A destructive relationship – Therapy with Dr. Stoneface, part IX

I guess it is about time to bring my account to an end. I will try to do so with this post.

What I will describe here are not so much concrete sessions and arguments with Dr. Stoneface, but rather the style of arguing which really show how destructive our therapeutic relationship had become. I don´t know when exactly most arguments took place, I don´t remember their correct order. I only know that there were immensely destructive sessions already after one year of seeing him, if not all the time. Nonetheless I stayed for another year and about three months. I quit on some day in December over two years after I first consulted him, and I quit during an argument. I will talk about that, too.

So. I don´t remember the exact content of many of those arguments, but I certainly remember the style and my responses. I would try to get a point across, and he would interrupt me all the time, asking me questions (it could be as simple as explaining a word), and while I was trying to answer those, he would ask me additional questions until I had no idea anymore what we were talking about. In order to clarify my point, I can give you an example that never happened in quite this way, but definitely depicts his style of arguing.

Me: “I don´t want to lose the ability to enjoy safe, non-compulsive cutting for pleasure and turn into…”

Him: “Wait, what do you mean by “safe and non-compulsive”?”

Me: “I mean that I don´t feel like I have to do it because of some kind of inner pressure, but I decide that I…”

Him: “But what is inner pressure? Is a sexual urge not inner pressure?”

Me: “Okay, maybe what I mean is a destructive impulse…”

Him: “An impulse to cut is always a destructive impulse, it is an impulse to cause harm to your body!”

Me: “I´m talking about destructive on a different level, a psychological one, not the immediate physical level…”

Him: “But is it possible to separate mind and body? There is always a bodily correlate of emotional states. When you are angry, your muscles go all tense and…”

Me: “But that is an entirely different subject! Are we talking in two different languages or something?! Don´t you realize that I´m simply trying to say it makes a difference if you do something with the intention to harm yourself or with the intention to get pleasure out of it?!”

Him: “Now I´m feeling all stupid. You make me feel like I´m just a useless nitwit who has no clue about anything and can´t understand anything.”

This last line is something he indeed said quite frequently. Basically whenever I told him that something he said was nonsense. I didn´t know yet that using your brain constitutes emotional abuse. I do believe, though, that destroying your opponents intellectual abilities by systematically interrupting and overloading them with questions that distract from the point they are trying to make – does. As I recently learned thanks to an awesome post in another blog, there actually is a name to this: It is part of a thing called “confusion technique”. As I looked for them term in Google, I came up with this article, a pretty well description of what Dr. Stoneface did to me.

I also know now that Dr. Stoneface´s remark about me making him feel useless and stupid was probably not a mere passive-aggressive outbreak, but part of a therapeutic strategy. A few months back I already wrote about this article on treating narcissism. The article basically describes the approaches of two different psychoanalytic schools, the one by Kohut, and the one by Kernberg. With the help of some Internet research I found out that apparently Dr. Stoneface is an adherent of Kernberg. Kernberg´s approach suggests that the patient might evoke feelings of helplessness, frustration and incompetence in the therapist. The therapist should respond to this by pointing out that it feels to him like the patient is trying to make him feel impotent and defeated.

The assumption behind this approach is that the therapist´s reaction reflects the emotions of the patient:

“Because the patient treats the therapist as an extension of the self, the patient is likely to induce in the therapist certain states that reflect what the patient is struggling with.” 

So, basically, Dr. Stoneface might have assumed he was expressing how I was feeling. In a way, he did. Being bombarded with questions that undermine everything you could build an argument upon and an opponent who is completely unwilling to try and understand your the point you are trying to make necessarily makes you feel kind of stupid and helpless and defeated. So what Dr. Stoneface reflected back to me was a feeling he himself had induced in me through his own abusive behavior.

From afar, this either looks like utter incompetence – or like a very subtle and intelligent form of sadism. One mustn´t forget, though, that Dr. Stoneface (probably along with most other psychoanalysts) assumed that there was no difference between therapy and real life. He probably thought that if I felt stupid and helpless in therapy, I always felt stupid and helpless. The idea that he could do that to me all on his own was probably unimaginable to him. It must be transference. He also assumed, after all, that just because I didn´t trust him I didn´t trust anybody at all.

There were times when I refused to continue arguing. Sometimes I pulled out my mp3-Player, inserted my ear plugs and listened to Rammstein at full volume. Sometimes I just sat there, staring into the void and refused to answer. He continued talking to me, giving me easy baits or trying to provoke me, but even when I was fuming or shouting angry replies in my head, I kept my mouth shut. I didn´t even look at him. Nonetheless, I stayed until the session was over. I would leave exactly on time. And I always returned. Only once I left a session early, and while storming out I anxiously asked him if I would have to pay a fee for that. I was basically asking him for permission to “act out”, which rendered my “acting out” fairly inauthentic, ridiculous even. I still don´t fully understand my behavior, and I guess investigating this will require an entry of its own.

At other times I was trying to persuade him to let me go. To make him agree that I should leave therapy, that we were a complete mismatch. He, however, refused. Such a discussion could go about like this:

Me: “We are making no progress. I´ve been seeing you for two years and we´re still not getting anywhere!”

Him: “Well, what is your goal for therapy? Why are you here?”

Me: “I don´t even KNOW why I´m here! I don´t WANT to be here!”

Him: “Well, you ride through half the town once a week to see me, that is quite an effort. I´m pretty sure you wouldn´t do that unless at least part of you wants to be here.”

Me: “What if it is a compulsion? What if I merely feel compelled to come here, just like an alcohol addict feels compelled to drink!?”

Him: “I´ve never met an alcohol addict who  didn´t on some level want to drink or enjoyed it!”

Even if “part of me” wanted to be in his office that part could still have been wrong, but he didn´t take that into consideration. Neither did I, at the time. I find it remarkable, though, that he would speak of parts. He would say that “part of me” wanted to be in therapy, and then he would speak of another side of me who “wanted to destroy the relationship we built up in therapy and everything we achieved”. I wasn´t aware that we had achieved anything or that our relationship was anything other than destructive itself, but the more interesting point is that – wait a second? A goddamn wise, mature, analyzed, cured, neurosis-free psychoanalyst resorts to a “primitive” defense mechanism like splitting?!?! May I laugh for a moment?

Yes, I am being mean. Attributing a “destructive side” to me, however, was indeed a way in which Dr. Stoneface could make himself believe that he was the right therapist for me, so it actually did serve some personal purpose for him. I found that out during a discussion about just that subject: Maybe we were a therapeutic mismatch. Maybe this simply couldn´t work out. Dr. Stoneface denied that, saying that he felt he could cope and work with me very well.

“No, you can´t,” I said almost sadly, not really knowing where the words were suddenly coming from. “But you don´t realize that because each time you cannot cope with me or things get too rough you simply accuse me of destroying everything.” It was the first time I actually managed to shut him up.

After re-reading the article on narcissism I referred to further above, I realized that this client-blaming behavior is actually enabled by the Kernbergian theories Dr. Stoneface adhered to. In the article, it says:

“The therapist may begin to experience himself or herself as ineffectual, incompetent, invisible, and needing to work harder, with feelings of anxiety before the patient’s sessions and impotent frustration and self-doubt afterward.”  

These, in my view, are all signs that maybe the therapist shouldn´t be working with the patient. Neither should a therapist continue working with a patient at the expense of his own well-being, nor do I believe that it is of any particular help to the patient if he does so.  The article, however, goes on like this:

“These countertransferential feelings are important diagnostic and therapeutic data that the therapist ignores at the peril of the treatment. Indeed, the recognition and proper use of countertransference in the treatment are critical in working with narcissistic patients.”

So – the fact that the therapist feels useless is important data not for diagnosing the therapist (“apparently he is not the right person to work with this patient”), but for diagnosing  the patient?

The reason for this is that all the negative feelings the therapist experiences are seen as a result of the patient´s projection of his or her own inner states onto the therapist:

“Because the patient treats the therapist as an extension of the self, the patient is likely to induce in the therapist certain states that reflect what the patient is struggling with.”

The resulting treatment recommendation:

“Because narcissistic patients are likely to “bring out the worst in their therapists” by inducing in them feelings of anger, confusion, boredom, or lifelessness, it is especially important to scrutinize one’s countertransference responses before using them for therapeutic purposes. In particular, via projective identification, the narcissistic patient can bring about insensitive, unempathic, attacking responses if the therapist loses sight of the fact that these reflect the patient’s inner state”

So basically it is my own fault that Dr. Stoneface attacked me? So he was only abusive because it is  actually me who is insensitive, unempathic and attacking? So he basically wasn´t abusive at all – in fact I am the one who abused him? If anything, he cracked under the burden that is working with me, but he didn´t really do anything wrong? I am so inherently toxic and hateful and aggressive that I make selfless, skilled and empathic people who only try to help me so miserable that they act out all my dark, hidden intentions and impulses? Wow. I should really go kill myself, but that would be passive-aggressive, now, wouldn´t it? Then again, I had no idea I had that much power. I must be some kind of super-villain. Gotham City, here I come.

On a serious note, though: What we see here is a normalization, a pseudo-medical justification of what Dr. Stoneface did to me. According to this theory, it is normal that therapists feel like they cannot cope with their so-called narcissistic client. It isn´t even just normal, it is essential, because it provides them with secret knowledge about the patient´s evil intentions. In a way, the therapist is just as stuck with the patient as the patient is stuck with the therapist. It is normal that the patient wants to leave therapy, and it is normal that the therapist feels incompetent. Wow. Just what the fuck, really.

Is there anywhere, just anywhere a reality check built into this? Maybe the therapist really is incompetent, at least for that specific patient. Maybe the patient is right wanting to leave. Maybe it simply is a mismatch, or maybe therapy is complete bogus in the first place. The ideology to which the likes of Dr. Stoneface adhere doesn´t leave room for any of those options. Maybe on a theroretical level, yes, but there is no way you can ever prove that any of those options apply. All evidence is subject to interpretation – the interpretation of the therapist, and the result is bound to be: “Yes, I believe there are people who cannot be helped with therapy/abusive therapists/completely disastrous and destructive therapies….BUT you aren´t/I am not/this isn´t one of them.” Proof? Zero. Can you prove him wrong? Nope. A theory that cannot be falsified, however, is about as scientific as a conspiracy theory.

A typical reply Dr. Stoneface might give here is: “Does everything always have to be about science?” It is obvious that this is a possible next step. You can point out that a certain theory is not scientific, and then you can decide whether or not it nonetheless has some value. Of course you can question if it is good that our age is so fixated on science. We do that all the time in philosophy. Coming from him however, such questions  weren´t a sign of intellectual openness and philosophical interest. They were mild accusations. In the admittedly fictional example above he would be insinuating that I always make everything about science, which probably isn´t even true, and his tone would suggest that this is somehow bad.

While we never talked about science, there was an actual conversation in which he asked me why it was so important for me who was right, or that I was right. One would think that it is fairly self-evident that it is important to a person if she is right or not. It does make a difference if you are right about something or not. Imagine you suspect that you have cancer. The question whether you are right or wrong might be a matter of life and death.

I understand that it is supposed to be part of therapy to “challenge” your beliefs and preconceptions. But not all beliefs and preconceptions a patient has are necessarily bullshit or pathological. They might be mere  common-sense, they might also be very elaborate and thought-out. And if you “challenge” such beliefs, then you´d better have a good reason for that. If you cannot in any way explain how the belief is supposed to relate to the patient´s pathology, then you are obviously just “challenging” random beliefs with run of the mill “critical thinking”; and that is mere filibustering. And even more so when you do that during an argument. Imagine a conversation like that in real life:

Wife: “How could you cheat on me, I feel so betrayed!”

Husband: “Why is it important to you not to feel betrayed?”

Now look at my argument with my therapist:

Me: “I believe x, you believe y, but because of factor a, b, c and d I believe that I am right!”

Him: “Why does it have to be such an issue who is right?”

Huh. Maybe not so much who is right, but what is right. It is a matter of x or y, not a matter of him or me. He didn´t even distinguish between those two questions, making me feel like an obnoxious, pedantic know-it-all. That aside, he also made me feel like an ignorant for having any beliefs at all. I know that most of our beliefs rest on a Mount Everest of assumptions; assumptions which we might or might not have thought about. I´m only starting to understand that he wasn´t entirely as dumb as he sometimes seemed to be, because he definitely could point out assumptions. He did it all the time. Or rather: He questioned my unspoken assumptions all the time. Assumptions like: “Yeah, it kinda sorta IS important if you are right or not.” Merely by pointing out the assumptions on which my arguments were based made me feel immensely insecure because I realized that I hadn´t thought about nearly half of them. I was quick finding arguments for these assumptions, but before I could make them – Dr. Stoneface would interrupt me with another question challenging the assumption my argument for my previous assumption was based on. My insecurity, my feeling that I was stupid and thoughtless just increased.

I know now that doesn´t mean that I am really stupid and thoughtless, not more than any other human being. Show me the one person who truly doesn´t make any assumptions! After trying hard for many years, I believe it is simply a psychological impossibility to not have any opinions and not make any assumptions – and having attended an epistemology class or two I also know that so far we haven´t found a way yet to prove that we aren´t all being deceived by an evil demon, or that we aren´t all brains in a vat, so all of our assumptions are relatively insecure on a larger scale. In order to cope day by day, though, we need to make assumptions and on a smaller scale, there are good and not-so-good arguments for the different assumptions we can choose between, and in order to decide what to believe, we have to rely on those arguments, or rather evaluate them; and if we don´t agree on something, we will use those arguments in order to sort it out.

In a normal argument, however, both participants use arguments which are based on epistemologically unproven assumptions. Of course such assumptions are sometimes challenged in an ordinary argument. But the one who challenges the other´s assumption typically has to provide some kind of argument or reason for challenging it. Like: “Do you really think that all kids are stupid, because I know some really smart kids!” Both participants are equally vulnerable to the epistemological skepticism that questions everything up to their own existence.

This was not the case with Dr. Stoneface. I was doing all the arguing, and he was merely asking questions. He didn´t have to justify his questions, he didn´t have to explain his own point of view. I guess I asked him many times what his take was on things if he believed I was so wrong. He could always block such questions by telling me that 1) he never said I was wrong and 2) therapy was all about ME and MY beliefs. Or by asking me why it was so important to me to be right.

This rendered me powerless. I couldn´t return the challenge. All I could do was trying to justify and explain my views in a fight which was designed in a way that made it impossible for me to win. Basically I spend two hours a week subjecting myself to a sophisticated intellectual humiliation. I sometimes wonder if Dr. Stoneface was aware of this. Even did it on purpose. It must be quite obvious, after all, that my intellectual abilities are what my “narcissism” is clinging on to. Did it merely give him some aggressive kind of satisfaction to obstruct and defeat them, or did he even believe it was therapeutic? Maybe helpful in battling my resistance? Or wasn´t he quite as almighty and omniscient as I sometimes see him as? Maybe he had lost all control over the sessions long ago?

Provoking him into losing his cool was the only way I could feel some kind of power again. Sometimes I would simply sit there and eat and watch with a mixture of satisfaction and wonder as he started to raise his voice and demand that I stop eating in session immediately. Another time he gave me a questionnaire and asked me to fill it in without thinking much about it. I, however, comfortably read through the questions, and he started to yell at me that I was abusing the questionnaire in order to avoid talking to him. His accusation (“abuse” is a very harsh word) shocked me, but it also gave me an sick feeling of satisfaction that I could make him behave like an idiot by doing fuck all. I simply couldn´t take him seriously. How could anyone be that upset over me eating in session, or for looking at a questionnaire? I had a feeling that he was merely displaying anger in order to affect me in some way, and sometimes I felt like I was part of some stupid play or some secret melodrama.

The situation when I finally left for good was very similar. We had been arguing in a destructive fashion, I had probably been quite a bitch and I had somehow accused him of being arrogant. He really lost his cool and yelled at me: “Why, it´s YOU who is arrogant…” Once again, I had this weird, mixed reaction. On the one hand, I felt adrenaline shoot all through my body, a mixture of shock and rage. On the other hand, though, I felt like I was part of a staged therapeutic outbreak again. I felt reminded of the movie “Girl. Interrupted.”, where people are healed because they provoke someone into screaming the ugly truth into their faces. Wow, I thought. This is probably the moment where I should crumble because suddenly I am shown my true face. I didn´t crumble. I grabbed my stuff and said: “So you´re trying the asshole method? Fine. I´m outta here. It´s useless, and we will never get anywhere. I quit!”

Dr. Stoneface tried to argue me into seeing him for four more sessions in order to talk about how to cope with the break-up and why it had happened. I declined. He tried to pressure me by saying that I had agreed to have those sessions if I should quit, and indeed I had back then, over two years ago. I didn´t nearly respect him enough anymore, though, keep my “promise”. I asked him if I would have to pay him a fee if I didn´t have those sessions. He asked me why that was so important to me, as he always did when we talked about money. I told him to cut the crap and asked him again, and eventually he told me I wouldn´t have to pay. I left his office for good.

A few weeks later he sent me a letter asking me to pay a fee for a session a few months back which I had supposedly missed. I had no idea if that was true or not, but I seriously didn´t feel like arguing. I just payed. Just days afterwards, he sent me another letter.

“I forgot to mention that I wish you all the best. It is important that you pull through your own thing.”

Or something the like. I cannot be arsed to dig up that letter now. I have no idea why he wrote me. Maybe he wanted to end our therapeutic relationship on a more positive note. Maybe he also wanted to retrospectively own my decision to leave by approving of it. Me doing what I thought was best for me, even if it meant leaving therapy, had never been one of his top priorities while I was still seeing him.

I never regretted leaving therapy. I am once again struggling with several mental health issues, but I´m fairly sure Dr. Stoneface would not have been of any help.

I have hereby finished my account of my time with Dr. Stoneface, though I might add another entry or two if I remember more stuff. What I am not done with, however, is dealing with the aftereffects and the issue of therapy in general, and I will certainly keep on writing about that, though maybe not straight away.

So long.

 

 

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3 Responses to “A destructive relationship – Therapy with Dr. Stoneface, part IX”

  1. I have read your account with interest and also on other blogs. Dr Stoneface sounds AWFUL. ‘Client blaming’ – yes, indeed. Quite an effective strategy. The losing temper stuff – hmm, he sounds like a control freak – OCD maybe. Or maybe, the therapy was nothing to do with you and everything to do with him. Perhaps that is why he is a therapist – he wants to end up controlling and dominating his patients. All the transference crap is just another control and ‘patient blaming’ strategy.

  2. Hi, sorry for the late reply. 🙂
    I don´t know how I´d diagnose Dr. Stoneface; I guess I´d need to read his notes on me first so I know for sure what he was thinking and doing. I think it is possible that the job as a therapist might be attractive to controlling, domineering or even sadistic persons. You get to know peoples´ secrets, they tell you things they are ashamed of or stuff that hurts them, you can dig in it all you want and tell them whatever you like. You get paid for having asymmetrical relationships in which you have the upper hand. Dörte von Drigalski, who wrote “Flowers on Granite”, an account of her own bad experiences with psychoanalysis, says that many therapists might be “deformed” by their own analysis which they have to undergo in training. They become more anxious and dependent on authorities and rules. I think in a way they might just be dishing out to their patients what they themselves had to take during their training.

    • Yes – I would not disagree with what you have written! I think there are quite a few controlling and even sadistic therapists. I’m getting right out of the whole thing . Also agree – the therapists are dishing out to patients what they themselves had to take – yeah – but who needs all that crap!

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