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Default Aug 10, 2020 at 11:45 PM
  #1
Hi all, new here and I guess looking for other opinions on my experience in therapy.

To short hand it, I've been in intensive relational dynamic psychotherapy for about 12 years, during most of which we've been meeting 4-5x per week (5x currently). My insurance has been great for most of this, so I'm only out a few $K out of pocket per year rather than 10s of thousands. My continued investment of time is problematic however, as I've put a lot of things on hold to be able to deal with the emotional fall out of meeting that frequently.

I've absolutely seen changes and have developed tools that benefit me but on the whole I find myself feeling as bad emotionally now as at any point in my treatment with little to no interest in hobbies, mostly withdrawn from friends (don't really talk to family) and no romantic relationship or much libido to speak of.

I'd say most/all of this originates with a deep-seated emotional resistance that started developing ~5 years ago and has gotten more and more powerful over time. I'd understood resistance was something to be worked through and so have tolerated not feeling great/motivated/interested in things, but it's gotten 'tighter' and tighter in the five years and at this point, and for maybe the last 12 months, I've been wondering if it's time to call it a day, stop therapy and just try to make do.

It's disappointing because to leave at this point (versus, say 5 years ago where I had a bit of vitality) would feel like I'm jumping off from a 'bottom' of sorts, and in ways starting from scratch. As I've only felt worse and worse for the last 5 years it isn't clear to me that the work my therapist and I are doing will get me to where we've talked about; he asserts he wouldn't continue if he thought we'd done everything we can do, but also acknowledges he doesn't know whether what I have going on can be successfully worked through.

In brief, I couldn't really say anything negative about my therapist. He's been invested, empathic and barring small stylistic changes, don't think I could say he's done anything wrong. I'd say my main gripe is that the 'process' we've been trusting for over a decade may simply not be able to address whatever is holding me back.

Anyone have thoughts, either based on personal experience or that of others, about course forward? Would also welcome thoughts about ending treatment because, as I've verbalized to him, having invested this much in the process, to leave getting very little of what I'd invested for would be close to the biggest disappointment of my life so far (nearly 40 yo).
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Default Aug 11, 2020 at 10:53 AM
  #2
Hi largess12. Welcome to Psych Central. I am sorry you are hitting a low point in your therapy. Sounds like it may have taken you as far as it can.

One thought is to spend less time in therapy and more time working in real life to do things that give you energy. For me a 7-8 hours a week of exercise help me maintain vitality. Eating a low carb, moderate to high protein diet really helped my mood swings, especially in this hot weather. Like I usually have porridge for breakfast but in all this heat had egg white cooked and tofu and feel less hot even in this torrid weather. Not sure if there is science there but it works for me. I think you need to find your own things that help energize you.

Many people include meds in their treatment program because they work on brain receptors and helping them work as they should. Meds can also help with low energy that could be a sign of depression. My own thoughts is you seem to believe you cannot get more benefit from this therapy but are not sure what else to do. One option is to do the life style changes that work for you. Another is to get a psychiatrist who can prescribe meds that can help you live the life you want to.

Another is mindfulness. Some links you may find of interest are here.

What is mindfulness, how can I make it part of my day? If you like that there are more by this author here: Padraig O'Morain - YouTube

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Default Aug 11, 2020 at 02:25 PM
  #3
I found it much better to quit therapy. It was completely pointless - I tried to find a point for 5 or so years and never did. I would suggest stopping and seeing how you feel. Qi gong, yoga, meditation, exercise, finding interesting activities, etc - all much much more useful to me than I ever found therapy to be.

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Default Aug 11, 2020 at 02:44 PM
  #4
Hi - Welcome,

I can relate to the disappointment of spending time and energy towards goals that do not seem to have manifested. I have a similar fear. I'm about to complete my 5th year with my T. As I have stabilized, we've shifted focus towards more analytic, including the increasing number of sessions to 4x week now. I can clearly see the major changes from when I first started as I was very depressed and suicidal when I started. Now, I rarely even have violent or death wish thoughts. I still do not have friends, I still struggle with my feeding/disordered eating issues, I don't know what joy feels like, I don't have hobbies, or any of those things. I do things, I make to do lists of the things I want done and I do them. That's how I live my life. There's no pleasure in doing the things.

You talk about "a deep-seated emotional resistance", what does that resistance look like? How does it show up in your therapy? What have you tried to break through it? I figure you have already talked this out with your T. I'm curious as to how this path looks.

With Covid, I've had to move to remote visits. This has seriously impacted my therapy because a large portion of my therapy has been around play. If you have also moved remote, do you feel this has impacted your progress in any way?

Like Candc stated, if you have not tried meds, meds might be an option. Another thing might be to try to cut back on sessions rather than stopping all together. But really, anything that might shake things up might help or not. I looked into a psychodrama group thinking it might help but then got really scared and felt like it wasn't the right time. Not knowing what you are trying to work through it's hard to say what might be helpful. All of the things typically suggested help someone, which is why there are so many things out there to try. It kind of sounds like your gut is saying that it's time for a break. What would be the worst thing that happened if you honored that part of you that wants to take a break or wants to see what life would be like without therapy? After a rupture with my T, we went 6 weeks of doing mostly jig saw puzzles and we watched a few movies. It was my way of taking a break from therapy without taking a break from my therapist or the safety of that space. I tried a few times to talk early on and it made things much worse. Would your T be open to doing anything like that?
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Default Aug 11, 2020 at 03:14 PM
  #5
It seems you've reached an impasse either with this T and/or their approach.

Maybe you need a reset, be it a break from therapy altogether or simply testing the waters with other Ts. This is how one can get 'unstuck' when reaching a plateau
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Default Aug 11, 2020 at 04:17 PM
  #6
Quote:
Originally Posted by Elio View Post
Hi - Welcome,

I can relate to the disappointment of spending time and energy towards goals that do not seem to have manifested. I have a similar fear. I'm about to complete my 5th year with my T. As I have stabilized, we've shifted focus towards more analytic, including the increasing number of sessions to 4x week now. I can clearly see the major changes from when I first started as I was very depressed and suicidal when I started. Now, I rarely even have violent or death wish thoughts. I still do not have friends, I still struggle with my feeding/disordered eating issues, I don't know what joy feels like, I don't have hobbies, or any of those things. I do things, I make to do lists of the things I want done and I do them. That's how I live my life. There's no pleasure in doing the things.

You talk about "a deep-seated emotional resistance", what does that resistance look like? How does it show up in your therapy? What have you tried to break through it? I figure you have already talked this out with your T. I'm curious as to how this path looks.

With Covid, I've had to move to remote visits. This has seriously impacted my therapy because a large portion of my therapy has been around play. If you have also moved remote, do you feel this has impacted your progress in any way?

Like Candc stated, if you have not tried meds, meds might be an option. Another thing might be to try to cut back on sessions rather than stopping all together. But really, anything that might shake things up might help or not. I looked into a psychodrama group thinking it might help but then got really scared and felt like it wasn't the right time. Not knowing what you are trying to work through it's hard to say what might be helpful. All of the things typically suggested help someone, which is why there are so many things out there to try. It kind of sounds like your gut is saying that it's time for a break. What would be the worst thing that happened if you honored that part of you that wants to take a break or wants to see what life would be like without therapy? After a rupture with my T, we went 6 weeks of doing mostly jig saw puzzles and we watched a few movies. It was my way of taking a break from therapy without taking a break from my therapist or the safety of that space. I tried a few times to talk early on and it made things much worse. Would your T be open to doing anything like that?
Hi Elio, thanks for your thoughtful response. By 'deep-seated emotional resistance' I mean any manner of behaviors that have shut me down emotionally and, at least as we've formulated it, impede progress in therapy. T regularly highlights how we'll get to something seemingly impactful, I'll feel a certain relief, and invariably be in a similar shut down state in a few days. We've talked about this colloquially as a very young part of me that isn't on board with moving forward in my life and is doing everything he can to undermine and prevent me from moving forward. This has physically, to date, included significant weight gain (~60 lbs to date), the start of which is pretty clearly tied to a very impactful emotional experience that represented moving forward, as well as a body rash that covers the majority of my back, neck and traps. I've also become more anti-social (though I've never been terribly outgoing) and withdrawn socially, and have real difficulty attempting to develop myself professionally (reading to take in information is nearly impossible and motivation to pursue new work that would likely improve my circumstances is fleeting at best despite being very unhappy with my current work situation).

I generally short hand the motivation/interpersonal effects as feeling 'shut down', and I have felt increasingly shut down without real respite for the past five years, possibly even slightly longer, again tied to an extremely impactful emotional experience that represented moving forward.

In short, 'little me' isn't on board and unfortunately he's stronger, smarter and more emotional than 'big me' and is dictating how I feel. Our approach at this point to breaking through has, through trial and error, focused on making the 'little me' feel understood, as that typically provides some relief, albeit not for extended periods. Aside from that, we've also talked about EMDR and have tried it briefly, but haven't fully invested given meeting remotely of late.

I've seen psychiatrists in the past, mostly for depression, but had been off anti-depressants for close to a decade. I did meet with another at the beginning of this year as a 'worth a shot' approach and we tried several different medications with any real impact.

My T has actually brought up the idea of meeting less frequently, though I've mostly tabled it as I feel my orientation to therapy would still be mostly the same (ie, a kind of waiting until the next session) until I stop completely.

My response is already wordy, but to address your Q about the 'worst that could happen' briefly, I think it's the prospect of trying to do what I've always wanted to do (ie, move on, meet someone I care about, find fulfilling work) except now starting at a sort of bottom rather than years back where at least I had some native level of motivation and interest. On the other hand, at times it feels like I'm throwing good money after bad (figuratively) and part of me thinks I should just suck it up, end treatment and just try to get started where I am. It's a tough thing to consider having, in a lot of ways, put my life on hold to clean things up via therapy only to leave having not really gotten most of what I came for.
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Default Aug 11, 2020 at 04:18 PM
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Quote:
Originally Posted by Rive. View Post
It seems you've reached an impasse either with this T and/or their approach.

Maybe you need a reset, be it a break from therapy altogether or simply testing the waters with other Ts. This is how one can get 'unstuck' when reaching a plateau

Thank you. Any experience with this? It's obviously occurred to me to change Ts or take a break, but given I'd intended to go start to finish with my current T, it's a bit strange to consider it as a potentially necessary part of completing successfully.
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Default Aug 11, 2020 at 07:17 PM
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From experience I can tell you it us really hard.

I saw the same T for 10 years. We did a lot of work and she helped me in many ways. She worked with trauma and helped me understand it but we still hit a wall. I mentioned seeing a second T for EMDR. I told her that I would only see the nest T if I xousl see them both. So I saw her weekly and Emdr T biweekly. After about 10 months I tragically lost my long term T. I never thought I would move beyond the loss. Emdr T was patient and started working together weekly. We have made some big steps in my trauma work in the last 2 years. I never thought I could do it without long term T. However, the reality is that a fresh perspective and a different modality we are moving forward and I am healing in ways I didn't think possible. long term T and I accomplished so much and without our work I dont think O w oi ult have been ready for EMDR T.

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Default Aug 11, 2020 at 09:09 PM
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Is is possible to take a long-term break? Therapy, like many things has diminishing value over time. It is important to develop life outside of therapy.

Follow your instincts.
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Default Aug 12, 2020 at 12:23 PM
  #10
So much of what you wrote resonates with where I seem to feel like I am in my therapy. This kind of stood out to me:

Quote:
Originally Posted by largess12 View Post
My response is already wordy, but to address your Q about the 'worst that could happen' briefly, I think it's the prospect of trying to do what I've always wanted to do (ie, move on, meet someone I care about, find fulfilling work) except now starting at a sort of bottom rather than years back where at least I had some native level of motivation and interest. On the other hand, at times it feels like I'm throwing good money after bad (figuratively) and part of me thinks I should just suck it up, end treatment and just try to get started where I am. It's a tough thing to consider having, in a lot of ways, put my life on hold to clean things up via therapy only to leave having not really gotten most of what I came for.
What caught my attention was the separation between your life and your therapy that I hear in your words. It feels like you are saying 2 different and related things.

First, that there's something holding you back from pursuing things in your life because you have not reached some place you feel you need to be at before you can begin the rest of your life. Because of not being at some "magical" or expected place, there is fear or dread, maybe even anger (or something) that is keeping you from trying. Oddly, it is "at the bottom" that we are able to be open/vulnerable to trying different things with a different mindset. Through this openness we learn about ourselves, we grow, and are able to become something else. Be put together differently, make different connections or neural pathways. (ok, a bit woo woo and significantly easier said than done)

The second is in line with the first and yet a slightly different take on it. This is the concept/feeling that one must end therapy before you can start the rest of your life. I know that there are limited number of hours in a day and energy we have for stuff. So maybe a cutting back on analyzing yourself (so the therapy part of therapy) might be helpful while you try to engage in other elements of your life. Still seeing your T so that you can discuss what you are doing and how these other elements are playing out. It does require your T to be willing to go with you on a change in how you use your time with them. Again, this is so hard especially when motivation is low and you might not know where to even beginning.

My thoughts around this again is to listen to that little you voice. What does that little you want. Ok, it doesn't want to talk about or deal with this emotional thing that happened. What does it want to do ?? If it was a true child of yours, how would you manage those wants with compassionate guidance? How would you allow it to explore the world to learn what it likes? This is a major part of what I'm working on so there maybe lots of projection here.

I'm also a bit curious as to the conflict between that little you and the adult you. You state that the little you doesn't want to address some emotional thing, so it seems not all of you are in agreement that it's the right time to deal with that. And yeah, I know you've been in this internal struggle for several years now. The parts that want to address it must think that addressing it will get you somewhere or is there only a single another part that is dictating that you must address it because it believes that's how "this" works? In my work with my inner world, it seems that I have several parts and sometimes most of them don't have a thought/concern about something so it ends up with those parts sitting on the sideline while 2 or so battle in their unique ways on how to keep me safe and how to get me where I want to be. If it is similar for you, any chance of enlisting one or more of the sidelined parts to help bridge the different needs of these parts.

Sorry for so long of a response. Feel free to PM me.
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Default Aug 13, 2020 at 12:51 PM
  #11
Thanks again for your thoughtful reply, Elio. Responding in parts to address your points.

Quote:
Originally Posted by Elio View Post
First, that there's something holding you back from pursuing things in your life because you have not reached some place you feel you need to be at before you can begin the rest of your life. Because of not being at some "magical" or expected place, there is fear or dread, maybe even anger (or something) that is keeping you from trying. Oddly, it is "at the bottom" that we are able to be open/vulnerable to trying different things with a different mindset. Through this openness we learn about ourselves, we grow, and are able to become something else. Be put together differently, make different connections or neural pathways. (ok, a bit woo woo and significantly easier said than done)

It's interesting you use the word 'magical' because at points my T has asserted (though has backed off the idea more recently) that I'm looking for a 'magic bullet'. I would typically respond to him by saying I'm not looking for magic, I'm looking to feel sufficiently better so I can go out and try. While I definitely have more tools, I don't feel better and feel like a lot of the obstructions that have historically been in place are still there (to make it explicit, believe most of these are self-created via 'little me').

Quote:
The second is in line with the first and yet a slightly different take on it. This is the concept/feeling that one must end therapy before you can start the rest of your life. I know that there are limited number of hours in a day and energy we have for stuff. So maybe a cutting back on analyzing yourself (so the therapy part of therapy) might be helpful while you try to engage in other elements of your life. Still seeing your T so that you can discuss what you are doing and how these other elements are playing out. It does require your T to be willing to go with you on a change in how you use your time with them. Again, this is so hard especially when motivation is low and you might not know where to even beginning.
I wouldn't say I need to end therapy to start working toward something better, but I would say I'm looking for 'something', and have this whole time, from therapy before moving forward. This hearkens to the obstructions I've referenced (ie, obstructions are mostly gone so I can get to work). Making therapy a side dish instead of the main course could shift perspective somewhat.

Quote:
My thoughts around this again is to listen to that little you voice. What does that little you want. Ok, it doesn't want to talk about or deal with this emotional thing that happened. What does it want to do ?? If it was a true child of yours, how would you manage those wants with compassionate guidance? How would you allow it to explore the world to learn what it likes? This is a major part of what I'm working on so theremaybe lots of projection here.

I'm also a bit curious as to the conflict between that little you and the adult you. You state that the little you doesn't want to address some emotional thing, so it seems not all of you are in agreement that it's the right time to deal with that. And yeah, I know you've been in this internal struggle for several years now. The parts that want to address it must think that addressing it will get you somewhere or is there only a single another part that is dictating that you must address it because it believes that's how "this" works? In my work with my inner world, it seems that I have several parts and sometimes most of them don't have a thought/concern about something so it ends up with those parts sitting on the sideline while 2 or so battle in their unique ways on how to keep me safe and how to get me where I want to be. If it is similar for you, any chance of enlisting one or more of the sidelined parts to help bridge the different needs of these parts.
This is kind of where we're at (and what we're focusing on) of late (so, definitely not a projection). Namely, what does little me want. I'd say we aren't entirely clear yet. Him feeling understood, him feeling seen and acknowledged helps. If I had to pinpoint it, I'd say his motivation is really, unfortunately, simply maintaining a sense of his person and autonomy. Brief backstory was that he (and I) endured a fair amount of childhood trauma (anxious, depressed, controlling mother; alcoholic, absent, low self-esteem father; depression and mental illness was rampant on mother's side, father's side were all alcoholics--paternal grandfather died of cirrhosis).

Then stuff happened. He was tested and identified as very smart growing up in a family that very much wasn't and they saw him as a golden ticket. Maternal grandfather said he'd 'save the family', mother asserted I was her 'nest egg' and that it was 'only right' that I give back to them when I began studying things that paid well, father had always 'wanted a smart son' and had his wish fulfilled. This was complicated further because father felt inadequate in comparison which manifested, in addition to his absence, in not really talking to little me when he was present (said he didn't want to sound stupid).

So, you've got this backdrop of a very emotionally, and at times, financially, hungry family with a son that has some resources that they, without malice, wanted for themselves (to exploit). All of this despite never really feeling loved or accepted by them for the most part, or even liked by his father due to his absence and reticence. I think I'd say '***** that' too when people I didn't think even liked me were all of a sudden super invested in what I could do. I'd make a point to do well enough in school (~93/94) but would avoid doing my best lest family try to get some for themselves (still not 100% that this is the fear causing the holding back), aside from a couple quarters where he really wanted it and got 99s and 100s on everything. This has become a central theme of late (ie, what, precisely is going on with the 93/94 thinking).

And then with all of that, parents still don't really know/acknowledge what went sideways. Mother has acknowledged she was too controlling growing up, but nothing really beyond that. Father still doesn't understand why I was furious and wouldn't talk with him in my early teens when he reentered my life. Which is all unfortunate because at his core, little me is extremely generous and forgiving.

Interesting to hear about your multi-part inner world. Would be interested to hear how it operates, PM is fine.
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Default Aug 16, 2020 at 07:02 PM
  #12
Sorry I haven't replied. I will reply when I have a bit more time to talk. I've been very busy this weekend. I did read your message. There's a lot there and a lot to share. I'll probably PM you my reply.

Take care.
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Default Aug 17, 2020 at 11:10 PM
  #13
ok, PM'd you a reply.
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