My ongoing therapy dilemma

[gooblax]

I'm officially confused by this.

Isn't that what talking to any therapist is all about? What about it makes you think it's not okay?

I dunno, just... It seems wrong to get emotional support and it's going to change into a "stop that and just do better" sort of thing sooner or later so it's not safe to trust it.

 

[David Baxter PhD]

It is safe to trust it, @gooblax, for however long you find it helpful.

 

[gooblax]

It doesn't seem possible for it to be safe to trust it. I've been feeling like I trust my psych more and have been giving more information but I'm wary that it's not necessarily a good thing. It's weird being able to say things and get a non-intrusive and non-upsetting response. There's various factors in not trusting how long that will last. I discussed them with psych a couple of sessions ago - he could just get fed up and start judging me the way I judge myself, he could decide to change career, or he could become incapacitated somehow and unable to continue. The first seems the most likely, even though he said it's not likely. Everyone has problems and mine are so non-problem-ish that they don't deserve help or even to be mentioned. I re-triggered emotional buy-in to the thoughts by reading a Q&A thing somewhere but they're true - continuing to see my psych is just because I'm pathetic.

 

[David Baxter PhD]

@gooblax

You say you don't think OCD applies to you, yet the paragraph you just wrote is a textbook example of negative self-critical intrusive OCD thinking, from start to finish.

After a period of difficulty getting this therapist to understand what you need and don't need, you are starting to trust him more and you have anxieties or worries about whether that can last. You are also trusting him more and therefore disclosing more to him and that also creates anxiety because it's unfamiliar ground for you and goes against your previous coping strategy from childhood of revealing nothing to avoid the negative reactions you received from your parents.

The anxiety is normal and fully understandable.

The OCD part is taking those worries, twisting them into self-critical and self-denigrating statements and conclusions that this is all doomed to failure and that you don't "deserve" it anyway so it should be doomed to failure.

The normal anxiety is something you need to experience and sit with and explore in future therapy sessions.

The OCD part on the other hand needs to be ignored for what it is: a distortion and exaggeration and black-and-white negative version of normal worries and anxieties that has no basis in reality.

 

[David Baxter PhD]

@gooblax

You might find this of interest:

Where Our Inner Critic Comes from and How to Tame It

Where Our Inner Critic Comes from and How to Tame It by Debra Mittler, TinyBuddha.com June 8, 2021 "Your inner critic is simply a part of you that needs more self-love." ~ Amy Leigh Mercee We all have that critical and judgmental inner voice that tells us we’re not good enough, smart enough...

forum.psychlinks.ca

 

[gooblax]

You say you don't think OCD applies to you, yet the paragraph you just wrote is a textbook example of negative self-critical intrusive OCD thinking, from start to finish.

After a period of difficulty getting this therapist to understand what you need and don't need, you are starting to trust him more and you have anxieties or worries about whether that can last. You are also trusting him more and therefore disclosing more to him and that also creates anxiety because it's unfamiliar ground for your and goes against your previous coping strategy from childhood of revealing nothing to avoid the negative reactions you received from your parents.

The anxiety is normal and fully understandable.

The OCD part is taking those worries, twisting them into self-critical and self-denigrating statements and conclusions that this is all doomed to failure and that you don't "deserve" it anyway so it should be doomed to failure.

The normal anxiety is something you need to experience and sit with and explore in future therapy sessions.

The OCD part on the other hand needs to be ignored for what it is: a distortion and exaggeration and black-and-white negative version of normal worries and anxieties that has no basis in reality.

I follow you up until the bit about the extra statements and conclusions being distortions. Because to me they're more based on what I see as universal truths. And with that article, it's not a good idea for me to reduce the 'inner critic' because that's an open invitation to messing up and getting hit by one of the universal truths.

 

[David Baxter PhD]

But objectively they are definitely NOT universal truths. They are universal distortions of truths.

 

[gooblax]

Believing that is too big of a risk to take.

 

[David Baxter PhD]

Believing that is too big of a risk to take.

Why? What do you fear happening? What exactly is the risk to you? What's the worst case scenario that you imagine?

 

[gooblax]

Worst case... Everyone judges me as weak and pathetic but I don't realise because I'm not guarding against it. Because of not realising that my actions and words are pathetic, I don't act in a way that's worthy of respect or tolerance. So everyone hates and rejects me and either belittles or ignores me. My family would be embarrassed of me, and they'd try to correct the problem by telling me what I'm doing wrong but I wouldn't understand so there'd be some conflict there. I'd be upset because of all the rejection but wouldn't know what I'm doing wrong and there'd be no way to fix it. My psych would hate seeing me and would end therapy, and you guys wouldn't talk to me anymore. Maybe not to the comical extent of rotten tomatoes being thrown at me from passing cars, but I wouldn't have a job because no one would be able to stand working with me, I'd have to try and do some online freelancing but I wouldn't realise how much I was overrating my "skills" so even that would fail.

 

[David Baxter PhD]

Worst case... Everyone judges me as weak and pathetic but I don't realise because I'm not guarding against it. Because of not realising that my actions and words are pathetic, I don't act in a way that's worthy of respect or tolerance. So everyone hates and rejects me and either belittles or ignores me. My family would be embarrassed of me, and they'd try to correct the problem by telling me what I'm doing wrong but I wouldn't understand so there'd be some conflict there. I'd be upset because of all the rejection but wouldn't know what I'm doing wrong and there'd be no way to fix it. My psych would hate seeing me and would end therapy, and you guys wouldn't talk to me anymore. Maybe not to the comical extent of rotten tomatoes being thrown at me from passing cars, but I wouldn't have a job because no one would be able to stand working with me, I'd have to try and do some online freelancing but I wouldn't realise how much I was overrating my "skills" so even that would fail.

Wow. That's very extreme, even for a worst case scenario.

How likely do you think that is as an outcome?

 

[gooblax]

Wow. That's very extreme, even for a worst case scenario.

How likely do you think that is as an outcome?

It seems pretty likely. The only mitigating factors are:
1) I might choose not to bring up unknowingly weak/pathetic things while I'm at work because of the context so that might limit the damage done there.
2) It would take a pretty long time for me to meet and lose the respect of literally everyone, as a numbers game. So it might be a slow decline into the worst case scenario and I'm not sure how many people I'd eventually get through over the rest of my life.

 

[David Baxter PhD]

The disconnect from objective reality in your thoughts is pretty extreme.

The reality is that, parents aside, none of what you described is at all likely. Indeed, it is very unlikely.

 

[gooblax]

I know you don't have any reason or motive to lie about it, and you've interacted with more people than I have, and cultural differences are surely not large enough to produce such a discrepancy. But I don't think I'm wrong.

 

[Daniel E.]

But I don't think I'm wrong.

Are you are trying to fight fire (thoughts) with fire (more thoughts)?

When I do that with existential OCD, I can get somewhere but not very far.

Only when I am sufficiently bored/frustrated with my OCD am I more willing to take a leap of faith and do other approaches that increase "cognitive flexibility" like mindfulness (metacognitive therapy, tai chi, etc), behavior therapy (e.g. "fake it till you make it" or "the therapy of desire"), and anything else that is good for the brain (more exercise, more stimulation/novelty/vacations, decluttering the house, meds -- even a low dose can be helpful, etc.) -- in addition to therapy.

 

[gooblax]

I don't know that I'm necessarily trying to do anything, except compare a felt sense of correctness between the two options.

My therapy homework this time is to go to the shops and scope out places to buy clothes, in advance of buying them so I can see if there's certain places that seem more comfortable than others. I put it off last weekend, put it off today, so that leaves tomorrow if I'm going to do it before my parents visit. I'm dreading it. I don't know what's worse, going into the shops or knowing how much time will be wasted not buying anything. Very tempted not to go but then it'll be even worse as the date of the party approaches.

 

[Daniel E.]

I don't know that I'm necessarily trying to do anything, except compare a felt sense of correctness between the two options.

As a reminder: "Increased neural error monitoring, as measured by the error-related negativity (ERN), is a transdiagnostic neurobiological marker of anxiety." (Nature)

 

[gooblax]

As a reminder: "Increased neural error monitoring, as measured by the error-related negativity (ERN), is a transdiagnostic neurobiological marker of anxiety." (Nature)

I wonder how that contributes to the 'painful face zap' sensation when making a physical mistake like accidentally knocking something off a table. I don't know if it's a spike of adrenaline or what, but I've never found the right search terms to find anyone describing it.

 

[gooblax]

My therapy homework this time is to go to the shops and scope out places to buy clothes, in advance of buying them so I can see if there's certain places that seem more comfortable than others. I put it off last weekend, put it off today, so that leaves tomorrow if I'm going to do it before my parents visit. I'm dreading it. I don't know what's worse, going into the shops or knowing how much time will be wasted not buying anything. Very tempted not to go but then it'll be even worse as the date of the party approaches.

Man this is ridiculous. I can barely get myself into the stores. It hasn't been a total disaster and I've made myself buy a wallet and a hoodie but I can barely glance at shirts or suit stuff.

 

[David Baxter PhD]

Keep at it, @gooblax

It will get easier the more you do it.