I've been in therapy most of my adult life. Prior to my experience with Transference Focused Psychotherapy, I had many years of supportive psychotherapy - first with a therapist for nine years, diagnosed with depression and PTSD. Then, for another 6 years with a different therapist and a new diagnosis of Bipolar Disorder. In both cases, I saw the therapist twice a week or more. Throughout most of this time period I was also under the care of various psychiatrists who prescribed psychotropic drugs including Lithium, Depakote, Risperadal, and many, many others.

Despite being under the weekly care of these qualified professionals, my life regularly careened out of control. There were personal and business bankruptcies; there was the frequent alienation and loss of friendships, colleagues and domestic partners; there were reckless, erratic behaviors and alcoholism.

After two hospitalizations for clinical depression, I entered a day program at NY Presbyterian in White Plains, now with the dual diagnosis of BPD and Bipolar Disorder. I was functioning very poorly and had recently,
once again, “lost everything”. One of the psychologists affiliated with the day program informed me of a research study that the Personality Disorders Institute was conducting and suggested that I might benefit from participating in it. I was accepted into the study and was assigned a therapist who I would see twice a week for the following year.

As a result of having TFP treatment, substantial gains have been made in my ability to lead a fully functioning life. I noticed some significant differences between TFP and the supportive therapy that I had in the past. What follows is a description of some of my therapeutic experiences with TFP and their resulting benefits.

Initially, my therapist and I agreed on a treatment contract that addressed specific expectations that would be placed on me. The contract set a certain tone that our work together would be taken seriously and that I alone held the responsibility for making a disciplined commitment to the process and to the prospects of
achieving the best possible outcome.

As agreed, I stopped drinking, took medication as prescribed, spoke about suicidal thoughts as I was having them (usually), and showed up for sessions reliably. But one aspect of our work that I struggled desperately with concerned my level of participation within the sessions themselves.

From the beginning, I hated the therapist I was assigned, and made this fact undeniably clear. In my mind all therapists who had gone before her and all other therapists available were “good” or“better.” She, on the other hand, was very, very bad. Stupid, uncaring, and undeserving. A hack! I treated her with arrogance and resentment, and for a very long time I rarely bothered to speak to her or look at her. As you might expect, my withholding became a major focal point of the therapy sessions as we struggled to figure out what I was feeling towards her, and why. In previous treatments, my silence would go unchallenged.

I began to notice a second difference in therapeutic technique. Although I did not always respond outwardly, I was beginning to take notice of the contradiction within me (coming to treatment regularly, yet being sullen and withdrawn once I got there), a part of me started to listen; the part, I believe, that was actually committed
to getting better. There was a new expectation being placed on me. It felt like an unspoken demand to use my intelligence productively, to think through things and to analyze my behavior and its inherent problems, in a new, considered way. It was no longer ok to let myself run wildly through life uncensored.

This was a slow going, stressful process because I viewed my relationship with her in extreme terms. Either I could not live without her (and was humiliated by this fact), or she was the worst enemy imaginable, capable of utter annihilation. I would come into a session and stare at her as if it was the first time I’d ever seen her. It could take 15 minutes before I recognized her and accepted that she was, more or less, the same person who had sat there 2 days before.

The idea that she was a stable, neutral and caring presence was a very difficult concept for me to hold on to. Could it be possible that she was not going to “do me in” or take something away from me? Was I willing to allow her and her work to be successful, or would I rather undermine it and any potential benefits that I could receive?

Week after week I experienced this confrontation with warring parts of myself and I began to notice the same dynamics in many of my other relationships. I regularly struck out at people in my life, accusing them, and alienating them for not being the “perfect” mother, lover, friend-- whatever role they had. I had lived my life viewing all relationships in extremes and had acted out accordingly. I found I had a very low threshold for tolerating closeness, intimacy and the “grey-ness” that makes a person, particularly a therapist different from me.

This process was very painful. I would walk out of sessions enraged by her observations and would vow to never return. And yet I would return because some new tolerance level and self-understanding was building. I wasn’t “reacting” quite so much. I was beginning to notice that there were positive changes in my life: I had gone back to school and was doing well, I was creating and keeping new friends, I could tolerate being alone and I was taking care of myself more responsibly.

Within the safety of her office I played out every hostile, needy, aggressive, withdrawn trick in my book. And she helped me see how I not only treated others that way, but myself as well. In TFP I learned to “think” about my behavior and consider my thought patterns. My therapist would make “interpretations” that would challenge my often faulty, skewed way of thinking. Other choices that I could make would be pointed out and new levels of understanding were promoted. Conflicts were not shied away from no mater how devastatingly rude I could be, or intrusive, threatening or childish.

This treatment helped me to live in the world in a more evolved and adult way, to make more of myself, to love more responsibly, to know that I did not have to be anything more, or less than myself. I continued to see this therapist for many years. I was barely functional when I began, and it took years for me to be able to participate as an equal on any kind of regular basis.

I would say this: the changes in me are profound and speak to the depth of work that’s been done. There’s no going back. I am reasonably happy, living comfortably near family. I have a close and stable network of friends. I have colleagues with whom I have ongoing collaborations and I have a faculty position at a large
university. All of this was unimaginable when we began treatment. This is the stable life that the therapist envisioned me capable of living long before I imagined it possible, or even wanted it. She demanded participation, clear thinking and regular analysis of my behavior.

I have a sign that I made for myself that hangs in my office. It says, “Life is Grey.” Perhaps to someone else that would be a rather depressive message. For me it suggests the freedom to experience and understand others and myself in the context of a full gamut of subtleties.