After my appt. with therapist today, I am totally confused. I have been seeing her monthly since July 2015. She also hosted a weekly dbt group for six months with us that ended in early April. Today, she basically said that they, which I assume is either management, the state, or both, stay on her to achieve improvement with each client. I assume I haven't improved much. She's ready to cut me loose and in fact said that therapy isn't for a lifetime. She said that therapy is to set a goal or goals, and then achieve them.

To me, it's an accomplishment when I have days that I don't have a thought of self harm, and I have been doing better and not having days like that but every now and then. She said she did not think I was ready to go back to work yet. I would like to by all means, but I know myself better than anyone and I know that I'm not ready either. I can't physically handle hard labor anymore, and hard labor jobs are the only jobs that I can have where I can gripe, cuss, pitch a fit to get it all out of me so that I can go home and be nice to people outside of work. Working with the public makes me want to be nasty with people outside the workplace. So I'm stuck in limbo with this f'up brain of mine.

Anyway, has anyone had similar experiences with therapy that can elaborate on the topic? Basically, I feel rejected in the same way that I did when the vocational rehab program booted me out. They shot me a bunch of bs and make it seem all peachy, but when I got the paper work, it said non compliance which through me for a loop.

I think what the therapist was getting to was that I'm not very social and for me to be social, I've got to try to get out and meet people. I really don't want to be social, for their sake and my own. She said that I have a negative for each suggestion she offers, such as church. I told her that I get as much out of church by watching it on tv as attending live. Why? Because I don't have to put on a f'in fake smile and act like life is so grand just to be around and socialize with people so that they have news they can gossip about.

Can anyone give me a heck yeah dude, you're really one screwed up individual?

[BrazenApogee]

Question for consideration, why would you have to put on a fake smile or fake face? Would it be ok to just be yourself?

[BeyondtheRainbow]

Does insurance pay for your therapy? I know when I was working (I'm an occupational therapist) I sometimes had to cut people loose who were still in need of treatment but insurance felt they weren't progressing fast enough or meeting goals or participating enough or whatever, even when I felt the patient was doing as I expected and as was appropriate.

I pay out of pocket so aside from a brief period when insurance covered (and then denied because I wasn't getting better fast enough) those things haven't mattered.

Sometimes it's a matter of the therapist feels they can't ethically continue because they feel they aren't helping enough. That doesn't necessarily mean you are non-compliant but just that they have done what they can and it is time to move on. In that case seeing a different therapy might be helpful. They should offer a referral if you ask.

I understand the social goal thing. It's been one of my goals for pdoc and therapist for years and I seem to always fail. Church would be lovely but I'm currently asleep through most services (I'm in a small town without multiple service times). I've been supposed to go to drop-in center for well over a year but either felt too awful to try (they say I should and not worry about making a bad impression) but right now the sedation from clozaril is also an excuse. We talked about volunteering at the hospital and I'm going to look into that when I get home from vacation in June, if there is something that doesn't involve dealing with patients which feels too weird after being a healthcare professional for so long.

I know it's hard. But one therapist isn't the only one and if you think you aren't done you can find someone else and maybe even tell them you don't want to feel pressured to do social skill stuff immediately.

[raspberrytorte]

I hate it when therapists mention God and religion. My therapist tried pushing the god thing on me today and I was like DON'T ****ING EVEN GO THERE BECAUSE I DON'T BELIEVE IN GOD!!! Religion is not going to help me.

Anyway, I had one therapist who cut me loose, said she couldn't help me anymore.

Try not to take it personally. You'll find someone better. Hugs.

[Victoria'smom]

Does it really mean she'll cut you loose? My T and I had several conversations like that. My gaf score wasn't in providing and the company was breathing down his neck about it. It just ment we set smaller goals.

I agree that therapy isn't for life - but self care is. For instance, even though my CBT program is behind me, I continue to do the work nearly every day.

I also believe that goals should be set - ones that are both measurable and realistic to achieve. If that means small increments then so be it. Ultimately I think your therapist should have set an agenda with you and established what the overall end target will look like indicating it's time to move on. Similarly, s/he ought to be performing an ocassional check-in with how the plan is coming along and whether tweeks are necessary to it.

[BeyondtheRainbow]

I don't agree that therapy isn't for life. I've been going to the same place for 14 straight years and I am still benefitting. Bipolar is lifelong. Therapy makes it more managealbe. So why would I not do therapy as long as I can? Maybe I'll feel different when my therapist retires but for now I don't see myself not in therapy. My pdoc requires it actually I think so as long as I see her I'll be there for sure.

Originally Posted by BeyondtheRainbow

I don't agree that therapy isn't for life. I've been going to the same place for 14 straight years and I am still benefitting. Bipolar is lifelong. Therapy makes it more managealbe. So why would I not do therapy as long as I can? Maybe I'll feel different when my therapist retires but for now I don't see myself not in therapy. My pdoc requires it actually I think so as long as I see her I'll be there for sure.

Yeah, I'll probably continue going to therapy for a long time, even though I just started last July. I don't mind if it's a lifelong thing.

A lot of things in my life pop up and I just have a difficult time coping with them. It's always good to have a therapist, especially in my situation where I don't have anybody to support me in my life. My therapist is the only one who keeps me going.

[gina_re]

Originally Posted by BeyondtheRainbow

I don't agree that therapy isn't for life. I've been going to the same place for 14 straight years and I am still benefitting. Bipolar is lifelong. Therapy makes it more managealbe. So why would I not do therapy as long as I can? Maybe I'll feel different when my therapist retires but for now I don't see myself not in therapy. My pdoc requires it actually I think so as long as I see her I'll be there for sure.

I have to agree. It may not be that you see the same therapist for twenty years, but your life changes over the years. So having a therapist to work through life changes and other symptoms that can pop in the future is beneficial. BP doesn't go away, and we can all use a "tune up" here and there.

[Icare dixit]

I really fear such a thing.

Reading this, I wonder, is DBT really worth it?

I sound like a neurotic: I'm scared of therapy. I doubt anyone can understand these problems and not doing therapy at least gives me some hope. But maybe understanding them is not required. I wouldn't know.

Someone basically saying that it's useless to continue would be catastrophic. Especially if they don't actually say it. I mean, thinking you can't handle the truth. That's bad.

I hope you find a way to continue with and benefit from therapy or applying what you've learned yourself.

I had one psychiatric assessment which said i wouldn't benefit from therapy because i would 'outsmart any therapeutic endeavor.' I also got kicked out of a DBT Day Hospital -- 'referred back into individual therapy' was the party line. One psychiatrist fired me because she said she was scared of me. My interactions with the healing professions has been brief, explosive and upsetting. I've been with my GP for 17 years tho. He's really smart and funny and we get along well.

Originally Posted by gina_re

I have to agree. It may not be that you see the same therapist for twenty years, but your life changes over the years. So having a therapist to work through life changes and other symptoms that can pop in the future is beneficial. BP doesn't go away, and we can all use a "tune up" here and there.

I guess you're right. Unfortunately, BP won't go away. Just like my first therapist told me, at this point treatment is to try to make it manageable as possible. It's just been hard on me. I lived and struggled all my life not knowing about it until I got my dx a few years ago in middle age. So, now that I know I'm bp, and know that there's not much hope for me since I'm getting old, I just feel totally worthless and that there's not really a reason for me to exist any longer. If being miserable is permanent, why should I have to exist?

[Nammu]

For some reason this thread made me think of insurance companies and their lousy attitude about covering therapy. Would they deny insulin to a diabetic cause they weren't getting better?

[Victoria'smom]

misery isn't permanent. There are times that things lighten up. Keep fighting for treatment you deserve.

[gina_re]

Originally Posted by Lsswwdictb

So, now that I know I'm bp, and know that there's not much hope for me since I'm getting old, I just feel totally worthless and that there's not really a reason for me to exist any longer. If being miserable is permanent, why should I have to exist?

There is always hope

Originally Posted by gina_re

There is always hope

I'm like you. I'm sick and tired of being sick and tired, and have been for years, and I've been saying it for years.

I ran out of hope a long time ago as well, but I do appreciate your trying to help. You know, when I was well, if there really was such a time, and I worked, I presented a fairly positive attitude. A bad/negative attitude can get you booted from a job quickly, and people who are mentally healthy do not want to be around negative people, so that's why I always tried to be positive. I did a really good job of faking it until the last year that I worked.

My therapist says that it's a sympton of my sickness, and I have to retrain my brain. We even discussed it in dbt group. However, this wore out brain of mine just seems to be stuck. My therapist was trying suggestions on ways for me to be social to meet new people. I had all kinds of reasons to not be social. What's sad is the fact that I told her that being around people drives my paranoia through the roof.

Yeah, my paranoia can get scary at times. I never experienced paranoia until the last few years. What scares me is the things that some people have done when their paranoia got the best of them. I absolutely don't want it happening to myself, and I don't think it will, but it's why I have become so isolated. However, the isolation is not good because I no longer have any friends, and I could really use to find me a significant other. I don't even have someone to drive me to a doctor if need be.

Oh well. As Led Zep sang, I've "Rambled On" long enough.

Ever since I started this thread concerning my t visit, my depression has been worse, my anxiety is through the stratosphere thinking about the next appt., and I've just been sicker than normal. This is the only t that I've ever had with a great sense of humor. She has been my favorite t. Last visit, she mentioned the t that I had before her. He was the only t they would set me up with at the time, and I refused treatment for another 6 month until I was in crisis mode before I broke down and accepted treatment from him.

Anyway, this has knocked me around a lot. I feel as though if I get cut loose, I will lose ambition for therapy and not find another one, and I'm fairly certain without therapy I will not do well. I have always hoped that with therapy, if I get to far out/down, the t would recognize it and suggest hospital before I'm in crisis again.

I just felt the need to express myself.

[Victoria'smom]

I have always hoped that with therapy, if I get to far out/down, the t would recognize it and suggest hospital before I'm in crisis again. That's one of my therapists "jobs". Does your T know you need that from them?

My way of putting it to her was that I needed someone regularly overseeing me. She mentioned having 6 month psych evaluations. However she did set a very small goal which I assume was in order to show progress next visit.

I sincerely have the feeling that perhaps the paper trail is possibly showing an improvement and maybe that's why I need to be cut loose. I havn't improved any at all. I may be worse. All I do is stare at 4 walls. I go to grocery store once a week, and that's my life. I'm isolated. So, I have no one to go off on, curse out when pissed, unless cashiers count. While in traffic, no one hears me.

Heck, traffic had me irratable my last visit, and I told her. She tried using it as an excuse for me not coming, but I told her it had nothing to do with the appointment. I thought she would have seen my mood shift, because normally I'm a little more cheerful at my appts.

[MBM17]

It sounds like your therapist hasn't been very clear, that you were having to figure out or assume the meaning of what she was saying. Have you had a chance to clarify with her and ask her exactly what she's saying?

One of my very biggest fears in therapy is that if I talk about the biggest emotions or some of the most intense worries and fears, I will do or say something, the therapist won't like it, he'll end our therapy relationship, leaving me all alone to try to cope with things too big for me to cope with alone. Your posts, @Lsswwdictb, sounded similar. You are feeling rejected by someone who you feel is helping and whose help you feel you need. Is that right?

I have a fantastic therapist right now that understands my mind better than anyone I know. It took me two years of weekly therapy before we started talking about this fear.

I've had a lot of bad experiences with therapists. @BeyondtheRainbow is right that sometimes a therapist is unable to help the patient anymore. It isn't the patient's fault or failure, just a maxing out of that particular therapist's abilities. My first therapist told me we needed to stop meeting for a while. While I was meeting with all these therapists, I thought they were helping most of the time. It wasn't until I left and found a truly good therapist that I was able to see that they weren't helping at the time. I wanted to believe they were helping.

I'm not saying that your therapist isn't helping. I'm saying that though it will take a few tries, you may find someone with an even better fit, someone you can trust won't tell you to leave.

I've talked to my therapist about my own worries. "I'm still in therapy after 7 years. 7 years of nearly weekly therapy! I'm a failure. I should be fixed by now." (It was me worrying about stopping therapy, not my therapist like your therapist was.)

My therapist said what @gina_re said. For situational depression and anxiety, therapy can often be temporary because they are able to work on the situation and coping skills and the person is able to function again. Bipolar, on the other hand, is a lifelong illness. Therefore, it needs lifelong treatment. It's okay if I've been in therapy 7 years. If therapy is still bringing me some benefit, then I ought to keep going. If it isn't helping anymore, then I ought to stop.

That's what my therapist said, and it felt true for me. It's okay if you need a therapist longer than a few months. If your current therapist doesn't believe that, then you will probably feel more supported by a different therapist.

I'm sorry you've been feeling worse. Issues with the therapy relationship send me into huge downward spirals. I'm really sensitive to that relationship. It's quite intimate (not sexually) because we are talking about our deepest fears, worries, secrets, and struggles. I feel safe with my current therapist, and that is crucial to me actually being able to make progress.