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CBT Therapy And Transference

Question:

Dear Dr Schwartz,

I have recently been having CBT therapy for OCD. I found it hard to trust my therapist at first. But he has been very caring. Now I have had feelings for him which made me confused and worried. I am married and religious. I told him about this by telephone. Then I saw him, and I was very embarrased and worried. This was my last session till I start seeing him again in November. He gave me some homework for OCD. Then said call him in November. I got home and phoned him, as I was worried and said, “how will I cope till November?” He said okay, you can call me in between  to let me know how I am doing.

Next day I called and was very emotional. I felt I needed help at this time because I had all these feelings and emotions which I had never had before. A few days later I called and he was busy and he said I called twice and he was busy. I said I am so sorry. Anyway, he said I will speak to you soon. Then next time I called his supervisor would not let me speak to him. She said I called too much and that I should deal with my anxiety. I was horrified that im in trouble.

My doctor has sent a letter asking my therapist to see my again in November. I have had alot of abandonment issues and rejection. I have sent my therapist a few messages on facebook in inbox. I hope he read them. I said I feel rejected and I’m sorry for making him mad at me and hope he will still see me in november. I keep worrying about all this.

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Answer:

OCD or Obsessive Compulsive Disorder is an anxiety disorder that a person attempts to reduce by using compulsive or repeated behaviors and repeated thoughts.

From what you write, amount of time between sessions, from September to November, set off lots of anxiety. Evidentally, your have many unresolved abandonment issues. In other words, between the last time you saw him and your next visit, you feel abandoned, anxious and unable to comfort yourself. That is why you keep calling him. You want assurance from him that he is there and that he will see you again.

Perhaps I am mistaken, but I have an inkling of the idea that you see your therapist at a clinic. Clinics are ok but they have the disadvantage that patients cannot be seen as often as they would like. My hunch is that he can only see you once per month and that sets off your anxiety. I also have a hunch that he is a student therapist also known as an intern. If true it means that he is fairly inexperienced. That is probably why his supervisor interfered and told you to “deal with your anxiety.” If that is what she said, it’s really unfortunate because, after all, you are there because you cannot deal with your anxiety. If you could, you would have no need to be there.

It is difficult to give you advice in this situation because I am sure that you are at the clinic because of financial reasons. The cost of therapy is much less but therapists see more patients than they even have time for. They are over-worked and that short changes the patients.

Here are a couple of suggestions, all based on the assumption that you are attending a clinic for psychotherapy and psychiatric services:

1. Ask to see a therapist who can see you weekly instead of monthly.

2. Find another clinic where therapists have more time available.

3. Find a private therapist who accepts your health insurance. Assuming that you have health insurance, the company will have lists of therapists who take your insurance and at a low co pay. In that way you could see the person more frequently.

Best of Luck

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