Psycho-Babble Psychology Thread 413412

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Maintenance Therapy

Posted by Miss Honeychurch on November 8, 2004, at 16:40:41

I've just gone down from once a week to twice a month. My T calls this "maintenance." How will he know that I no longer need to be "maintained?" I'm in no hurry to go to once a month which is the next step, in fact, you could say this is causing me some anxiety.

Shouldn't maintenance last the rest of your life? What exactly is meant by this? Thoughts, anyone?

 

Re: Maintenance Therapy

Posted by shortelise on November 8, 2004, at 19:58:36

In reply to Maintenance Therapy, posted by Miss Honeychurch on November 8, 2004, at 16:40:41

No, Miss H/C. We're supposed to grow independant. We're supposed to be adult about all if this, and learn that we can live without therapy.
I hate it too. I have been at twice a month for about ... five months now I guess. And I don't feel ready to go to once a month anytime soon. I keep hoping he'll say, oh, dear, you'd better come back once a week again... but that would be failure.
Staying too long at twice a month would be failure too.

Just so you know you're not alone, I answer your posts. I don't have anything brilliant to say, nor do I have any intelligent opinions. I saw my T today and could have sat there and cried all afternoon.

I have a purring cat on my lap and a fragrant curry simmering on the stove. Life goes on.

ShortE

 

Re: Maintenance Therapy » Miss Honeychurch

Posted by Dinah on November 8, 2004, at 20:08:31

In reply to Maintenance Therapy, posted by Miss Honeychurch on November 8, 2004, at 16:40:41

My therapist would say that it means whatever you want it to mean. That if you found benefit in coming twice a week forever, then that's what maintenance would be. Or if what you need was to taper slowly to a more spaced out maintenance program, then that's what maintenance would be.

I know not all therapists think that way. Have you asked yours what he means by it?

At any rate you've only just gone to twice a month. This gives you a chance to try it out and see if you're ready to use what you learned from him solo, and check in with him twice a month for him to see how you're doing and to give you little course corrections if he sees any that are needed. No need to start thinking past that right now.

If you're using your skills in real life, and your real life is going as well as circumstances allow, then you're doing just fine. Enjoy riding that bike without trainers but with the security of someone being there if you need them. You don't need to worry about the final destination just yet.

(Pssst... do you think that between the two of you, you made a good decision as to when it was time to go from once a week to twice a month? I suspect any future decisions will go more or less the same way.)

 

Re: Maintenance Therapy

Posted by Daisym on November 8, 2004, at 20:13:09

In reply to Re: Maintenance Therapy, posted by shortelise on November 8, 2004, at 19:58:36

Not that I'm anywhere near this, but I think we all worry that we are setting ourselves up for being hopelessly dependent for a lifetime. My therapist argues often and passionately for interdependency. He believes that human beings need each other, and they need at least one person who can be completely accepting of their inner self. As I increase frequency "for now" he assures me that I won't always feel like this, and I won't always need him this much. But the frequency allows the emotions to be discharged regularly, because there is so much emotion right now. When the emotional build up is less, and you've "learned" how to discharge it with significant others, or through life coping techniques, you naturally move away from your therapist and need less frequent sessions.

Of course, if you don't have have resources to accomplish this discharge, or you are comfortable with continuing to use your therapist in this way, you may never terminate completely. My therapist is OK with this too...he says it is up to me. He still has folks he sees 4 or 5 times a year, just to check in with. Truthfully, I don't know what I wish for right now. I just wish the whole process wasn't so painful. Makes me have total empathy for the toddlers I work with when their mothers leave them.

 

Re: Maintenance Therapy » Daisym

Posted by Miss Honeychurch on November 9, 2004, at 12:23:17

In reply to Re: Maintenance Therapy, posted by Daisym on November 8, 2004, at 20:13:09

Daisy,

My T is SOOOOO against creating feelings of dependency. And I think the majority of my problem is that I am fine with therapy twice a month. I do not feel I need the weekly support anymore. However, I am not fine with only seeing him twice a month. I miss him terribly.

I suppose I fear that when I am ready for once a month therapy, I will fight it because I wouldn't only want to see him once a month. But then again, I don't want to disappoint him by not progressing under his genius tutelage :)

 

Re: Maintenance Therapy

Posted by Miss Honeychurch on November 9, 2004, at 12:28:13

In reply to Re: Maintenance Therapy » Miss Honeychurch, posted by Dinah on November 8, 2004, at 20:08:31

Dinah,

I am doing well in the real world without the weekly checkins. It is giving me a chance to use what I have learned and I know going to twice a month was the correct decision. The decision itself was actually mutual. I brought it up and he said he was actually going to bring up as well. Last March, he suggested I go to twice a month and I agreed. It was not my idea. A month later, I was back to once a week as my depression and anxiety seemed to return. So I think now he realizes that it should probably be MY decision on when to taper.

 

Re: Maintenance Therapy

Posted by Miss Honeychurch on November 9, 2004, at 12:32:39

In reply to Re: Maintenance Therapy, posted by shortelise on November 8, 2004, at 19:58:36

ShortE,

Life does go on. I suppose what distresses me somewhat about the situation is that to my T, this twice a month thing is no big deal. IN fact, it may be great for him as it opens up his schedule for new clients, new problems. And the less frequently he sees me, the more he knows he has succeeded. So he feels GREAT the less he sees of me!

 

Above for Dinah and ShortE (nm)

Posted by Miss Honeychurch on November 9, 2004, at 12:38:46

In reply to Re: Maintenance Therapy, posted by Miss Honeychurch on November 9, 2004, at 12:28:13

 

Re: Maintenance Therapy » Miss Honeychurch

Posted by shortelise on November 9, 2004, at 14:40:07

In reply to Re: Maintenance Therapy, posted by Miss Honeychurch on November 9, 2004, at 12:32:39

Are you sure?

They get used to us, they like us, and they watch us go through all the crap and see us come out of the other side in way better shape. There must be a great deal of satisfaction in that.

My T once said to me that it might be easier for both of us if I kept seeing him once a week forever, but it would be unethical. Unethical in the sense that the point was for me to be whole, and certainly the point is not for me to have a psychiatrist appendage forever.

Miss H/C, I have to believe that my T likes me, that he likes to see me, that he feels affection for me. Well, I believe it most of the time.

When you say seeing him less frequently frees up his schedule. The same would have been true a year ago. The same will be true a year from now.

What does he say when you tell him it feels like he just wants ro free up his schedule? Oh, I feel so badly for you - I would hate hate hate to feel that way about my T. I could if I let myself, could imagine that he is sick of me and my repeat business, and would just love to sink his teeth into an INTERESTING new case. But NO! I am NOT going there. Luckily I can avoid it, I don't know why, but I can.

Do you feel rushed? What does he say to that? I haven't even broached the subject of going to once a month with my T and don't intend to until the idea doesn't make me feel like crying and crawling under my bed.

Miss H/C, I send you hugs, and reassurance. He is not rejecting you, but extending his hand out with you into the world. You and I both will learn to do without that hand, won't we? In our own time. It will always be there, and we can trot back to him and ask for it for a while again.

Now I would like to go and weep for a bit, but I won't. I'll go to the library instead.

ShortE

 

Re: Maintenance Therapy » shortelise

Posted by Miss Honeychurch on November 9, 2004, at 15:33:14

In reply to Re: Maintenance Therapy » Miss Honeychurch, posted by shortelise on November 9, 2004, at 14:40:07

ShortE,

I've never told him I thought he was perhaps a little gleeful to have freed up his schedule by not seeing me so often. I would never bring that up as I'm sure he would never admit it even if it were true. But, in the back of my mind, I think he must be thinking this.

And I haven't felt rushed at all. It was a mutual decision to go down to twice a month. And for me, I've been doing well with that. I don't miss the once a week therapy so much as I miss seeing him once a week.

I know I need to give myself more credit, that I am indeed a likeable and pleasant person and he probably thinks so too. Well, at least he says he does. HE says I am a remarkable, intelligent, funny, and creative person. When we were role playing last week, talking to an empty seat pretending it was my father, he told my "father" that I was an extraordinary person and that he has really missed out on having a wonderful daughter.

However, a large part of me knows that is his job to say those things.

 

Re: Maintenance Therapy » Miss Honeychurch

Posted by shortelise on November 11, 2004, at 1:54:25

In reply to Re: Maintenance Therapy » shortelise, posted by Miss Honeychurch on November 9, 2004, at 15:33:14

Miss H/C, this makes me crazy.

Rereading this, it sounds a little angry, but I didn't write it with anger, but indignation. I would love my T to love me the way my good friends do, to think he'd like to be able to go for coffee, come to my house to eat, and go for long walks in the park of a sunny afternoon. But that's not on. He doesn't feel that way about me. He sees me when I have an appointment with him, and cares about me when he thinks about me, but that is the extent of his affection for me. Ok, I am tearing up - I really do wish I were so loveable that he couldn't resist loving me as my friends do. I regret that he can't and doesn't. But I truly do not believe that it's as mechanical as you put it.

The people who care about me see the wonderful parts of me, those parts might be what makes them care about me. The warts, well, one would guess they see those too, but the interesting person in me - or the artist, the mother, the friend, the cook, the volunteer - outweighs the warts.

When I really like someone, I tend to begin to find beauty in them, even if they are not attractive. For example, my sister has the most beautiful coloured eyes. Another friend has gorgeous skin, another extraordinary cheekbones. Yet another has a laugh like a bubbling brook. Oh, and another has grey hair that fits her head in a wavy cap.

So why oh why would our T's be immune to our better bits? You make it sound like their regard for us is just short of feigned, if not entirely feigned. You don't think there is a tilt to your head, a glint of red to your hair, a way you have of saying certain things, your laugh, or they way you look at him, that makes you dear to him in some very appropriate way? Must familiarity breed contempt?

Is there something that keeps you from allowing yourself to believe that he actually does care about you?

I know just what you mean, Miss H/C. I do I do I do. But I also need to believe that he really does care, that I am worthy of that. Writing that makes me cry. I need to believe he cares about me because that means I am worth caring about.

I have had fights with my T, not for the past year, but before that, about things like this. I just couldn't believe that he didn't hate me, that he wasn't hoping I'd leave and never come back, and I could point out all sorts of evidence to comfirm it. He would admit that he sometimes got impatient, and that he had bad days sometimes when he wasn't as present as I might like him to be. He told me the truth, or as least, I believed him. I HAD TO KNOW if what I was perceiving was the truth or not. I needed to know because my mother was incapable (and still is) of saying what she really felt. She'd clam up and we'd have to try to figure out what she wanted, how she felt, what we had done, and how to fix it.

I too miss seeing my T. The therapy is the icing on the cake.

Miss H/C, please know that I read your posts with great interest. You help me think things through.

ShortE

 

Re: Maintenance Therapy

Posted by Miss Honeychurch on November 11, 2004, at 8:55:06

In reply to Re: Maintenance Therapy » Miss Honeychurch, posted by shortelise on November 11, 2004, at 1:54:25

ShortE,

It's an interesting question you ask, why I won't allow myself to think he cares for me. I suppose I chalk it up to experience. There have been many experiences in my life where I care deeply for someone and for some reason assume they must care for me. When I disclose my feelings, expecting these same feelings in return, I am met with apathy and as it turns out, my feelings are always a lot more intense than the other person's.

So I end up humiliated and chastise myself to no end for being so stupid. I suppose I am scared of the same thing happening with my T. I feel it would be 100 times worse to learn that he doesn't care for me. I would be devestated. SO it is easier for me to go on thinking that it is part of his job to pretend to care for me.

But ShortE, you are making me rethink this stance. You are so eloquent. Thank you :) I short change myself all the time. You have really made me rethink this issue.

The world is just so full of people saying things they don't mean, just to get along in the world. I need to realize that not everyone is like this.

 

Above for ShortE (nm)

Posted by Miss Honeychurch on November 11, 2004, at 8:56:11

In reply to Re: Maintenance Therapy, posted by Miss Honeychurch on November 11, 2004, at 8:55:06

 

Re: Maintenance Therapy

Posted by shortelise on November 11, 2004, at 13:20:18

In reply to Re: Maintenance Therapy, posted by Miss Honeychurch on November 11, 2004, at 8:55:06

Miss H/C, There are enough twits in the world, plenty to go around, to make anyone wary. Maybe we are born with a specific number of them on our lifelist and once we get through them all, there are no more.
That's a funny idea.

Have you talked about this experience of rejection in therapy? Don't we choose the people we care for? I think I have always made a point of caring for people I knew would care for me back. Most of the time. Maybe there is psychopathy in that - no, I'm sure there is. There have been those who have not cared for me in the way I would have chosen, granted. And because I tried to choose only those who would care, when they didn't, aie!

Therapy has turned out to be in part about overlaying old experiences with new ones.

As I said, it is so important to me to be able to trust my perceptions. And I have learned with my T when to question them, when I need to ask myself if I am projecting or perceiving.

The thing I like most about my T is the way he cares for me. Who he is, I don't really know. I know lots of things about him, have seen him an hour a week for more than six years, but all I really know about him is that he is a good therapist for me.

The thing that makes for less humilitaion about caring so much for these damn T's is that they do everything they can to help us to feel that way - it's such an important part of the process. So it's not like we saw them across a crowded room and were smitten. We simply have participated in psychotherapy. And how we deal with those feelings, where we go with them, HOW we feel them, is, I believe, and I could be wrong, a crucial part of therapy for many of us.

I am thinking this through as I write. And the above feels really true for me.

You know you don't have to go there with your T; I don't mean to imply that if you don't, you're not doing therapy "right". You know what's right for you, I don't.

I'm so glad you find my insights valuable. I find yours so too.

ShortE


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