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.

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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.

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Taking Responsibility For My Own Insecurites

There are times where I find myself feeling insecure about the smallest things. Only, these things aren’t so small to me in the moment. During these times, I see them as something that threatens my very happiness, sanity and survival.

For example, if someone doesn’t respond the right way to a text or email. Often though, there is no ‘right way’. I can find something wrong no matter what someone may say. I put them in a position where they can’t win. Being oversensitive is a common BPD trait. It’s not fun.

Another example is someone not responding to a text or email in the time frame that I think they should, in order to make me feel secure.

Both of these examples rang true for me yesterday with regards to my girlfriend. I’m going to call her Jasmine from now on. She went home yesterday to continue working on her thesis. She works on it when she’s here too, but there are more distractions… Me being one of them, of course.

A few hours later, my Rational Mind went offline. It was as if I had forgotten that Jasmine had work to do, and that was what she had to focus on. In those moments, I thought that it had to do with me. That maybe I had done something wrong, and she was angry with me. I was about to ask her whether she was mad at me, but then I realized something.

I can’t expect others to be responsible for my insecurities. They’re mine. They don’t belong to anyone else.

So instead of asking for reassurance this time, I decided to deal with it myself. I’ll never learn how to self-soothe and deal with my own emotions if I constantly expect others to make me feel better. Just because I didn’t get the care and reassurance I needed as a child and teen, I’m an adult now. And I’m perfectly capable of reassuring myself. It’s easier said than done of course, but that’s not going to stop me from working on it.

I started thinking about what I could do to deal with these insecurities, and came up with an idea. I took a piece of paper and made a few columns. And since I like making things as easy as possible (otherwise I just procrastinate), I made the same thing in MS Word and saved it as a template for future use. For the purpose of this post, I’ve put my exercise in as an example and made a screenshot.

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After doing this, I felt so much better, and could focus on my own activities. When those same insecurities would rise up, I would just look at my list. I’m the queen of catastrophizing. I don’t want to be this way anymore. And only I can change it.

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.