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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by DaisyM on May 18, 2004, at 16:13:12
I asked this question in Open last night and received good feedback from the group.
"Have you ever felt this overwhelming sense of urgency surrounding therapy, that had nothing to do with the need to see your therapist?"
GG said, in her best therapist voice, "Say more about that," which I loved, because that is what MY Therapist always says. So here is more...
Last Wednesday I had a therapy session right after the retreat. I knew I'd need to process stuff and so we set it up that way. It was a good session, I rattled on, etc. I have a standing appointment on Thursday. Thursday morning I called and left a message that I wasn't coming because I was so busy at work. My Therapist called me back to check this out and ended up talking me into to coming in. I admitted that, yes, I was avoiding him. We talked about how scary it was to recognize that I needed him when I was over the top anxious and I missed him and was happy to see him when I got back. And I had let my guard down, a lot. So drawing back, pulling away felt a lot safer. We also talked about that fact that this week is my 1 year "anniversary" in therapy. And I thought I'd be done by now. And I'm not even close. And my fears about him getting fed up, or bored, or frustrated with such little progress were really huge and overwhelming. He told me AGAIN he wasn't going anywhere. That he would say it a million times but words are just words and I needed to allow myself to feel him with me. And let myself just "be" in therapy, not keep peeking around the corner for the end. It was an intense conversation but I left feeling better.
But Friday I got hit with this intense urgency. Anxiety that felt like me trying to get away from me. I was driving too fast, gripping the steering wheel too hard, playing the music too loud. It wasn't about needing my Therapist. I didn't even think about calling him, actually. The feeling came and went all weekend.
Yesterday was unbearable. I was anxious all day. And this sense of "not enough time!" was huge. We tried to work on it in therapy yesterday. We talked again about this anniversary marker. And we talked about whose need for progress was it, his or mine? He also pointed out that I've just come off of two months of work overload and maybe having some "free time" feels like I need to use this window to really work in therapy. There are subjects I've been avoiding and he knows this. In fact, he said since I'm anxious already maybe we should push into the topic of sex. (I identified that I knew we needed to talk more about it a while back but I also said it was going to be hard for me so he was going to have to bring it up.) I felt near tears most of the session and kept batting away his attempts to take me down to a deeper level and give a voice to the anxiety. Maybe I'm afraid of what is just below the surface. I've had a few more flashbacks and memory intrusions again.
When he checked in today, My Therapist said he had been thinking about the urgency and the timing of it. He wonders if I don't feel like I'm running out of time with my husband, running out of time for me to find a way to "fix it." Which of course I know I can't do. But there have been several blows again over the past weeks, including the sudden and unexpected death of my middle son's best friend's dad. My Therapist reminded me that I don't take people leaving me very well (you think?!) and maybe this is playing over and over again in my unconscious. So he said, "I know you know, but I'm telling you anyway, I'm still here for you. You aren't done with therapy, even if it has been a year. And I'm not done being your therapist." He then made a joke that he wants us to write a paper about Therapist-permanence as a therapeutic developmental milestone, similar to object-permanence for children.
The group last night suggested that maybe the urgency is internal. That something is about to break free. That I'm changing in some fundamental way. I said then, and still hope today, that it is a butterfly coming out this time. I'm sick of being a worm!
Thoughts? Things that help settle the urgency down? (Besides Open which REALLY helped last night...thanks guys!)
Posted by fallsfall on May 18, 2004, at 17:00:59
In reply to Therapist-permanence (long, windy, *sigh*), posted by DaisyM on May 18, 2004, at 16:13:12
I know the urgency, but I don't know what to do about it. I have felt the urgency when I've felt like I'm falling apart (oozing). I've felt that if I don't "fix it" that it will be too late (i.e. I won't exist any longer).
So mine is similar to yours in that it has to do with progess in therapy. I have found the urgency incredibly terrifying. I haven't been able to explain it in a way that makes sense to my therapist yet, so he hasn't been able to help me with it. The last time, he was able to convince me that *he* wasn't scared that I would fall apart. I'm still not sure that he understood what I was saying, but I was able to convince myself that if he wasn't scared, that I should be panicking.
I think that when you look at how far you have come in therapy (i.e. trusting and needing your therapist), that you should be able to see that you really have made a lot of progress. You have done incredibly hard work. You have more to do, but you have shown that you can *do* the work, and make progress. No one knows how long their therapy will need to last (at least if the therapy is "significant") - so don't try to put an end date on it. As long as you are (in general) moving forward, try to let that be enough.
Posted by Aphrodite on May 18, 2004, at 18:47:40
In reply to Therapist-permanence (long, windy, *sigh*), posted by DaisyM on May 18, 2004, at 16:13:12
Hi Daisy,
I went for a walk to think over your post. This is complicated. If you're anything like me, deadlines and goals are very important. I'm in a hurry to get everything done -- working, cleaning, even vacationing -- classic type A. So, naturally I'm in a hurry to be finished with therapy. I started posting here at my 6 month mark. I wanted to be finished then. It was with the help of all of you that I discovered I've only just begun.
So, you raise an important point, one I question myself all the time. Are you in a hurry to be well for you or for him? "Both" is my answer, and I think that is OK. If making your therapist happy means an incentive for you to get better, I think that works. Just be sure it's working mostly for you.
I wouldn't be the least be surprised if your anxiety isn't about the sex topic. You're getting close to the pain you thought you would be over by now. It could very well be a breakthrough, but since you are also pushing your therapist away some, you may not be ready or just rightfully terrified.
I really believe that your therapist isn't at all bored or frustrated with you. You know, I can't speak for other Babblers, but I look forward to your posts. I find you extremely interesting, and I have a keen interest in your progress. How much more magnified must that be with your therapist who sits across from you! I have asked my therapist a zillion times if he was frustrated with me, and I told him of course he would have to say he liked me, etc. What would he say -- "I'm so glad you brought this up. You are a total loser and a bore, and I'm glad when your session is over." So I pushed and asked, "If you really dreaded sessions with me, which of course you couldn't directly tell me, would I know?" And he said, "Absolutely. Things would be very messed up between us." And it's not. And things are not messed up with your therapist either.
Take your time. You'll go to the next level when you're ready, and keep asking him to reassure you that he'll be there.
(((Daisy)))
Posted by Racer on May 18, 2004, at 18:52:06
In reply to Re: Therapist-permanence (long, windy, *sigh*) » DaisyM, posted by fallsfall on May 18, 2004, at 17:00:59
For once, I'm not likely to be long-winded, because I"m just back from the dentist, heavily medicated, groggy, but I wanted to put in my own experiences, for what they're worth.
Obviously, this is going back more than a few years, to my successful therapy experiences. I went into cycles with that therapist, where I would feel this build up of anxiety so intense it felt as if I would literally fall down in a quivering heap and just shake for the rest of time. At the same time, I felt as if I had to get something done, RIGHTTHISVERYSECOND, but I didn't know what it was. Those were really, really terrible times. I felt as if I just couldn't live through them.
They were usually followed by major breakthroughs. Things that I couldn't even think about looking at would suddenly break out one day, get processed, and resolved. Then, of course, comes the let down phase. I called that the "dishcloth" phase, because I felt like a wrung out dishcloth.
Once I learned that that build up usually led to a breakthrough, of course, I'd try to force it, but that didn't work at all -- the pressure of trying to force it actually made it worse. I'd think and say things like, "I know this means something new and big is coming, and I want to get it over with so that I can get back to being perfect and not needing therapy, so let's start digging!" Uh-uh. Not happening. Whatever it was would wait until it was good and ready.
At the time, I didn't drive, but I can certainly relate to the driving too fast, white knuckles, loud radio -- that's the same sort of sense I'd get then. (Remember where I grew up: bus stops on every corner, and the last legal parking space was taken in 1963.)
I hope that helps some, DaisyMae. You know I want the best for you, and I hope that this is a sign that you're making much better progress than you think.
(Oh, yeah, and I'd want to cancel appointments at those times, too.)
Posted by Speaker on May 18, 2004, at 20:38:14
In reply to Therapist-permanence (long, windy, *sigh*), posted by DaisyM on May 18, 2004, at 16:13:12
(((Daisy)))
I remember a time very much like what you are describing. My husband was very ill and my children...were children needing a great mom! I felt like I was waiting for the shoe to drop at anytime with my husbands illness and yet trying to live each day to it's fullest because I knew they were limited with my husband and with my children having a father. I felt so anxious and I got so many speeding tickets I had to take defensive driving to keep my liscense...oh my the insurance rates!!! Anyway, for me it was like I needed the answers to get things under control. If I had it to do over again I would go to therapy every other day just to talk through the anxiety. I haven't been able to accomplish this myself but...Your therapist is there for you and he is being paid for his time...use it!!!! Your T does enjoy you as a person and I can tell from what you say he really wants to help you. It isn't about the T its about what he represents and can give you that nobody else can right now. Please set your cruse control and take care of you!!! I'm not sure this will help but know I care and my heart goes out to you. I pray for you and your family daily.
Marie
Posted by DaisyM on May 19, 2004, at 13:28:30
In reply to Re: Therapist-permanence (long, windy, *sigh*) » DaisyM, posted by fallsfall on May 18, 2004, at 17:00:59
Thanks for the support Falls, as always. You are such a good friend!
I had forgotten (forgive me) about your "ooze." It does sound totally similar. I was thinking about it as breaking apart, but melting works too.
I guess I do realize I've made some progress with therapy, I just haven't made progress with my life. Does that make sense? So if I could just live in therapy, I'd be great...:)
I'm sure we will talk about it today. I'll let you know how it goes.
Posted by DaisyM on May 19, 2004, at 14:11:48
In reply to Re: Therapist-permanence (long, windy, *sigh*), posted by Aphrodite on May 18, 2004, at 18:47:40
A -
Thanks for that very thoughtful response. I'm not sure I've ever induced exercise in someone before! :)
I think you are right, I'm definately a type A and want timelines and milestones to pass. It is hard for me to "just" let anything happen. And when being this self-centered, I feel guilty about taking such a long time to keep focused on me.
I am anxious about talking about sex. But I was anxious and urgent before that. I keep trying to imagine how this conversation will go. I consider myself enlightened but then again, I'm not usually talking about me in that context. There is a part of me that thinks maybe this really is something I should struggle with on my own. There are limits on what I can bring to therapy, to ask him to help me with.
I like what your Therapist said about being able to tell if they were bored with you or disliked you. For me it is the seemingly never ending sadness. I sometimes feel like I'm living in a soap opera. At some point, he HAS to reject what feels like an assault on his positive energy. I think I'm ziggy...the guy with the cloud over his head. I don't want to make it rain in the consulting room too.
Thanks for what you said about my posts. Glad they aren't too long for you. I ramble sometimes.
:)
Posted by DaisyM on May 19, 2004, at 14:37:25
In reply to Re: Therapist-permanence (long, windy, *sigh*), posted by Racer on May 18, 2004, at 18:52:06
It is always nice to hear that someone has experienced some of this and lived through it. And gotten better!
You might be right about a break through coming. I've cycled through this before, thought not quite this intensely. And, the last few times the urgent need was for contact with my Therapist. The need is undefined at this point... except that I feel like I'm running out of time. I just don't know for what.
Before I started therapy I was depressed. Haunted by a sadness I couldn't define. I had lost my joy.
Now I've added anxiety to the mix. Which sucks. Because the sadness moves over for work. Anxiety gets in the way. I've avoided meds up until now. But boy, am I thinking about it around this. Crawling out of my skin and not sleeping isn't working for me.
And I want to force the breakthrough! Tell me how...please!
Posted by DaisyM on May 19, 2004, at 14:46:32
In reply to Re: Therapist-permanence (long, windy, *sigh*), posted by Speaker on May 18, 2004, at 20:38:14
Marie,
I so appreciate how much you are willing to share with me. Please keep telling me to stay in therapy. Sometimes I feel like I should have waited until all of this is over and then gone in and dealt with it all. Other times I think it's going to take me down too, too many people looking to me to hold them up and together. I know you know what I mean.
It feels really selfish to be healthy physically and yet still struggling emotionally. I'm trying to make myself slow down and not push back against these demands. I've decided that I should try to focus on meeting more of the needs of those around me and see if that will help calm things down. Creating a happier environment should result in a trickle down effect to me. It just feels hard to do right now, even if it is the right thing to do.
Posted by LG04 on May 19, 2004, at 15:25:03
In reply to Re: Therapist-permanence (long, windy, *sigh*) » DaisyM, posted by fallsfall on May 18, 2004, at 17:00:59
Daisy, I always feel urgency, though I think mine is based in many ways on reality b/c ever since I've been seeing my therapist, I always knew our time was limited because I was scheduled to leave and return to the States. The sense of urgency has been a huge part of my therapy relationship. It's a very difficult feeling to deal with.
I also think that my urgency is often about wanting to hurry up and fix the pain. I don't want to go thru the pain, to get into it, I want it all to happen really fast so I don't have to feel it or experience it. I don't know if that's part of it for you but I wanted to throw out that possibility.
LG
Posted by DaisyM on May 19, 2004, at 16:01:51
In reply to Re: Therapist-permanence (long, windy, *sigh*), posted by LG04 on May 19, 2004, at 15:25:03
You could be right. I'd much rather not relive much of this.
Have you decided to return here? I know you were considering staying, in part because therapy is going so well.
Posted by Racer on May 19, 2004, at 17:43:54
In reply to Re: Therapist-permanence (long, windy, *sigh*) » Racer, posted by DaisyM on May 19, 2004, at 14:37:25
T'ain't no way to force it. If you're like me, and you do try to force it, you're likely to start wracking your brain for what it could be that wants to come out but isn't quite ready, making up things it *could* be, and wasting a fair amount of time.
This is just what worked for me, but I'm going to mention it without suggesting it. When I was in therapy years back -- the more successful version, and bless that wonderful therapist -- I got to a place where I just couldn't get the breakthrough, and it caused a huge depression and anxiety storm that just about stopped me from being functional at all. Psychologically, it felt as if I were outside a door, with all my goblins behind it, key in my hand, but I couldn't even touch the door. I tried an anti-depressant, and it allowed me to face up to what was hiding behind that door -- which turned out to be much less daunting than what I had dreaded. For me, at that time, the anti-depressant allowed the therapy to work.
Do I suggest you consider meds? No. If you think they'll help you, and you have a doctor you trust to discuss it with, then you have the tools to make a decision that will work for you. See, I have faith that you can do whatever you decide to do -- after all, didn't the Republicans give you money? ;-P Whatever you decide to do, you'll do what's right for you at the time. I'm just telling you my own experience, in hopes that, if you do decide to try a med, you'll have a little more support for yourself in doing so.
Best ever, DaisyMae, and my warmest affection for you.
Posted by DaisyM on May 19, 2004, at 19:07:25
In reply to Got some bad news for you, CupCake :^) » DaisyM, posted by Racer on May 19, 2004, at 17:43:54
Racer,
We did talk about medication today, though the anxiety has abated somewhat. He had two thoughts (of course!) but is open to whatever I decide. He, like you, encouraged me to talk to my MD.
For the past few months I've been going to therapy 3xs a week mostly. We added in the third visit when things were really rough as "extra" support. Plus 2 days in a row worked well to open up something hard and work on it without it killing me waiting until the next session. But I've had it in my head that since the third session was "extra" I should get to a place where I don't need it. So I keep picking dates and saying things like "ok, I'll give up that slot on such and such a date." Up until now, he just cocks his head and says, "I'm not sure you are ready to do that, are you? Convince me." Today he said, "I think you need to call that slot your own. I'm not in a hurry to give it to anyone else and I think 3x a week, solid, might help you be less anxious about getting into some of the hard stuff." I, of course, joked that I thought we *were* into the hard stuff...but it does feel like a pressure is off to be "well enough" to give up that slot.
The other thing he said is that while medication might really help, he'd like me to consider using the anxiety in our work. Looking at what it is trying to tell me and talking it through. He said it might be uncomfortable but it could be really valuable if we listen to it. And he talked about centering myself, relaxing at the end of each session, to try to calm the anxiety. We tried that today and it was a good way to end.
He talked a lot about trust and letting him help me deal with whatever is coming up. He knows I'm still not telling him about everything. He respects that I'm not ready yet. Saying it out loud makes it so much more real. He told me again today that I *need* to do this work. It's important and not selfish but he knows it is very painful.
He's pretty great...have I mentioned that? :)
As always, thanks. I don't know what I'd do without you and the other Babblers.
Posted by rs on May 19, 2004, at 19:30:42
In reply to Re: Got some bad news for you, CupCake :^) » Racer, posted by DaisyM on May 19, 2004, at 19:07:25
Hi daisy. Do not post here often feel like intruding. Just want to say your a remarkable person with everything that is going on. Also your T sounds wonderful in many ways. Please let him take care of you. You deserve it in many many ways. Hugs if ok
Posted by Aphrodite on May 19, 2004, at 20:08:12
In reply to Re: Got some bad news for you, CupCake :^) » Racer, posted by DaisyM on May 19, 2004, at 19:07:25
I do not take meds either -- never even considered it until I started therapy and started having panic attacks and intrusive memories. I get the distinct impression that my therapist is not fond of them in general, and has specifically said so in my case. He said it makes it difficult to work through the emotions.
Still, a few months ago I had to go to the emergency room for an anxiety attack that felt like I was having a heart attack. That can't be good or something to work through. My GP suggests medication. The longer and harder this therapy road gets with no end in sight, the more those samples of Effexor she gave me start to look appealing.
So, he did not give you his opinion on meds one way or another?
I will add revisiting the discussion of medication on my list of things I can't seem to discuss with my therapist;)
Posted by LG04 on May 20, 2004, at 11:07:28
In reply to Re: Therapist-permanence (long, windy, *sigh*) » LG04, posted by DaisyM on May 19, 2004, at 16:01:51
Hi Daisy, I'm also definitely returning to the States, mostly for financial reasons, I am down to my last penny.
The pain of leaving my therapist makes me feel like I will die. I will probably write about it here in a new thread.
LG
Posted by DaisyM on May 20, 2004, at 17:41:09
In reply to meds » DaisyM, posted by Aphrodite on May 19, 2004, at 20:08:12
A-
His opinion on meds is that they help and hurt. They bring down the anxiety and help get through the hard days. He also thinks they mask some of the pain so people don't work through what they need to work through and sometimes they even leave therapy. He does, however, recommend something to help me sleep (Ativan) because middle of the nights are so hard for me. I haven't followed up on this yet. There is a part of me that really wanted him to say, "I'm there with you at 3am, you are not alone," Not, "take a pill to go back to sleep." He rarely misses an opportunity to reassure me, but he missed this one.
We talked today about being depressed. He asked me if I thought I was depressed. I said sometimes I felt "just" depressed but I didn't think it was that simple. If I screened me, I have many of the factors that point to depression. But realistically, I get up, shower, dress with care, keep my house clean, take care of my kids, do my job and live my life. So how I feel and what I'm capable of still doing are very different.
I said it was more about black moods and psychological pain. That some days were just intolerable and "that" didn't feel like depression. He agreed, said I was very borderline between things (PTSD among them) so it was a hard call to make. Which is why he hasn't recommended an ad before and still doesn't. But he is willing to talk about it more if I want. He thinks this is really and truly a huge midlife crisis which has resulting into me "finally" dealing with the child abuse issues. It is complicated further by the situation of illness I live in every day and the job stresses I face. Oh, I'm so glad to be complicated and such a cliche!
I again expressed my desire to do three intense days of therapy and "be done with it." He agreed that it would be great if it could work like that. He also, again, cautioned me against forcing memories. He gets really worried about how deep into the black hole of despair I go. *sigh*
He did tell me again that I needed to do this work. That I *needed* to be in therapy, which helps alleviate some of the guilt about it being so self-serving and selfish. And that he was still here, doing it with me.
And I got a gold star for all the hard work we did yesterday: (we talked about sex) :)
How did your conversation go?
Posted by LG04 on May 22, 2004, at 12:05:53
In reply to Re: meds, posted by DaisyM on May 20, 2004, at 17:41:09
Daisy, I started taking Ambien sleeping pills (1/2 each night) a few months ago b/c i just couldn't sleep or stay asleep once I finally did fall asleep. and being awake in the middle of the night was hell for me. it's when i'd feel the worst and have horrible thoughts and anxiety and all kinds of things. the sleeping pills have been such a savior for me. i don't plan to be on them forever...just to get me thru this period. so, that's my two cents about sleeping pills. I'm for them.
LG
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