[skysblue]

Okay - so I get 50 minutes for $80.00. I've almost always taken control of session. I guess I want to get my money's worth and utilize time to its best advantage.

I have made lists of 'topics' and just before session I prioritize. I tackle the issues that seem the most important at the time. I force myself to confide in T my most vulnerable feelings. I face my fears as much as I can.

BUT, does this 'taking control' have a downside? Am I missing out on some possibilities of insight?

I guess I fear wasting a session. I guess I fear T and I will stumble and just flounder and not get anywhere.

Today I have session and my mood is amorphous. Lots of stuff going on emotionally but I don't know what or how I should approach the issues. AND, T will be gone next week on vacation so it seems like a lot is riding on today's session - even though I'm not sure what.

How do any of you extract the best possible outcome with each session? I guess I want to do something different today but I have no idea what.

[Perna]

My therapy was a process over time, not an each session sort of thing (any more than each day of a week is equally as significant to that week but they all go into making it). If a lot of stuff is going on emotionally, I would make that today's topic, explore what is happening "now", not what's on some dead/lifeless piece of paper. It's the relationship between you and the other person, not the agenda, "the map is not the territory".

[skysblue]

Originally Posted by Perna

My therapy was a process over time, not an each session sort of thing (any more than each day of a week is equally as significant to that week but they all go into making it). If a lot of stuff is going on emotionally, I would make that today's topic, explore what is happening "now", not what's on some dead/lifeless piece of paper. It's the relationship between you and the other person, not the agenda, "the map is not the territory".

So, just try to know what I'm feeling as I enter her office?

[rainbow8]

Originally Posted by skysblue

Okay - so I get 50 minutes for $80.00. I've almost always taken control of session. I guess I want to get my money's worth and utilize time to its best advantage.

I have made lists of 'topics' and just before session I prioritize. I tackle the issues that seem the most important at the time. I force myself to confide in T my most vulnerable feelings. I face my fears as much as I can.

BUT, does this 'taking control' have a downside? Am I missing out on some possibilities of insight?

I guess I fear wasting a session. I guess I fear T and I will stumble and just flounder and not get anywhere.

Today I have session and my mood is amorphous. Lots of stuff going on emotionally but I don't know what or how I should approach the issues. AND, T will be gone next week on vacation so it seems like a lot is riding on today's session - even though I'm not sure what.

How do any of you extract the best possible outcome with each session? I guess I want to do something different today but I have no idea what.

I used to think the same way about my former T: $100 out-of-pocket and 50 minutes. I made lists too. It was never enough time. I'm sorry to be negative but the only solution for me was to switch to a T on my insurance so it now costs about $26 for 90 minutes. No worries about not getting anywhere because there's plenty of time (though it still flies by like a blink of the eye!).

Okay. I know the above is totally useless information for you unless you want to change Ts, which is always an option for everyone no matter how attached we may be to our Ts.

I wish there were an answer as to how to make the best use of a session. I know you've brought up in other threads about your planning your sessions and taking control. I used to do that too. I think, even though you want to be sure to cover the most important issues, and have a prioritized list, that can work against you. Or, has it worked for you in therapy? You don't complain about your therapy so if it works, why do you want to change it?

Throughout my years of therapy, I've found that the most productive sessions have come without planning. If I plan, I'm in my head, and intellectualizing. If I go with the flo, I'm more likely to let my feelings come out more fully. My current T likes to take the lead with her techniques such as the SE we just did. I was more mindful because I didn't know what to expect and had not planned to do it. Can your T take the lead in your session? Yesterday we spent a few minutes on meditation. I didn't want to open my eyes, and told T I was relaxed. Then I said "I'm wasting time." She emphatically said "no, you're not! This is not a waste if you feel calm and relaxed. Take your time!" So, who is to decide what is a waste of a session or not?

If you want something different, what about getting up and walking around? Doing an exercise with boundaries like I did? Drawing? Writing? Will your T do something other than straight talking?

Just some ideas. I hope it goes well for you. It's hard to get all you want from a session before your T goes away. Maybe try to think what you need to say before she goes, that you would regret if you don't say it. Or maybe there's a question you want to ask her.

I think just beig prepared to say what is in your mind, regardless of how much a minute costs. If we lived life timing cost we'd never achieve self honesty

[rainbow8]

Originally Posted by Perna

My therapy was a process over time, not an each session sort of thing (any more than each day of a week is equally as significant to that week but they all go into making it). If a lot of stuff is going on emotionally, I would make that today's topic, explore what is happening "now", not what's on some dead/lifeless piece of paper. It's the relationship between you and the other person, not the agenda, "the map is not the territory".

I can relate to this, Perna. My T hates when I look at an email or paper so I rarely bring them in anymore. She wants to know how I feel "now", in the moment with her, and what comes up for me right then! skysblue, that's what I was trying to say but Perna said it better.

You sound a bit frantic about controlling every moment of your sessions. (Might be a wrong perception on my part). What would happen if you just went in without your prioritized list and without planning in your head how things are going to transpire in your session? (Again, maybe I'm misreading what you are saying.) Can you let things just happen "organically" in your session without the fear that time will be wasted?

I have never been a planner about my sessions -- kind of the opposite of you I guess. That also has its drawbacks. But I always went into my sessions feeling pretty calm and willing to let our discussions flow pretty naturally. Yes, there were sessions when we didn't "get as much done" as others, but sometimes just sitting there and having that place to de-stress and talk about whatever, even if it wasn't some deep, intense subject, was the most therapeudic thing that happened to me all week. Sometimes not having a "plan" means that we get into topics we never, ever would have explored if I had been dictating off a list of notes what I wanted to discuss. Those are often the best, most insightful sessions of all because they come as such a suprise and awakening.

[skysblue]

Maybe I can ask her how to best proceed. She'll probably ask what's going on with me or what's on my mind. Or she may suggest sand tray which I don't want to do again. When my emotions are in high gear it's easy to know what to address.

My life is on the verge of imploding/exploding but amazingly my emotions are muted about that. I guess there's too much to address and not one specific high intensity triggering event in my life. (Last week I told her that I feel like I'm on a runaway freight train and that I'm holding on for dear life.)

It's correct not to calculate by the minute. I guess since finances are tough right now, I want the best bang for the buck. Oh, and I will not change therapists. Maybe I'll look to upgrade my insurance and see if it's cheaper to pay higher premium or cheaper to pay T out of pocket. I already pay $500.00 per month on catastrophic health insurance that does not cover squat.

Oh well, I think I'll just ask her when I see her in 3 hours how we might proceed. I want to do something different. I feel like I'm at a standstill.

[Perna]

Presumably you will feel upset/angry/glad/worried/anxious/

http://www.psychpage.com/learning/li.../feelings.html

about this being the last session before your T goes on vacation or about the week your T will be on vacation and your ability to cope or about what someone said or did to you ten minutes ago/at work/at home, etc.

You think and feel, look inside yourself to see exactly what, and respond to that by sharing with your T and elaborating or discussing whatever you come up with and then taking in her response and processing that, etc., back and forth.

[skysblue]

I think part of my problem is that I'm confused now about my goals in therapy. The predominant issue that I presented to T when I began 1 1/2 years ago has been more or less resolved. Therapy was a life saver for me.

Other issues have popped up but I've been taught tools on how to manage emotions to some degree. So, if those emotions do not threaten to upend my life, then why do I still continue with therapy?

Do I go just so I can talk to someone without reserve? Do I continue just because T knows me almost better than anyone else?

Of course she cannot solve my personal problems and I do not expect her to do that. Do I talk to her about my depressed state last week? I survived it so what's the point of bring it up?

Do I tell her about my anxiety of my life situation? Why? I'm managing the tension that exists in my life. So what that I can talk to her about it? It's not like her hearing me will change the challenges that I face.

I am maintaining a semblance of equilibrium even with the assault of emotions I'm experiencing. Isn't that the goal of therapy?

So, what do I talk about and what is the purpose now? Maybe that's the topic for today.

[sunrise]

Originally Posted by skysblue

So, if those emotions do not threaten to upend my life, then why do I still continue with therapy?

To me, therapy is more than just crisis management during times of high emotion or conversely, in times of numbness. For me, once all that is manageable, then I can move into a more positive type of therapy to develop meaning in my life, seek out and know how to maintain healthy and loving relationships, find my life's true calling--all that kind of thing. I found I couldn't do that type of positive work when I had crises and was falling apart. It is a great place to be in to have the crises under control and be freed up to work on being happy, finding joy, contributing to the health and well-being of others, etc. I know some people only want to (or only can afford to) use therapy to come up from the negative to a sort of neutral zero state and then they can take it from there without a therapist. I think I am at that place and moving into positive territory now, and yet I still like to have the assistance of my therapist on this part of the journey. He's super helpful and is actually great in this area of work--human potential and all that. I think I am under-utilizing him here but want to do better. skysblue, your post helped remind me of that. It can be hard to get over the idea that a therapist is there just to help with big problems.

Skysblue, have you told your T what you posted? I think it could be a great discussion! He might have some ideas and be able to help you articulate what you are wanting from therapy now.

Originally Posted by skysblue

I am maintaining a semblance of equilibrium even with the assault of emotions I'm experiencing. Isn't that the goal of therapy?

There is no one goal of therapy. Each person has different goals. Good work to be thinking of this instead of just drifting. I look forward to hearing what you come up with.

[Perna]

I don't feel one manages emotions; one just feels them. They are felt to help us, inform us about what is going on with us inside and how we are perceiving things outside. They are not meant to be assailants? If you are still in an adversarial role with your feelings, are trying to manage/control them, I'd talk about that. "Surviving" depressed states, is that what you want for your future, to "survive" or do you want to live?

[skysblue]

Sunrise - yes, 'human potential' is one of my overriding goals. I guess I've always thought that if I focused enough on trying to determine my interests, I would be able to achieve my human potential. But, I see that exploring that in therapy may be more useful than my typical analytical approach.

Perna, yeah, I guess I see what you mean - do the emotions need to be seen as assailants? But what do you mean by 'living'? Don't we 'survive' those low moods or is there a verb that you would choose to better describe getting through those times?

There is such upheaval in my life right now. Maintaining emotional equilibrium, I guess, will help me make best choices, right? I fear though that I might be suppressing emotions. How can one tell if suppression is happening or true balance exists?

Sorry for all this meandering. Wishing there were quick fixes and easy answers. Oh well...

[rainbow8]

Originally Posted by skysblue

There is such upheaval in my life right now.Sorry for all this meandering. Wishing there were quick fixes and easy answers. Oh well...

Originally Posted by skysblue

I think part of my problem is that I'm confused now about my goals in therapy. The predominant issue that I presented to T when I began 1 1/2 years ago has been more or less resolved. Therapy was a life saver for me.

Other issues have popped up but I've been taught tools on how to manage emotions to some degree. So, if those emotions do not threaten to upend my life, then why do I still continue with therapy?

Do I go just so I can talk to someone without reserve? Do I continue just because T knows me almost better than anyone else?

Of course she cannot solve my personal problems and I do not expect her to do that. Do I talk to her about my depressed state last week? I survived it so what's the point of bring it up?

Do I tell her about my anxiety of my life situation? Why? I'm managing the tension that exists in my life. So what that I can talk to her about it? It's not like her hearing me will change the challenges that I face.

I am maintaining a semblance of equilibrium even with the assault of emotions I'm experiencing. Isn't that the goal of therapy?

So, what do I talk about and what is the purpose now? Maybe that's the topic for today.

I think everything you wrote here would be a good place to go in your session. All of these questions about where to go now with your therapy would be productive. If your life is in upheaval, then it doesn't seem like you're ready to quit therapy, does it? I think that's a good question for your T? In light of your questions about the therapy process, I think you need to focus on them rather than let the session just evolve.

[skysblue]

Rainbow - thanks for your suggestion. Although I'll go into session with my notebook, I have no notes to refer to. I'll take it because it's my 'security blanket' and I fear not having it if I want to write something down that T says.

I'm not sure what I'll do or say in session. My only plan now is to tell her I don't know what to talk about or address. Let's see what she comes up with. She's usually very astute about asking the right questions and then I'm off and running.

I want to try to resist blabbering away and just try harder to 'feel' what's going on. Well, I guess that step #2 of current plan.

[stopdog]

I get the concern about cost per minute. I often think why did I just spend X for the therapist to ask about my dogs or my girlfriend? I can talk about my dogs for free to friends. I am not going to a therapist because of my relationship with my girlfriend. When I ask if any of it has a point, the therapist is not forthcoming. And I become enraged and frustrated.

[skysblue]

Stopdog, I never get enraged but sometimes I think I'm disappointed. I guess wanting visible concrete easy-to-recognize results might be the cause.

25 minutes until session and I'm feeling anxious not having a list to refer to. Hmmmm, interesting...

[sittingatwatersedge]

Skysblue I hope it goes well for you and that you will come back and share with how things went in general. I am feeling particularly weird this week & have torn up several lists... still several days to go...

[skysblue]

Originally Posted by sittingatwatersedge

what if you're convinced that honestly speaking your mind is risky?

That's sad that you feel speaking honestly is risky. So sorry for you.

Me, now, wondering how I should open the session. T always waits expectantly for me to say the first word.

Should I say, "I have no words" or "What should we talk about today?" or "Hey, great weather we're having" or "Sorry I'm late" (I'll be late if I don't get going) or "hmmm, whaddya wanna do today?" or "feeling nervous, no list prepared even though there's a ton of stuff going on" or say nothing at all and just let her feel uncomfortable with my silence. oh my goodness - 17 minutes. I gotta get dressed and get out of the house!!!!

Good luck! Fingers crossed for you.

[KazzaX]

I can relate to the not wasting a session thing. This is a big issue for me too. The T I had (not the last one, the one before - a psychotherapist) wasn't much into me bringing in lists etc and wanted me to just go with the flow. I wasted 3.5 years with that woman (with no results whatsoever) because of this - she just wanted the cash in hindsight. I am not a person who makes the same mistake twice, so that is why it is an issue for me too.

If you are paying money, I would say bring a list. You can never tell which psychs are in it for the money and who aren't. They are all businesses underneath everything, their purpose is to make money. If you aren't paying for the sessions (community mental health etc) then yeah you can get away with going in there with nothing. Mine is community mental health so its free, so I can get away with that.

If I ever magically get the ability to get a job and can pay for therapy, I will never again "go with the flow". Its inefficient. You don't know what is relevant and what isn't. You waste years of time talking about irrelevent stuff and therefore you get no results. You might as well throw your money off a cliff! Same thing

[skysblue]

My T is wonderful and my session went well. I will post details tomorrow. It was almost a battle of wills, it seemed, who would break the silence. I understand her method. She wants what would bubble up naturally for me instead of her imposing an agenda. She's good. But it WAS awkward at the beginning.

[Perna]

Originally Posted by skysblue

My only plan now is to tell her I don't know what to talk about or address. Let's see what she comes up with.

Not taking control?

It's hard to learn to get out of one's head only. What do you feel, if you think about not even having an only plan, not saying, "I don't know what to talk about or address;" but waiting until you get there, in the room, sitting, to check how you feel about being there, how your T "looks" to you; what has happened here, at work, at home, with traffic on the way? Find something you feel/felt, and open with that?

Sky, do you know about active and passive voice in grammar and writing? http://grammar.ccc.commnet.edu/grammar/passive.htm Taking control is kind of like that; it's "let's see what I come up with" rather than "let's see what she comes up with."

All parts of our lives are parts of our lives. All parts are good, to be lived through, not just endured. The hard parts can teach us better than the easy parts can because they require more work. Before a hurricane, some people are buying supplies, boarding up their windows, getting alternate heat and light sources, etc. Other people are planning to party until the lights go out or just waiting until the lights do or do not go out and then, sighing, (this would be me :-) mostly complaining about the lights being out and scrambling to figure out where to go and what to do to find comfort.

One does not really have to "plan" before hurricanes, but giving it a little thought, "What was it like for me the last time, what would I change?" and just doing a few "natural" activities that match what might feel good to you in those circumstances (no one else can tell you what would feel good to you) and you can live well during hurricanes. You have fire wood and marshmallows, plenty of blankets and a couple of battery blow-up mattresses, so you "camp out" in front of the fireplace instead of running around frantically trying to find the candles and a lighter source?

[skysblue]

Originally Posted by Perna

Not taking control?

It's hard to learn to get out of one's head only. What do you feel, if you think about not even having an only plan, not saying, "I don't know what to talk about or address;" but waiting until you get there, in the room, sitting, to check how you feel about being there, how your T "looks" to you; what has happened here, at work, at home, with traffic on the way? Find something you feel/felt, and open with that?

Sky, do you know about active and passive voice in grammar and writing? http://grammar.ccc.commnet.edu/grammar/passive.htm Taking control is kind of like that; it's "let's see what I come up with" rather than "let's see what she comes up with."

All parts of our lives are parts of our lives. All parts are good, to be lived through, not just endured. The hard parts can teach us better than the easy parts can because they require more work. Before a hurricane, some people are buying supplies, boarding up their windows, getting alternate heat and light sources, etc. Other people are planning to party until the lights go out or just waiting until the lights do or do not go out and then, sighing, (this would be me :-) mostly complaining about the lights being out and scrambling to figure out where to go and what to do to find comfort.

One does not really have to "plan" before hurricanes, but giving it a little thought, "What was it like for me the last time, what would I change?" and just doing a few "natural" activities that match what might feel good to you in those circumstances (no one else can tell you what would feel good to you) and you can live well during hurricanes. You have fire wood and marshmallows, plenty of blankets and a couple of battery blow-up mattresses, so you "camp out" in front of the fireplace instead of running around frantically trying to find the candles and a lighter source?

Sorry it's taken me so long to reply to this amazing comment. Perna, I am always very impressed with your insight.

I guess I wanted T to try something new, something bold, something possibly outrageous to tap into a part of me that all my planning would not be able to do I suspect. I guess I wanted to see magic in action. And magic has happened in session, when I least expected it. But, this time I just felt like I wanted to be led completely and enjoy where the ride took me.

What happened was a bit awkward. I know my T is doing what is best. I know she knows that whatever comes up for me is what is most important at that moment. Very rarely has she insisted on addressing a particular topic. And those moments were critical moments for her to take control.

She is very wise when there is a necessity and when she sees no urgency for her to lead.

So, even though initially I was resistant to talking. There was so much going on in my mind I could not determine which was the most important. But, by gentle questioning, I did indeed talk about what was needed.

The session ended up flowing and was natural and I gained a lot from it. The whole contol/no control issue may come up again. Normally I am self-propelled because I have so many thoughts and so many emotions that they just erupt during session.

It was just this time I felt a need to kinda 'give up'. And I did 'give up' and still it worked. My T is awesome!!!!!