My ongoing therapy dilemma

[David Baxter PhD]

I don't mean to suggest that trusting people until proven wrong means you should spill your innermost feelings and fears to them. For me, that is reserved for those who have gone beyond just not proving themselves to be trustworthy; that's reserved for a select few who have proven repeatedly that they can be trusted.

As for boundaries, first that's something you can become better at with practice and I've found that it became easier for me as I got older.

 

[gooblax]

Yeah I didn't think you meant just anyone for that sort of thing.

I'm just scared that opening up to my therapist is going to come back and hurt me somehow. Once again tonight I'm having thoughts about postponing next session (even though it's 2 weeks away) but for the first time I'm very much aware of some kind of fear and using it as a way to protect myself.

 

[David Baxter PhD]

Life and positive change always entails some risk but without risk nothing changes and you condemn yourself to living a life that is not making you happy.

“And the time came when the risk to remain tight in a bud was more painful than the risk it took to blossom.” ~ Anaïs Nin

 

[gooblax]

Making myself sad about being unworthy again. I know I'm supposed to be disagreeing with the critic but it's hard. It's like a mental wall that makes it physically difficult to think the disagreeing thoughts. If I was going to disagree I would say that my psych said he did want to help and tried to help, so the situation back then can't be used as evidence that he just saw something in me and knew I wasn't worth it.

 

[David Baxter PhD]

It is hard, very hard to dismiss such thoughts.

I think the best advice though comes from the book Brain Lock by Jeffrey Schwartz.

Basically, the approach he recommends is not to try to fight the thought or push it away (because that can make it stronger) but rather just to label it for what it is and let it go into the background, like a noisy vehicle passing you on the street (you can try imagining watching it come toward you and then passing you with the doppler drop and fading into the distance).

So acknowledge the thought along the lines of, "There's that annoying thought again. Just ignore it. Just let it go. Pay it no attention. Eventually it will stop for a while like that annoying yappy little dog. Yes, it will come back but when it does I'll just do the same thing again: ignore, let it go, pay it no attention."

 

[gooblax]

Avoided sabotaging myself for now. But it's very tempting to postpone next week's session so that it can go to someone else who needs it more or so my psych can have the time for himself / his family.

 

[David Baxter PhD]

gooblax, your needs are not less than anyone else's.

And it is not your responsibility to manage your therapist's time and to balance work with personal and family life. That is totally his job.

The one place where you should ALWAYS try to put yourself first is in your therapy sessions. They should be about you and your concerns and nothing else. And you should not feel the need to protect your therapist or anyone else in those sessions. Make them about you and you alone.

 

[gooblax]

gooblax, your needs are not less than anyone else's.

I think they are, though. I'm in a fortunate position and not dealing with anything difficult, I'm not in lockdown like millions of people, not dealing with oppression or war etc. etc. etc.​

​

I know it's his job to manage his time, but I could make it easier.​

 

[David Baxter PhD]

It's not up to you to make his job easier. Your job is to use your sessions to address the things that are troubling you or discouraging you or causing you distress. Everything else is his to worry about.

You've spent far too much of your life putting other people first — your parents, your boyfriend, your colleagues at work to a lesser extent — and feeling that it's your responsibility to keep them happy. And that impacts everything you are trying to address in therapy.

In some ways, this may be your biggest issue or problem in that it underlies almost everything else you have talked about here.

And we both know that if you were to ask him your therapist would echo what I am saying here.

 

[gooblax]

Realistically I know it's not all (or even very much at all) on me to make my therapist's job easier. But I'm sure he's finding it hard with the extended lockdown and not being able to do the things he normally does, having to do homeschooling with his kid, not being able to see his other family... Plus then having clients with the same sorts of problems, plus other problems... It just seems bad to add my stuff as well, plus why would he want to help with that when there's more important things to do?

I know he'd say that he wouldn't do it if he didn't want to, but he could just decide he doesn't want to deal with it anymore. And he'd also say not to make assumptions or think for him, but it really feels like I'm doing the wrong thing and I should know that it's wrong and to assume otherwise is a mistake that will hurt him and hurt me somehow.

I'll admit I do kind of try to put other people first (or avoid situations so that I won't have to)... Like I have to set up another mentoring meeting (cause she eventually replied) but I was trying to get my boyfriend's "permission" to set it up for next week, knowing it usually means not seeing each other that evening. He was just like "That's up to you" but I know he doesn't like it when we don't spend time together so it's a no-win situation.

 

[David Baxter PhD]

Realistically I know it's not all (or even very much at all) on me to make my therapist's job easier. But I'm sure he's finding it hard with the extended lockdown and not being able to do the things he normally does, having to do homeschooling with his kid, not being able to see his other family... Plus then having clients with the same sorts of problems, plus other problems... It just seems bad to add my stuff as well, plus why would he want to help with that when there's more important things to do?

I can tell you from experience that working with clients as a therapist was frequently a welcome break from whatever was stressing me in my personal or family life. It meant that for a period of time, at least, I could leave my own issues behind and help someone else with theirs.

 

[Daniel E.]

Your therapist raised his rate not long ago. So that will keep his schedule more open maybe A lot of therapists here have openings every day of the week. So everyone can access therapy if they can afford it. My current therapist generally requires a session at least every three weeks, but I always do weekly therapy now that I have better health insurance.

 

[gooblax]

I can tell you from experience that working with clients as a therapist was frequently a welcome break from whatever was stressing me in my personal or family life. It meant that for a period of time, at least, I could leave my own issues behind and help someone else with theirs.

Would that only work with positive things where the client makes progress? I can't imagine it being a welcome break if it's just something negative.

Your therapist raised his rate not long ago. So that will keep his schedule more open maybe A lot of therapists here have openings every day of the week. So everyone can access therapy if they can afford it. My current therapist generally requires a session at least every three weeks, but I always do weekly therapy now that I have better health insurance.

I've heard that here it's difficult to find anyone who's taking new clients due to people struggling with lockdown stuff.


Like... I'm less worth caring about than some other clients so doesn't that make it my duty to move on?

 

[Daniel E.]

If you have a moral obligation to anyone, it is to ruminate less for your own benefit. Easier said than done, and one day at a time. There will always be endless content in the world that one can ruminate/agonize about. As mentioned before, one way out is to slowly continue to take your negative/unwanted thoughts less seriously. That makes it easier to concentrate on other things, which in turn makes one more relaxed.

Here's a metaphor. Ruminating is like flying at low altitude. Eventually, you pay the price (e.g. low self-esteem, low job satisfaction, low relationship satisfaction, or low life satisfaction) since the brain doesn't necessarily come with its own "PULL UP" warning.

In other words:

Frontiers | Protective and Vulnerability Factors in Self-Esteem: The Role of Metacognitions, Brooding, and Resilience

The aim of the current study was to explore protective (resilience) and vulnerability factors (dysfunctional metacognitions and brooding) for self-esteem. A ...

www.frontiersin.org

From a metacognitive point of view, low self-esteem could be understood as the result of a maladaptive coping style, when a person responds to negative thoughts about oneself by ruminating about one’s flaws and shortcomings and engaging in self-criticism and negative self-talk. This response style, influenced by metacognitive beliefs, traps the individual in a vicious circle that further reinforces lower levels of self-esteem.

 

[David Baxter PhD]

Would that only work with positive things where the client makes progress? I can't imagine it being a welcome break if it's just something negative.

I've heard that here it's difficult to find anyone who's taking new clients due to people struggling with lockdown stuff.


Like... I'm less worth caring about than some other clients so doesn't that make it my duty to move on?

No, not just positive things. And you can't always know immediately whether a client is making progress.

You are not less worth caring about than other clients.

It is not your duty to move on. It is your duty to do what's best for you and to try to work toward a self-concept and a life for you that can make you happier, more at peace, or at a minimum more content with your life and more accepting of yourself. I see progress in that regard. But you are not ready to move on yet. You need to continue the work in therapy to maintain that progress and move further toward your goals.

 

[Daniel E.]

BTW:

OCD - Thinking the Unthinkable

Thinking the Unthinkable by Steven Phillipson, Ph.D., Center for Cognitive-Behavioral Psychotherapy Originally printed in the Obsessive-Compulsive Newsletter, 5 (4), 1991 As I conceptualize Obsessive-Compulsive Disorder, the tree of the overall syndrome has three main branches: the...

forum.psychlinks.ca

I must think through the consequences of even my smallest actions.

It is essential for me to consider all possible outcomes of a situation.

I am more likely than other people to accidentally cause harm to myself or to others.

Even if harm is very unlikely, I should try to prevent it at any cost.

For me, not preventing harm is as bad as causing harm.

It is ultimately my responsibility to ensure that everything is in order.

Harmful events will happen unless I am very careful.

 

[gooblax]

But it's very tempting to postpone next week's session so that it can go to someone else who needs it more or so my psych can have the time for himself / his family.

This, again. More about how it'd be better for him if I stopped being his client.

 

[Daniel E.]

See other-directedness, etc: Schema Therapy

The idea being that these schemas are developed in childhood. So they will take a while to overcome. "Baby steps." So not letting these thoughts control your actions is a huge improvement, even though the thoughts continue. Like suicidal thoughts -- it's okay to have them. It's acting on them that is the problem.

 

[gooblax]

Had my session today. I managed to avoid arsing it up, at least.

I wanted to play a song on piano for him but got super nervous while waiting for him to log onto the session and was going to give up on the idea, but I told him about it and he encouraged me to give it a try. It went reasonably well. Hopefully it brightened up his afternoon a little during their long lockdown, and it gave me a chance to see if I could play without getting totally distracted by nerves.

He's suggesting that I view the usual negative thoughts as "a habit" and not take them too seriously. They're very emotionally compelling thoughts though, so it's not obvious how that's going to work out.

Then, of course, there's the other problem - the "I like him so much because he's a kind, listening, encouraging therapist" feelings and missing him 🤮

 

[David Baxter PhD]

Nothing wrong with having positive feelings for your therapist, gooblax. He's the one person in the world right now who wants to help you be happier with being you.

Well other than us here.