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Dear Dr. Saltzman,

Thank you for inviting your visitors to send questions. Here is my mess.

I have been in psychotherapy for more than a year now for issues of low self esteem, trust, etc. This is the first time in my life (I am in my forties) with this sort of treatment even though my issues began very young. And, though I consider my therapist a very good doctor, I am thinking of terminating all this. The problem is the therapeutic relationship. I feel burdened by it, as if it were unfairly balanced. It takes away my strength, so to speak. I feel vulnerable, exposed, loving and not receiving love back.

I am not "in love" with this doctor, but I have learned to care deeply for him and now I fear I am in a position where I can be easily hurt, and, the more I stay in here, the more hurt I will eventually be. The doc is helping me with my issues but, is this all worth the risk of getting hurt and ending worst than when I started?



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© 2006 Robert Saltzman

Dear Broken-Hearted--

You are most welcome.

Judging from what you have written, this therapy is going along just as it should. One of the things that happens in good therapy is the transference, as it is called, of feelings, attitudes, and emotions once experienced with early care-givers onto the person of the therapist. In other words, the love that you feel for your doctor is made up largely of feelings of love that you once had for important people earlier in your life.

In this case, I would speculate that you once felt great love for someone or other in your early life, and that love was not returned as you wished it would be. Now, in the safe container of therapy, you have the opportunity to reexperience those feelings, but this time--if your doctor is any good (and he seems to be)--those feelings will be accepted, treated gently, honored, and will be open for discussion in a way that will make things clearer to you, and will help you with the problems of trust and low self-esteem that you mentioned.

In fact, if you can see this, your letter to me is all about trust--whether or not to trust that your doctor will be able to receive your feelings of love and admiration without hurting you in return (as someone probably did when you were a little boy).

If you continue this therapy, I do not think that you will end up either broken-hearted or worse off than you were. In fact, judging from your letter, you are now very close to breaking through into an important understanding of your pain and suffering which could make a big difference in your life. I suggest that you continue the therapy, and, if the idea seems OK, you might want to share your letter and my reply with your doctor to help you to open up this material (trust, fear, and the feelings you have for your doctor) for therapeutic consideration.

Be well.

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page last modified November 20, 2006

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