I think elliemay's suggestion is a very good one. It seems like a useful way to think about the whole "work" thing.

My T has told me a couple of times that he thinks I work very hard at therapy, which is very good to hear (and was very unexpected - it happened in situations where I felt that I was really not saying enough, or expressing myself well enough.) He has also said something that I think is worth keeping in mind: each of us can only work as hard as we can, at any particular time. Sometimes the words flow, and the associations come freely, and we are able to make really useful connections in our minds and become unstuck, but at other times it's slow, painful, frustrating, and we may feel that we are in fact moving backwards or getting more stuck. But as long as we show up, and try to communicate as best we can at that particular time, that is the work.

Can you ask him questions in writing?