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Lilly2 · Nov 05, 2019, 02:49 PM

Sometimes I'd have those "therapy hangovers."

It would usually occur under two conditions, maybe more:

1. If the session dealt with tough trauma issues and/or "me" issues.

or

2. If the session felt unproductive, dissatisfying, or harmful.

Under the first condition, I'd ruminate about what I shared, what I should have shared, what I felt I should not have shared, what the therapist thought, what the therapist is going to do next week, and why the therapist brought it up during the last half or quarter of our session, which didn't give me enough time to process that with her/him to begin with. I felt like such sessions should allow enough time and room to process, and such sessions should be planned well ahead of time. Some T's will allow for a double-session or time-and-a-half session in order to go through a series of trauma processing. It may cost more, but it's better than experiencing a therapy hangover. And then there are times when the therapist would have non-trauma-related issues brought up, such as when you're working on changing a behavior pattern, or when you're dealing with an interpersonal conflict. In those cases, it may not be traumatic, but a lot of what is processed requires time to unravel. Leaving the session too abruptly may cause this. Again, better planning and forewarning on the part of the T should have been in order. Overall, there should be a tapering down during the last 10 to 15 minutes of the session, where reflections about the session could be made, and where affirmations and goals for the week could be discussed. Therapy isn't easy when you're dealing with life-changing strategies, and even identity-changing ones. It's not healthy for anyone to leave a person hanging without some beneficial closure at the end of the session, meeting, etc. The end-of-session process should allow time to debrief and room to feel safe before leaving. Why leave the T's office upset, shaken, wet from tears, or "retraumatized"? That's like a friend bringing up a bunch of horrible things and then saying, okay, gotta go, seeya next week! Would you want to see a friend like that again? No. Or, if a boss calls you in, tells you all the crappy things that have happened, or all the crappy things that you've done, and then says, I've gotta go, got another meeting, see you next week for our one-on-one. Would you feel comfortable working for a boss like that, who wraps things up in a de facto manner without first considering what his/her words would mean to you, to your production, to his/her business? No! In the same vein, T's should not wrap up their sessions with trauma or life-chaning processing. There needs to be a period of time to debrief, not the 5-minute: Well, we've got 5 minutes left, tell me how you're feeling speech. 5 minutes is NOT enough time to debrief. Asking for what you need in therapy is your right and your boundary.

In the second point I made, I feel therapy hangovers whenever I have felt that the session wasn't productive. Maybe the T was late, too preoccupied with answering phone calls, or inconsistent from what was discussed the previous week. Maybe you feel disconnected from last week's session and had spent the entire session talking about everything other than what you wanted to talk about. Maybe you experienced a rupture in treatment and left feeling misunderstood, hurt, mistreated, etc. Maybe you were actually emotionally, physically, and/or sexually abused by the T. In any of the given scenarios above, you may feel therapy hangovers - the kind that makes you afraid to return to therapy, or the kind that keeps you ruminating about what the therapist was doing and why, or the kind that distresses you for the entire week because you have issues that you weren't able to deal with but wanted to. Either way, these are things that should be discussed openly in treatment and with a trusted therapist. There should be ground rules, expectations constantly revisited, goals clearly explained, accountability clearly laid out, patient rights clearly agreed upon, boundaries set from the client as well as from the T, and more. If the T is able to set those ground rules up in the beginning, and then revisit them once a month, give or take, then ruptures could be handled more smoothly, safety could be established, expectations could be met and adequately understood, etc.

Feeling icky, anxious, nervous, scared, retraumatized, depressed, or any other strongly negative emotion and/or thought pattern is not what should be happening at the end of every session.

I had a good trauma and dissociation therapist while inpatient who told me to request any T I speak with before to allow me time to debrief at the end - at least 10 minutes, if not 15. He allowed me to speak about the session we had that day, time to consider what homework I could do to make progress out of our session over the week (or over the night, since I saw him every day), and time to answer two questions at the end of every session we had: (1) What are 3 affirmations I can say about myself (e.g., "I am strong," "I am courageous," and "I am working hard toward my recovery") and (2) What are 3 positive goals I will do when I get home tonight (not for the week, but for that night, such as "I will watch a favorite show" and "I will burn some incense to make my house smell nice" and "I will go for a short walk after I eat a healthy dinner"). Leaving with a good debriefing coupled with three affirmations and three goals for the night helped me to refocus on the positives every time I left the T's office. It's a suggestion you all can make to your T's.