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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by rskontos on November 24, 2007, at 16:01:45
I haven't posted about therapy cause I thought it was a waste and the last time and this time she was too booked to see me every week so it has been like almost 2 weeks but not quite. It makes me mad but do I say anything. No. Weak that is me. This last time she said I made progress these last two times but I felt flat. And to me to wait that long there is so much that has happened and I dealt with it that I don't always feel like tellling her. Plus I don't remember if I did tell her so I feel like why bother. I feel like she is going through the motions of therapy. Like how some of you have said your therapists dont seem to remember important things. I am tired to reminding her. So I don't so when she says good progress I think who made the progress. And then my neuro asks are you making progress and my husband asks are you making progress and my inner voices says no progress so I don't know. Too many around to question it so I don't know to whom I need to listen too. I have too many in my head to sort out. And then we had my father here and he says things. And everyone inside my head gets ill or mad. And now it is not until dec 3 to talk to therapist and by then who knows how I will be or feel. Again too long. And I told her I need weekly and she just doesn't keep something open nor do we talk about what to do since we won't be meeting after this horrible holiday. I decided my brother-in-law brings up bad feelings too and I don't know why. He just does. IN fact my sister's whole relationship does. I don't know why. I am so uncomfortable around her H and their kids. Weird is all I can say. I love her but I want them to leave asap. And now I can't talk to therapist until dec3 so by then who will care. I will bury it too. Too much is buried and now more will be. I am afraid one day I will not feeling anything much anymore. I too don't think she gets it......I either don't feel or I want to cry but don't because I too must bury that. Next year I want to skip Nov thru Feb. I will go from Oct. to March. That will work for me. I do know from my sister that our family had some horrible thanksgivings. I am sorry I am ranting and rambling. Thanks for listening. rk
Posted by twinleaf on November 24, 2007, at 17:22:41
In reply to Tired of T and having to make myself clear....., posted by rskontos on November 24, 2007, at 16:01:45
The schedule you have with your therapist seems FAR too spaced and unintensive to do the kind of work you'd like to do. Would you like/can you get more frequent, regular sessions? When you say that your T is telling you you are making progress, and you don't feel that way yourself, it could be that parts of you aren't yet entering the therapy. For those parts, progress hasn't yet been made. There is a wonderful book by Philip Bromberg called "Awakening the Dreamer" in which he talks about that very thing. He feels dissociation- of various degrees and types- is the main thing that occurs after trauma, and that it is usual for some self-states to take a long time to be present in therapy. He actually uses almost the same words as you- that those parts don't feel improved even though a more conscious and present part may feel that way.
Since your therapist knows the degree of dissociation you have, I do hope she can make the commitment to seeing you more often. I think twice a week would be a minimum effective frequency. It sounds like a lot is happening that you have to manage and contain yourself.
Posted by Phillipa on November 24, 2007, at 18:21:07
In reply to Re: Tired of T and having to make myself clear..... » rskontos, posted by twinleaf on November 24, 2007, at 17:22:41
Lucky me see mine once every three weeks. Phillipa
Posted by Dinah on November 24, 2007, at 18:43:59
In reply to Tired of T and having to make myself clear....., posted by rskontos on November 24, 2007, at 16:01:45
I have to agree with Twinleaf. I wouldn't think once every two weeks would be enough.
Is there some reason that she can't see you more often? I know therapists paid by insurance or national health services or colleges often don't have the discretion to do what they'd most like to do.
Or is she practicing a style of therapy where every two weeks is the most common practice?
I admittedly have a poor memory, and a low ability to keep someone in mind when they aren't there. But I think I'd have trouble with that too.
Posted by RealMe on November 24, 2007, at 19:48:08
In reply to Re: Tired of T and having to make myself clear..... » rskontos, posted by twinleaf on November 24, 2007, at 17:22:41
I agree with twinleaf; you need at least twice per week. Is it a possibility for you with this therapis or would a different therapist be in order??
RealME
Posted by twinleaf on November 24, 2007, at 20:11:35
In reply to Re: Tired of T and having to make myself clear..... » twinleaf, posted by Phillipa on November 24, 2007, at 18:21:07
Gosh, Philippa, if I went only every three weeks, I wouldn't know what I was doing. I know you've got some financial constraints, but isn't it true that Medicare will pay SOMETHING for twice a week therapy? Actually, I don't know if you are using Medicare or Medicaid. I think for Medicare it's usually between $110-140 per session. At least that's what it is in my area. Many, though not all, therapists accept Medicare. They don't pay for more than twice a week, but you can get a lot done going at that frequency.
I guess another difficulty is that you haven't found a therapist whom you feel suits you since the young hospital-based one. There surely is a good one out there for you! I guess one thing we all agree on here is that, once you find a T whom you fit with, good things begin to happen. I do hope that can happen for you, too.
Posted by JoniS on November 24, 2007, at 23:35:40
In reply to Tired of T and having to make myself clear....., posted by rskontos on November 24, 2007, at 16:01:45
RK
I really like the "skip Nov through February". I think we should skip it and stay at Christmas Camp Comfort.
I hope you're doing better than when you posted at 16:01:45 today. I think I understand how you feel.
Joni
Posted by Muffled on November 24, 2007, at 23:36:51
In reply to Tired of T and having to make myself clear....., posted by rskontos on November 24, 2007, at 16:01:45
(((RK)) Its hard but it can get much better.
I too agree with the others. For a period of time, for a variety of reasons , my therapy was sporadic, and I didn't go far. It was more maintenance and crisis control.
And if I went more than a week btwn appts, it took 3/4 of the appt for me to reconnect fully that this was in fact T and its safe etc. Too much time passes and all connection/trust seems to go.
I would like to have done 2x/wk but not able to. I think if you could find a T that you get along with, most of you anyways, specially inner kids, then if you could manage 2x/wk would be ideal, but even 1x/wk is better.
I think you can make no real progress with this intermittent T.
Too hard for the parts.
No continuity.
Oh I hope you can get more consistant T somehow.
Until then, guess babbling helps some.
Post away.
M
Posted by Phillipa on November 24, 2007, at 23:42:09
In reply to Re: Tired of T and having to make myself clear..... » Phillipa, posted by twinleaf on November 24, 2007, at 20:11:35
Twinleaf I asked her for more than every three weeks she said no and it's not enough. Right now I'd love twice a week yes it's medicaire. But I do start a new pdoc in January and that one from the hospital said she has friends that do thearphy there so maybe then. She said this pdoc would coordinate things. Problem is the others said that too and it didn't happen. It has to though as I'm sinking deeper and deeper each day into misery. Thanks for caring twinleaf. Love Phillipa
Posted by Reggie BoStar on November 25, 2007, at 1:12:55
In reply to Re: Tired of T and having to make myself clear..... » twinleaf, posted by Phillipa on November 24, 2007, at 23:42:09
This seems to be the time to year to be sinking into misery. I'm doing the same at this end. I wind up sleeping in 30+ hour marathons, then staying awake for about 12, then repeating the sleep cycle.
During that 12 hrs of being awake I am "manic", which for me is having a slightly elevated mood (the pdoc suggests that I have some traits of BP II). I spend too much money, fortunately on cheap stuff but too much for me.
My therapists sees me once a week when I'm in trouble, then backs off to once every two weeks. She's been doing that pretty consistently for some time now.
However, she specializes in a combination of psychological and substance abuse counseling. Her reasons for making that shcedule may be slightly different for someone who is not an addict of some kind.
At the moment, though, it seems like once a week isn't enough either. Fortunately one of my former therapists started a group session that meets every monday. I go to that as well. Of course I'm not the focus in the group, but at least I get some coverage and exposure to other folks who are going through the same.
My pdoc sees me once a month. This is the problem with schedules I have because my bouts of total exhaustion and sleep have caused me to miss two appointments this year. When that happens, I have to wait another month to see him again. In his case he's heavily overbooked.
I'm supposed to see him in two weeks. I'm running out of options for meds because I've tried everything under the sun for the last 10 years. That leaves ECT, which I've already done once.
For some reason I'm spooked about a second pass. I didn't have any memory issues the first time around (at least none that I remember !!!). But lately I've been hearing from more and more ECT patients who acknowledge losing some long term memory permanently.
Without exception they've all said the loss of those few memories was worth the gains they experienced.
That's the rub. I have a few good memories from my childhood. Not many, to be be sure. But the ones I do have are precious.
If I lose those memories, I won't have any good memories at all from my childhood.
Obviously though I can't keep going the way I'm going. One look around and I can see the effects of what a total waste product I am.
Phillipa, I am also on Medicare. I frequently wind up seeing two counselors a week because of that group. I'm sure I average more than 4 visits per month for the same reason. So far, Medicare AND my supplemental coverage is picking up the tab.
Unfortunately I can't tell which plan pays what amount from these confusing statements they send me. When this was all explained to me another lifetime ago, I was told that Medicare would always pay the bulk of therapeutic costs.
If there's a yearly max I haven't hit it yet. If there's a lifetime max... I can't believe there would be a lifetime max for Medicare.
Who knows. Nice to see your messages again, Phillipa
Reggie BoStar
Posted by star008 on November 25, 2007, at 7:17:52
In reply to Re: Tired of T and having to make myself clear..... » Phillipa, posted by twinleaf on November 24, 2007, at 20:11:35
My insurance pays for about 12 visits per year..loll.. what a joke. I go every other week and he gives me a reduced rate since I pay for it.. It hasn't been enough lately and I told him its just not adequate when I am feeling like this.
I agree that every two weeks is not enough when you have things going on.. It is okay if you just need to talk things out and things are going relatively well but it is not enough if you want to work on anything.. You start diggina round in the garbage heap and then are stuck dealing with it all by yourself for the next two weeks. If you can't get through to her maybe you need to look elsewhere?? Damn.. that is so hard.. have you noticed how many of them are strange or dumb??lol
Posted by antigua3 on November 25, 2007, at 8:09:47
In reply to Re: Tired of T and having to make myself clear..... » Phillipa, posted by twinleaf on November 24, 2007, at 20:11:35
Wow, that's a lot more than my private insurance pays. They only pay $30 of my T session and about $50 for my Pdoc, which leaves me with $300 of my own to pay, which is ridiculous!
sorry to hijack--this just caught my eye.
antigua
Posted by Daisym on November 25, 2007, at 12:23:35
In reply to Re: Tired of T and having to make myself clear..... » twinleaf, posted by antigua3 on November 25, 2007, at 8:09:47
It would be rare to find a private practice therapist who took medicare or medical in my area. The rate is too low - about $60/hour, it takes too long to get paid and there is a general thought that clients tend to be unreliable.
If I might try another perspective - many types of therapy are about helping you manage your life. Most people are not in analysis or long-term, existential therapy to help them evaluate their life, per say. If you are "getting through" the two weeks without major disruptions - no hurting yourself, not substance abusing, going to work, getting dressed, keeping things fairly even -- your therapist may indeed see this as progress. I'm often reminded by my son's therapist that the goal for him isn't that he doesn't have anxiety -- it is that he copes with it and keeps going.
It isn't unusual for "us" as clients to rail against being told there is progress. We need to look at the secondary gains of staying stuck (for me, it is my fear of losing therapy if I get better) and talk about that.
Many people make progress at 2x per month, but typically they are doing work themselves in-between sessions. Many more people make great progress or obtain stability at 1x per week -- it is the norm, actually. I worry that people think that more frequent sessions are the only way to "get better" or feel better -- when I think there are many things a person can do to support an ongoing, less frequent therapy. Group is a great example.
All that said, I'm sorry you are feeling so frustrated. I hope you can talk it out with your therapist and work into a schedule that suits you better.
Posted by twinleaf on November 25, 2007, at 12:31:06
In reply to Re: Tired of T and having to make myself clear..... » twinleaf, posted by Phillipa on November 24, 2007, at 23:42:09
Philippa, that sounds promising and hopeful. I really think when you ask for more sessions and your T says "no"-no reason or discussion about it, apparently- thast's not the T for you. I hope you can get one you like- perhaps a friend of the other one you liked. I'm assuming all states are basically alike as far as Medicare. They pay something like what I mentioned: they won't pay for more than two sessions a week, but there is no limit on what they will pay for. It's about 100 sessions per year for as long as you need it. It sounds like you have all the coverage you need- you just need to find a good T! Many Ts where I live "opt out" of Medicare, so that they can charge more per hour (in the $200 plus range). But they don't usually do this until they have a lot of training, say, as a psychoanalyst, and also a lot of experience. Younger Ts almost always take Medicare. If you explore the young colleagues of the T you liked, I bet you will find someone great.
Posted by twinleaf on November 25, 2007, at 12:34:31
In reply to Re: Tired of T and having to make myself clear..... » twinleaf, posted by antigua3 on November 25, 2007, at 8:09:47
Yeah, Medicare looks kind of good, doesn't it? My insurance pays the full amount for 25 sessions a year- two months' worth, and then I'm on my own.
Posted by rskontos on November 25, 2007, at 14:24:33
In reply to Re: Tired of T and having to make myself clear..... » rskontos, posted by twinleaf on November 24, 2007, at 17:22:41
Hey guys, twinleaf I think you are right. I read the DD links that Muffled posted and I have tried to read everything I can find to help me. I will get this book plus the one REalme recommended. I think you are right. Parts of me don't trust therapy or the T. And now especially since it doesn't seem like she is listening to my needs to have more therapy not less. The first time I thought ok just this once but if this is a pattern I will have to ask for a referral to another T that sees patients all day not after work. I know she has loads of experience with DD but that should mean she understands more why I need to see her consistentently not every 10 to 12 days. I should just do therapy on my own then. Or you guys can be my therapists. I pay her directly and so far havent used my insurance. Maybe she doesn't want to do my therapy since I am a longtermer. She is the one who told me that my degree of dissociation is huge. So maybe there is a part of her that doesn't want this at this time. Then that makes one inner voice right and me wrong. I also just myself off my Ad and having withdrawals. Although they aren't that bad. thanks everything for your support and responses. I would like to answer everyone individually but just cant. rk
Posted by RealMe on November 25, 2007, at 14:31:49
In reply to Re: Tired of T and having to make myself clear...., posted by rskontos on November 25, 2007, at 14:24:33
rk
If she is so knowledgeable, I would want to know if she were my therapist why she was only seeing me every 10 to 12 days. It seems odd to me that someone with expertise would think that is okay. I know when I worked at Menninger's, we saw trauma patients two to three times per week. Sometimes more is too much, and so starting out at twice per week would seem reasonable and then going to three times per week later when you feel stronger and able to manage things without them bleeding out of the sessions. But, every 10 to 12 days, I would sure want the rationale. Has she said why so infrequently??RealMe
Posted by rskontos on November 25, 2007, at 14:38:04
In reply to Re: Tired of T and having to make myself clear.... » rskontos, posted by RealMe on November 25, 2007, at 14:31:49
Just that her schedule is booked. And that is why I am mad. If she knows it can get booked up and I need the time why can't we just schedule a running or standing appt. Would it be a chicken to email this to her. Since she is hard to get on the phone, and I don't see her til 12/3. By then I will not care to talk about Tday and how I am feeling. IN fact I haven't shared alot of my feelings. Or rather a lack thereof. I had already asked for a p-doc recommendation. My neuro asked me if I thought I was making progress with this T if I called her and said no she could recommend someone I think, or a p-doc or someone else. rk
Posted by Phillipa on November 25, 2007, at 17:24:59
In reply to Re: Tired of T and having to make myself clear.... » Phillipa, posted by Reggie BoStar on November 25, 2007, at 1:12:55
Reggie don't we usually meet on the meds board? And twinleaf I'm so hoping you're right. And I think a therapist should not committ to patients if she can only see them every three weeks as what happened a week ago especially three weeks ago is forgotten. Different with meds as the four week appointment there will be progress or none don't you all think? Phillipa
Posted by RealMe on November 25, 2007, at 22:03:44
In reply to Re: Tired of T and having to make myself clear...., posted by rskontos on November 25, 2007, at 14:38:04
I think it would be wise to ask your therapist if you could have standing appointments for each week and even for twice per week. Then you will know where things stand. If I were in your shoes I would email her to see if this was the case and let her know about how things are REALLY going for you. I would be feeling hurt and angry if I were in your shoes. Sorry it is so long before you see her; maybe she will see you sooner if you send an email.
RealMe
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