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A key word that you will see:

Fragmentation: a mental process where a person becomes intensely emotionally focused on one aspect of themselves, such as “I am angry” or “no one loves me,” to the point where all thoughts, feelings and behavior demonstrate this emotional state, in which, the person does not or is unable to take into account the reality of their environment, others or themselves and their resources. This is a term that my therapist and I use and is on the continuum of dissociation.

Thursday, September 11, 2008

Therapy sessions ~ Fragmenting, anger, making connections and feeling better!

I had a therapy session on Monday and afterward was worse in terms of my depression, fragmenting, suicidal thoughts, etc. I was having difficulty staying present, tracking conversations, was hesitant in my speech, halted in mid-sentence and was indirect. This is what I usually do when I am fragmenting or disconnected from myself. I was also over-reacting to situations. I could not understand what was going on only that I was really angry at Geoffrey, so the morning of the session, I wrote this letter which I read to him. Information in [brackets] is additional commentary or explanation written on the same day. Come and read how crazy my head can be and also how I was able to turn it around and feel better by reading this and making connections on Wednesday's session.

Wednesday ~ September 10, 2008 ~ 9:13 AM


I know that I’ve been fragmenting since Monday. Actually, for a long while now. Which I know is partly why I am angry with you and I know that there is a lot of transference and projection going on. Even so, I am angry. I’m angry at you that the letter for the appeal was not completed in time and that I kept forgetting to prompt you. I’m angry that I had to prompt you. I feel resentful that I called the insurance company instead of you even though it is my responsibility. I’m angry that I don’t trust that you faxed it Tuesday as you said you would I’m angry that I am filling out my own bills because otherwise, I feel like I’d never get them. I’m angry that your answering machine keeps getting filled and I keep getting cut off. But, then I realize that I’ve been cut off four times in the last three weeks and that means I’ve been calling a lot, so I feel bad. I understand that you have had a lot going on with your mom and other personal stuff and I am sorry for that. The paperwork is a lot like my mother not following through for me with stuff like that growing up.

[My therapist generally does not complete most insurance forms and does not deal with insurance which is an agreement known at the beginning. However, in my case he decided that he wanted to help me, but I need the letter by 180 days which was Tuesday. He is horrible when it comes to stuff like that and I’ve always known it. I brought up whether or not he wanted to continue with this arrangement and he said that he did and apologized for not meeting the deadline. I also called him three times since our session on Monday to leave a message because I was not doing very well.

Although the situation with Geoffrey was frustrating, the amount of anger was out of proportion to what I was feeling. This morning I realized that it was triggering stuff with my mother. When I was in school, I used to leave papers for her to complete for school. When she hadn’t completed by the time I went to bed, I would remind her that I had to bring them to school the following morning. My step-father couldn’t sign them and my mother would leave for work without completing them. It left me feeling embarrased and with the teachers asking me uncomfortable questions…at the time, divorce was not as common. In fact, all through school I didn’t have any friends whose parents were divorced. I also cried in session remembering how I felt.

Last week, via the Internet I found out some personal about him that I will not share with you, but it made me feel like he really understood what I was going through and we talked about it and I felt closer and more trusting. Today, I asked him a couple of personal questions. The first one he answered and the second one he did not. I immediately felt bad and started to cry…I knew, it triggered something. I really cried.]

I did not like that I found out via the internet. I really would have liked you to have said something. I also know that it was my responsibility to ask. It feels like how I used to try and piece things together with what little resources I had. But, I also feel like I always felt in asking anything personal about my mother or my father. My mother would just become angry and start yelling at me. The worst time I remember was when I asked if she was married to my step-father. It was for a class assignment, but she started yelling, screaming and slapped me telling me that was personal and none of my business. Then, they started arguing and both started yelling at me. It was a horrible day. I felt so bad and like I should have known the answer. I was so confused.

I am also angry with myself because I keep getting stuck by not talking about what I’m writing on my blog and the flashbacks. Also, angry with myself because I keep getting stuck with crying. I’ve been wanting to ask you if I could have an extra hour, maybe next week. Meaning having two 90 minute sessions because I think it would help to get unstuck. But, then I think what if it doesn’t work then, I’ve wasted both of our time. I also am wondering when we can have a joint session with my husband to watch and talk about the slideshow, but I’ve been afraid to ask…I know I’m fragmenting. I’m angry that I keep doing that. [I asked him directly for both and we scheduled the to longer sessions and will schedule one with my husband.]

Because I am fragmenting, I am having much more difficulty with you taking vacation. I feel much more abandoned. I guess, it is intensified too because that is some of what I need to talk and cry about. I did talk with my psychiatrist yesterday and asked if I could see him the week that you are mostly away because that is not my normal week to see him. So, we arranged a session for Thursday. I did tell him about my increased depression, suicidality, sleeping more and fragmentation. He said that it was like I was going into hibernation, so I didn’t have to deal with the issues in therapy. He basically said that medication is not going to help, but that I need to work it through my therapy. I know that he is right. I know part of my anger toward you is about my being angry with myself and with my mother.

My psychiatrist also, at my request, showed me his appeal letter. I pointed out a few typos. He made me sound a bit worse off than I am which was necessary, but it also sank in a little more how severe my symptoms and my abuse really are. His diagnosis didn’t include borderline personality disorder, but did include Dissociative Disorder which wasn’t really a surprise to me, but to actually see it on paper was difficult because it is an indication of my symptoms and of my abuse. I think, that made me fragment more and I became more tearful, sad and angry. I wondered about your diagnosis of me as it helps me put things into perspective and context. [My therapist said, the same with PTSD, major depression. But, he adds borderline and does not include dissociative disorder NOS although I have symptoms.]

So, I actually have some questions in here. I am also feeling more focused and feel like I can be more present today with you. But, I am so scared. I also think that feeling closer to you last week scared me and now I’m trying to push away. All of a sudden I just want to cry. I’m glad I wrote this out. It helped me to clarify some things and make some connections.

[Overall, it was a really good session. First time in a long time, that I felt better afterward. I was able to really process and really felt proud of myself. I was able to say what I needed to, he took responsibility where necessary. However, most of it was my own issues and I was able to recognize it and express my emotions over what past issues the current ones triggered. I knew from the beginning that only a small fraction had to to with Geoffrey, but he was safer than having to deal with my past. Great session, but extremely difficult.]


April_optimist said...

It takes courage to acknowledge anger we feel at therapists. And having them go on vacation is always difficult because of course it's going to remind us of being abandoned before.

Years ago my rule of thumb became that any time I felt intense emotion about any situation, I would assume it was resonating with the past and I needed to stop and separate what belonged to NOW and what belonged to the past.

I'm not saying it was easy or always worked but...it did make life easier.

Tamara (TC) Staples said...


I am so sorry that I have been away for a few days. Seems like you have been going through a lot. I know how hard it is with therapists and trust. We have to trust them more than anyone else in our lives (at least for me this is true) because they hear ALL of our thoughts, secrets etc. It can really be a vulnerable relationship! It is good that you are so aware of when your anger is justified and when it is triggered from the past.

You are doing wonderful work!

Many hugs,

Clueless said...

April, Yep, that is exactly what I did...this time.

Tamara, thank you!!!

Anonymous said...

Hey you. I have to agree with both of the above commenters. It does take courage to be able to speak freely with your therapist (or any practitioner you are dealing with.)

Plus, your relationship with your therapist is incredibly intimate. You tell them so many things and work on so many delicate and even painful issues! Sometimes people may not even share these things with others in their own lives!

I never (well, pretty much never!) speak up to anyone but one ex-therapist got me so riled once that I just had to confront her. I basically said: "Are you censoring me in my own sessions?"

It was tough but I did it. You (well, we all do), deserve to be heard by the professionals that are trying to help us. If that means making them realise that they have to stand up and be accountable or whatever the problem, then we have to summon up the strength and "be accountable" as well.

Take care,

Clueless said...

Yes, everything you said is true. But, I hope people get the real point of what I was saying is that I expressed my anger, but most of it really wasn't toward him and by expressing it toward him, I was able to make connections to my past which is why I was angry in the first place.

Ana said...

Writing has this power sometimes.
I've remembered some years ago when my therapist was o vacations and I was feeling very bad.
I wrote almost everyday and once a week I went to her house and left the written pages.
I don't have any idea what I've wrote but that was the way Ive found to deal with this situation.
I hope you find some relief and get better.

Wandering Coyote said...

It's interesting how something like paperwork can bring up so much stuff. One therapist kept asking me, whenever something came up: "how is this familiar?" That's quite a powerful question to ask yourself when a strong emotion arises, because I believe these things come in cycles and we revisit stuff all the time without fully understanding why. So, now I try to ask myself, "how is this familiar?" It's a great exercise and you totally illustrated why with your paperwork story.

Clueless said...

Thank you Wandering Coyote!!! I usually, when I'm not fragmenting, ask myself, "what is this triggering?" I like your question better. Thanks, CC

Anonymous said...

No human being has escaped the experience of having felt different kinds of emotions i believe. This may be caused by a lot of things like people get stuck in various situations in some point of their lives which enable them to feel towards that situation. Some learn how to hate. Some learn how to forgive. Some just fall in love. Every feeling is valid. It is a right of a person involved. But again, people also have inherent right to choose their kind of feeling in order for them to straighten up their paths and piece things together. Stay positive is the best solution to feeling better again.

Clueless said...

Elisabeth, Thank you for visiting and leaving a comment. Much appreciated.

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