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Re: Started out as a short-term CBT patient fallsfall

Posted by mair on September 30, 2004, at 8:33:19

In reply to Started out as a short-term CBT patient, posted by fallsfall on September 29, 2004, at 9:09:52

falls

I can identify with so much of what you wrote. When I went into treatment with a different T/pdoc about 10 years ago I started on this odyssey of one unsatisfactory drug trial after another and therapy that went no where. I got so I hated hearing about all the wonderful new miracle drugs and about how treatable depression was if properly diagnosed- I couldn't figure out what was wrong with me that neither drugs nor therapy seemed to adequately address. After awhile I stopped regular therapy because I had run out of insurance benefits and patience with the process and I guess by that point I was on a drug combo that, while not great, stabilized me somewhat.

I decided to go back into therapy a year or 2 after that because I was worried that I was leading the kind of life, mostly with my work, which was bound to trigger a relapse and I needed to try to restructure things to insulate myself. I also couched things in these terms because I wanted my T to refer me to someone else but I didn't want to hurt his feelings. He simply didn't do any kind of CBT. He referred me to my current T. When we first started working together, we were exclusively doing CBT and when I'd start talking about stuff in the past, she'd cut me off and tell me it was irrelevant to the kind of therapy we were doing. However, it didn't seem to take her all that long to decide that CBT wasn't going to fix what was going on, and I've been working pretty intensively with her now for about 5 or 6 years. (I've totally lost count)

I've always felt that I arrived on her doorstep under false pretenses, and I sometimes worry (alot) that she really wants to ditch me as a patient because I am so much more work and trouble than she bargained for when she agreed to work with me. She's spent countless hours trying to convince me that working with more longer term patients is more rewarding for her.

All that may be true, but what I've struggled with in therapy as much as anything is the issue of why I'm so hard to treat - why everything seems to take so long for me. I've never been sexually or physically abused, have little or no history of mental illness in my family and had a maddeningly boring childhood. It frustrates me some of the time and shames me nearly all of the time. All of the medical care I've gotten somehow feels self-indulgent to me without a real framework to explain ti and I've wondered whether maybe I just don't want to get well.

I liked what Daisy and Racer said about how we present. I've always functioned on a pretty high level and have always presented pretty well, I think. So I've always felt pressure to mask how I really feel. And although I don't believe in living the unexamined life, I'd trade the last 10 years of on and off therapy and only moderately effective drugs in a heartbeat for some more effective drugs and a few months of CBT, if it would have worked as well. Like you said, the idea of working so hard to figure things out is only appealing if you know it's all going to eventually work.

My T doesn't talk in terms of cures, but in terms of quality of life. And when I look at things over a longer continuum, I can see that there has been much improvement. And my T is very good at mapping out where we're headed and what we're trying to accomplish; she knows now that it's helpful for me that she periodically review our progress and why we're talking about the issues we are. I never knew any of this with my last T. She's also a very upbeat optimistic person, or at least if she's pessimistic about my future, she works to hide it. I decided awhile ago that as long as she felt I was making progress, it would be ok if I didn't always see that progress and as long as she felt optimistic about how far we could go, I'd just try to feed off her optimism. That helps, but I'd surely feel better if I could see light at the end of the tunnel. I don't obsess as much as I used to about how many years I've been in therapy (mostly I just try not to think of it), but I really don't want to accept being on a therapy for life track either.

Thanks for bringing this up.

Mair


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