Couch 220: Second To None!

I hope you do too! Actually I'm a lot better this morning. I took nyquil last night and slept like a log. Pretty sure it's just a stupid cold and I was being paranoid yesterday about the 'rona.

Seeing L yesterday evening helped a lot with that.

Yeah. This perspective makes a lot of sense to me. The feelings, not the behaviour, are the primary issue.

T's perspective is sort of the opposite--he says that in his experience, people have to stop doing these behaviours before they can really get into the feelings, and they won't get better until the behaviours stop.

I'm not really sure which one to believe, but T won't work with me unless I agree to contact him before engaging in the behaviour so I guess that's what I'm going to do.

Oh, I definitely will tell him that I tried a bunch of stuff--I don't think he gets how hard this is for me.

Tbh I've been engaging compulsively in this behaviour for over a decade now, and I've tried to stop approximately a bazillion times. I don't think that T forbidding it makes it more enticing, I think that the behaviour is just really entrenched in my dopaminergic reward system

I find myself thinking about my treatment for similar behaviors, and it seems that my clinicians think that both are problematic. I had a treatment plan with 6 where I would refrain from SH to the extent possible, but he recognized that there was the possibility that I do something. We also spent a lot of time talking about urges and how to reduce/minimize those. When I did do something, we would reemphasize coping skills that I could use to refrain.

I guess what bothers me is this notion that you have to contact him before you do anything. Sure, that would be a huge deterrent for me, but at the same time I think that it fosters a dependence on the T that would make me uncomfortable.

Hi all. Started out being an anxiety provoking day at work but then it settled down and I even got some Christmas shopping done. Yay Amazon and Target! Esther is doing good. No infection. Sometimes I just forget she is old. But yesterday she hopped up into my Mom's chair and sat with my Mom while my Mom wasn't feeling well and that was so good to see. Esther in her Momma Cat role that she does so well.

If it were me, having to contact my T first would likely make the behavior more enticing on some level (though not necessarily consciously). I like my T, and I like talking to her, so a part of me would want to nudge myself in the direction of having an urge to do the thing because it would mean I could contact her. (Not saying that it's healthy, just saying that it's one reason why this agreement wouldn't work for me!)

Do you know why you do it? Like, what the feelings are? My (very stripped down) DBT card showed me loud and clear after a few months that my maladaptive coping strategy pops up only when my shame levels get high. Not fear or anger or anything else. So if I start to feel myself moving in that direction now, I think, "Ah. Shame levels are high. Maybe I can find ways to reduce them," and then the urge starts to go away on its own. It releases the pressure inside when I can see why I'm feeling the urge and then approach a solution to the why. It also helps reduce the shame and defectiveness I have around having the urge that would otherwise be a terrible positive feedback loop.

It's funny--sometimes it's a deterrent because I don't want to bother him, don't want him to come to resent me... I'm ashamed to say this, but sometimes it almost feels like giving up my problem behaviours means I have to give up having an excuse to contact him, because sometimes when I'm really struggling all I want to do is talk with him, and trying not to engage in a problem behaviour is a legitimate excuse.

Ugh.

ETA: Exactly, EM.

I think with this particular behaviour it can be something as benign as boredom all the way up to full-fledged shame or panic. It's sort of an all-purpose, "I can do this and have a little spark of dopamine instead of feeling this other thing" activity. Though maybe I should DBT card it and see if I can't get a bit more specific.

I wonder if, rather than focusing on stopping the behavior, would finding something very finger/hand intensive to do that is positive/productive be of any help? Sometimes in our idleness we resort to those habits, but if we stay absorbed mentally and physically in something else we aren't so focused on that habit. I crochet, work puzzles, play games . . . things that occupy my mind AND my hands. It doesn't get to the root of the issue, but it might interrupt the habitual nature a bit.

So today, Dr. T did well in talking about concerns with my D--we're having a meeting next week with various teachers and administrators because she's doing so poorly with virtual learning. But the therapeutic relationship part (continuation from Tuesday) seriously sucked. I think I really do need to leave. I do have a consult with a therapist next week (Thursday)--the idea was to consult about my therapy, but maybe I should ask her if we can just make it a regular intake session...I suppose I can see how Monday, then maybe Wednesday go with Dr. T.

I opened the box my childhood friend's mom sent me. It's beautiful and funny and heartbreaking in a whoopee-cushion next to a school picture of a girl who died at 13 kind of way.

Ugh, LT I'm sorry.

You sound more resolved than before--less, like, angry and reactive and more just like someone who's had enough.

So leave rather than try seeing two therapists at once?

I ended up texting T and he called me. He suggested that I go for a walk (since I won't do the thing outside of the house) and to keep my gloves on (even though I have my fellowship meeting over zoom tonight). He also asked me to consider ways in which I might be wanting to enter the sick role, since he and I think that might one of my triggers for this behaviour.

He was nice about it.

(I wish he would be nice about it and give me practical suggestions and also say warm things that made me feel cared for.)

LT, I wonder--does leaving outright (rather than staying on and seeing him along with another T, or taking a break, or what have you) feel at all like an act of punishment or protest? Like, a way to communicate to him that he's failed you? If so, it might make sense just to be aware of that just so you know why you're doing it?

(I only ask because when I am angry with my T and consider leaving therapy with him, the thought of Leaving feels satisfying, like I'd be punishing him and communicating to him how inadequate he is.)

I am so close to adopting another dog. I want my chihuahua to have a companion and I have enough money that I can afford another dog before I graduate in the Spring.

There are two dogs I'm looking at and have applied for. I feel really torn about choosing between them. They are both about two hours away from me, but not in the same area. I need to pick one to go visit and see about adopting, but I can't decide.

One is a girl, S, and she is 5 years old. She has the saddest big brown eyes. The other is a boy, T, and he is about a year old. His little face reminds me of my chihuahua. I feel a connection to both of them. I want both of them. Choosing feels impossible.

Is there an option of having them meet your dog? Like a playdate sort of thing, see how they get along?

Thanks. Yeah, it does seem more like...I'm tired of going through this with him. He's known me for 3 years. We've spent an average of 100 minutes a week talking. How does he not get how things affect me by now?

I think? My problem is, the guy I could have seen at the same time, he said this thing in the consult about how he's not as into working on mood regulation and coping. So that concerns me if I were to see just him. Because I need coping help right now, with Covid and my D's virtual school. I suppose an option could be to try seeing both?