My therapist keeps asking me what I want to work on and I simply don't know what she can help me with.

Hi spikes. Does your therapist know some of what you write about here?

I recall you posting about stopping your medications and being worried therapist will tell your psychiatrist. Are you still taking any of your medications? If not, I frankly don't know what you'd even need from a psychiatrist. If I were in your shoes, I'd tell your therapist why you quit medications. I think that definitely needs to be discussed. If your plan is to lead a life without medications, you need to be super duper up on coping and healthy living skills. Your therapist can teach them to you. Or even if you know a lot of them, she can work with you on perfecting mastery of them. That is just a start. A therapist is a great support and guide for anyone (even those on medications) to process stressors and triggers and move forward with goals in life. I imagine you have some goals in life? If not, you can work with her on why you don't, if that's good enough for you, etc. Are you unhappy with your current situation? How can you find a way to find more satisfaction with it? Or work to change it?

If coping/health skills and therapy are not enough to stay mentally well, what are your action plans during a period of crisis?

[Skeezyks]

I'm not in therapy anymore. And, in fact, I've really never done much in terms of therapy at all. I've tried seeing a few therapists for brief periods. But it never really amounted to anything. The last therapist I saw was the best of the lot though. I recall her asking me, during one of our sessions, what I needed. And, like you, I could only think to say: "I don't know." And this is one of the reasons I don't expect to ever return to therapy.

For one thing, there are some things... important things... I simply could never ever talk about. The humiliation meter would be off the charts! But also, as I once told another therapist I spoke with briefly, "I know what my options are. I just don't like any of them." So, at least in my case, if I'm not willing to at least consider the possibility of making changes in my life, then what's the point of being in therapy; because, at least to my mind, the goal of therapy isn't simply to talk, talk, talk about one's problems but rather to make it possible for one to make positive changes in one's day-to-day life.

So with all that said... perhaps what's going on with you in therapy is that you don't yet see if or how therapy can lead to you making positive, constructive changes in your life? Perhaps you haven't yet figured out what positive, constructive changes would look like? Perhaps you have yet to figure out what it is (behaviors or life circumstances) need to be changed? Realistically I don't know you nor do I know anything about your situation. So I can only offer up some possible explanations based on my own admittedly brief experiences with therapy. But perhaps what you need to do is to take a look at your past & present life circumstances & figure out what changes need to occur to make your life more satisfying for you. And if that's not something you feel able to do, perhaps that's what you need help with in therapy at present. At least those are my thoughts with regard to your post.

[Jedi67]

Originally Posted by spikes

My therapist keeps asking me what I want to work on and I simply don't know what she can help me with.

BirdDancer makes a lot of good points, spikes! I talk about a lot of different things including meds and coping skills. I discuss my moods, what I am feeling at the time of the session, and of course any cognitive distortions I may be having (which are many at any given time lol).

my therapist is a "listener." he asks questions of course and he occasionally interjects when he thinks he needs more elaboration from me. what I dig about him, is that he calls me out on my ********, and knows when I am not being very honest about something. we also talk about my PDoc and how things progress with him whenever I seen him. my T is quite invaluable to me for my recovery and I hope he doesn't ever leave or move to another MH facility since there is an unusual turn around there which is prompting me to search for another provider.

hope everything works out spikes! keep reaching out here! take care

[Jedi67]

also, spikes, you can definitely make therapy work. it won't be easy but you can do it. put in the work and you will see results. talk about anything you are comfortable with!

[MickeyCheeky]

Is it possible to just talk about what you're struggling with the most, @spikes? It can be anything - you can even start from very simple events such as "My neighbour made me REALLY upset last wekk" and things like that! I COMPLETELY AGREE with EVERYTHING that the other wise, wonderful posters have already wisely said better than i ever could! You can even try to share some of the things you wrote here if you feel comfortable enough. Your therapist will hopefully start from there and decide with you what is the best route to follow. Hopefully it will work out! Sending many safe, warm hugs to you and ALL of your Loved Ones, @spikes, my AWESOME, dear, kind, sweet and WONDERFUL Friend!

[~Christina]

If Therapy isn’t hard then it’s not being done right.

That’s my standard answer.

Some people have a T and they just pretty much chit chat about surface stuff. I have no desire for that, at all..

My T is very goal oriented. I see a problem with X and we look at it from all angles and then work towards resolving it or mentally getting over it or whatever is takes to help me feel better about it.

I think every person on the planet can be helped with a session or 2 of T.. just learning a few coping skills can literally change someone’s whole life.

[Jedi67]

Originally Posted by ~Christina

If Therapy isn’t hard then it’s not being done right.

That’s my standard answer.

Some people have a T and they just pretty much chit chat about surface stuff. I have no desire for that, at all..

My T is very goal oriented. I see a problem with X and we look at it from all angles and then work towards resolving it or mentally getting over it or whatever is takes to help me feel better about it.

I think every person on the planet can be helped with a session or 2 of T.. just learning a few coping skills can literally change someone’s whole life.

well said, Christina!

[fern46]

Originally Posted by spikes

My therapist keeps asking me what I want to work on and I simply don't know what she can help me with.

Maybe you can ask her to anonymously walk you through some of the struggles other clients with bipolar disorder face. Maybe something will resonate and give you a launch point for a good conversation. My therapist does this from time to time when we are struggling for content. She'll tell me about a challenge someone is facing and I'll try to relate to it.

[Jedi67]

Originally Posted by fern46

Maybe you can ask her to anonymously walk you through some of the struggles other clients with bipolar disorder face. Maybe something will resonate and give you a launch point for a good conversation. My therapist does this from time to time when we are struggling for content. She'll tell me about a challenge someone is facing and I'll try to relate to it.

my T does the same thing! when I feel we are at a type of roadblock, he suggests getting my opinions and thoughts on what other clients of his are going through. all anonymously of course. great idea, fern46!

[Moose72]

One of the last T appointments I had, I started talking about my dad. He's 72 and an alcoholic. Somewhere in there, I began to cry until I was a red-faced, nose-blowing, sobbing mess! I could see I was stuck in that state but was helpless to get out right then. That was very difficult thinking about my life with my dad and his dying.

Yes! Remember it doesn't have to be a bipolar issue. In my sessions we've been dealing with my BDD, which causes me a LOT of trouble. It is a very hard thing to talk about, but has gotten a little easier as this is the third T I've braved this topic with (took me 5 years to even bring it up with the first one). Honestly, I can't see it ever being ok -- can't see that place from here-- but it's worth trying.

Or maybe you aren't happy with reactions to certain things. Things you wish didn't hit you the way they do. Maybe there is some cognitive distortion going on. Stuff like that.

[Wild Coyote]

I am not sure my new pdoc knows what to do with me.
She sits back and watches a lot. I feel a bit like an entertainer. Lol.
Some of our subject matter has been a bit bizarre... and I tend to make some funny material out of it -- just to be able to cope, of course.
We are still sorting out just who is who in these sessions!

[BeyondtheRainbow]

We talk about many things and coping skills for all of them. I am very shy and we're trying to get past that a bit right now. We've worked a lot on dealing with my father's death and the loss of being able to fix our broken relationship and my fear that I will also lose my mom who I am close to. I think those are the big ones lately. This week should have been nightmares but I forgot most of the worst ones.


Sometimes we don't have something specific for a session and work on talking with eye contact, maintaining a conversation, etc. Just social skills most people have that I don't. I know more about my therapist's shoes than his face (the sole on his black ones is wearing down and I hate his new brown ones . After 13 years we have a lot that we can just chat about when we do social skills days.

[*Beth*]

I can tell you what I do, which is tell my therapist that I don't know what to say when she asks what I want to work on. I mean, that's exactly the issue right there...you don't know what you want to change, even though you have the intuition that there needs to be change. Or maybe you feel a lack of hope, a lack of ability to change.

The thing about therapy is that there isn't a right or wrong. When it comes to therapy, anything goes...whatever I'm thinking I stop thinking about it and just say it.