My ongoing therapy dilemma

[Daniel E.]

One winning scenario would be greater self-compassion, e.g:

How Stress Can Cause Weight Gain

Stress can have a serious effect on health, including your body weight. Learn how high stress levels are linked to weight changes and what you can do about it.

www.verywellmind.com

“Bodies change. This is a fact. If they changed in the last 12 months, they may well have changed, pandemic or not. Your body is not a problem. Please don’t let wellness culture suggest that a changing body is a reflection of your humanity, your goodness, and your belonging.”

 

[gooblax]

Best I can hope for is that I inadvertently end up at a COVID exposure site and have to isolate on the day of the party.

 

[David Baxter PhD]

That might seem best but would it get you any closer to self-acceptance?

 

[gooblax]

Well no. But do you think going wearing something ridiculous and ill-fitting will either?

 

[gooblax]

On the COVID front we've got mandatory masks back (have to wear them in the walkways/kitchen at work but not at the desk) and a 3 day lockdown here starting tonight. Sydney has a 2 week lockdown which is obviously worse.

Although the lockdowns don't affect me much, I'm kind of glad that we have something here too so that I don't just feel bad for my psych having his school-holiday-plans to see his kids squashed again.

I don't know when the store is going to ship my clothes. Their email said they were moving warehouse over the weekend and would let me know. But it doesn't look like I'll get them this week.

 

[David Baxter PhD]

When is the event? How much time do you have?

 

[gooblax]

It's on the 17th (assuming it goes ahead), so there's still plenty of time for the clothes to arrive. But I will need some time to get the pant and sleeve lengths sorted out... So I dunno if I try to book in a tailor for that in advance, or wait til it arrives.
I also still need to buy a shirt.

 

[gooblax]

The therapy billing is back on schedule, with my last session's receipt within a week of the session.

I've still been making myself a bit miserable about things, but have been trying to remind myself that it's the exact opposite of what my psych said (e.g. thinking that he doesn't care and doesn't want to see me anymore, but he said that he does care and that he wouldn't keep treating me if he didn't want to).

At least things are a lot better when he's not routinely saying/doing something that upsets me, then I start blaming myself for being upset and trying to make emotionally-unconvincing excuses/reasons for why it's ok. He was saying that he's had to work on communicating differently with me and I'm curious about what he's intentionally changed on his side to have made these improvements. I've been pretty open about what I intentionally changed on my side... Main ones being no emails so he can't upset me through that, and having a 'good things list' to share with him at the start of the session so I can practice being more open and sharing stuff and/or feel more prepared to share those things rather than him asking about it and me not being ready to talk about it, or feeling like I don't get a chance to talk about what I wanted to. E.g. the difference between "Did anything good happen over the last 3 weeks" "I dunno, nothing remarkable" vs. "Well #1 on my good things list is ____." Which ends up feeling a lot more connecting and good, even though it can be hard to get myself started.

He's got better at noticing when I've started checking out in my head too, and last time he caught it before I'd even really noticed. So that's also an important part of avoiding unnecessary communication upsets.

 

[gooblax]

How do I get over my feelings about not getting sufficient help from therapy the first time around? People on psychlinks at the time tried to help but otherwise everything was screwed up.

 

[Daniel E.]

On the positive side, that would imply you are getting "sufficient help from therapy" now?

My negative thoughts/feelings tend to override my positive feelings, especially, of course, when feeling more depressed or anxious. It is much easier for me to remember things that went wrong, like the dog that ran away, or think about things that could go wrong. Or, in the case of therapy, the therapy that didn't help rather than the therapy that did help.

One way to acceptance (or greater cognitive flexibility) is cognitive defusion, which is often my go-to since it's a relatively stable Zen-like perspective (or non-perspective), even for when I feel depressed/angry/pessimistic. Otherwise, I tend to throw the baby out with the bathwater.

Or to put it in another way (Marsha Linehan style): You have enough problems now. Life is hard enough in the present. You don't need more problems (from the past or future).

 

[David Baxter PhD]

How do I get over my feelings about not getting sufficient help from therapy the first time around? People on psychlinks at the time tried to help but otherwise everything was screwed up.

How old were you back then?

 

[gooblax]

On the positive side, that would imply you are getting "sufficient help from therapy" now?

Comparatively on a binary sufficient/insufficient scale, yeah.

One way to acceptance (or greater cognitive flexibility) is cognitive defusion, which is often my go-to since it's a relatively stable Zen-like perspective (or non-perspective), even for when I feel depressed/angry/pessimistic. Otherwise, I tend to throw the baby out with the bathwater.

Or to put it in another way (Marsha Linehan style): You have enough problems now. Life is hard enough in the present. You don't need more problems (from the past or future).

It's just upsetting. Like I was trying really hard to do the right thing and just couldn't get anywhere. And it's like why can he help me now when he couldn't back then? What's so bad about me that I'm worth it for some things but not for others?

How old were you back then?

17-19

 

[David Baxter PhD]

1. Clients need to learn how to adjust to therapy to communicate what it is they need help with and to maximize the benefits of therapy. You are still learning how to do that with this therapist.

2. Therapists also sometimes (perhaps often) need to adjust their communication styles in order to help clients. I gather from your comments recently that he is at least starting to do that, partly in response to changes you havemade in how you communicate during your sessions, and partly because he now knows you better/

 

[Daniel E.]

17-19

I was hospitalized during that age several times, for about two months total. I didn't respond well to therapy, at least how people "should" respond to therapy. I still tried to kill myself, still quit jobs, and still quit college. I was very verbal/articulate in therapy -- still didn't help. I thought therapists were well-meaning but amazingly ignorant -- just like everyone else. OTOH, I didn't kill myself either.

So part of the reason I became interested in psychology was to gain insight on my own. And then after that, I was more receptive to therapists since I had a better understanding of where they were coming from. Not to mention that insight/habituation/acceptance generally increases in adulthood.

 

[gooblax]

So because I never made a suicide attempt it's all fine then and I should shut up then yeah? Only real problem is that I can't hack being my weak pathetic self.

 

[David Baxter PhD]

So because I never made a suicide attempt it's all fine then and I should shut up then yeah?

No. That's not at all what Daniel said. Not even close. He was simply describing his own experience and how he learned to derive more benefit from therapy.

Only real problem is that I can't hack being my weak pathetic self.

You are not weak or pathetic.

However, clearly there are things you don't like about yourself or things you would like to change about yourself. A desire for change is the single most important requirement for success in therapy so you're on the right track. Just keep going and don't let the negative self-critical thoughts deter you from that path.

 

[Daniel E.]

I would assume the ideal is to have preventative measures even in very young childhood. But that rarely happens for things like anxiety. Instead, traits like perfectionism are rewarded by parents and the school system -- despite the trend of mindfulness in schools:

Schools Are Embracing Mindfulness, But Practice Doesn't Always Make Perfect

One in 5 American children struggles with anxiety. To help students cope, more and more schools are turning to mindfulness — but the explosion of interest has some researchers advising caution.

www.npr.org

One in 5 American children struggles with anxiety, according to the National Institute of Mental Health, and almost half experience at least one serious stressor at home — like divorce, poverty or a parent's addiction — according to the nonprofit Child Trends...

It's hard to do mindfulness effectively unless teachers walk the talk. And that, of course, takes a holistic approach, with lots of resources, time and support — three things that are often in short supply in the nation's schools.

Personally, I think my OCD wouldn't be as bad if I didn't have a very religious upbringing. That just reinforced everything, like all-or-nothing thinking.

 

[gooblax]

It's just surely he would've pretended to care back then if:
- I was worth caring about,
- I had real problems,
- I was someone else and not me, which is really what it comes down to in the end.

 

[Daniel E.]

“Most people experience occasional doubt about relationships, but for people experiencing relationship OCD, anxiety, and doubt hijack their relationships.” ~ Misti Nicholson, PsyD

That's why I mentioned the zen of cognitive defusion since that helps my "though-action fusion." All humans have some degree of magical thinking at times. But with OCD, there is specifically thought-action fusion, a kind of negative/painful magical thinking. So just having a thought about something makes it feel more real/possible -- activating anxiety, avoidance, etc.

This is one reason OCD is related to paranoid/schizophrenic thinking. e.g. Just having the thought that one could be arrested triggers the fear that it could happen. or in the case of relationship OCD, just having the thought that someone important to you doesn't care makes it seem more real. But in the case of OCD, there is more insight/doubt than someone with simply paranoid thinking.

Another negative form of magical thinking is taking things personally even when they are not personal -- which is something everyone does.

 

[gooblax]

Ok, although I'm still not on board with my thoughts being OCD-like. But I'm feeling better this morning and not so upset, so I'm more willing to take in other input.
Maybe I need to find a way to "grieve" the experience and how alone I felt and how crappy everything was, first, before I can move on. I dunno.