Did you ever go to a pdoc to get a diagnosis? Maybe if you did, it would help you with therapy goals. Have you asked your T what she thinks is wrong with you? What do you want to be different about yourself? What are you looking for? You said you almost ruined your life. Have you explored that period in your life and worked through what and why you did?

I used to plan my sessions but with this T I don't. We just work with "this part" or "that part", whatever seems important.

I think it would be a good idea to write down your goals with your T, or have you already done that?