A simple answer of how I evaluate my progress in this most recent round of therapy (about 6 years) is a significant increase in well-being. I recently read an article by a research-oriented neuroscientist summarized the factors that resonate with me in terms of understanding well-being:

The Four Keys to Well-Being | Greater Good

1. Resilience. I am more resilient now, the negative life events over which I have no control or problematic interactions with the people in my life do not bother me as much as they did before therapy. I think this is because therapy gave me a safe space to discuss how much I was bothered by these things, the ability to realize where my own destructive actions were causing me pain, how to change the things I wanted to change and how to accept the people and situations I was facing if I couldn't or wouldn't change them. Therapy also helped me reach out to others, including my spouse, for support, because my T showed me that even when her reactions weren't perfect, they were still useful. I became more willing to accept what people offered rather than what I thought they should offer.

2. Outlook. As a naturally critical person, including of myself, therapy has helped me learn to appreciate the good and positive more in people, including my family and friends and experiences that are not always what I anticipate they might be-- from unrealistic expectations about vacations to realistic expectations that my wife can meet my needs if I communicate them in a way she can understand. In general, I see things and people as less positive or negative, most seem like a thoroughly mixed bag, and I enjoy myself and my life more than I have in the past. I am more willing to try new things and ways of doing old things rather than be so stuck on it must be my way or the highway. The people in my life appreciate my increased openness. I think a lot of this is because my T has very subtly encouraged me to accept the positive in myself as well as the negative (which I was much better at before therapy) and has taught me how to hang onto the positive more than the negative. She encourages me to accept responsibility for what is mine and to question whether others' perceptions of what is mine is really the case. Somewhat paradoxically, as I have learned to accept the positive in myself, it is easier to acknowledge the negative to others and take responsibility for pain I have caused, while also being willing to let go of the negative feelings about making mistakes or being less perfect than I'd like to be. Self flagellation greatly reduced.

3. Attention. I have suffered from severe to mild PTSD for much of my life, coming to this latest round of therapy with a lot of symptoms, including flashbacks and nightmares and triggers for anxiety and panic. My symptoms have all but disappeared, and I can be present for sustained periods of time in my life in ways I couldn't before. Although I came to therapy practicing meditation, I also started Tai Chi about 4 years ago. Therapy with a T who knows mindfulness has enhanced my meditation practice, and Tai Chi has reinforced and developed my mindfulness as well. Although I've always had good focus in work, I now experience much less anxiety and far greater flow, especially in the public nature of some of my work. In my life, I feel more grounded in relationships and conversations and my kids especially say I pay better attention to them when they talk than I used to. The reduction of PTSD symptoms comes from speaking about the past in therapy with a T who created a calm and centering and mindful place for me. When I first started, I couldn't talk about my past without dissociation and generally freaking out with panic. She encouraged me to go slow and helped me develop better grounding skills that we practiced in the last minutes of session. Now I can actually say what happened to me in words that resemble normal English, with emotional resonance and staying present.

4. Generosity. For me this is not about "charity" or doing volunteer work, both of which I have always done, but developing a state of mind where I don't always see threat and danger and hostility from other people. I give other people the benefit of the doubt, not for their sake or because I "know" what is true, but because therapy has helped me realize that behavior I interpret as negative towards me just often really isn't. My T has helped this directly by being willing to discuss my negative experiences with her and share her perspective with me about an interaction, even if it's just a "look on her face." I have realized that I don't always "read" people right, even if it's an email, and that knowing what's inside another person's mind and heart is pretty much impossible to know unless they share it with me.

If people question whether I know how I've made progress and how I can interpret it as a result of therapy in ways that aren't explained above, I would answer that I know what is true for myself. Just as those who have been harmed by therapy know that this is true for me.