Unbearable ambivalence

I’ve been ambivalent about therapy for the entire year and a half that I’ve seen my therapist. He’s my first therapist and it took me a year of looking up T’s online before I scheduled my first appointment with him. I think he’s kind and good, and part of me wants to fully show up and participate each week, yet another part of me is looking for any reason not to go. This inner tug of war is exhausting and feels like torture. Right now I’m in the very familiar place of having decided that I shouldn’t go to my appointment tomorrow. Of course, part of me really wants to go which is why it feels like torture.

When I look for reasons for this behavior I think I just don’t feel comfortable being the center of attention (twice/week!) and I don’t have anything therapy-worthy to say. I want to go, but feel very strongly that I shouldn’t want to go. I feel a bit like an imposter who doesn’t deserve to be there and I don’t know how to get past this. Last week I asked him to email me telling me he wanted me to come in and talk, and he responded saying just that. It felt wonderful, but I can’t ask that of him every single week. Any thoughts on how to get past this?

Let him know that the struggle you had last week is actually an every session struggle and see if he can help come up with ways for you to feel more confident about showing up.

This is what came up for me upon reading your post:

Pain at the end of the day is pain. It's not competition to see who has it the worst. You won't believe me now but I hope you can see it for yourself one day- you do deserve that care and attention, despite the years of learning otherwise.

keep telling him what you need from him.

Thanks, Omers. We’ve talked about it quite a few times, but it doesn’t feel like we get anywhere. I do feel a little bit like I’m being rude by bringing it up over and over and over again although I know that’s what I should do. Also, this is so NOT the reason I came to therapy so it’s weird to me that has become such a big theme in my therapy. It makes me feel stuck.

Thanks. I’m not completely sure what I need from him and I think that’s the problem. I also don’t know that he knows. What I’d like is for him to reply to my emails. A one-liner would even be ok, but he doesn’t want to do that and I don’t want to beg, so we’re stuck.

I hate feeling stuck in therapy. Thankfully my current T only lets me stay stuck for a little while and then is really good at getting me unstuck.

Just the fact that you don’t feel like you deserve T’s time suggests that you need it.

Hugs

Have you ever considered online therapy, e.g Betterhelp or similar? Then you would get responses to your messages as that's how it is done, and likely more frequently than your current sessions. You also would not need to go to appointments. Perhaps that structure would help you focus on actual issues you want therapy for, instead of creating this parallel universe being so preoccupied with the therapy itself? Maybe you could just use that as a supplement to your in-person therapy?

I think the part that makes it hard is that I genuinely like my therapist and there’s a part of me that would like to do the therapy thing with him. If I stop seeing him I might feel like I failed and right now, I’d likely not seek out another therapist because the whole idea feels daunting to me.

I know that people have differing opinion about this but for me it seems quite likely that this ambivalence is the manifestation of a real problem - one that you just did not know about when you started therapy. And these problems that you listed when you started therapy are just superficial problems that are far less important than this ambivalence that has come up.

It seems that this ambivalence has many facets: it's related to wanting something for yourself and feeling that you don't deserve it, it's related to the difficulties related to being vulnerable and needy, it's related to difficulties of not being in control etc. To me this looks like a manifestation of a fundamental issue and no wonder that it just comes up again and again and again. These are the things that therapy really is for. Solving these kinds of problems cannot be manualized, prescribed, neatly described - it's a hard and dirty work between the two people involved. I'm not sure I have anything else to say.

I am going to try and find the book on Impasse I read when my T and I were so very stuck. It helped me so much understand what the unconscious dynamics were, and how to find a solution. There are a few psychotherapy books that illuminate the process in a way that helps understand the overall dynamic.

SE, is this it?
Resolving Impasses in Therapeutic Relationships by Sue Nathanson Elkind

When I was in therapy, there was always a more or less constant flow of emails between the Ts and myself, sometimes a lot other times more scarce but rarely a week without emailing. They also quite clearly had ambivalent feelings about it but never stopped responding completely until I did towards the end. I doubt that I would ever have the urge to email like that with a professional service provider again because it never enhanced anything, more the opposite. It did sink in finally and I just completely lost the desire to do it. But it took years... I had a history of similar behavior with others as well (e.g. colleagues, which was sometimes the worst as it affected my work) for years before the Ts and there was one case somewhat also after, with a lawyer I hired. Definitely a long-standing pattern that started with a pretty controversial professional connection-turned-romantic-partner in my mid 30's and then spread out like the plague.

It was very hard to stop indeed but now I've been free for a good while and the max I do to act on some remnants sometimes is posting on forums like this. But without much internal obsession, compulsion and ambivalence now - it was a torture for me as well, for years. For me it only manifested as virtual communication, I never felt obsessive and needy when I interacted with people in person. Interesting story but I really had enough, it was very draining at times and a huge distraction. Probably the most useful lesson I learned from it, which was always part of it during those years, is that I should not allow myself to be so socially deprived and isolated, also other lifestyle and environmental conditions that are not suitable for me. That's when I sought those poor substitutes, which just made everything worse for me. Also that putting all my energy into one person at any given time is the worst strategy for me. It was not hard to understand but very hard to stop and change the pattern. It definitely had some roots in my relationship with my father but with him, it never got extreme the way I did with others (who were all males). Interestingly, now I have quite minimal interest to develop anything super intense with a single individual (that was a life-long thing) and prefer groups and more balanced interactions that are productive in other ways. It's been a great relief but there was no sharp awakening or turning point if any kind, more a gradual, slow process. My second T's style helped a bit because he did not engage the way pretty much everyone had in the past. He never completely stop responding either but remained quite minimalistic, which was a good thing. We even continued scarcely for a while after I stopped seeing/paying him but eventually it seemed to have run its course and I never had the urge since. That was one thing I found helpful in therapy. The closest from the psych literature I can relate my process is a behavioral extinction (losing the desire in the absence of reinforcement). I know very well it does not work for many people but it had worked for me in other contexts as well, so not a huge surprise in relation to these virtual interactions. I actually figured out what was happening quite some time before I stopped therapy and told my last T about the extinction idea and that I found his non-engagement super helpful. Not pleasant in the moment but helpful for the sake of a bigger goal.

I think this is probably right. I just don’t know what to do with it. I’ve brought it up repeatedly, but it seems like we just skim the surface. It’s the big elephant in the room that we don’t really acknowledge.

Yes!! Such a helpful book to me in struggling through ambivalence.

Holy crap. I’m glad I went today. My head is spinning a bit, but in a good, unexpected way, I guess. We addressed the elephant in the room. We talked about my guilt about coming to therapy and having needs, How it took me a year to make my first therapy appointment because I feel guilty about having needs. How I feel angry about having needs. I also talked about comparing myself to others who have it much worse (I work with pediatric cancer patients, so it’s pretty easy to do on a daily basis). I didn’t think he’d have a good comeback for that one, but he did. It was good. What are the chances I’ll be able to hold onto this? Knowing me, I’ll need to relive this experience many more times.

I think it will last because you are opening up to him now but of course it will need repeated over and over until it gets ingrained. That's normal.

Also, since you struggled with this too-this is an example how it must be the client who comes up with the insights rather than the T telling you notable observations. I pointed out your guilt weeks ago, but it did no good/was not helpful. These patterns have to be experienced with your T and in person for change to come about.

Sounds like relief coming from you.

Yep seems to be my normal. When you think about it, we've repeated whatever is our old patterns many many times. So it makes sense that it takes a while for a new pattern to be repeated to get it ingrained.

I'm glad you felt progress in your session.

Honestly I feel like I’ve been working at a snail’s pace but I got there a teensy bit faster because of you and a few others on PC who have helped me process things better than I could have on my own. This stuff is hard.

Feileacan, I’m not sure if you’ll see this but for whatever it’s worth I was all set not to go to my therapy appointment today until I saw this post of yours when I woke up this morning. It hit a nerve and prompted me to go. I’m so glad I did. So thanks for that.

Oh, it feels nice to read that But, as you say, the ambivalence is huge and while one part of you generates reasons for not going, another part of you searches for reasons to go. So, I don't think my post was anything special in this respect - it was probably just in a right place and right time to serve for this other part of you as a reason to go. You may disagree, but I find it quite likely that if it would not have been my post then probably something else would have served similarly well for that purpose.

But it's good that you went and it's good that you were able to address the elephant a bit. I don't know if it is of any interest to you but in my therapy I also talk about basically the same things every f.... day over and over. I've understood that this is the essential therapy work. It does not look on the surface as if one immediately achieves anything by doing that and for some people it might even look that you are just wasting time and not addressing the real issues. But as I said in my previous post, to me it seems that most "real" issues are surface-level symptoms and the real issues don't look like "real" issues at all. But if you somehow are able to grasp or change anything in the real issue level then it very likely brings along significant changes also in various surface-level issues. Some people prefer to work directly on the surface-level stuff and I suppose that's ok too. I've found it useless and meaningless for me.