Setting the pace in therapy?

(I haven't really figured out what triggers people so I'll just put that little icon there. I briefly mention I cut this weekend.)

I need some insight or at least some encouragement from the long-timers. As you know, I’m new to seeing a T…35 years old and I’ve never been willing to talk to even a family doctor about some of the things going on. But I am now. I want help. I need help. I can’t do this alone. If I don’t get help, I’m going to end up dead.

Before my latest major problems, I have muddled through my life by avoiding thinking about some of the bad/hard things. (I’ve heard the term “stuffed feelings”- I guess that’s what I tend to do.) No, it hasn’t worked out so well when it bubbles up; those times have been really bad. But that’s been the way I deal with things. And at least when I am ignoring how bad those things hurt me, I don’t have to feel them. I could go through my days and not be thinking about it every freaking minute.

Well, now I’m seeing my T. And he is being so very cautious as he is exploring what has caused the last big breakdown and what issues from my past got me to this point. And while I feel like that should be comforting that he is being careful not to push me too hard, I find myself filled with huge amounts of dread for the time when we will start getting into the hard stuff.

I don’t want to drag this out forever. (I do, however, realize I may be in therapy for years. I’m not expecting to just talk about it once and be over and done. ) I found myself this weekend really struggling to turn around some really dark thoughts about harming myself. (I cut a little, but then told myself to pull it together and went and exercised instead. I was proud of myself for stopping. Turning around those thoughts was really hard.) I think most of those dark thoughts were stemming from fears about there being a prolonged amount of time where I am going to have to anticipate talking about these things. I KNOW it is going to hurt really, really bad to have to talk about the abuse/trauma/etc. other issues, but I just want to get into it already. I guess the best analogy I can think of is taking off a bandaid. I know that soaking it in water and letting it dissolve some should be more gentle on me. I know ripping the bandaid off will hurt like hell. But ripping it off will at least be faster. I won’t have to be filled with this awful feeling of dread for weeks and months. I just want to hurry up and walk through the fire so I can be on the other side already. I don’t like standing on this side and looking at the hot coals. It’s making me more and more afraid and wondering why I can’t go back to just stuffing my feelings most of the time. That doesn’t hurt so bad as having these thoughts in the front of my mind does.

I am deliberately choosing to trust my T and his professional ability to guide me through this at an appropriate pace. But my goodness. This wasn’t something I expected. Does this feeling of dread go away? Can I ask him to just start asking the hard questions already? In my head, I think am willing to face the pain of him really pushing me. Or maybe I really don’t realize how dumb that is and that it will be too much for me to tackle yet. I don’t know. Ugh. This is miserable.

Great job turning around your thoughts and doing something good for your body by exercising!

I'm wondering if you've talked with your T about the feelings of dread - they seem important to address. The question of pacing is definitely a joint conversation too. I imagine that most T's would try to err on the side of caution when it comes to bringing up difficult topics. They might rely more on you to bring them up when you feel you're ready.

In the meantime, having your T work with you on coping skills and bringing your anxiety down to a more manageable level seems like a good place to start. I know it's scary, and the telling can be difficult.

I am not so good at talking, but have been in t for some time. I think it is really really important to have some coping skills in place before digging into any trauma. Has T taught you some skills? Breathing, Muscle relaxation, meditation...there are tons more. When you start digging things become a little intense and difficult to manage...at least from my experience.

Look for WePow's response, she knows this stuff well!

I thought I was a rip the bandaid off kind of person, and to some extent, that is how I've done therapy. The basic stuff: I was abused and by whom, how incredibly depressed I was, etc., I just got it out there and we worked on it right away. As a result, the depression lifted relatively quickly. However, my T was pretty careful to quickly give me tools to use to calm myself and cope when he realized how much faster I wanted to go than he was initially expecting. Just tell your T that you want the bandaid ripped off approach and see where that discussion goes.

Yeah, you guys have described what he is doing. He said we are going to be focusing on some of the coping methods right now. Meditation, breathing, some binaural beat thing that helps you relax while listing to it sort of like music I think, etc. I guess maybe I am trying to get the cart before the horse. He knows I want to try to avoid medication so I guess I need to really have these coping methods in mind so I am more prepared to deal with talking about the hard stuff. I just really hate the dread of waiting weeks and months to discuss this stuff when it is constantly on my mind...

Thank you guys.

whoops...no "cart before the horse" there. You need to talk about what's on your mind too. That's as important as learning coping skills. I didn't mean to advise stuffing it. Be honest, tell him what is in your head.

I push myself VERY hard. I can't quite get away from the belief that I need to sit down & throw everything out on the table so that I can efficiently sort through it with T. I'm ready to do the work, nothing should hold me back, right?

Sometimes this works. My T has commented that I work very hard & that he can tell a lot of thought goes into the questions I ask him.

Sometimes it doesn't work. I tried giving my T a letter telling him some tough stuff. He tried to discuss the letter w/me and I totally shut down. I didn't want to shut down but I spent nearly an entire session unable to talk. I was pushing myself too hard - I can't go that fast. I still wish I could though. I get frustrated with myself. I can tell him stuff in my head, but then I get in the room and I don't say half the things that I would like to say.

Okay, yes. I see what you are saying. I will make an effort to bring up the feeling I have about wanting to push through some of the hard stuff but how waiting is making me feel dreadful so that he can know what it is I'm experiencing right now. I can see why that would be beneficial. thanks.

I started with my current T in january, after having seen someone else prior. I really barreled through those first couple of months - it seemed like every session was some huge disclosure of tough stuff.

At one point, T told me that he was concerned about how fast I was going. He thought I was outpacing my ability to process the crap I was disclosing. He quite deliberately slowed me down. Since then, a lot of current life stuff has been the primary focus, but the last couple of session have been more focused on things from the past.

I finally realized why I was doing that. My previous T had terminated with me fairly quickly because he moving to another state. The more I thought about it, the more I understood that I had been racing through trying to get my CSA all out in the open and "dealt with" before he made a similar announcement. Also, I wanted to get it "out of the way" before my mom passed away, so that grief wouldn't keep me from dealing with it.

Since I made those connections and now have more faith that he's not going to ditch me, I've been able to relax and let things come at their own pace. It sometimes surprises me, since I no longer walk into sessions with a checklist of "things I must cover today to stay on schedule". Things tend to wander around a bit and, as a result, more things are revealed than I ever expected.

Hi Piper-

I had those feelings of wanted to just spill all the pain and get it over with. I did ask my t to push me harder as I was feeling stuck and getting frustrated by the process. But I also have issues trusting people who I feel are getting too close to me emotionally (like t). So my t would push, but would also be very gentle when I started sharing. Finally one session t said "I think you need to talk about ____. You've brought it up a dozen times, but then you pull back." I told her I didn't know where to start, so she would gently ask prompting questions and I ended up telling it more as a story. It was one of the most productive sessions I've had.

I am not sure if that is at all helpful, but I think your feeling of wanting to share it and get through the pain isn't unusual. I think it's good your t is giving you coping skills first. My t did that as well and after we started delving into the painful issues, I found having those skills was amazingly helpful.