the negative feeling about therapy that I had been in the week before.
    Later, at home, I was so unnerved by that sudden ending that I texted him (which is how we communicated about scheduling).
    I said in the text…”That was disorienting. I didn’t mean to end therapy, but when I mentioned I had felt like it the week before, YOU started ending it. I had no plans to end my therapy.”
    He didn’t reply.
    I knew by the lack of a reply that he wanted me gone.
    I was shocked by that realization. I cried like a baby.
    I called him, crying, and he coldly quoted me from that last session, “I felt like leaving therapy…” and said that to him that meant I wanted therapy to end.
    I was shocked by how cold he sounded, and how unaffected he was by my obvious distress.
    He told me he would refer me to someone “better suited to where you are now” and would agree to 3 more sessions with me in order to end gradually.
    I said, “I don’t want to end my therapy! Do you want to end it?”
    He was silent and then said, “I don’t know.”
    I knew he just didn’t want to say yes at that moment.
    He also informed me that he had scheduled something else during my appointment time that week (that’s how quickly he had written me off-this was just two days after my previous session) and couldn’t see me until the following week.
    I told him that I felt traumatized and abandoned.
    He said he understood that, but unfortunately he couldn’t see me until next week.
    After we hung up, I realizd that in my vulnerable, heart-broken state, I couldn’t sit across from a therapist who had turned hard and cold towards me.
    I texted him that I was not going to see him again for those reasons, and I never heard fom hm again.
    I understand that I was a cold, hard bitch towards him, and he just couldn’t take it anymore.
    But I’m very, very sad, angry and disappointed.

    • Joseph Burgo, Ph.D. says:

      If you were, in fact, a “cold, hard bitch,” it was his job to understand the reasons why and to help you. I understand how awful you feel, but you’re better off shifting to someone who knows how to work with you.

  56. Sara says:

    Maybe I was a semi-hard, cold bitch.
    Thank you for your quick replies to my post here and on another thread.
    They are very much appreciated.
    It’s really nice when someone reaches a hand out.

  57. Lou says:

    Thanks for your interesting site. I have Borderline Personality Disorder and I have been trying to get help from various therapists over the last two years, but I find I get very attached and then the relationship turns toxic and I end it. In my last attempt, I have been seeing an analyst who allowed me to become very dependent on him – seeing him 2-3 times a week and emailing and calling him whenever I needed, which quickly became every day. As I grew closer over a six month period, the attachment feelings became so unbearable that I increasingly engaged in serious destructive behaviours to signal my distress. He never seemed to know what to do with this behaviour except to “be there” for me. I appreciate this and am grateful to him for many things, but ultimately I feel that he doesn’t understand me and is only making my symptoms worse. I have recently ended it, but after reading your article on the corrective emotional experience, I am again confused about the value of this relationship. I guess my questions are: can the relationship be damaging if the therapist is not attuned to the client and doesn’t have the skills, and can dependency without clear boundaries be damaging also? Or are these things outweighed by the mere fact that another human being is willing to journey with me to resolve the chaos, rage and shame?

    • Joseph Burgo, Ph.D. says:

      If you find someone who is “willing to journey with [you into] the chaos, rage and shame,” that’s worth an awful lot. Most therapists don’t want to go anywhere near those feelings. On the other hand, if you don’t feel understood or if you sense he has poor boundaries, that’s worth paying attention to. Maybe you should discuss your concerns with him and see what he has to say.

      • Lou says:

        Thanks for your reply, Joseph. Much appreciated. I have decided for the moment to accept that these feelings of shame and rage exist within me and to deal with them as they arise in the course of my life, rather than igniting them every time I walk into a therapist’s office.I find it so stressful that I can’t function properly. I am also disheartened by the many many stories I hear of people being painfully attached to their therapists for years and without respite. It seems like a kind of torture to me!

        But I do appreciate the work you all do – its truly amazing and valuable. And thanks again for your website and forum – its really helpful.

  58. Emily says:

    I spoke to my therapist about having a crush on her and she said, “thanks for sharing.” she also said it was up to me if I wanted to talk about it more. I asked her if she had any other thoughts and she said she didnt have anything intelligent to say right now. Any suggestions?

    • Joseph Burgo, Ph.D. says:

      “Thank you for sharing” … are you kidding me? Sometimes therapists can sound like such parodies of themselves.

      I don’t think your therapist has the skills to help you navigate those feelings.

      • Emily says:

        Thanks. I really appreciate your response and your entire website. This is such a strange situation since I had invested a lot in this therapist and have seen her for 5 years. I have been in therapy with other therapist for about that long. I was really hoping that she would be my last therapist. I thought I might see her for another couple of years and finish once and for all. Instead of being so freaked out by my admission of the “crush” I wish she had said, “wow. We have a lot of material to work with… Let’s figure out what this is about… Let’s get to work.”. I also feel a little dissapointed in myself for not realizing that she could do significant, rich work with me. Ok, making myself feel bad about this doesn’t help… Again thank you so much for creating such an amazing, open space on your website to discuss these issues.

  59. Annie says:

    I can’t begin to tell you how helpful this article is for me. It makes sense of so much of what I’m going through it helps to know that my experience is ‘normal and helps me appreciate how good my therapist is in offering a loving healing relationship.

  60. Susan M says:

    Dr. Joe, thank you so much for this article! I have had several different therapists through the years and have suffered severe abuse and abandonment by a couple, but finally decided to consult with a PHD and am so glad I did! My current therapist of 3 years has been very empathic but with good professional boundaries at the same time. I have come through feeling completely untrusting of professionals to finally feeling safety, trust, and even love, the unconditional kind I have never experienced before! I applaud you and your profession for the hard work you do and for giving me a ‘life’ back, one I thought I would never experience.

    • Joseph Burgo, Ph.D. says:

      Susan, I’m glad you mentioned “good professional boundaries” — being empathic doesn’t mean the therapist can’t maintain boundaries and a certain professional demeanor. I’m so glad it worked out for you!

  61. Nina says:

    Dear Dr. Burgo,
    You wrote “And over time, we will come to love each other.” There is nothing quite like therapy love. My Doc is professional with strict boundaries which I respect, though I wouldn’t mind if she’d bend them a little;) I have expressed my love for her in many ways over the years, and once, or perhaps I was dreaming or hallucinating, she actually said the words “I love you.” That was quite a while ago & to this day, although I know she really said it, I feel like it was a dream. Like I said Doc is professional, not all loosey goosey or flighty, and she would never say those words lightly.
    OK, now that I’m mentioning it,I think I need to work on our therapy together in between sessions more, as she works so hard for me. Anyhow, I know you understand all of this. Thank you.

  62. Steven says:

    Hello Joseph, I really liked your post and the way in which you emphasize the healing power of the client-therapist relationship. I think that has something to do with affirmation therapy, but I am not that sure. I want to know if you could tell me your opinion about how my therapy process is going. My general problems are that :I suffer from social anxiety, and have a lot of anger towards my father. I always feel he is kind of like my worst enemy, a danger to my safety, and like if he was constantly against me and attacking me.
    My question is that: after 4 months of therapy I feel worse than ever. My therapy consist in talking about my problems in group sessions (talking cure sort of thing). The problem is that many of the people I have therapy with, were people with whom I fought in the past, so I dont really feel the trust to become vulnerable and talk about things with feelings attach to them.
    I feel that this circumstances have caused me to repress or hide all the anger I have towards my father. I think this may be the cause why I started to have—for the first time— panic attack while talking with other people. I have also developed depersonalization and derealization symptoms which I also link with the repressed anger. I feel very false around people, false emotions, and like if everything was forced.
    Do you think I should continue with this therapy?
    thanks for all

    • Joseph Burgo, Ph.D. says:

      Steven,

      Based on what you tell me, it doesn’t sound as if the group situation is conducive to the work you need to be doing. If you don’t feel safe with the other group members, because of your history, how can you make yourself vulnerable enough to explore your anger? It sounds like some one-on-one work might suit you better.

  63. Ahna says:

    My therapist has discussed this very same concept of love with me. We have been working together for about three years and I had finally gotten available enough in the relationship and open to any sort of closeness at all. That is the time when this conversation came up, while we discussed the visible differences in our relationship now, compared to earlier… my changing relational patterns, etc. It helped solidify our bond for me… moving me along from feeling objectified (as I have in my life and as a “patient” or “client”) to feeling equal on a deeply human level. My greatest fear when I started therapy was accepting any sort of connection (either in giving or receiving) but I was committed to ‘fixing myself’… sometimes getting myself to session was like dragging a screaming toddler to bed when they weren’t tired yet and their favorite show was on but I have showed up to almost every single scheduled session (my poor therapist!). Talking about love in the context of our relationship punctuated the process as if to say “we’re here”… and it hasn’t been so bad and I’m glad not to be afraid anymore. It’s taken our work from a primarily relational level to work on things that require the level of trust we have now to work on. So… so so SO thankful there are other therapists just as “open” to talking about what is natural… I don’t know how I could see someone so regularly – even people in my community I pass, or friends, etc – and not hold them in my heart. Thanks for posting this I hope other therapists will be less afraid to admit love – I think the hardest part really is also understanding the context a client views love, I know I have similar views to love as my therapist but I think depending on someone’s definition it may mean something else maybe that is why it makes it scary to say. Anyway, sorry… verbose…

    • Joseph Burgo, Ph.D. says:

      Not at all verbose. And thanks for chiming in. It’s always nice to hear a “good” therapy story when there are so many bad ones out there.

    • Lisa says:

      Thank you for posting such an honest response! It sounds like you have truly done the tough work and have come out on top….I am sure the road was not easy! Although I have been in therapy for many years, I feel that I have not let down my guard (even in therapy) and, I believe, my therapist is being patient and allowing me to move forward at my own pace. As I read your response, I realize it is time for me to to open up, put myself in a vulnerable situation so that I can grow and develop more meaningful relationships in my life. Reading what you wrote made me understand that until I open up and allow myself to be seen I will never have a truly honest relationship…..including with my therapist!
      And I thank you for that and to Dr. Joe for providing such a wonderful and very helpful forum,
      Lisa

  64. Ruth says:

    I have regularly read most of your posts for over a year now, and get value from the things you have to say, thank you! I decided to write today, because I am hitting a wall, and trying to understand. I am in a difficult situation. The church I started attending is very much against psychology and analysis. Although I accept that is there opinion, I am finding myself breaking my attachment with my wonderful analyst with little effort because the power of influence the church has is very strong in me, and is automatic. I am going through a horrendous divorce and the church community is helping me with the transition in some powerful ways. I now feel like I am in a catch 22….if my church knew I was in an analysis, I am afraid they would cut me off, and right now, their support is getting me through. ON the other hand, my analyst has stood by me through thick and thin for over 3 years now. Any suggestions?

    • Joseph Burgo, Ph.D. says:

      How genuine is that support if you feel they would cut you off if they knew? It feels like conditional love — you can only have it if you conform to what they expect of you. I’d stick with my analyst and find a more open-minded church community.

      • Ruth says:

        thank you….very kind of you to reply. Being authentic is very important to me….sometimes that is what costs relationships, other times it is the point of growth, where we can agree to disagree and still love each other. I just don’t want to loose either….awww life!

  65. Lulu says:

    I am finding your posts extremely interesting and very useful in my own therapy. I have just bought your book and am looking forward to catching up on your discussion forum as you go through the chapters. I have a strong attachment to my therapist and we have recently started to explore this. I suffered abuse as a child and could rationalise my attachment to my therapist. He’s the one stable focus in my life, always there to listen, never lets me down, doesn’t judge me and so on and yet this rationalisation wasn’t enough. I’ve found the feelings of attachment very painful, but through his amazing presence, intimacy and love I’m starting to really feel and be present with that understanding and this has been far more powerful than having a cognitive understanding of my attachment. I feel a deep intimacy with my therapist and he says he feels the same. This intimacy has felt a risk at times, but being able to speak about this in our sessions and keep defining the boundaries has been important and although I’ve felt deep pain, I feel the intimacy and attachment is an important step in my healing. He has shared his feelings and his experiences with me and I find this far more natural and human and this honest openness has made me feel more comfortable in therapy. I wonder what your thoughts are on intimacy in therapy between client and therapist? It seems to be a controversial area with some saying that there can’t be intimacy as it upsets the balance of power and any intimacy that is felt must be an illusion … however, when my therapist shows his vulnerability and honesty, our connection grows and that seems to be when our real healing work is done. We seem to then be able to gently go so much deeper to uncover the core of my difficulties and then I feel more grounded to resurface to deal with the day to day strong emotions that arise from my traumatic past. I guess, like my therapist has done, it’s important to tread carefully through such areas, particularly when I’ve had strong emotions arise in therapy sessions around issues such as self harm. I feel privileged to have such an connection with my therapist and he has often told me that he feels the same.

    • Joseph Burgo, Ph.D. says:

      “Intimacy” can mean so many things. After a time, I usually feel an intimate connection with a client but that doesn’t mean it’s a reciprocal relationship where I share my feelings and difficulties. I don’t like the idea of a “balance of power,” but I do think we have to respect boundaries and keep our attention focused on the client’s needs and feelings.

  66. Joan Marie says:

    I really liked your post, came across your site by accident. I do believe my therapist and I have had that strong bond between us, that “love”, but I feel he does not “love or need” me as much now, but I still need him in the same way. I think he has come to terms with his feelings, he got attached and now has pulled back and everything is sort of back to normal. How to cope with this? I’m rather devastated. I have talked to him but says he doesn’t see any difference in his actions than before. That’s true, but the FEELING is different.

  67. Erica says:

    I feel very emotionally attached to my therapist. I find myself thinking about her a lot and Im unsure what to do. I wasn’t neglected as a baby by my mother. I have felt this way towards many people. I don’t really want to bring it up to my therapist because Im afraid it will change our relationship. I’m only 17 and I do have friends and a mother who is in my life. I just feel like I want her to be part of my life and not just my therapist.

  68. liskam says:

    I have enjoyed reading the comments and your advice- but one concern I have. As I grow older
    (I am there already) is there a time when one has to leave therapy even though one has much
    more to wor.k on and a deep admiration for their therapist? My disorder will never make me
    what he wants me to be but is it time to cut the cord.? I too have given my doctor little cards etc and I really appreciate his kindness-but…..

    • Joseph Burgo, Ph.D. says:

      I look at it as a cost-benefit analysis, rather than a “should.” If you feel you’re still getting something out of the work, that it’s worth the money you pay, then why not keep going?

  69. NS says:

    Thank you for such an insightful and beautiful post. From experience it takes tremendous courage to admit loving feelings for a therapist (which I have only done recently after many years of treatment) but it is even more extraordinary for them to be reciprocated by someone who knows you better than anyone else. For me it has brought about deep inner change and healing and immense gratitude for having the therapist I have.

  70. Christina says:

    I been seeing my therapist for 4 years. I feel like she has helped me but I bored seeing her every week. I basically tell her about my week and she listens is very nice then an hour later she says, “see you next week”. Let me give you a little back ground about myself… I was diagnosed with post-trauma stress disorder. My parents abused me and other children when i was little and as long as I remember I been depressed and full of anxiety. I have made some big steps in recovery of self acceptance but I’m ready to take it to the next step I am now forty and I want to finally live life after all these depressing years. I want help on how to achieve my goals and simply be happy but for the last year I feel like my therapist is my old ball and chain. What should I do?

  71. Cat says:

    My therapist said, “This is not a love relationship,” in response to my question whether therapists can say that they love their patients. It broke my heart.

    • emily says:

      That seems like a really harsh response. I am so sorry to hear that. Did your therapist explain their response?

      • Cat says:

        She gave the impression that it is beyond the boundaries of acceptable responses for a therapist.
        Thanks for your comment.

        • Emily says:

          Hopefully she would choose to rephrase this if they had the opportunity. I’ve been on sides of the fence- receiving and providing therapy. There is no shortage of unusual moments on either side. I think what really matters is what you feel their general intentions are and where you guys are able to go with the feelings that have come up. It really isn’t easy but hopefully something valuable can come of it.

          • Cat says:

            My therapist said that she was, “reparenting me,”
            so I was confused by her initial comment. Unfortunately, this feels like a repetition of my past to me. More “grist for the mill” as they say.

  72. Carley says:

    I’ve been seeing a therapist for two years. Lately I told her I didn’t trust her. she said she was aware of that. Now I feel a dependency on her. I don’t even want to go back. I don’t see how this can be good thing. Most of the time I get angry at her and once she told me to leave but that she wasn’t telling me not to come back. How do I bring up these feelings I have for her?

    • Joseph Burgo, Ph.D. says:

      Be brave. I know it’s hard, and you just have to trust that it will lead to something better. Keeping those feelings a secret certainly won’t help.

  73. JJones says:

    Hi, just before Christmas I cried like a baby for my therapist, my ‘good mother’ but by the time January rolled around I felt differently. Over the past 12 months I have found a lot of useful books and forums to help myself and now my therapist is quite sarcastic about them I’m not sure of myself anymore. Last week she asked me to go for coffee and I said no I didn’t have time. I can see the relationship is kind of competitive now, anything I find she has found one better. I read your blog on transference and I think the relationship is along the lines of codependency because that’s what I bring to the table. I had decided it must be me because the relationship is a lot like those I have with friends and family now. So…not sure what to do next really…

    • Joseph Burgo, Ph.D. says:

      It’s inappropriate for your therapist to ask you out to coffee. I’d give some thought to finding another one.

  74. Sam says:

    Hey there,

    I really love your article for many reasons but one in particular…the honesty despite feeling vulnerable in revealing what you did about your own experience. I have developed an intense attachment to my therapist too and it has never really concerned because I knew it was ‘normal’ but recently I’ve started to get a little scared.

    One of the many issues I’ve been trying to work through is what I have called my ‘relationship malfunction’ which is something I still don’t understand fully. Work in progress. But I am convinced (although I don’t think my therapist is) that most of my relationship failures are my fault. I often think of the lyrics from the NIN song “Hurt” in trying to describe it. I have confessed to him that I no longer trust how I feel because it changes so suddenly and without an apparent good reason. It’s always an extreme shift that sees me being totally in love with the boyfriend I’m living with at the time to suddenly wanting out. All I want to do is cut and run and that’s always what I do. That lead me to my recent confession to him that I felt like ours was the only relationship in my life that I can’t break.

    Unfortunately since then my attachmentto him (I suppose understandably) grew stronger and much more intense. Since then I’ve been trying find reasons to contact him. I have no sessions booked because I’m currently unemployed so I’m in the process of trying get back into therapy. This lack of access though, has been driving me nuts (so to speak)! Hence the constant need to try and contact him. He doesn’t respond immediately to a lot of these (mainly emails) and I assume this is because he’s trying to maintain the boundaries but I’ve started feel a little paranoid now. I’m afraid that I might have been wrong and that maybe I can actually break this relationship too. And if I can break it I will. So I’m trying to back off. I have stated in one of my communications with him that I believe attachment can be a useful tool in therapy and would like to explore that with him but I really need to wait until I am actually back in his consulting room so we can explore in the appropriate time and manner.

    It’s just really frustrating though because I don’t have any other outlet for this attachment addiction or need. As a result I’ve been really up and down. One day feeling quite positive about the whole experience as an opportunity for me to learn and understand better. Then the next day I feel completely lost and hopeless.

    I don’t have a question for you really. Just wanted to add my two cents. Mainly though, I wanted to thank you for your honesty in what you’ve confessed as a therapist. It has provided a temporary satisfaction in my curiosity in what this whole experience must be like for my therapist. I do have a keen interest in what it must be like to do what you do for a living and psychotherapists cope personally cope and experience the therapy relationship.

  75. Carina says:

    Hi, I have had years of counselling due to depression and aspergers. In fact my mother is a counsellor. I recently moved so started seeing a new psychologist during a rough patch. In what i’ve decided will be the last session, I told her I was off my medication and things had been going well. She then told me I probably never needed to be on medication and I probably didn’t need any more sessions. I felt like she dismissed how much I struggle often. I also asked her an opinion on a family difficulty and she cut me off while I was speaking a number of times and said things like it doesn’t work like that, or you’re making an assumption, without asking me to explain my thoughts. I left feeling much less emotionally secure than when I went in. I have since been wondering if she thought I was just stupid for feeling the way I do. Was she using a constructive technique or was this just destructive?

  76. Diane Carr says:

    Wow, thank you for this post. I too encountered such a rich relationship with a therapist. It wasn’t her style of therapy, but it was evidently mine, and I essentially drug her into it. Her willingness to learn as we journeyed essentially saved my life. For 5 years she was that surrogate parent I had not bonded with. While I am not perfect, either, I now teach many young people and in little ways each day offer what she once gave me. I care within the boundaries of my position.

    As a youth I was abused by a pastor, and then another. I imagine bonding issues often paint targets on people who predators then seek out. It was for this issue that I sought therapy – only to discover the deeper bonding issue. It was harder to acknowledge the damage from something I didn’t get than from something that happened to me. Yet, the lack of bonding had to be healed in order to find healing for the other.

    I am no longer need professional therapy – though I will always remain open to returning if the need arises. The fact that you spent 14 years on the couch yourself, is in itself nice to hear. I tended to put a lot of pressure on myself to finish the process and it wasn’t something that could be fixed in a quick way.

    I hope others struggling right now with these issues will find encouragement to put the one foot out that is required this day.

    Diane Carr

    • Joseph Burgo, Ph.D. says:

      ” I imagine bonding issues often paint targets on people who predators then seek out. It was for this issue that I sought therapy.”

      What is so awful about predators is their ability to identify and exploit people who have such issues. I try to keep an open mind and not judge most people, but the ruthless, amoral quality of the sexual predator fills me with loathing and contempt.

      • Diane Carr says:

        I confronted him 5 years ago, 30 or so years after the abuse. I had reported him about 5 years prior to that but had not received a very satisfying response as to what he had said when confronted. I knew he had admitted it – which I was grateful for – but while he was read my full statement, I was told nothing else of what he said. To move on I needed to hear it. I met with him, his son-in-law, also a pastor, and my pastor.

        By that time I had healed enough to respond rather than react to what he said. It was quite fascinating to watch him in action.

        His memories were not mine and he saw no reason to consider that mine might be valid. He “remembered” that our sexual relationship grew out of a close friendship while the truth is that the day after I met him, he kissed me. When I spoke the truth, he replied that those were not his memories – as if that changed reality. It was interesting to see his ability to completely deny and wipe away reality.

        Not pretending to be a professional, I believe he pretty well fits the definition of a sociopath. He was obviously a very sick man. He seemed to want to be sorry for what he did (probably brought on by the fact that his wife, daughter, son-in-law and church leaders knew about it) but kept offering limp defenses that only he could have believed were valid. (Hey, I like that “limp” word….LOL) Things like, “Diane, what you need to understand is that I did not see you as a child” or later ” as a parishioner”. It was very evident how sick he was and this was after years of therapy on his part.

        He had a very rough childhood and I am sure that accounts for much of his sickness. I can’t help but think he would have been a very different man had his early life written a different story. That doesn’t undo what he did by any means but it has allowed me to see him differently.

        Now on the other hand, the second pastor who I went to with the shame of the first relationship – he took 2 weeks to begin a sexual pursuit of me – that betrayal came out of relationship and he was not the sick sociopath. His evilness was cloaked a lot more. This has been much harder to work through. I accepted the lie that something was horribly wrong with me, after all this had happened to me twice, and it took a LOT of work to walk away from that lie and replace it with truth. “I make mistakes but I am not a mistake!”

        It is odd how only recently have I seen the betrayal of that second pastor clearly. My mind only lets me clearly register things as I am ready. Otherwise feelings often remain in a foggy state – I could state the betrayal in words but not feel it in the entirety of its hideousness.

        I am grateful that so many others in life have not betrayed me but stood by me and walked with me and supported my journey to healing – including my husband. I don’t want to just give the bad guys the attention!

        For me, facing the pain and fear within the healing process was worth it – but it was by far the hardest thing I have ever done. It was sort of like cancer. Chemo is hell but the other choice is sure death.

        Maybe knowing I made it through it will help someone else.

  77. maya says:

    thank you for this post… i was afraid of “love” in therapy- it is such a taboo… you have to wonder why “love” scares us so much… perhaps it is insecurity and a desire for control and safety. i think as a profession we have become so risk averse that we are at risk of losing what makes us healers… i am grateful that there are therapists who have not lost sight of love. i read a brilliant book on this topic- called the “Love Cure- Therapy Erotic and Sexual” by John Haule… it is a Jungian based book and is excellent in exploring Eros in therapy. He specifies that Eros is more than sexuality- that love is the soul element of therapy and is a necessity. (partial disclaimer: there is one chapter at the end that i did not agree with- where the author suggests that in rare occasions after much deliberation it could be “ok” to carry out a sexual relationship).

    Here’s a bit from the book on the push and pull of transference love, dependence and the fight against it, and the desire for merger/attachment:
    “This is the work the Greeks ascribed to as Eros- the bringer of Union. He infects us to the core of our being, transforming us into a single pole of a dyad that yearns to trade its duality for a luminous oneness in which all meaning and vitality seem to dwell. But in the midst of the immense draw a dissent rings out. Deep in our conservative and habitual sense of being, our own unique selves. We rebel against this union.”

  78. Elise says:

    This was very interesting and helpful to me – thank you. It describes me and my therapeutic relationship quite well, but stops short of what I’m trying to deal with now: how do you end that relationship? Or, more specifically, how do you know when maintaining that attachment is the only reason you are still going to therapy? I want to stay in therapy if I can continue to ‘get better’; I don’t want to stay just to ‘have someone’. I always hoped that what I experienced in the therapeutic relationship (trust, safety, openness, etc.) could be generalized to relationships outside therapy, but that hasn’t happened. And, may not – I know that. So, I’m afraid of a) staying for the wrong reason, and b) what losing it will do to me. Very, very confused…

    • Joseph Burgo, Ph.D. says:

      I think it’s a difficult choice. There’s a kind of trust, safety and openness that you experience nowhere but in therapy (except maybe if you’re lucky enough to have good, reliable parents). Ending that relationship involves grieving the loss of that closeness. I would think your therapist would help you to face those feelings and come to a decision.

      • Vinny says:

        Loved the article. I had a therapist that you describe and similiar issues, neglected childhood, abandonement issues, depression, etc. Saw her close to 400 times over 4 years. The closeness for me ( female, close to 50) was something I never felt before. She was very professional, caring, ethical, insightful. I knew not much about her life: trivial things like she had 2 dogs, was getting a PhD, had many pairs of shoes, the make of her car, her date of birth. However, in march of this year, she told me she was taking a job at another clinic and we would have 3 more sessions to terminate. I asked if I could continue to see her . She said no, it would not be possible. I was so blown away at this I think I actually stopped hearing. I felt hurt, betrayed, abandoned, misunderstood,embarrassed for what i had shared and said . My demeanor was unpleasant, yes, angry. I gave it the juvenile, “you said I could trust you and you are leaving me, what a joke, (all the sarcasm I could muster up.) However, I did not use any bad language, call her names, or even raise my voice. I was terrified and my behavior was unlike me. I could see she was boiling and she quickly said our time is up. Knowing her for so long, and myself, I didn’t want to leave it like that. It was a friday and i didn’t want to ruminate about it during a weekend. I waited until her next seession was over as I knew it was her last for the day. She refused to talk to me and said she was done for the weekend and would see me next week. I felt sick the enitre week. The next visit I started, ( as I always had to speak first) and said how upset I was about her leaving and I only got so mad beacuse i was/am terrified at the thought of losing her. That it ws like a reflex and if I said anything disrespectful, I did not mean it personally. She told me that ” I had vommitted on her, she was not going to take that, and that there was going to be consequences for my behavior, and my verbal assault was very unattractive. ” She added that she had aleady turned down other job offers to continue with me, and she had devoted so much time and effort into me and I was ungrateful. Wow, she had explained tranference over the years to me over and over and now, she was unable to take my reaction to her leaving, professionally. I was devastated and did not want to return, but I did not want it left unresloved either. We had done so much good work together and I had learned so much from her the thought of it ending like that was too much to bear. In addtiotn I had lost my father in January, an anxiety provoking fear for several years, that was one of the reasons I sought out therapy. The next 3 visits she was cold and distant. I knew her facial expressions and body language as I am sure she knew mine from all the sessions we had. She was still angry, flat expression, arms folded. She had from the begining of our sesssion told me that what happens in the therapeutic setting happens out in the world, but this setting was safe. On the last visit, I gave her a card, which she said she would read later. I put a note inside. I gave her a gift. A lanyard I made out of gimp in the colors of the flag or her country of origin. I attached a keyring with a silver plate I had engraved with her name, with PhD after it, the name of her Unuversity, and date. She attained the degree during the time of our work, eventhough she had been counseling for over 2o years.
        She looked at it, put it back in the box and said ” Why are you torturing yourself ? “. Was I suppose to answer that? The session was ending and she had said nothing. I asked if she had anything to say to me. She said, “like what ” . I said, “If i have to tell you what to say after all the time we spent in here together, then maybe I should go now.” She said she thought I had worked very hard, and that I had alot to offer. Then I asked if I could ever see or speak to her again. She said she did not know “because she did not have a crystal ball.” She told me she made her referral recommendations for me to the clinic director. I could hardly breathe at this point so I said I guess that’s it then. She said “it’s been real”. I wanted to shake her hand , but she said she does not shake hands.
        I said ” take care doc” and walked out. I heard her say, “You too Doc” as I am a doctor myself, but she had always called me by my first name. Needless to say I am about as devasted as I ever have been in my life and I have no idea what the hell happened. Yes, having poured my guts out, only to have her behave that way to me and end it that way has been traumatic. I have not been myself since the last session. I am sorry I ever went to therapy. The sick part is, I miss her or maybe I miss the idea of her and having what i thought was a safe place to talk. If I had to guess, I think with time since that last session, maybe she realizes her inability to tolerate my anger, or maybe she has not thought about it at all. I just don’t know and feel sick to my stomach.

        • Joseph Burgo says:

          This account makes me really angry. Any therapist who works with a client for two years and gives 3 weeks notice of termination is not only unprofessional but deeply insensitive. I can’t argue with the benefit you feel that you received, but in the long run, you’ll be better off working with someone else.

          • Vinny says:

            Thank you for the reply Doc,
            That’s what is perplexing. She was never insensitive, always listened carefully, gave me so much insight,always made up an appointment if she had to cancel, went way out of her way to see me 2 times a week at this clinic, because they don’t do that with the patient load they have. Always returned my calls quickly, although I only called maybe twice.
            I worked with her 4 years, not 2, the first 2 years was 2 times per week. Almost 400 sessions.It was not the 3 sessions notice for termination that hurts so badly, although that would have been bad enough,
            it was the way she conducted herself during them. It was like she knew me 5 minutes.I had known when she completed her PhD she would be leaving, but that was suppose tobe July of 2013. I assumed, probably a mistake on my part, that she would never end it coldly, abruptly or unkindly nor choose to never see or speak to me again, chewing me out, not speaking to me after I waited for her to apologize for my demeanor.What did I do wrong. ? Was my reaction to her leaving so unacceptable.???? I am the patient, she is the doctor. If I could conduct myself calmly and rationally, at the sudden news of someone I care for very deeply leaving me, I would not NEED TO BE IN COUNSELING !
            She knew that, she knew that…she knew all of it. So how do I get passed this. ? It took so long to trust her…and look at the outcome.
            I am absolutely devastated.

  79. Snow says:

    Hi there J.B., I know submitting yourself to the therapeutic process and alliance is what enables healing and growth. However, there are times, like right now, where I feel so hurt and mad at my therapist for using what she knows about me as a tool in therapy. Everything was going well, and then out of no where she became very clinical, analytical, and separate from me. I am so upset that she chose this tactic rather than just talking with me about whatever it is she felt needed to be evaluated, measured, tested………………………………….I cancelled my following session and have not rescheduled because I don’t know if I want to experience that again. I think it has happened before, I guess this time I just don’t want to, actually. I don’t know what I think. Would you mind sharing some of your thoughts?
    Much appreciated,
    Snow

    • Joseph Burgo, Ph.D. says:

      I think continuity is very important in psychotherapy. Rather than cancelling when your therapist says something that angers you, it’s important to maintain the relationship and bring your anger to her. As in all relationships, you can’t simply break it off whenever the other person does something you don’t like, not if you want to sustain that relationship.

      • Snow says:

        Hi, thank you of responding. I understand. I know what I should do but, right now I just want to take an angry hiatus from it all.
        Many thanks,
        Snow

      • Snow says:

        Hi
        J.B., I again come to you because I don’t know “how to”. My therapist inadvertently shared with me that she counsels people who I am not a fan of. I can’t find it in myself to return to her office nor sit on the same couch as these people. My skin crawls and I can’t breathe. I don’t want to not work with her because she has helped me, yet I can’t, I physically can’t be in her office. I haven’t returned since the disclosure, canceled my next appointment and have yet to reschedule. Just thinking about returning makes me start to feel panicky. What do I do? How do I overcome this? I am not at a place where I am able to forgive. How can I forgive her and not begin to forgive another? what do people do when they become aware of their therapist also treats ……….? how does attachment theory work in this situation? that first attachment wasn’t secure nor healthy. How now can this attachment with my therapist begin to recreate what should have been?

        • Joseph Burgo says:

          This is more than I can address is a reply to your comment.

          • Snow says:

            Hi, I understand. It is more than I can bear too.
            Snow

          • Snow says:

            Hi J.B., close to five months ago I found a new therapist to actually explore real attachment with. I find it interesting and incredibly scary to have such a therapist. I had my first ever “I Thou” moment during a session last month. That experience awoke some feelings and desires I had ignored, denied existed and avoided. I am now experiencing the ups and downs of avoidant ambivalent insecure attachment. My question to you is, can I just relax into my therapy and be insecure? I feel incredibly needy for wanting this. I don’t want to pretend anymore, I want to be my true self with no shame.

            Again, thank you for any guidance and enlightenment you can share with me.

            Snow aka Miriam

            • Joseph Burgo says:

              Hi Miriam,

              I’m not sure how to answer that question. I think it won’t be a matter of “just” relaxing into your therapy but will be a back and forth process over time, testing the water, retreating in fear. It takes time to build up trust.

  80. Gracie says:

    I was hospitalized for the first time ever last fall. My plan had been to take time off work and go to the beach, but my therapist recommended a specific 6-8 week in-patient program across the country featuring milieu therapy, many educational classes, intensive psychodynamic therapy, psychological testing, group therapy, etc. When I received my test results, they included my attachment style (a mix of ambivalent and fearful) and I read some materials we’d all been given about attachment, how insecure attachment styles impact other relationships in life, etc. It was frightening and devastating, and I asked my really superb individual therapist to help me understand what this meant for me, was I doomed to the loneliness and fear I’ve lived with for decades? His explanation tracked very closely to what you describe, above, and he explained that psychologists now know that other secure attachments can be quite healing, and that the first can be a secure attachment with a psychotherapist.

    A few weeks after I learned about attachment theory, the topic was covered in one of our “classes.” It was very hard to watch the faces of my fellow patients as they realized what must have happened in their past, and how much of their current pain had arisen (as I understand it – I may be overestimating the impact of attachment problems). I looked around the room of 20 people and saw one after another person begin to cry.

    The good thing is that learning about this theory, and the big impact the right kind of therapeutic relationship can have, could give many people the motivation to seek and stick with therapy (and to understand better why it is so important to have a therapist that you are comfortable with). Therapy had always been completely mysterious and rather frustrating to me, but now I have real goals and am working WITH my therapist to achieve them. Your articles help me to understand more about what therapy can do, what I need to put into it, and what I should expect from my therapist. I’m sure that your articles about attachment theory are helping more people than you know. Thank you for helping us.

  81. lizzie says:

    Thanks so much for this blog – I have heard a lot about attachment theory but never really understood it before. Sorry for joining in so late – I only just found your website.

    Having read some of the comments on your blogs I am even more grateful for my therapist than I already was! I feel like I have been working through a lot of the issues you mention here for the last five years, and there has been a lot of intensity along the way. He’s never shied away from anything I’ve expressed or done, however extreme, and is nothing but loving and supporting. He readily talks about feeling love and tenderness for me, and recognises that I experience that in relation to him (even though I’ve never expressed it directly).

    I have historically felt a lot of shame and guilt about my feelings of love for him and disbelieved that he could have such feelings for me. Reading your blog brought tears to my eyes – if you say that this is something that can and does happen in good therapy, then maybe it really has happened with us. Maybe we really do love each other, and maybe that is really ok.

    • Joseph Burgo says:

      Good for you! I’m glad you found such an excellent therapist and that the healing work is going so well.

  82. Margaret says:

    I can barely manage to read these powerful topics without crying .The therapist I have been seeing for a long time no longer wants to have more than weekly session. She has scheduled two sessions per week based on need , but feels and thinks strongly that i have become too dependent on her. I recognize that I have and yet cannot manage this well without having these addition sessions each week. Icontinue to request them and /or bargain for more by asking for extra sessions whenever she can,but she is now refusing. The posts have helped me feel less alone and I want to thank you.

    • Joseph Burgo says:

      You can’t force someone to become less dependent by cutting her off. Maybe you NEED to be dependent.

  83. Ruth says:

    Thank you for this blog, there is much to value in the stories and comments of others…illuminating and helpful.It has taken me 3 and a half years to finally begin to go in to the pain of being given up for adoption, and then being adopted by a paranoid schiz mother, who repeatedly threatened to return me to the children’s aid. I was then molested by my brother for 4 years. My ‘mother’ is old now, and near death, i am somewhat estranged from my parents because they believe it was my fault, as the adopted child, that my brother molested me….blood is thicker than water. I then married an extreme narcissist, who just walked after 21 years of marriage. My early strong attachment to my father, surrogate mother’s of my choosing, and my faith in God, and a very strong constitution, gave me what I needed to survive these horrors without becoming severely mentally handicapped….i am neurotic, anxious, and have some dissociation. Yet, my therapist so graciously acknowledges me when I admit feelings that drive up embarrassment and shame. He has walked with me through the monotony of my story and stood for my personal growth, being a witness to my pain, and a stand for my true self expression. He has also been less than perfect, he is a human being, who is good enough and caring enough. For these reasons I am devoted to our work, and my personal growth. I am feeling more fear approaching as I enter deeper waters with my therapist, as I tackle issues with mother, but I have confidence because of the safe space my therapist has provided that I can ‘go there’. This is as good as it gets. I know greater freedom is in my future.

  84. Kp says:

    Thanks for your words Dr. Burgo. You have really helpedme develop a great relationship withmy therapist. While it’s not alwsys easy being on the client side of transference – nothing has helped me grow faster and deeper than bringing it up with my therapistand batting it around.

    One silly little question in reading your views on hugging. Mytherapist and I never hug, but occasionally when I’ve stumbled on a new piece of insight and get very excited about it I will high five him. I think it’s because we high five a lot at work when good things happen! He has never shiec away or brought it up but now I’m second guessing myself. Insppropriate?

  85. K Wilson says:

    I’ve been reading your posts about the therapeutic relationship and would like to comment.
    I began therapy over 20 years ago with someone who insisted that he loved and cared about me from the beginning. I resisted this and regressed in the process…making an even stronger case for the therapist and his insistence that he cared greatly. He encouraged fusion by sitting with me, holding me and breathing with me…reassuring me that i would find a comfortable place in his arms. and I went a long with this because i was attracted to him…however I resisted the fusion … feeling all the more like a disturbed person because of it. Eventually, after nearly a year fusion did happen…I was attached and there was no turning back. I found my regressed hysterics fed his need to intervene and comfort and the drama continued for a very long time.
    I wanted so much to be him that i went away to grad school, got my degree and moved back to the area. (he encouraged me through the whole process on the phone in a way that was not all that helpful in making healthy social and professional connections … i.e., reinforced angry feelings distortions and isolating behaviors). NO one knew anything about me or about counseling more than my therapist. The dependency was huge and disturbed.
    I eventually ended up working in his office with him and his wife and another co-worker. I soon discovered that he had kissing affairs with women (some clients). He eventually included me in on the action and began coming to my house for lunch and make out sessions. I was completely charmed and “in love” and lost my moral compass. During one session, while lying on my bed, I opened up completely…call it hormones…but i was ready to have sex with him. He sensed this immediately and pushed me away harshly and that was the end of the “affair.” I continued to work in his office. His wife started turning off the heat when i was still in the building in the dead of winter among other things…but i was in denial. I even heard him kissing a co-worker in his office…but convinced myself that, while our kissing days were over…he still loved me.
    He was eventually sued by a young woman he was seeing for no fee. Her mother worked in the clinic and he was dependent upon her to sign off on our paper work, as she was an LCSW and we were LPC’s. The young woman was very vulnerable and had NO boundaries…I saw them together once, and it was alarming. She said he had sex with her…he, of course, insisted she was lying. I don’t think he had sex, but I do believe he was kissing her in a very sexual way (tongue in mouth for long periods of time).
    After the law suit he became distant and irritable. No longer a comfort at all. I eventually left the offices because it was increasingly more painful to be there.
    Shortly after i left i had major surgery. He called me every day while i was in the hospital to ask about how i was doing. Continuing to say “I love you.” After 25 years of hearing “i love you” i did come to believe it…even with all the issues i’ve explained…and of course, i had been professing my love for him too.
    After i returned home i invited him to come and visit me…and his voice faded away… and stopped calling altogether. I called and left a couple of messages saying he didn’t have to visit me…i knew i had asked for too much…and i was on pain pills and not thinking.
    He never returned my calls. (oh, he did make one call to tell me the locks on the office doors were changed) I was devastated. 25 years of attachment and he thought he had to change the locks? 25 years I settled for him being enough my life…never making an effort to find a partner of my own. He would say things to me like “I want to keep you for myself.”
    3 months later I got a call from him and when i asked him about the locks and his disappearance he became defensive. Said the trouble with me is I always want to get together and he doesn’t have the time or the interest.
    I realize i was a fool here…but the feelings go very deep. They are very primal…and I was confused through the whole ordeal. Dependent, confused and “in love.”
    It’s been a year since the surgery and his sudden retreat. I have nearly forgiven myself and him as well…but, seeing your remarks about the therapeutic relationship and attachment compelled me to write this story.
    I am extremely careful with my clients. I NEVER tell anyone I love them…and I NEVER encourage fusion.
    People are vulnerable and often come to therapy because they are wounded. They don’t need to be re-wounded to heal.

    • Oonagh says:

      Kay – that man is not a therapist. He is a predator. You have not had therapy. Period.
      I don’t know if I misunderstand – but it sounds like you are working with clients yourself? Have you had any professional therapy help since your 2 decade involvement with that man? IF not – you need to re-engage with a professional therapist and get some therapy. I would suggest that you seek out a therapist who specialises in borderline personality work – just because your putting up with that sexual deviant for 20 years would indicate you might be a bit cut off from your feelings, your sense of self?
      You deserve a therapy to heal from this. Working as a therapist yourself is not sufficient to heal those wounds – both the ones that led you to seek therapy and the ones you must have from engaging with this sexual deviant in the guise of therapy?
      I hope you get some help and I wish you the best with that.
      ps You could also report him to his affiliated professional organisation. He needs to be barred from the profession – he has not only betrayed you but also the profession.

  86. Diana says:

    Of all the pains to bear in life, psychological suffering seems the hardest. It is laregly invisible, very personal and deeply traumatic with repetitive experiences that can become self-generating and perpetuating. At the end of the day, we all need to be loved for who we are needy, greedy little beings who just want to be told they are ok by someone who matters to them. Our society is very good at creating psychological deficiency and very, very poor at fixing it if at all. Those with the insight and ability to heal it are truly blessed. Thank you.

  87. Bushbaby says:

    Thanks for this post. I had a har time understanding when my therapist told me that the only way to heal from pain that was caused by people is through people. I just couldnt understand why I couldnt get there all by myself without getting attached to someone; especially a therapist. Attachment= hell for me. I will do anything to distance myself from it. Sometimes Id rather endure the pain of lonliness.
    Although I havent figured out a way to let me attach to my therapist… I can say I have gotten to the point where I feel safe around her… Deep down. Thats a baby step I suppose.

  88. Blondina says:

    I am so happy to have discovered your website! It is amazing that a person that is intimately involved in emotional wellbeing and redirection can be so open about his own emotions without the fear of rejection…or should I say without showing the fear of rejection! You are truly an inspiring soul! I have read this blog from top to bottom and cannot tell you how it has helped me to recognize the possibility of transference in my work with my therapist. I am a registered nurse in a very busy cardiac ICU and have some serious stress-related depression going on right now. I have sought the help of the hospital’s employee assistance program to work through this period and have realized that most of my depression stems from the abusive relationship that I left 16 years ago and working so closely with patients has brought me to realize that sometimes I am the only person available to advocate for my patient’s safety and quality of care. Thus, my fiercely protective nature to protect the helpless ones under my care is in the very front of my psyche. Recently (the reason I sought help) I had a situation at work that caused me great concern for my patient and my concerns were not acknowledged by the rest of the team. It turns out that I, the lowly RN, was right about the situation, but I was not listened to and the patient’s condition deteriorated. This caused me such grief and so much hatred for our healthcare system that I just wanted to quit that day and worry about paying the bills later. Not wanting to completely lose control over my emotions at my colleagues, I did what I thought was the right thing to do and go to see the therapist at employee health. At first, I was unable to open up because of the shear fear that this would get back to my boss and I would be deemed unfit for clinical work and the fact that I have serious trust issues didn’t help either. So, now I am 3 months into this therapeutic? relationship and my emotions have gone from anger to suicidal depression. My situation has become worse to the point of needing medication for anxiety and depression and I have now been placed on FMLA. So, my worst fears have come true. I have become a threat to my own existence. The transference that I feel toward my therapist is one that I want to be able to tell a male how I am feeling and he doesn’t try to protect his own precious feelings by shutting me down by hitting, blaming, judging, controlling or berating me. However, I feel that this therapist is unable to recognize this transference and is unable to help me to find solace in this very safe professional relationship. I recognize that my transference deals with my history of being brutally raped, physically abused, and completely unacknowledged as an intellectual individual. During our previous session the therapist just suddenly stated that we would have to end our therapy and that he would not leave me without a therapist and that the women’s group has therapists there. A couple of sessions into my therapy he actually told me that he wanted to keep seeing me so that we could finish what we started, but now he is saying the opposite. I am hurt that he really didn’t mean what he said to begin with. I have gone to a women’s issues group to find a therapist that deals with abuse, but I have been told that they also treat perpetrators/abusers at the same location. This is not what I consider a safe environment, which is what I need to be able to completely open up without feeling vulnerable to yet more abuse. I feel so guilty for feeling hurt. It’s such a trivial thing to be hurt over. Now that the therapist has shut me down, I don’t know how to proceed in the self hatred that I’m feeling right now. Do you have any way to research therapists in my area that will do the psychodynamic therapy that you have discussed in your blogs? This is such a long post, I apologize.

    • Joseph Burgo says:

      I get so angry when I hear stories about therapists like yours who abandon their clients and insisting they could be trusted to stick around!

      The best way I know to research therapists is to use the professional directory at Psychology Today and search under “psychodynamic” or “psychoanalytic” orientation.

  89. Isabella says:

    Wow I am late on replying to this! Merry Christmas(es) and happy Summer!

    I am very glad I found this article; it was exactly what I was looking for. While reading, I found many comforting analyses of the psychotherapy relationship. I am in therapy with a very kind and loving man who has been in the practice for decades. He is incredibly understanding and empathetic, and the transference relationship we have (however scary) is indeed one that– after many hours of research on the subject and extra appointments many times– I have come to not only understand the relationship better, but also myself. Where my personal conflicts come from is generally what you stated in your article; a broken parental bond. Mine was with my father. I never realized how much pain and compensation behaviors came from my lack of maternal and paternal affection throughout my life. Turns out this actually has a lot to do with why I have suffered anorexia for so many years.

    The transference is still a bit overwhelming for me even now (seven months into psychotherapy), but it is again something that I understand very well and am grateful for. The people who feel it must be traumatizing (excluding those whose crappy therapists have dumped them), they must have either not had a very good therapist or have never been in therapy at all. Or they need some more therapy. Transference is by far one of the most useful parts of psychotherapy, or as Freud would have it, the most essential part of a truly healing therapeutic relationship.

    I also must tell you, my therapist has indirectly (though nearly directly) expressed that he does love me, and I love him much like I would a parent– he is like the father I never had; and I adore that. So please do not feel vulnerable or hesitant about loving your patients. As both a patient and a college student studying psychology, you are completely right that love is a gratifying and important part of therapy.

    Isn’t love an incredible thing?

    All the best,
    Isabella

  90. marquis - daughter of narc mother (father too) says:

    Hello! I read a book called Mean Mothers by Peg Streep, heard of her? She talks about her in book attachment theory (she isn’t a mental health professional) but she uses her life experiences to tell her story about mean mothers and she challenges the topic of mean about mothers; how we are all accustomed to believe that mothers are like in the fairy tale books/movies.

    I’m 27 years old and I never got the attention/nurturing I got when I was a kid. My siblings are much older than me and I am the youngest – nobody under me or a couple years older than me. I had no connections to people, what my therapist seems to fail to understand is, I couldn’t do a lot of things without those nurturing tendancies that a child would need. People do have this misconception that going to therapy they can find a “parent there.”

    My therapist said since I am an adult, I can do the things I want to do. I see a social worker at the women’s center once a month and she told me it’s very hard to have these positive feelings when it was never taught/shown growing up as you never got a pat on the back sincerely on the good things you have done – that makes it very difficult to believe anything is possible. I told her I agree.

    I told her life is hard when you have zero direction, basic life skills, and guidance. She is having me to do all of this by myself and I am still lost. I mean there’s a big difference when a parent guides vs a stranger at least with a parent there’s an emotional/physical bond. My therapist told me how my parents didn’t have such a good role models nothing new to me, but why should I give them the benefit of the doubt is the question I keep asking yet I get no answers.

    I have been seeing her for almost a year and made some progress. I was told at the women’s center how true healing will come when I am out of the house for good. It got to the point in my life how I feel so disconnected from people because I feel most can’t be trusted as my parents can’t be trusted at all. I learned a lot of bad stuff from them which people couldn’t understand anything about me and I feel when I share my story how it is very difficult because these people have no idea what a narcissus is or what they do to other people they simply believe in any lie these narcs will tell them.

  91. Question says:

    “It won’t restore the brains of our clients to some pre-damage state, but it can make a very large difference.”

    Can you explain then what’s the difference between a human who didn’t have any attachment issues and a human who had, but healed most of the damage during therapy?

    You make it sound really scary and permanent.

    • Joseph Burgo says:

      I always use the analogy of physical disabilities. Some people are born with a physical limitation, but with hard work and training (say, physical therapy), they may accomplish a great deal without ever really ridding themselves of the “defect.” I don’t mean to make it sound scary. In my zeal to counter-act the hopeless idealism of so much written in my profession — about healing and cure — I sometimes go too far in the opposite direction!

  92. JLB says:

    I will just start by saying that I was raised by a very self-absorbed mother and an alcoholic father who was rarely around until I was in my late teens. My childhood was less than stellar and it forced me to grow up quite quick, become independent and I learned that I can’t rely on anyone but myself. I carried all of this into my adult life and marriage. My husband also had a bad childhood and has military related PTSD. He was injured in a skydiving accident, hasn’t been able to work for a few years, and requires a moderate level of care, care that I give him. All in all, I am the very Co-Dependent person in this relationship and I have been for years.
    I entered into therapy several years ago after struggling with my grandmother’s death (she was one of the few positive, loving people in my life and I adored her). At the time, either I wasn’t ready for therapy or my therapist wasn’t a good match for me. I suspect it was the former rather than the later. I wasn’t forthcoming with important information and I wasn’t willing to take the leap of faith and trust her. While I did get some good work done with her, it was more like putting bandages on the wounds. Because I wasn’t willing to be an equal participant in the therapy, I decided I was finished with the work and terminated the therapy.
    Fast forward a few years…..things in my marriage have deteriorated to the point that separation and divorced are discussed on probably a weekly basis. Pair that with the fact that my husband is now in chronic pain and requires a powerful cocktail of daily medications just to survive and my hesitance to reach out for help, and I found myself seeking therapy again. However, this time I did more research about therapy and ended up here, where I have learned a lot.
    I am not sure which treatment modality my therapist is using with me but I know that therapy would not work for me if I wasn’t invested in doing the hard and often times VERY painful work required for healing. I also knew from the start that at some point I would HAVE to trust her in order for her to help me (I was very lucky and have an excellent fit with the first therapist I tried). Having said that, I STILL have trouble trusting and spent a good number of sessions dancing around the real issues or working on problems that I saw as minor. I also frequently behaved, and probably occasionally still do, like a child and tested the boundaries to see what type of response I would get. As pathetic as it is to say, it’s almost as if I wanted my therapist to prove to me that she wanted to work with me and she could handle whatever I had to dish out. I am grateful that she is patient, caring and kind with me.
    She has been a therapist for 17 years, so I know she has seen a lot, but I somehow felt that I was still going to throw something out there which would be a shocker for her…..and I might have. But she handles me, all of my moods, my joys and my pain with empathy and understanding and I always feel heard and validated. Even without having to inquire, I feel that she likes me. I would NEVER ask though because I don’t know how I would handle the answer (whether it was a yes or a no). I feel that she wouldn’t invest in feeling my pain and helping me work through it if she didn’t care about me. I have read articles in which therapists claim that they can help anyone, regardless of whether or not they “like” that person. And that may be true, but I think the strength of the therapeutic alliance would be compromised, and counter transference issues would begin to surface. I think the quality and healing power of the therapy would not be nearly what it could be if the therapist didn’t genuinely like the clients.
    I’m not sure I would go as far as to say that my therapist loves me, or that I love her. In my opinion we haven’t worked together long enough for those feelings to surface in either direction. And, considering our “relationship” is very one sided, I’m not sure how love could play a part, especially for me, since I know very little about her. I decided early on that I was not going to lie to my therapist or withhold information because I knew it would only hinder my healing and fuel my anxiety, so she knows a LOT about me. And I am constantly impressed with her ability to recall information that I have told her, despite that fact that she must see 30ish clients per week.
    I am sure there are days when she sees my name on the schedule and wonders if she has what it will take to get through a session with me. I also think that there are sessions we finish, in which great progress is made, that she must feel a sense of pride and accomplishment for the help that she has offered me. This us a very long winded version of my 2 cents on “love in therapy.”
    By the way, your blog is excellent and eloquently written; please don’t ever stop writing.

  93. marquis (daughter of narc parents) says:

    My therapy was suppose to finish last week, but we got to talking about other things. Next Monday, therapist and I will finish up on the last bit of criticism/assertiveness and then we will be done. I am glad, it was nothing more with her and me arguing. She has this mentality of a leave it beaver life (she isn’t that much older than me) and all she did was try to “project her ideologies” on me and expect me to believe it.

    We had a falling out this past summer which led me not to sleep for 2.5 days that’s how angry I was. One more day again and I will free from therapy! 3rd time I had to use counseling: first time in high school, 2nd time in college, and 3rd time on my own using the state insurance. A lot of these therapists can’t be trusted and I am not gonna waste my time finding another set of MHPs – I am done! I have no interest in keep speaking about my parents not when you indirectly treat me like some liar.

    So, I am gonna have to figure this out on my own and dealing with issues. The only good thing about therapy is I was able to get to the rooted problems, the deep rooted stuff. Nothing won’t be complete until I move out – until I have a job then the healing will start. I am hoping I get this job I had an interview for last week and then I can start on saving money.

  94. anon says:

    I sit with my caring and insightful psychologist twice a week. I have been in therapy with him for 3 years. I have PTSD. An unbearable sadness has overtaken me during our sessions. It started a few months ago when I realized that I felt loving feelings for him and was able to tell him after I shared this dream I had. I realized at the end of the dream that the doctor I was loving was the therapist which caught me off guard. I am carrying my husband on my back in the dream. I am started to grieve a number of things all at once. I am metaphorically sitting with my dying father (who is dying of cancer now).

    I have an urgency to come to peace with my father yet I know I am wasting precious time avoiding him. I know I need to use this time wisely, but I don’t. I grew up with extremely severe domestic violence as long as I can remember. I grew up with a critical mother, and I was the parentified middle child who shielded the younger one. Older sibling hated me.

    I am beginning to care deeply for the psychologist in similar ways that I love my father. I thought I didn’t “do transference”. I do not want to feel it in the here and now let alone with the very psychologist I respect. I am placing my vulnerabilities in his care, and I am thankful to God that he is kind and patient as I work this through- my falling in love with him. I think that it is cushioning the pain of father’s impending death. Yet morally is it a sin to feel this way towards another man other than your husband?

    I know I am losing my father to cancer in the next year or less. Every day, every week I hear my father’s voice whisper to me on the phone as his vocal cords grow weaker. His once unbreakable body which became an adrenaline filled cauldron of anger is changing shape and form. I know that I gave him the grace he needed in our family to feel loved despite his violent behavior. I love him unconditionally despite the trauma he caused me and my family of origin. I forgive him because he loved me in a way that I know he saw my authentic spirit, my essence. The same part of him that I love about my father. His deep sensitivity, creativity, vulnerability, and kind heart. He is a good man despite his mistakes and that part of his spirit can not be denied.

    I am now clinging to this counselor who listens to me with a lot of care and skill. I will be losing the love of my father through death, and I find myself stepping deeper into the muddied waters of transference in order to hold onto that love. Is it healthy? Subconsciously I may feel that if I love my counselor I will replace the love I have for my father to make it less painful. But I am feeling deep guilt for loving the counselor more than my own husband because my husband does not give to me emotionally. It doesn’t matter that it is always asymmetrical. I have grown quite fond of the psychologist because I know he will not hurt me. He is showing me that it is not asking for much to be in a relationship to be on the receiving end of kindness. This sacrificing of myself is all too familiar and I’ve grown weary and forlorn. It is familiar. I am started to wonder what it would be like to be on the receiving end of a mutual relationship, but for now I am hopelessly stuck with 2 kids and not for divorce.

    Loving my husband who is not emotionally available feels unbearable at times. I want to fix him, but I can’t. Husband is the only one who can make that decision to love me unconditionally, to think about what may make me feel loved. I am beginning to grieve as I have come to this painful realization my husband has no motivation to love me in the ways I am capable of loving him. That is the way it is in my marriage, and there is no motivation for him to change what he does not know how to give away. I can not sacrifice myself for the sake of a dysfunctional equilibrium.

    So I sit with this uncomfortable feeling in my heart and body, as I allow my husband to be who he is. That is my way of loving him, and I will not ask for his love unless he gives it to me freely. It is the only love I know. I am done with the power struggles. I don’t have the time for it emotionally. Yet, I am completely demoralized. I am where he wants me to be, but it is okay for me right now as it gives me the opportunity to grieve so many things right now.

    My husband says he married me because he thought I was selfless. That I was self-sufficient. That I would be a good mother. A good wife. It does not occur to him that I may need some genuine displays of mutual love. I am his mother. I am his child. If I ask for anything at all it becomes unbearable for him. He wants my love, my unconditional love without the emotional capacity to give me any part of himself. The vulnerable part of himself that I guard with my heart is not mutual. His wounds are bleeding everywhere.

    So here I sit with this kind psychologist week after week. Sitting with the unfamiliar feeling of receiving his wise counsel without needing to take care of him. It is healing me and saddening me at the same time. I love my therapist more than my husband. Is that abnormal or a part of transference? Just knowing that it is possible for a therapist to come to love their client is heartening, but the grief that it will never be a “real” relationship makes me sad. Do you consider the clients you have come to love as “relationships” within the therapeutic boundaries? Is it ever okay to ask my therapist if he loves me “in a therapeutic context” or would that be inappropriate? Thanks for your wonderful blog.

    • Joseph Burgo says:

      I consider my relationships with my clients to be real, even if there are boundaries. We have real relationships with teachers even if we only see them at school. We have real relationships with colleagues even if we only see them at work. I think it’s okay to ask your therapist anything, but be prepared for him to be a little cagey. We therapists have a hard time acknowledging the love we feel for our clients plus our codes of professional behavior don’t encourage it.

  95. anon says:

    Thanks for your honesty Dr. Joe, and for taking the time to respond to my very wordy comments above. Your blog has been such a well-spring of kind wisdom and guidance to me. I appreciate your ability to be vulnerable. I can see all the hard work you have done with your own therapy in order for you to be where you are today emotionally. It gives me a lot of hope and joy knowing that we can all transform our traumatic pain into something quite beautiful as you have. I probably won’t ask my therapist if he “loves” me as your response was very direct and helped me a lot- to ask my therapist is not necessary… as I think that I know that he does deeply care in his own way and that is enough. I love my husband too- just feel sad I was not more healthy when I got married to him. I have hope for him- as others had hope for me.

    I can watch your videos, read your blogs and learn a lot from others and their responses, and I find your refreshing words of guidance resonate very deeply with so many of us wanting to understand ourselves and others better. You are a good egg, Dr. Joe!

    I am a therapist as well as you may have guessed, yet still young and figuring it all out as I continue to try my best to be brave and authentic in my own journey with “self” and the journey I travel with my clients as well. It meant a lot to hear that these relationships to you are real as real as any other type in their own way- despite the limitations that a psychotherapeutic relationship has on us. The boundaries within it are what may be allowing me and others the freedom to love- and therefore experiment in new ways of being with someone very healthy and loving. I think the courage that you show by being you- and your contemporary views are very generous and certainly healing. Thanks for making a difference Joe. Keep being you! Love you as well!

  96. Water lilly says:

    Ahhhh… i have been there- a helpless truly smitten patient. My therapist was my world. He was literally all i had and the only person i had to turn to. I glowed in his attention. There is nothing i wouldn’t do to please him. I dressed my best for him, bought new shoes and wore all my make up. I lived from one session to the next. I have no doubt he was a competent, professional, compassionate and caring therapist, and he wasn’t afraid to show his human side too- we would share a joke together, exchange funny comments and he treated me like a respected dear friend.

    Notice i say ‘was’ – the bitter part of therapy is when that bubble of reliance, trust and dependence goes- suddenly, all at once. WHAM! It leaves you confused, shocked, terrified, hurt so hurt, betrayed and then a seething rage with the whole world. His news was like an explosion that left me in pieces. Emotionally i’ve felt more injured than i can remember and psychologically i’ve disintegrated.

    He moved on- got a great new job, moved to an exciting new region, washed his hands of me. Other things. Doesn’t want to know. Forgotten, Dumped.
    I’m a mess. Nothing. No one. Betrayed. Lost. Bewildered. Broken.

    This is what transference can do to you.

    • Joseph Burgo says:

      I’m so very sorry. When I left Los Angeles, I had to end treatment with some of my clients. It was painful for them and for me, but I offered to continue working by phone with those who wanted. I also gave them long notice. I hope he did the same for you.

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