Maintenance of Effort

Every so often the question of therapy comes up. Either my pdoc brings it up or perhaps I start thinking it would be a good thing to get back into, or it comes up in some other way. But, ya know, I'm in my 60's now & I've been struggling with the same issues since before I can remember.

So why would I think that therapy, or anything else, is going to make a serious difference? It won't. At this point in my life, we're talking maintenance of effort... keeping things on an even keel, so to speak. I take my SNRI every day. It's not great, but it helps. And I have PC to come to for hugs. I think that there comes a point in one's life where chasing the cure begins to look allot like the proverbial dog chasing it's tail.

It's true that my mental health status limits what I can do. I don't go out much. I have acquaintances, but no friends, except on the internet where I have many. I don't cook alone much anymore like I used to. It makes me nervous. And there are other ways in which my mental health status limits me. But, for the most part, I don't particularly care about most of this anyway.

So, from this perspective, I think that what's important for me at this point is simply to be able to accept things as they are... to not get into the frame of mind that if I could only get on the right med... or find the right therapist... that a cure of some sort might still be within my grasp. After all, at my age, my tail is beginning to get a might short

It's the journey of healing I've benefitted from. Anyone can begin their journey from any place at any time.
There really isn't a destination, it's about smelling the flowers.

What has been your experience of therapy in the past?

There is only so much we can do. Certain things are chronic, much like certain physical illnesses are chronic and impact our lives. I won't ever be 100% cured. I will be better, but never completely free of mental illness. I'm okay with that. It took some time to get there, but I am now. I have had to accept that.

If youre staying on an even keel without a therapist, id say youre doing pretty well. Thing is, with various meds, they're keeping us alive when we woulda been dead years ago, what with blood pressure meds and all. So you could be around a while! You dont want to be too miserable. And now that more boomers are retiring, there will be more dialogue about it. Ie about us older folks, who arent necessarily travelling our butts off or maniacally enjoying our golden years, but just being quiet.

I'm 61 and still have some hope of finding a med that keeps at least somewhat happy. The longer I'm left in a depressive state the more withdrawn I get. I may be 61 but I still want my life back and still ready to fight for it. I'm not ready to stay in a vegatated state for what years I have left.

I am extremely middle-aged and have no diagnosis, take no meds, have never seen a psychiatrist and very rarely only in extreme urgent crisis (broken bone type thing) see an md - so I don't have any real urge to be healed from anything by a therapist. I don't think they can and it is not what I go for. I have found some parts useful and other parts not useful at all. I can see it even being harmful if one was not cautious. It is a curious thing and from that stand point - I keep doing it. An expensive experiment of sorts.
I have not had it result in love of therapy or therapists or any epiphany or great insight etc from the therapist.
Giving it a try could be interesting and possibly even useful if one is flexible in how one defines such.

Ah yes, Mouse... thank you for this. There is a concept I have heard spoken of by the Buddhist nun Ani Pema Chodron: enlightenment is a journey, not a destination.

I bow to you...

Thanks for asking, Bill3 Well... I probably couldn't write a book. But I could fill a few pages with this topic. However, I'll just say that it's been disappointing for the most part.

The only therapist I thought was worth the bother was my last one whom I quit a few months ago. I liked her personally very much. In fact I actually miss her now. But our sessions were more like two friends meeting over coffee than they were like therapy sessions. I'd tell her about my adventures on the internet. (Almost my entire life is on the internet at this point. If the internet ever goes down, it will take me with it- ) And she would tell me about her horses. I just couldn't justify what she was charging even though my insurance company was paying for most of it. I began referring to my sessions with her as "rent-a-friend" (LOL!) But, still, she was the best of the lot by far.

If the best therapist is the one who told you about her horses...I see what you mean that you have not had good experiences in therapy.

How would you feel about it if you could actually find a proper, fully professional therapist?

So she wasnt a horse-whisperer exactly, more of a horse-chatterer?

The healing is in the relationship. I would encourage you to follow your heart and return to her. Rent-a-friend isn't a bad description of a good therapeutic relationship, really. Having a safe confidante to be yourself with can be therapeutic. The deeper work that happens after that can be amazing too. How long had you seen her?

Hi Bill3: Hope you're having a great weekend! Well... since I've never experienced this... I don't know. Part of the problem is I don't know where to look. I live in a medium-size metropolitan area. So you'd think there would be plenty of options. But when I have searched, mostly what I've seen are young women with social work degrees. Oh... & then there's the Christian counseling crowd. The other problem that I see with almost everyone is that they appear to specialize in everything! You name it, they specialize in it! I find it hard to put much stock in someone like that.

Also, though, I know I'm a tough sell. I'm kind of like the doctor who's a patient. Way back when I was a real person, I was a Certified Rehabilitation Counselor. So I know a thing or two about the counseling process & I believe I can smell a fake a mile away... I also have transportation problems. I don't drive. There's a metro bus system but I won't use it... I'm agoraphobic & also allergic to being shot or stabbed. Cabs are incredibly expensive. I do feel too that, at my age, it really is too late for any really meaningful change to occur. So I'm disinclined to inconvenience myself to any great degree. In my heart-of-hearts, I doubt it would end up making any significant difference.

I wouldn't want to be working with me!

Hello Leah123: Thanks for commenting! Boy... it's hard to remember. (My short-term memory is pretty much shot at this point! ) I would "Guesstimate" about 10 months. Yes, she was an exceedingly nice lady. But our sessions simply weren't going anywhere. Every time I saw her we just kept going over the same old ground. I guess, to some extent, it's probably true that I'm just intransigent. (You get that way when you get old... ) If I were to decide there was something specific I wanted to accomplish, I would consider going back to her for support. But, lacking that, no... I won't return.

Hope you're having a great weekend!

Ha-ha-ha... thanks for commenting, hankster! Yes, I suppose you could put it that way! Actually, she was just contributing to the conversation... self-disclosing... as they say in the biz... I'd tell her about my exploits on the internet & she'd share horse stories. It was actually quite pleasant... but it wasn't worth a couple of hundred dollars an hour or whatever it was she was charging. Maybe if I had been willing to keep on going indefinitely, it could have evolved into something more... but I wasn't willing to do that.

How did you handle transportation with the "horse chatterer"?

I would guess from some other posts of yours that you might benefit from a T who is knowledgeable about LGBTQ-related issues. If so: I wonder if there is an LGBTQ community in your city. If there is, there may also be a list available of therapists qualified to work on these issues.

Another thought is that in my area there are counselors who specialize in older clients and will come to see those clients. I don't know, though, if such counselors would also be sufficiently competent in LGBTQ issues.

Hello again Bill3 I'm married & my wife & I own 1 car which she uses for work. So we scheduled my appointments for late afternoon & my wife would come home a few minutes early & drive me there. Fortunately the T's office was only a few miles away.

I have a driver's license. But I never drive. The combination of psych med's, plus my previous suicide attempts, self-harm activities, & just my age have combined to make it such that I just don't feel safe driving. I also have Meniere's Disease which is a condition of the inner ear that affects balance & coordination. So, while I can legally drive if I have to, I think it's safer for all concerned if I don't.

Actually, the LGBTQ thing is a long, long story... interesting (or at least I think so ) but long. The T I was most recently seeing is actually the best known person, working with the transgender population in our area, I'm aware of. A large percentage of her clientele are TG.

The problem for me is that I've struggled with major depression, along with various anxiety disorders for about as long as I believe I can recall being TG. So it's pretty much impossible to say which came first. And the reality is that, at this point, it really doesn't matter. For practical purposes, at this point, I've struggled with all of it since as far back as I can recall.

Yes, I've thought about contacting some senior citizen agencies to see if they are aware of any T's who like to work with us old folks. I just haven't done it. Somehow it all just seems to be more trouble than it's worth. I guess that goes back to the idea of my mental health objective as being "maintenance of effort" again.

To what extent would you say that this perspective arises from depression--versus--from lack of success/progress with previous Ts?

Maybe the result of this therapy suggests that depression, not TG, is the more useful concern to address in therapy. What do you think?

Here again, this gets complicated. But to put it into the proverbial nutshell: there is nothing I can do about my TG issues at this point. So, a while back, I made a conscious decision to view my difficulties as being primarily mental health related rather than gender identity related. There may not be much I can do about my mental health issues either. But at least there is something. If I begin to focus on my gender identity issues, this is where it gets really dangerous. But, yes, I think you're correct. My depression & anxiety related issues are probably the more useful concern to address in therapy. One additional problem, though, is that I am full of, & constantly under attack from, strange compulsions mostly related to my gender identity issues. They needle me 24 / 7 & sometimes I just get so tired of fighting them that I just want it to be over.

That perhaps explains why therapy wasn't sufficiently helpful when the therapist was a TG expert.

Would you be willing to say something about what the compulsions are like?

Hm-m-m-m-m... well... I think I've probably said enough on this subject for the most part... especially considering that it will all end up indexed on Google!

What I guess I can say is that they only involve me... at their core, what they mostly boil down to are self-harm types of behaviors, & taken as a whole they are life-long. Individual compulsions have come & gone over time, but for every one that goes, a new one comes along to take its place. Oh, & they don't go away if I distract myself with something else. This, of course, is one strategy that is sometimes suggested as a way to deal with compulsions. It doesn't work for me.

I guess the other thing I should add is that from an early age, I developed two quite distinct aspects to my personality. I learned very early in life, I don't know how, that I must never talk about any of this & so until quite recently I haven't. Some of it is still a closely held secret. But, outwardly, if you met me, I don't believe you would ever sense the pressure cooker that is steaming along inside. You might think I seemed quiet & reserved, maybe even a bit uncomfortable socially, but that's about it.

How has it been for you to talk about these things?

There is an intertwining of depression, anxiety, and compulsions. What about seeing a T who specializes in OCD or anxiety disorders generally?

Yes, someone like that might be helpful if I could find someone. It seems as though every therapist I run across specializes in everything! You name it, they specialize in it. And I would have to admit that the minute I see this in a listing, such as PC's, I become immediately suspicious. I don't believe it is possible to specialize in everything. It may be good for the therapist's wallet. But it's not possible. Specializing in everything is tantamount to specializing in nothing... hey that's pretty good you can quote me on that!

Besides, I keep asking myself, what's the point? Another 5 or 10 years or so & I won't be around to worry about it. I suppose that sounds negative. But it is the reality of my situation. As the saying goes: there's no point in kicking a dead horse...

I agree that someone who "specializes" in everything is not what you are looking for. I do believe, though, that there are therapists who actually do specialize in anxiety disorders.

Perhaps this could be useful?:

International OCD (Obsessive Compulsive Disorder) Foundation - About Us

Under the icon "Find Help" there are some possibilities.

Depression does encourage this line of thought. I would suggest, though, that it is possible for a lot of good things to happen in 5-10 years. Perhaps don't give up just yet...

Oh yes, I'm sure there are therapists who specialize in a variety of different disorders. I just haven't been able to find anyone in my area. I'll definitely check out this link though.