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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by mair on March 9, 2005, at 13:05:36
First my T recently returned from a l week vacation with the news that she spent some time on the plane catching up on some journal reading, and that she read two articles that made her think about me alot. One related to anxiety disorders in children and the other to GAD. I know she thinks I probably had an undiagnosed, untreated anxiety disorder as a child, but GAD is not anything we've ever spoken about before, and I frankly don't think she gave it alot of thought until she saw that some of the symptoms described in the article brought me very much to mind. She read me sections from both articles which was strange, because I don't like hearing myself described in clinical terms; hearing her read these articles, felt like that. Also, after reading one characteristic (I don't remember from which article), she exclaimed something like "well that's certainly you!") That really threw me off because while I think she's right, the characteristic described, has only been discussed by us very briefly on one occasion. So it's weird to see that she's thinking about things that aren't really being discussed - things that aren't being discussed because I don't want to raise them.
Over and above that I recently told her that it was starting to occur to me that maybe I'm in the middle of another major depressive episode. All the depressive feelings I've been experiencing for awhile now are having a permanent feel. I haven't experienced this sense of permanency for years - For a very long time, I've been able to tolerate alot of depressive feelings with the knowledge that they would go away quickly. It dawned on me that I've been feeling especially down for weeks now and I seem to have lost the confidence that my worst feelings are just transitory.
So now my T keeps coming up with all these new suggestions about what I should be doing and new theories as to why I'm struggling so much and she's expressing them in the context of anxiety and not depression. It sounds like so much psychotrash to me and she sounds unclear enough about it herself for me to feel like she's floundering trying to figure out how to help me - sort of grasping at things.
The worst of it is that while she thinks I struggle alot with the conflict between wanting to be closer and needing to protect myself, at the moment the pendulum has definitely swung in the direction of not really wanting her to know me any more than she does now. There's so much I don't want to talk about.
Yesterday, very much out of the blue, she asked me if I'd like to start seeing her 3x a week for awhile, until I feel steadier, I guess. Several weeks ago when I was feeling more attached to her, I would have grabbed this opportunity in a flash. Now I can't see why I'd want more therapy when therapy is so difficult and anxiety-producing for me.
I really need one of us in the room to be clear on what direction we should be taking, and I know it can't be me. The anxiety components are too new and confusing to me; I'm too overwelmed I think to take them in and make some sense out of them. And I don't know what to do about the offer of an extra session. If it would help stop this episode from escalating, I guess it might be worth it, but I've spent so much of the last couple of sessions floundering around trying to avoid opening up to her - more therapy just might make things worse.
I really can't figure out what I should be doing.
Mair
Posted by annierose on March 9, 2005, at 16:16:52
In reply to My T is confusing me (sorry, long), posted by mair on March 9, 2005, at 13:05:36
Mair -
I didn't want your post to go unanswered, but I don't know if I have any words of wisdom for you to consider. You wrote about the direction your therapy is taking, and I think that is a fair question to ask your T and discuss. I agree that reading that article would have thrown me for a loop. Anytime my T describes me, I'll tell her "now be careful". She knows I'm extremely sensitive and no matter what is said, I'll find a way to see the worse in it.So, a clinical article would make me feel defensive. Maybe you can ask her, "I don't understand why you thought it would be helpful for me to hear that article? Can you say it in your own words?"
I'm not very good with words, but I am able to tell my T when I feel offended (in a nice way). Or I'll say, "rationally, I know this is not what you meant, but I heard ...."
I do go 3x per week (I just added the third session in Nov/Dec). It feels right for me, but it is such a personal decision, AND it is so costly. I do think the third sessions makes the relationship even more important and intense. Something to think about. Good Luck,
Annierose
Posted by Aphrodite on March 9, 2005, at 16:52:09
In reply to My T is confusing me (sorry, long), posted by mair on March 9, 2005, at 13:05:36
Considering the hard life events you have had of late, it is no wonder that you feel things are not going well. I, too, bristle at being described in clinical terms. And frankly, if what we have and need to do about can be found in articles or books, we would all save some money and heartache and fix ourselves! We pay them to analyze the problem in a personalized way, not a checklist. On the other hand, it bodes very well that she is researching and thinking of you so much -- she's committed to you and obviously cares. However, maybe she should just have applied what she learned to you in a personalized way instead of reading it to you.
Did you tell her about your reactions? I think it's definitely worth mentioning and how it's affecting your decision about how many sessions per week you need.
I'm sorry you are having such a difficult time right now.
Posted by Dinah on March 9, 2005, at 17:24:49
In reply to My T is confusing me (sorry, long), posted by mair on March 9, 2005, at 13:05:36
I found that three times a week helped me during my most agitated period. But now, I'm sort of thumb twiddling the third session. I suppose nature's telling me I'm ready to back down.
I know it's hard, but do you think you can look deep inside, beyond the distance and the irritation and see if you can figure out what you really need right now? It might be an extra session, or it might be extra time to work or sleep in.
I hate it when my therapist goes to a seminar. He comes back wanting to try out what he learned. :) It takes a session or two for it to wear off. And I help by telling him frankly when he's off the mark. Is she off the mark?
Posted by mair on March 9, 2005, at 18:19:01
In reply to Re: My T is confusing me (sorry, long) » mair, posted by annierose on March 9, 2005, at 16:16:52
She did ask me first if I'd be ok with her reading parts of these articles to me. So I guess I had a choice there, although it's hard to make an informed choice without reading them myself.
It's taken some very hard and intensive work for me to reach the point where I can acknowledge that she cares about me and that I care about her. I couldn't have gotten there at all without going at least 2x a week, and I suppose 3x a week would have worked better. Frankly though, I've sort of lost that longing for attachment I had a few weeks ago, and I really feel resistant to getting any closer. Within that framework, 3x a week sounds excruciating to me.
And yes it is costly. I got the wonderful news just a couple of hours ago that my car either needs a simple $125 part, or a whole new transmission to the tune of $3-4,000. And I'm about 3,000 miles beyond my transmission warranty. So between that, tons of other bills, and the fact that my income is down as a reflection of much poorer work production, I'm not feeling particularly flush.
Thanks
Mair
Posted by mair on March 9, 2005, at 18:27:45
In reply to Re: My T is confusing me (sorry, long) » mair, posted by Aphrodite on March 9, 2005, at 16:52:09
I think I will tell her tomorrow that she's making things too complicated for me right now. That I can only process a limited number of theories and solutions at the moment. And when she suggested coming 3x a week, I did suggest to her that it wasn't a very appealing idea since therapy is a trigger for me now. Her idea seems to be that she needs to keep me grounded in the present - to avoid ruminating about the larger issues of what another depressive episode might mean. I can't quite envision a session where I successfully stay grounded in the present.
I guess I was taken aback also because the offer of another session seemed so unlike her. There have been times when I thought I might really like to see her for an extra session or two, but I just never felt that I could ask for that.
BTW - I would have been incredibly touched by your T's suggestion. I know it sounds like an incredibly difficult thing to do, but I hope you reach a point where you feel you can take him there.
Mair
Posted by mair on March 9, 2005, at 18:37:32
In reply to Re: My T is confusing me (sorry, long), posted by Dinah on March 9, 2005, at 17:24:49
Yes, dinah, I do think she's off the mark. I've thought in the past that she has occasionally been too quick to draw vast conclusions from a small amount of fact. So, for instance, I've never been able to buy into her conclusions of how I must have reacted to my parents as a child because I have no independent memory of having the feelings she suspects I had. You know how we can all find ourselves in the most generic horoscope? Her reading me into these articles had the same feel as that.
I like it so much better when I have a clear sense of where we're headed. Even if I don't have that sense, I'm ok when I have the confidence that she has a clear direction. It makes me feel pretty insecure when it seems that she's floundering some. I know it's temporary, but still annoying.
Mair
Posted by Aphrodite on March 9, 2005, at 19:06:02
In reply to Re: My T is confusing me (sorry, long) » Aphrodite, posted by mair on March 9, 2005, at 18:27:45
> I think I will tell her tomorrow that she's making things too complicated for me right now. That I can only process a limited number of theories and solutions at the moment. And when she suggested coming 3x a week, I did suggest to her that it wasn't a very appealing idea since therapy is a trigger for me now. Her idea seems to be that she needs to keep me grounded in the present - to avoid ruminating about the larger issues of what another depressive episode might mean. I can't quite envision a session where I successfully stay grounded in the present.
I've worked for at least a year now on techniques to stay in the present. It's so, so hard for me. One thing that worked is when my T said to gauge my life on staying calm for 15 minutes, and then for another 15; in other words, since I can't stop thinking about the future, put some parameters on how far ahead I will think. It kinda sorta works when things are really unbearable.
>
> I guess I was taken aback also because the offer of another session seemed so unlike her. There have been times when I thought I might really like to see her for an extra session or two, but I just never felt that I could ask for that.Even though the third session doesn't sound good now, at least the ice is broken for any future need for it. Perhaps you will feel less inhibited about asking since she's laid the groundwork by offering.
>
> BTW - I would have been incredibly touched by your T's suggestion. I know it sounds like an incredibly difficult thing to do, but I hope you reach a point where you feel you can take him there.
>
> MairThanks so much for the encouragement. I hope I get there, too.
Posted by fallsfall on March 9, 2005, at 20:07:58
In reply to My T is confusing me (sorry, long), posted by mair on March 9, 2005, at 13:05:36
I wish I could give you a long thoughtful response, but this will have to do...
There are things that you are avoiding talking about. Do you know what they are, and why you are avoiding them? Does your therapist know what they are? What would happen if you collected all of your courage and talked about them? (This doesn't work for everyone, but it does work for me)
Perhaps seeing her 3/week would make them less scary. I know that since I see my therapist 3/week I don't worry so much about opening things up because I know that he will be there to help me process them.
I found a vast difference between 2/week and 3/week. It is an individual decision (I have compared it to knowing how many kids you want to have - 2 wasn't enough for me, but 3 is plenty). You know that she cares and that she is skilled. You could try it for a month and see how it goes?? I know it doesn't sound like fun, but it doesn't sound like you are having fun at 2/week, either...
(((Mair)))
P.S. I owe you ice cream...
Posted by mair on March 10, 2005, at 7:04:38
In reply to Re: My T is confusing me (sorry, long) » mair, posted by fallsfall on March 9, 2005, at 20:07:58
You do owe me some ice cream (-; My tastes are pretty basic.
The stuff I don't like talking about is all very pedestrian. My reluctance to talk about them I'm sure makes them seem like they must be matters of great importance, and they really aren't. I don't know why I get so hung up. Maybe the issue for me is just engaging in the act of revealing things, however minor, which reflect poorly on me.
I don't know what to do about the 2x vs. 3x issue, although right now the prospect of seeing her more isn't particularly alluring. I see her today and will talk to her about it.
Thanks
Mair
Posted by annierose on March 10, 2005, at 12:13:26
In reply to Re: My T is confusing me (sorry, long), posted by mair on March 10, 2005, at 7:04:38
Posted by mair on March 10, 2005, at 17:05:53
In reply to Re: Let us know how today went, o.k.? (nm) » mair, posted by annierose on March 10, 2005, at 12:13:26
From my perspective it went pretty well although maybe for some of the wrong reasons.
I told her that we had to stop talking about anxiety disorders because it was too confusing to me; I told her I understand myself to be a person with a depression history who has alot of anxiety problems as well, but I don't want to make it any more complicated than that. Giving me a GAD dx isn't going to change the treatment, at least not the therapy portion of it. She agreed with me that it wasn't going to change things, escept that she'd like me to be taking more xanax to control my anxiety. She told me the significance of the anxiety discussions is that she wants me to understand and accept that the extent to which I get anxious about things I haven't done at work, for instance, is outside of the normal range. She believes my anxiety tends to set off a chain reaction of mushrooming anxiety and self deprecatory thinking, and she'd like to help me forestall the chain reaction.
I also told her that I thought I'd hit the panic button too quickly in my statement that I've lapsed into another major episode of depression. What it really boils down to is that my mental state is usually a factor of how good I feel about the way I'm working and the quality of my work. And I have been more productive over the last couple of days and some of the unfinished items which have produced the largest measure of anxiety are getting addressed, albeit slowly. This morphed into a discussion about how much my self esteem is tied up in work issues and we started reviewing my work history to see if we could determine when I started attaching so many negative judgments to how well I do with my work. I think this review can easily eat up a whole bunch of sessions.
She never asked me if I wanted to come tomorrow for an extra session until I was getting ready to leave. I told her no but I did make an offhand remark about having maybe wanted to discuss this in today's session. I don't know if she picked up on that or not.
The upshot is that it was good because it was a controlled and easy discussion. It was also good in my view because I never had to get to the issue of why I don't think I want to come more often. That's a far riskier discussion in my view. And if we keep pecking away at my work history and I continue to be a bit more productive at work, maybe I won't have to talk to her at all about why it's so hard for me to talk about things that probably place me in a negative light.
Giving credit where credit is due, I honestly think I could talk about the things we did cover with seeming ease because I wrote about them here first. It really does help me organize my thinking. I think I'm pretty logical - I really don't deal well with free ranging discussions or venturing into topics I haven't analyzed for myself first.
Thanks so much
Mair
Posted by annierose on March 10, 2005, at 18:22:29
In reply to Re: Let us know how today went, o.k.? » annierose, posted by mair on March 10, 2005, at 17:05:53
Glad to hear that things went well and you left in good spirits. Hopefully she picked up on your comment about the additional session, it would be a good discussion to have, whether or not you decide to take it. I know what you mean about avoiding certain discussions. But this is the safest person in the whole world to talk to, she won't react the way you think. It may take me 1- 4 weeks to address a sensitive topic, but once out there, it never seems so bad as it was all boiled up inside of me. Have a nice weekend. It's snowing again here - enough already!!
Posted by Dinah on March 10, 2005, at 18:24:28
In reply to Re: Let us know how today went, o.k.? » annierose, posted by mair on March 10, 2005, at 17:05:53
> From my perspective it went pretty well although maybe for some of the wrong reasons.
>:-)
Congratulations on your perspicacity. I'm not saying a work discussion won't be productive. Heaven only knows it's my main life problem right now, and we've talked about it plenty.
But my main impression from your post is that you feel like you've diverted her from dangerous territory into the safe, that you've re-established control. And I wonder if maybe you're missing an opportunity to figure out the why of what you do. Because perhaps your dislike of discussing things that put you in a negative light is an important but unspoken part of the puzzle, and your potential progress is limited until you see how it fits.
Or maybe I'm all wet.
It's been a long long... geez, how long has it been?
Posted by annierose on March 10, 2005, at 19:17:31
In reply to Re: Let us know how today went, o.k.?, posted by Dinah on March 10, 2005, at 18:24:28
Dinah -
Again, you put into words what I was thinking. You really should consider a career in writing. We would all buy a copy ... at RETAIL.Mair -
At least let her know that something else is bothering you and you are not able to put it into words. That can also open the discussion on what you may forsee as potential "danger" zones.
Posted by mair on March 10, 2005, at 21:56:39
In reply to Re: Let us know how today went, o.k.? » Dinah, posted by annierose on March 10, 2005, at 19:17:31
Geesh, I know you guys are right, and I don't think I'm fooling her at all, although she can sometimes get distracted away from things for awhile. She knows there are categories of things that I just can't talk to her about and we have tried to discuss why, but the conversations are always so excruciating because I just can't seem to force myself through this invisible threshhold. And the fact that the things I struggle with are so pedestrian makes it even worse. The longer I go, the bigger she's going to think the issue is and the more ridiculous it's going to seem to let her know how truly trivial it all is.
She thinks I have this huge fear of being mortified or feeling humiliated or embarrassed - maybe she's right, but right now I can't seem to force myself to think about what that means or why it might be true.
It's been a very long time since I walked out of her office feeling like I'd dodged a bullet because neither she nor I raised an issue I wanted to avoid. Most of the time we have a way of getting to those issues; even if she doesn't raise them, I steer our way there no matter how difficult it might be. But I think I felt ok about feeling relieved today because the things we did end up talking about seem like promising topics, even though they are also less frightening to me.
So it'll be interesting to see how long we can stay off the scarier topics.
Mair
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