[neutrino]

Just like the title says I started therapy recently. I started three weeks ago and I've been to five sessions in that time (one "normal" session and two double sessions). I've tried therapy once before (in May) but that only lasted less than a month and then I quit because I really didn't like or trust my therapist. She seemed quite unprofessional and we really didn't get along. The new psychologist/psychotherapist seems much better and I hope I'll keep thinking that as things progress. Anyway, I hardly have any experience with therapy so I've got some questions:

1. Is it normal to feel exhausted and even quite depressed after a session? So far I've left the sessions feeling exhausted because of the sessions being very psychologically challenging. I've also felt very scared and low afterwards.

2. I'm afraid of pretty much everything and so far I haven't even been able to do the "small" and relatively "easy" exposures the therapist has asked me to do. Do you reckon it's possible that he'll give up on me if I don't do what he asks me to? I think I need to take things slow and I need my therapist to be patient with me. I'm afraid he thinks I'm annoying for saying no to the exposures he's suggested so far.

3. This might seem weird but I've lived with depression and anxiety disorders for so long it's like they're a part of me. I don't know who I am without them. That + me being very scared of changes and uncertainty makes me very anxious about therapy in general (though I want to be in therapy). What if I become "a different person"? What if I lose my sense of self? Could that happen?

There are so many thoughts in my head right now. So many questions. I've dealt with mental illness since I was a child (though I didn't start seeking help until about a year ago) but it's still just as confusing.

Thank you for reading,

neutrino

[lrt1978]

Hi I have had CBT.

Yes I always exhausted after my sessions, I think that is normal plus being bombarded with lots of information in one go was exhausting in it self.

On your T giving up, I hope T wouldn't do that, the exposure stuff is hard but your T should help you get to a place where you feel you can attempt the homework. My T attitude was as long as I gave it go.

My experience of CBT I looked at it like self discovery, you are finding better ways of coping, maybe finding out about things you enjoy that you didn't realise you enjoyed.

I had a positive experience with CBT and it helped me get my eating disorders behaviours under control, I also think with CBT you have to go into with an open mind and willing to try what your T suggest's, hopefully your T should support you through it all xx

Hi,
I have been going to see my t who is cbt orientated for the last year. I can't remember a session where she didn't challenge me. Now I have learned to challenge others and ask for what I need or want(still in progress) but from this challenging have come a lot of things, I am sure of who I am and what I want and I am able to cope when life becomes hard. I know I have options and choices, things aren't just black and white. Yes, it is tiring but I believe all the questions and challenges are worth it. Good luck. I think cbt will be great for your anxiety and depression.

[A Red Panda]

I've just started with CBT recently too.

I'm also on holiday, and was given a big old booklet on self-esteem with a bunch of work things that I need to be filling out. And T asked me to do things that are challenging for myself while on holiday.

I've been doing all of it, but I don't know if this is going to work for me or not. I'm already well-aware of my negative thoughts, and I already follow them up with other things - the problem is that I'll believe both thoughts, so it doesn't really change what I think or feel about myself - and I've been doing that for years now, long before going to T. So all the homework just makes me feel frustrated and hopeless because it seems like I'm going backwards.

So far, I have been upset for days after each session (due to summer and conflicts in our schedules I haven't seen him very often) and then get super anxious before going in to see him.

[Perna]

Originally Posted by neutrino

This might seem weird but I've lived with depression and anxiety disorders for so long it's like they're a part of me. I don't know who I am without them.

One thing it helped me keep in mind was that things do not change totally/all at once. Change is always quite slow and can often be too slow/boring! You literally cannot go from being depressed and afraid to not being depressed and afraid (like waking up tomorrow a new person :-) that fast. I relaxed a little knowing it would not go faster than I could go and my abilities/defenses were really really good so if it felt too fast or too much I would shut down. Trust your defenses and try some things out! You won't let yourself do too much.

Just don't let your head/thinking be in charge, they aren't any good at it which is why you are afraid and probably partly why you are depressed. Trust your body/automatic responses and don't feel ashamed if you shut down. Defenses work to defend and that's good, let them. Yes, they are too much but you will gradually learn that nothing bad happens and loosen them up as you go along.

[WikidPissah]

Originally Posted by neutrino

1. Is it normal to feel exhausted and even quite depressed after a session? So far I've left the sessions feeling exhausted because of the sessions being very psychologically challenging. I've also felt very scared and low afterwards.

Yes. Most people feel like that. It can be quite lonely to open yourself up, and then leave. Scary even. A lot of people have a difficult time with the "in between", I always tried to compartmentalize therapy, I'd allot a certain time each day to ruminate and dwell on a session, but distract myself the rest of the time. I just couldn't be "in my head" all the time, it was too much for me.

Originally Posted by neutrino

2. I'm afraid of pretty much everything and so far I haven't even been able to do the "small" and relatively "easy" exposures the therapist has asked me to do. Do you reckon it's possible that he'll give up on me if I don't do what he asks me to? I think I need to take things slow and I need my therapist to be patient with me. I'm afraid he thinks I'm annoying for saying no to the exposures he's suggested so far.

I think it's okay to ask him for reassurance. Even handing him these questions would be huge. The only one that knows his level of patience is him.

Originally Posted by neutrino

3. This might seem weird but I've lived with depression and anxiety disorders for so long it's like they're a part of me. I don't know who I am without them. That + me being very scared of changes and uncertainty makes me very anxious about therapy in general (though I want to be in therapy). What if I become "a different person"? What if I lose my sense of self? Could that happen?

You will become different, but it's a gradual process. No one is going to wave their magic wand and turn you into a Newt. lol. We all fear change, that's normal, but change isn't always a bad thing.

[neutrino]

Originally Posted by A Red Panda

I'm also on holiday, and was given a big old booklet on self-esteem with a bunch of work things that I need to be filling out. And T asked me to do things that are challenging for myself while on holiday.

I've managed to do one exposure so far. A tiny one. I did it yesterday at home. However, I said no to the exposures the therapist suggested during the session. The main reason for that was because he wanted me to do the exposures while he was there and I hate being observed. I couldn't do it because I knew he'd sit there and "evaluate" my "performance". I guess that fear is part of my social anxiety disorder as well. The thought of having to go through with the exposures makes me panic.

Originally Posted by Perna

One thing it helped me keep in mind was that things do not change totally/all at once.

Originally Posted by WikidPissah

We all fear change, that's normal, but change isn't always a bad thing.

Is change ever good though? Scares the crap out of me. I like my personality and I like the way my brain works (though I hate the anxiety and depression etc). Those are not things I want to change. Is that weird? Don't misunderstand me, I definitely want to get better because I can't really function in life right now. I just don't want to become someone I don't know.

[A Red Panda]

Yay for you for doing an exposure!

My T wants to get me to go to something like zumba or yoga or the gym on my own. I want to go with a friend, but so far none of my friends will commit to going. I just can't go on my own - I wouldn't return a second time. I have issues with trying new things in front of people, and I'm terrified of how red my face goes when I exercise - plus I do not like making mistakes, or having people wonder why I'm there on my own. I think when he told me that I said "Good luck getting me to do that" or something.

So instead I've been doing things that I have done before, but that still make me uncomfortable (like going to the theatre or to a restaurant on my own). Although I DID go and get a pedicure and was horrified while I was going through it and I can't say I enjoyed it at all, but I did get through it and I did not have a meltdown.

You'll stll always be you though, you know. Even if you change, it'll still be YOU.

[neutrino]

Originally Posted by A Red Panda

Yay for you for doing an exposure!

My T wants to get me to go to something like zumba or yoga or the gym on my own. I want to go with a friend, but so far none of my friends will commit to going. I just can't go on my own - I wouldn't return a second time. I have issues with trying new things in front of people, and I'm terrified of how red my face goes when I exercise - plus I do not like making mistakes, or having people wonder why I'm there on my own. I think when he told me that I said "Good luck getting me to do that" or something.

So instead I've been doing things that I have done before, but that still make me uncomfortable (like going to the theatre or to a restaurant on my own). Although I DID go and get a pedicure and was horrified while I was going through it and I can't say I enjoyed it at all, but I did get through it and I did not have a meltdown.

You'll stll always be you though, you know. Even if you change, it'll still be YOU.

That sounds a lot like me. I'm incredibly afraid of mistakes and doing things in front of people. Anyway, good on you for going to all those places alone without having a meltdown! Can I tell you about a small exposure I did yesterday? I just want to tell someone so if you don't want to read about it skip the next part:

One of my disorders is social anxiety disorder and I fear pretty much anything involving people unless I know the person very well and we're in a safe environment (i.e. at home). Whenever I go out I bring my backpack because it, for some reason, makes me feel a little bit safer. I think I feel like my back is protected from other people's eyes when I wear it. Going out is quite a big problem for me in general. I do go out quite often but as soon as I leave my room I think that people are looking at me, laughing at me and judging me. I think that they think I'm weird or fat or have a bad posture and things like that.

Anyway, yesterday I managed to go to the supermarket (which is about a 7 minute walk from my parent's house) and back without my backpack. My parents live in a small city and it was during the evening so not many people were out or in the supermarket. I wasn't too anxious and it went well. Feels pretty good. It will be much worse when I'm back home though (I live in a bigger city) so my anxiety level will be higher then, but still.

[growlycat]

Congrats on doing some exposure work!

I work with a cbt guy on health and anxiety issues. The hardest thing for me too is the exposure exercises.

A good T will work with you to find a homework assignment that is challenging but not too overwhelming. I was afraid in the beginning that T would get mad at me if I didn't do the assignments perfectly-or at all. As long as you try, T will be supportive.

Even if you don't try, they will explore what happened. I'm finding the process kind of comforting, surprisingly.

It is important to let your T know what you are worried about, like being judged.

I think that any therapy just enhances the part of you that is happier and healthier, but it doesn't change your identity.

[neutrino]

Originally Posted by growlycat

Congrats on doing some exposure work!

I work with a cbt guy on health and anxiety issues. The hardest thing for me too is the exposure exercises.

A good T will work with you to find a homework assignment that is challenging but not too overwhelming. I was afraid in the beginning that T would get mad at me if I didn't do the assignments perfectly-or at all. As long as you try, T will be supportive.

Even if you don't try, they will explore what happened. I'm finding the process kind of comforting, surprisingly.

It is important to let your T know what you are worried about, like being judged.

I think that any therapy just enhances the part of you that is happier and healthier, but it doesn't change your identity.

Thank you.

Right now I'm actually quite anxious about my therapist giving up on me and/or being annoyed with me. I can't stop thinking about it. I'm planning on trying to tell him about it when I see him on Thursday next week (too bad it's such a long time left until then because I will keep worrying about it) and in my head I'm going over how I will tell him over and over and over again. I'm not sure how it'll go. I'm still trying to figure him out. The therapist.

I think I'm ok with the thought of homework but having to do exposures in front of the therapist really scares me because, like I said, I hate being observed and judged.

I realise this might sound weird but the fact that "therapy just enhances the part of you that is happier and healthier" scares me too. I honestly don't remember what it feels like to be happy and/or peaceful. Stupid, I know.

[A Red Panda]

*hugs* I'm so proud of you for going out without the backpack! That isn't a "little" exposure, that's huge!

The only one of my experiments that was totally new to me was the pedicure - I've gone to the theatre before and I've ate out before on my own. Those took me YEARS of working up the guts to do it.

I worry about my T quitting too, because what he wants me to be able to do I just am not capable of doing it yet, and I'm not sure how that is going to work. And I have a pretty poor attitude towards even going to therapy, and the fact that my first and primary goal since starting meds is to get back OFF them (which he doesn't agree with), the fact that the thought-diaries I'm to be keeping I feel are more harmful than anything else, the fact that I am reallllly slow at any change in myself and worry that he'll get impatient with me, and that I think I'm a bigger can of worms than he anticipated.

So... I worry a lot about it. And I haven't told him that, because I don't know him well enough yet and don't trust him at all. Which isn't very fair because he seems like a good person - but I can know someone and hang out with them and consider them a friend and not trust them an inch. So how I am going to manage it with him is beyond me.

Why don't you try to switch your thinking about the exposures with your T. Instead of thinking "My T is here to watch and evaluate me" try to think "My T is here to support me so that I'm NOT truly doing this alone... I've got someone here with me whom I trust". Hard, right, but just say it to yourself every time you think that he's going to judge you. His job is to support, not to judge. ((I hate being observed too, and is why I can manage going to the theatre solo, but can't stand the idea of going to a fitness class solo)).

I understand feeling scared of being happy and healthy. When I go through a good phase for long enough I tend to get worried and wonder where on earth my depression went and when is it going to come back and kick my butt next? It's like... I never know what's around the next bend, and I don't seem to trust myself when I'm feeling good for too long. But, it's easier now than it was a decade ago.

Just keep doing the things that YOU feel are an appropriate challenge. If it's too big, tell him that. Like... if your T wants you to do some exposure therapy with him there? Why not start with by doing something like grocery shopping without the backpack? You've done it once now, maybe invite him along. Try getting used to being somewhere with him where you DO already feel safe, so that you can learn to feel safe WITH him. Does that make any sense? You could always suggest it and see what he says.

[neutrino]

Originally Posted by A Red Panda

*hugs* I'm so proud of you for going out without the backpack! That isn't a "little" exposure, that's huge!

Thank you. I don't know if it's huge but it's a first step at least. Anyway, this morning my mother asked me to go with her to the city centre to buy some things. She's got a spinal disc herniation at the moment and is waiting for surgery and since she, because of that, can't really carry stuff she needed my help. I really didn't want to go but I wanted to help her so I went anyway. During lunch. Without my backpack. It went quite alright. Was a bit more anxious than yesterday and I spent quite some time doing compulsions (touched things, evened things out etc) for no reason. Anyway, I made it.

Originally Posted by A Red Panda

I worry about my T quitting too, because what he wants me to be able to do I just am not capable of doing it yet, and I'm not sure how that is going to work.

Are you going to talk to him about it? Once you trust him more that is.

Originally Posted by A Red Panda

Why don't you try to switch your thinking about the exposures with your T. Instead of thinking "My T is here to watch and evaluate me" try to think "My T is here to support me so that I'm NOT truly doing this alone... I've got someone here with me whom I trust". Hard, right, but just say it to yourself every time you think that he's going to judge you. His job is to support, not to judge. ((I hate being observed too, and is why I can manage going to the theatre solo, but can't stand the idea of going to a fitness class solo)).

But what if he judges me anyway? I don't even want him to think positive things such as "she's doing a great job" or "she made it!" etc. I don't know why it scares me so much. I just really don't want to be observed by anyone.

Originally Posted by A Red Panda

Just keep doing the things that YOU feel are an appropriate challenge. If it's too big, tell him that. Like... if your T wants you to do some exposure therapy with him there? Why not start with by doing something like grocery shopping without the backpack? You've done it once now, maybe invite him along. Try getting used to being somewhere with him where you DO already feel safe, so that you can learn to feel safe WITH him. Does that make any sense? You could always suggest it and see what he says.

You're right. I hope he agrees (I worry that he won't, of course). Last time I saw him (which was on Monday this week) he told me that if I did some exposures in town without my backpack and the anxiety level didn't get lower every time I did it he'd come with me. He said if the anxiety level doesn't get lower then I'm probably doing something wrong (as in still avoiding things even though I don't necessarily realise it). That makes me nervous too because that means he'd be evaluating me. Again.

I feel like I'm quite messed up.

[A Red Panda]

You're not.

It sounds like your T is trying to be the little voice in your head that's helpful, and maybe you're somewhat lacking in that? He wouldn't be evaluating you, he'd be investigating and exploring! Sorta like a little Sherlock Holmes in your head "Hmmm Watson, why has the stress level not gone down?" "Why, I don't know Holmes! Is it because she doesn't have her backpack?" "No, it's rather elementary my dear Watson. It is because she feels like everyone is watching her, notice that she is still doing X?"

You're Watson. Your T is Holmes. They work together! The goal is to get you to be Holmes and your T to be Watson, but right now he might help take the lead to help teach you how to do it yourself.

You worry about people judging you and evaluating you all the time (I so get that). Do you smile or make eyecontact with strangers often? That might be a goal to work towards. I find that when I smile at someone, well, they're way more likely to judge me in a positive light, because a lot of people sorta ignore everyone around them and they usually look so sad or grumpy! So I smile to make them smile. Then they just notice that I've smiiled at them and might forget about anything else. And then I'm helping make someone's day nicer and I feel less stressed out, so everyone wins! And then I'm acknowledging their presence (and my own) instead of trying to ignore them and hide.

I'll be trying to trust my T - I'm usually pretty good at pretending to trust someone (if that makes any sense?!) because I can usually SAY the things that someone should say to show trust... I just don't actually trust them.

[Asiablue]

I picked up that you've done double sessions. Double sessions are exhausting because you're under stress for longer. Could you consider 90 min sessions and see if that helps? Maybe one you are more relaxed with the therapy and the relationship wih your T you could go back up to the 2 hours?

[neutrino]

Originally Posted by A Red Panda

It sounds like your T is trying to be the little voice in your head that's helpful, and maybe you're somewhat lacking in that? He wouldn't be evaluating you, he'd be investigating and exploring! Sorta like a little Sherlock Holmes in your head "Hmmm Watson, why has the stress level not gone down?" "Why, I don't know Holmes! Is it because she doesn't have her backpack?" "No, it's rather elementary my dear Watson. It is because she feels like everyone is watching her, notice that she is still doing X?"

You're Watson. Your T is Holmes. They work together! The goal is to get you to be Holmes and your T to be Watson, but right now he might help take the lead to help teach you how to do it yourself.

I like this way of looking at the situation. I guess I have to try to realise he's on my side and that we're working together. That we're some sort of team. It's easy to overlook that when you sit there in the chair in the therapist's office and feel pressured, challenged and incredibly anxious.

Originally Posted by A Red Panda

Do you smile or make eyecontact with strangers often?

Not really. I do it sometimes but not often. I don't really smile or make eye contact that much with people I know either. I find it rather difficult.

Originally Posted by Asiablue

I picked up that you've done double sessions. Double sessions are exhausting because you're under stress for longer. Could you consider 90 min sessions and see if that helps? Maybe one you are more relaxed with the therapy and the relationship wih your T you could go back up to the 2 hours?

Apparently a single session is 45 minutes so my double sessions are 90 minutes long. Not two hours. 45 minutes feels like a very short amount of time so I'm quite grateful for the double sessions.

[A Red Panda]

It's hard to feel like you're on a team with someone when we're so used to being alone and dealing with everything solo. I guess it's something we both are needing to learn!

Maybe once you get more comfortable with being backpack-less you could try that as a new goal: just smiling at strangers as you walk past them. Even just little smiles.

My sessions are 90mins too. I'm a talker though so I think it's helpful, because I tend to run around the topic a lot and it takes a while before I really say anything worthwhile.