Dependence On Therapy

Since we’ve started working together, my therapist has mentioned quite a few times, that she doesn’t want me to become dependent on therapy. Whenever she’d say that, I’d feel uncomfortable and get defensive. Even though she would tell me that she didn’t say I was dependent on it, I still took it as an attack. And I think I have figured out why it bothers me so much. Deciding to see a psychologist (or any mental health professional) is terrifying. I was terrified when I first reached out to my therapist. Deep down inside, on an unconscious level, I felt ashamed.

Even up to today, that shame is still there. It’s died down a lot, but a few fragments of it still exist. The man who calls himself my dad contributed to that most of all. He’s told me so many times how some people need therapy, while others have strong minds, so they can deal on their own. How do I take it? I take it as him telling me, and thinking, that I’m weak because I’m getting help, when I should just suck it up and get on with life the way he does. So here my therapist is telling me that she doesn’t want me to become dependent on therapy, and in my mind it sounds like an affirmation that therapy is “bad, so you shouldn’t get used to it”. I know that’s not what’s being said, but that’s the way my overly sensitive, reactive mind takes it.

I see now why regular therapy sessions are so important. It’s not about being dependent on it. How do you become dependent on the process of therapy? It’s damn hard sometimes, and even if I’m okay during a session, it hits me afterward and sometimes I just want to crawl under the covers and shut the world away for the rest of the day. There were many times that I didn’t want to have a session. Where I wanted to cancel. But I knew that those were probably the times when I should have one. So I didn’t cancel, no matter how much I wanted to.

I read a lot of your blogs, and from what I’ve read, the majority of you have weekly sessions, some of you twice weekly, and you’ve also expressed a hesitation and even downright resistance to attending a session from time to time. So I know I’m not alone in this.

As my therapist mentioned during our short phone call on Monday (which was strangely helpful, which I didn’t expect it to be- mostly because I didn’t know what to expect in the first place), I need structure. I thrive on it. I feel unstable, and everything feels chaotic without it. My nervous system feels under threat. When things are structured, I feel calmer.

When I had 3 therapy sessions a month, I felt more secure. It felt more structured than it does now. Now it’s just all over the place.

Sometimes we open up a topic, but there’s not enough time in a single session to really delve into it. Then having to wait two or three weeks, I don’t want to talk about it anymore. I don’t want to talk about something painful, difficult and shameful, and have two or three weeks go by before we can pick up on where we were. It feels like something is lost, and it gets disrupted. I know that the nature of therapy is that just because it seems something has been worked through, it might come up in future sessions again. Sometimes we think the work may be complete, only to discover that it actually isn’t.

Even when I write down things to discuss in the next session, it’s not quite the same. Those emotions that I felt, that were so extreme, die down, and it feels pointless to talk about it. If I do talk about it in our next session, those emotions are a distant memory, and I talk about the situation, or whatever it was, without really connecting with my inner world.

I think it’s important to have that safe, consistent space every week. I don’t show up just to see my therapist. I show up because I want to do the work. If you’ve got a physical illness that requires you to see your doctor every week for a checkup, does that mean you’re dependent and happy to go for those checkups every week? No. You do it because you know it’s important.

In keeping an open mind, if a person can become dependent on therapy, is that necessarily a bad thing? We’re dependent on work for an income. Which enables us to live, to pay rent, have food to eat, etc. So why would it be any different with therapy? The purpose of therapy is to help you heal and to craft the life you want to live. To help us grow, giving us valuable tools in order to function optimally in life. We’re still doing the work during and between sessions. But knowing that the next session is only a few days away helps, as you can more easily bring up any observations, experiences, etc in the next session, as it will still be fresh in your mind. Which, brings that sense of continuity.

Of course, right now I can’t afford to have regular therapy sessions. But when I’m able to, I’m definitely going to invest in it. The point of this post is just to share my view on how I don’t believe that one can truly get “dependent” on therapy, and why I think regular sessions are so important. I’m grateful for my therapist, who really tries to bridge that gap between sessions, and keep the therapeutic relationship safe and secure, which has been so helpful.

A while ago, I heard someone say that attending therapy is a form of self-care. I hadn’t thought of it that way before.

It will be interesting to hear your thoughts on this. I like hearing different opinions and view points, so please let me know what you think about this topic.

Practicing Acceptance

For the past two weeks, we’ve been talking a lot about Radical Acceptance during our group sessions. I felt as though my mind was fighting against this idea. It wasn’t until Friday morning that it grabbed a firm, positive, foothold in my mind. Since then, I’ve been working through the concept, trying to understand it better and just basically thinking about it from every angle.

One of my biggest challenges is in accepting myself. I’m my own worst enemy. Aren’t we all? No matter how many compliments I get, what kind words come my way, I struggle to believe them. How can I believe that which I don’t feel is true? I’m still trying to get to that place of being able to accept compliments without feeling embarrassed and like I don’t deserve them. Or that people are just saying these things without actually meaning them. I have become better at this over the past year, but still have a long way to go. I also struggle with the concept of being accepting of myself, the way I am, while also working on changing that which needs to be changed.

Then there’s acceptance of others. It’s easier for me to be accepting of others, than of myself. But of course, I said “easier” not “easy”. One of my biggest irritations is having people cancel plans with me, too close to the time. The reason I feel so strongly about it, is because keeping commitments is very important to me. I stick to my commitments, unless of course, there’s a very valid reason for cancelling. No matter how depressed or tired I may be, or how much I want to cancel, I will keep that coffee date with a friend, for example. But I need to accept that not everyone is like this. We all have our own values, and what’s important to one person, might not be important to someone else.

In Thursday’s support group, near the end, I awkwardly shared a tiny bit of where I am in life. Living in an environment in which my boundaries aren’t respected, but unable to get out due to a lack of financial resources. One thing that stuck in my mind since then is when they said that I’m doing the best I can. But I can’t get the inner critic to stop telling me that I could do more. I feel this constant pressure to do better, be better, and I get so angry and frustrated with myself because I can’t think of how to do that. This constant striving and fighting is exhausting. Adding fuel to the fire is the feeling of excessive guilt. That maybe I’m doing something wrong, did something wrong, or just not trying hard enough.

I need to accept that I’m doing the best I can with what I have. The circumstances in which I find myself. But I still need to be aware, and open to anything that comes my way (including ideas or solutions that cross my mind) that will allow me to change these circumstances. I just don’t need to fight so hard anymore, which hasn’t accomplished anything worthwhile anyway, and just keeps me in a constant state of high anxiety.

Something else that came up during Thursday’s support group, is how much I tend to compare myself to others. Everyone there had such positive things to share, and seemed so mentally stable. While I was struggling, and in a very dark space in my mind. On Friday I realized that I need to accept that I might not be as far in my healing journey as some others are. Just like there are those who are not as far along as I am. We’re all dealing with different problems. Our lives don’t look the same. Besides, just because someone is having a good day (or seems to be), doesn’t mean that they’re not still struggling. Healing and growth looks different for all of us. There’s no mould for this.

As the writer of a good article I came across yesterday, says:

“Radical acceptance takes lots of practice. And understandably, it might feel strange and hard. But remember that radical acceptance is about acknowledging reality – not liking it or contesting it.”

You can read the article here.

It’s The Connection

For the past two weeks, I’ve been so fixated on the thought of not being able to afford to have therapy sessions, that I failed to see what’s been right in front of me this entire time. I was reading through some of my posts on being afraid of losing connection with my therapist, and that’s when it hit me.

I think I finally get what my therapist told me. That she doesn’t want me to become dependent on therapy. I get defensive when she says that and tell her that I’m not dependent on therapy. She counters that by telling me that she didn’t say I am. I realized it’s not the therapy I’m dependent on. It’s the connection with my therapist. The attachment. I’ve never felt a connection like this with anyone. Not even with my grandmother, who was my favourite person in the world. At this point in my life, and for the sake of healing, I need this stable relationship. Especially for those younger parts. They’ve had a hard week without her. I think one of the ways of healing those childhood wounds, and working on integrating the parts, is through a healthy, secure attachment.

The way I see it, is that there’s still plenty of time to focus on the work in therapy. But the relationship needs to be there. And going more than a week without some form of communication is the thing that’s hard for me. I’m not ready to go a full week without hearing from her. It feels like I lose that connection, and it’s agony. I still need to be able to keep that connection with my therapist alive.

I have my weekly group and DBT sessions with my OT, which is part of my journey toward healing. It will help me improve my functioning, and provides me with the tools I need to better navigate this world and my life.

I can have therapy once a month and I’ll be fine. If that’s the way it has to be until I get a job, then there’s nothing I can do about it. All I want is to be able to speak to Therapist and hear her voice once a week or every two weeks, with texts or emails the weeks I can’t call her. A 5-10 minute conversation is all I need. When I think of the situation this way, I feel a sense of relief. We’ll obviously need to talk about this in our next session, and work something out.

Kindness & Gratitude #1

It’s so easy to get stuck in the darkness, and feel that we’ll never get out of that place. To feel like the whole world is against us. Which is why it’s so important to notice the kindness and compassion that exists, and focus on those things for which we are grateful. I’ve decided to start a series of posts to remind us that there is hope. I don’t know how often I’ll write a post for this series, but I’ll try to do one at least once a month.

A little while ago, Jasmine and I went for a walk through one of the many forests in the countryside. On our way back to the car, a guy came running after us. I froze, my heart pounding. Until I saw what was happening. My driver’s license had fallen off my key holder, and he had picked it up to give back to me. I was so relieved. And exceptionally grateful. I had my driver’s license stolen in a smash and grab last year, so I know how much of an inconvenience and hassle it is to get a new one. The kindness of a stranger.

After our walk, I drove Jasmine back to the clinic where she was staying. Sitting with her on the bench just before I left, so close. Not talking. Just feeling. I felt sad. She wasn’t feeling too great, and lay her head on my shoulder. It was a bittersweet moment. I realized that we might have lost some of the things we had being in an intimate relationship, but the connection and love is still there. It’s the simple things that are the most important. Not taking anything for granted.

I was sitting on the beach a few weeks ago, enjoying my alone time, and watching the sun set. These words came to me:

If you can look at a sunset and feel the beauty of it in your heart, there’s still life and hope inside you.

Never Thought I’d Be Here – Part Two

My experience at the clinic was a positive one, excluding the Friday of course. Once I settled in, I started feeling better. Friday evening I slept straight through, as well as every night I was there. Which isn’t normal for me. Usually my first night sleeping out I barely sleep at all. What made it different this time? Maybe it’s because I felt taken care of and safe. That could be it.

The first night I got room service, since I had a lot of social anxiety, and didn’t want to be around so many strangers in the dining hall. The food there was better than I thought it would be. I lost a lot of weight last year, and from a healthy weight, I’m now underweight again. I’ve always been small built and skinny, and I hated it. I’d get mocked about it in school. While others were worried about gaining weight, I was desperately trying to pick up weight for most of my life. Four years ago, I finally achieved a perfect weight. But last year, I lost it all, and more. For the past few weeks I’ve been trying to go back to that weight. I’ve started eating 4 meals a day (including a protein shake). So the 3 big meals a day and 2 snack times (and hot chocolate in the evenings) at the clinic have made a difference.

I had two awesome roommates. One of them was a lot like me … The two introverts. We’re still in contact, and she refers to me as Psychologist, which I secretly love. The other one (Roommate #2) is a complete extrovert (I’m still in contact with her too), and would drive me and Roommate #1 crazy (but she knew that and was proud of it). Being in that environment, no one judges, and no matter how ‘weird’ you are, they accept you. After all we’re in the same place together, and there for somewhat similar reasons. I liked most of the people there. So many different characters. It felt like a big family. I miss the environment and the people there. Even the nurses were great.

Then there were the groups. The groups are focused exclusively on DBT, so I went to a few of those. We also had art therapy. I miss the routine there, so I’ve been trying to stick to it at home now. Lot’s of self care, eating better, having a mug of hot chocolate before bed (strangely enough, it helps me sleep), and a host of other things. It’s bound to become habit as long as I keep sticking to it.

If I could, I would have stayed for the entire three week program. At least I know that when I really need it, I can go back again.

Here’s what I learned from my time at the clinic:

It’s okay to reach out for help, and accept it when offered. It’s not a sign of weakness, but rather one of strength.

Just because I feel ashamed of doing something I never thought I’d do, like going into the clinic, doesn’t mean that I have to give in to that shame.

Support groups are valuable.

A non judgemental environment, where I’m accepted, is so important. I want to surround myself with such people, and spend more time with those who make me feel like I matter, that I’m accepted and loved just the way I am. I need to find those types of people too.

I need to keep my heart open. Because the most unlikely person, might just become someone really important. Go out and meet more people. You never know who might be going through similar challenges.

Routine is valuable and important to me.

I can’t just help and support others all the time, I must also allow others to help and support me. I can’t be responsible for everyone to the detriment of myself (thanks for this revelation Therapist).

Some people are just draining. Spending more time with those who lift me up and make me feel good, is so healing. Limit my time with people who deplete my energy. I say “limit” because I don’t want to not spend any time with them, as there’s a difference between those who drain my energy due to a difference in personality (introvert vs. extrovert), and those who are a negative force in my life.

And most important of all…
The clinic isn’t as scary as I thought it would be, hence my avoidance of them my entire life. Making assumptions and judgements about things, from other people’s accounts, or from what I see in the media, is a recipe for disaster. Everyone’s experiences are different, so why fear those things that might end up not being scary at all.

Making Progress Even When You Can’t See It

A few sessions ago, I told my therapist that I finally felt like I was making progress. That therapy is finally helping me. She jokingly asked me if I was saying that therapy hasn’t helped me before that? I told her that the seeds had been there all along, but I just hadn’t been aware of the growth until now.

Often, we don’t see the progress we have made. Hell, we may even feel like we’re just moving backward. And sometimes that’s the truth. We take a step forward, only to move two steps back. But that’s okay. That’s the thing with mental illness. There are no quick fixes. The road to recovery isn’t straight and easy. It takes a lot of work, and there will be relapses and set backs. It’s completely normal, even though it can be extremely frustrating.

When I do something different to how I would have done it in the past, Therapist will point it out and tell me to look at the growth I’ve made, and how far I’ve come. Most of the time I don’t even see what’s right in front of me, due to the negative way I tend to see myself. Other times when she points these things out to me, it fills me with a sense of pride. Because at that moment, I can see it. All the little things I do differently. All the ways in which I have improved. They’re there. I just need to open up my eyes.

If you feel like you’re not making any progress, take a look back, and you might be surprised to find that you have indeed made progress. Small steps in the right direction. When I’m in crisis, and I feel I’m getting worse or therapy isn’t working, and I just want to give up, I like using the DBT skills from the Distress Tolerance (Crisis Survival Skills) module. The Distract Skill, which is broken down into ACCEPTS as follows:

Activities – Find an activity you can get lost in.
Contribute – Help someone else. Contribute in any way you can, such as smiling at a stranger.
Compare – Compare your past self with your present self.
Emotions – Try to find a way to switch into a different emotion. Through music for example.
Pushing Away – If you can’t solve a problem right then and there, pick that problem up and imagine putting it into a box. Place it on a shelf until you’re in a better space to deal with it.
Thoughts – Name things around you. Or breathe in a word, and choose another word for the out breath.
Sensations – An ice cold shower, or lying on cold tiles seems to do the trick for me. Or if it’s raining, I stand in the rain until I’m shivering. Eat or drink something bitter or sweet. Anything that engages one or more of your senses is helpful.

I use the ‘Compare’ part quite often now. Looking at my past self, and comparing that to how I am now. It’s a very good way to see the little bits of progress I have made. It helps get me out of that crisis state, and into what Marsha Linehan (the creator of DBT) calls Wise Mind. Writing down all the improvements. It’s not easy in those moments of intensity, in the midst of the emotional storm, but once started, and written down, I usually find that storm start to slowly die down a little. Because then my mind is engaged in the current task. A positive task. Something that isn’t harming me.

Just as a side note. Using these skills in the heat of an emotional storm is difficult. Mostly because you won’t always remember them. At least that’s the case with me. So it’s important to write these skills down, along with a list of what you feel would help you in each of those ‘catagories’ during these difficult moments.

Right now, I’m treating myself to a delicious, creamy mug of hot chocolate to celebrate the ways in which I have grown over these past few months. It’s my special treat for a job well done. And even though I still have a long way to go, that doesn’t mean that I can’t celebrate the little steps I have already made.

So go on and treat yourself to something you enjoy, or that warms your heart. You deserve it.