How do your Ts help when you're really struggling?

I really like my T and feel connected to her, but the last few sessions she has not helped me at all and I've left feeling worse. I've told her how depressed and anxious I've been. I can barely work, feel like I'm going to have a break down, and have strong su*****le thoughts. She doesn't seem to be very concerned. She says she's seen me cycle into depression throughout the past five years and it always passes. I told her this is the worst ever and she reminds me that I have an extreme amount of stress in my life right now. I tell her I can't take it and need help. She tells me I know what she's going to say; exercise, eat well, do enjoyable activities with friends and take my medication. She's been no help or support at all in the midst of my despair. What have your Ts done to help you when you've been struggling this bad? I don't even know what I should be expecting from T. I tried the suicide prevention chat line and they were totally useless too.

Wow.... you made me think. I really don't know how to answer this. I guess by responding to texts or Emails. It doesn't always help, but I guess it's helpful to know someone's there...

Maybe you need addl meds? I took xanax for a while - a low dose. I couldnt move without starting to cry. When the stressful situations eased up, i was able to drop the meds i had added, going back down from 4 to 2.

Again, maybe a dumb question, but what could your T do to help you more? Maybe if you could identify that, you could tell her what you want from her to help you through this hard time.

Hi, I'm sorry you are struggling so much
What is your T's contact policy? Does she offer support out of session if needed? Maybe you need to feel she is there for you. Or do you think you could benefit of breathing/relaxation exercises? Maybe thinking about what you need to soothe the distress while you have those crises might help you to identify it and tell your T so that you can work on it together.

Perhaps your t needs to be specific. Asking you to name a few friends you could get in touch with, a few outside supports when you are struggling and then checking at your next session if you made contact with them. I also agree with Hankster that some medication could help you right now, a muscle relaxant, a low does, just to help you relax and calm these thoughts.
Yes, you go through these cycles every now and again and always come out the other side but what triggers them and how do you out yourself into this place, have you and your t looked at that?
I get into a similar mess by retroflecting so badly that I feel I can't live with myself anymore. The ultimate retroflection is suic***.
My trigger is to do with a situation in the past and my thoughts and actions, I turn them against myself , so I literally depress myself. I can see my cycle very clearly now. I wonder can you see yours, and what happens for you?

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Do you and your therapist work on the underlying issues that cause the depression?

Exercising, eating well, doing enjoyable activities with friends and taking medication sound just like dealing with the symptoms and not the cause.

My T allows email/phone calls.
She doesn't do coping strategies because, well, we know what they are really anyways, and I'm not sure they really help.
Struggling is part & parcel of the deep work that can be done.
I think to a degree the work can only happen in the session and with time the Struggling lessens as we grown stronger because of the work. 'Really struggling' isn't a stand alone thing.

My T offers pretty similar advice re: self care and all that but what she does that's helpful is that she breaks it down and helps me map it out when I'm in a bad space where I can't do it myself. Sometimes it feels helpful to me to have a concrete plan. When necessary I leave there with a list of tasks or a schedule of what to do for the next few days or a list of things to do when it all goes to hell.

They don't do anything. I am not sure what they could do that would be useful. I don't find therapists to be any good for help.
Do you know of anything you would like them to do?

I do t with a psychiatrist so if it's bad enough it results in med tinkering.

Sorry to hear that you're not finding ts approach helpful.

Sometimes my t tries to bring my mood up by being positive, but she usually knows when to leave the positivity behind and become more serious in her approach.

She asks questions so we can both figure out where I'm at. She will offer suggestions of things I can do to keep safe and get through until I next see her, she tells me to call or email her if I need to during the week, she tells me why I shouldn't *trigger* commit sui (talks me out of it). She tries to motivate me to help myself. Only if I can't guarantee to keep myself alive will she take her duty of care seriously and phone the emergency MH service on my behalf. Otherwise she just talks to me, listens to me and makes herself available for a check in email or an 'I need help' phone call if needed between sessions.

Couple of weeks ago I had a very hard time in session with No. 2. She listened and then tried to teach me some techniques for dealing with this particular issue (not stress or depression, something else). I pretended they had worked since time was up, but she called me on it and asked if I wanted to stay longer. I told her there wasn't anything more I could even imagine her doing to help and left.

So I agree with those asking if there is something reasonable you could ask your therapist to do that you know would help. Maybe there isn't, as with me, but just like the rest of us therapists do better with concrete suggestions.

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In my opinion, there is very little a therapist can do to help you when you are in the midst of depression and anxiety. I don't intend to sound harsh, but it isn't the T's job to make you feel better. What a T can do is help you come up with a plan for when you are feeling depressed, a plan that is tailored to you and the kinds of things that help you when you are feeling low. The way I see it, the therapist's job is to help you work through the issues that are contributing to your depression. Nobody, not even the best, most compassionate therapist can pull me out of despair.

My T usually asks me what I'm specifically thinking about and then we start to break that down. A majority of the time, I'm taking my irrational thoughts and acting as if they are reality. She also reminds me a lot to stay present since my anxiety is usually from trying to think too much about the future.

For me, it helps when my T can analyze my thoughts with me and help me become more aware of what I'm thinking//feeling and why I might be thinking/feeling that way. Figuring out my triggers is also really helpful.

Everyone is different though and different things trigger our depression/anxiety.

Honestly, when I'm doing that poorly, therapy becomes fairly useless and what really only can touch that depth of depression is medication. You don't mention if your have a psychiatrist or not. If you do and/or you are on medication for depression and anxiety, you probably need to contact that doctor and let him know things are not going well. If you aren't on medication, perhaps that is something you may need to consider.

My T will generally insist that is exactly what I do if I am in that bad a shape because therapy gets rendered rather ineffective when my depression level is so severe that my thinking is slowed to practically nothing and I start ruminating into suicidal thinking. All he can do is check in with me and monitor how I am doing until medication starts working and lifts the depression enough to actually do the therapy work effectively again.

I have been teaching my T how I want her to be supportive. She does allow emails and phone check-ins, so that help too. She used to do what your T is doing: stating coping skills, not validating your pain/emotions. I had to give my T specific examples of what she's done right and what I want to hear. Now she is much more supportive. She tells me she's there for me, she validates my pain/emotions, she encourages me, etc. And she still reminds me of my coping skills

My T said she never tried being supportive to me this way because she didn't think that's what I wanted. She thought being supportive meant pushing me, reminding me, and processing.

You need to tell your T what kind of support you're looking for. Be specific. They're not mind readers.

Unless you know what you specifically want them to help you with, a T doesn't seem to be any help at all. If you are feeling extremely low, it is worth going to a public place and be with people. It might help you feel better. Hope you feel better soon.

I agree with this 100%.

One of the things that's gotten me into trouble when I was younger was looking to a therapist to ease the distress or depression, but then I realized they can't do that. Not in any sustainable, long-term sense. Worse case scenario, it ends badly, with both sides feeling frustrated and upset.

I think the most my therapist does is to be calm and steady. When she replies to emails, her messages are short and reliable. If I haven't slid down the drain entirely, I can use her example to steady myself and work out what's triggering me and how to get on top of it. For me, there's no magic therapist wand (as much as I had hoped for one years ago). Just regular, slogging through the emotions with another human being who is not freaking out.

My therapist can be excellent when I'm really struggling, and as others have mentioned, learning how she can best help has been a learning process for us.

1. Extra sessions as requested
2. DBT workbook when I insisted on needing something concrete to work on
3. Anti-anxiety exercises to do between sessions
4. Visualizations and exercises done in session
5. Mapping out an activity plan for good self-care
6. A mothering, caring, gentle tone and approach
7. Hugs
8. A consistently calm, reassuring, hard to ruffle demeanor

I've read and re-read through all that you've wrote and thank you all. I do agree that T can't do anything special to bring me out of my distress. And my problem when I'm feeling this poorly is I have no idea what I need from her to support me. She doesn't allow contact in between sessions so that is hard. I can't even email when I can barely hang on. I do have a psychiatrist and it seems as if my meds might not be working. I see him in a few weeks but might need to call him sooner. I've just felt like it's all been because I've had three major life crises happen right at the same time. I guess I feel frustrated because I thought the point if therapy was to help you feel better and get over feeling like this, but it doesn't seem to help.

I don't know if you saw my post- I think you were writing while I posted too, but good therapy has definitely helped me and helped me feel comforted amidst struggles. I'm not happy in the midst of tragedy, but I am comforted, coping better, feeling stronger, more whole and struggling less. I wonder if your T isn't a great fit with you. Long term, is there progress?

My therapist does help when I'm struggling, others have noted that too with theirs. Therapy should be doing something after all... so what do you get out of it?

My T helps me set short term goals, very small steps, something that is really well defined. And then at our next session, he checks in on my progress on the goal. If I wasn't able to do it, we talk about what could help me do it, and then I am turned loose to give it another go.

I have no idea when you will read this but I hope this will help. It may be the medication it may not. Three major life crises is a lot to swallow. Sometimes what we need from therapy we may not just get. Everyone is different and I do understand you feel therapy isn't helping. That's the thing with mental illness, we don't know. If we knew how to deal with this we would.

Writing helps. It helps me a lot. I don't have contact with my T in between sessions so I just write. Write and write and write. Write it all down. You said the suicide prevention didn't work? I reached out to them, but by email. I think you need to put precisely what you feel, clear cut and dry on paper or electronically. Then read it to yourself over and over till you have that AH HA moment. Maybe read it to your T. But get it out of you. You sometimes don't know exactly what it is, until you see it in front of you. Hope that helps. Hugs.

He breaches my confidentiality, takes away all my pride and dignity that I had in my career. I think he wanted to push me in front of a bus so he wouldn't have to deal with me. That's his solution to "helping" me.