I have been in a building crisis for several months. Some things happened this week which have caused things to come to a head. Last week I saw my T and thought we had a good session, but it was about defining things about our relationship. Since then my life has crumbled bit by bit. I go to work and do my job like an automoton, then come home and cry... and cry and cry and cry. I drink too much and take far too much clonazepam. I research suicide methods online. Mostly I sit and stare into space or at my computer. I have no friends or hobbies. I am new to where I live.

I see my T monday, and have left a message for my pdoc. I will not go to the hospital, it is not an option. I left my T two messages so he will know what has been happening.

I just don't see how he can help me. There isn't a way out of this chaos I live in.

thanks for listening

[winterbaby]

Yes there is a way and no suicide is not the answer. The way "out" is through. There is no other way but through. Through the pain and misery to come out the other end with some relief and insight. You have to be honest with your T and lay your cards out on the table with him. I see from your other post you have a schema T? Well this can be very effective but you have to try a little to be open and honest with him. And then he can be effective in helping you the best way he knows how. From my experience therapy is effective when we do the hard stuff. How are you doing with meds? I am not on any and don't know much about what works, but maybe there is another type you can try. Just don't give up, whatever you do. Things will look a lot different a year from now ifyou keep going. Just don't give up.

[Direction]

Good post Winterbaby.,..

[tranquility]

Gerber,

Winterbaby had it right - the way out is to go through. It may seem like it will never get better - but it will! I attempted suicide at 16 and was caught and brought to the hospital. I had a year of therapy and then didn't go back.

At 24 I started having severe depression and when I had an anxiety attack so bad that I couldn't get out of my car, I was hospitalized. I was in the hospital something like 5 times in the next year and a half. I thought it would never get better.

I am 42 now. My 30's were a turning point and became the best years of my life. When I turned 40 my life completely changed again and I'm not done trying to figure out why it's changed or what I am suppose to do with it. But having gone through this before, I know it's growing pains and that even though I don't know the message or the lesson now, there is one and once I figure it out I will be a better and stronger person.

Hang on because you CAN do this.

Tranquility

Gerber, If you are drinking heavily, then the turmoil will not get any better...the drink creates more then enought...when I was a practising alkie, I would sit and stare into space...thinking drinking.....nobody can do anything for anyone if alcohol consumption is heavy...

I am bipolar II, so for a lot of this, there is no "through." There isn't any insight hidden in it. I got burned elsewhere for posting too much detail so I won't... and that's kind of unfair if asking for help. But I am caught in a very, very bad life pattern. If I cannot break that pattern then I won't survive another year, I can't, no one could. The human brain, mind and spirit cannot endure pain of that level for that long.

So, I am in a bipolar depression (vs situational) but it is aggrivated severely by situational factors.

The pattern has no escape. If I break it at the point at which I want to break it then I get my life back, but I will be circling that pattern for the rest of my life, with strong chances of repeating it. My T, along with others, seem to think that step isn't breaking it at all but just diving into the pattern deeper. If I break the pattern at the point at which everyone seems to think would be best, meaning it would be broken... then I lose everything I want in life. I lose all hope of getting my life back... the one which held hopes and dreams.

The life which breaks the pattern doesn't hold any hopes or dreams. That's not just depression. My life circumstances would change so much that everything I ever worked for, hoped for...everything...it would all be gone. Due to the reality of my own abilities and physical problems, I can't build much of a life for myself and so I am almost certainly going to be poor for the rest of my days. I face increasing medical disability with no resources.

So breaking the pattern doesn't look that enticing. In fact, the pattern has hit a high point which is very alluring. I have made a small life for myself, in moderate poverty in a bad neighbourhood and a min wage job that physically cripples me. The lure is from the other side of the pattern.. moderate wealth, going back to working on my art career, physical help to ease my disability.... and the other big thing that i don't have now - love. I could be loved again. I am starved for love.

The down side is that the pattern is a pattern. That means at some point all the bad things that have happened will happen again. I will suffer greatly (I can't explain, but please believe me that it is utter emotional and mental agony). I would also be more deeply entrenched. Right now I am emotionally and mentally stuck there, but physically I am removed, and I have that small life that is safe, even if it is pathetic.

And no, life did not look better after a year. In fact, in many ways it's worse. And even moreso compared to the year before that. My life has been chaos and pain for several years. So much so that I know little else anymore.

I'm not quite sure what my T or any T can do to help. Unless they are willing to financially help me and be there physically when my physical pain is so bad I can't walk. Unless they are willing to love me. I mean, they can teach me to not care so much about being unloved. They can teach me to be ok with depserate poverty. They can teach me to learn to blame everyone else and take on no blame myself. They can teach me to OK with me as me in my really crappy existence.

Any wonder I research suicide methods? The meds make me able to function...which means being able to get dressed and feed my dogs each day, along with trudge off to my crappy job. The crappy job has to end soon as I am in growing physical pain. Then the meds will be my way of numbing myself to the world or drugging myself into sleep and pass my days that way.

Thanks for responding

[Hopefull]

I am at a loss for words on how to express my sorrow at your anguish (the word pain sounds too weak for what you have described). I hope you find a way to hang in there until Monday and beyond.

[winterbaby]

Hi Gerber, how did it go today, I hope you were able to get the support you needed. Although I don't know your exact situation I tend to read between the lines and I think that your "life patterns" if you are referring to the drinking or another addiction, are treatable. And being bipolar does not mean the end of the world. Look at Margaret Trudeau, ex wife of the Prime Minister of Canada and many others. What I hope you feel is that, your life is not over. That there are ways to get help. Yes, it is hard. But you can do it. I hope your Schema T will give you the help you need.

You asked about what it's like to have schema T, and flashcards. It's the relationship between T and client thtaq is paramount. He or she will work with you the way you need. They "reparent" you in a way. Not like a parent , but that's how they put it. It's more like being able to trust someone for the first time.

Schema was invented, I don't know if that's the word, for hard to treat people, like me. And it has been clinically proven now for borderline personality disorder, to work very well. I don't have that diagnosis but I benefited from the treatment very well.
The flashcards are just like reminders we can read during hard times. You don't have to use them. I hope you continue on with it, and don't give up.

No, I don't have, nor have had, any addictions. When I am stressed I indulge a bit too much, but otherwise I'm a social drinker and have not had rec drugs in yrs. COuld never afford those habbits..odd that you'd say that. So, no, I'm afraid that has nothing to do with it. I don't want to explain the details b/c it's not safe for me to do so. I'm not mad or anything, but please don't press me for, or try to guess the details.

The session today was ok... but just ok. It sucks to have a therapy high, which is what I had last week. This weeks session was just ok.

I had several major anxiety attacks, break downs.. you name it. Put in a call to pdoc and he suggested i hospitalize myself to get some med issues straightened out. But, no, not happening. It's not like i am in danger, i just need these med issues fixed and I will just do that the slow way.

So today once again was crisis management. We couldn't talk about trust, or work on anything deeper. It was all about the situational circle I am stuck in. around and around and around.

We did get to an interesting point at the end, and of course at the time to go. I had mentioned something about being a freak and someone who is deprived of, and starved for love, and would see it as a positive even in the light of evidence of unhealthy results. He said that it would be beneficial then to look at what love is.

He did say somethings today that were of use... that he feels I don't know what my rights as a person are or why I should validate them and demand to have them. He said I never learned as a child to do that. He said that I learned to protect everyone else's feelings...that theirs are important but that mine aren't.

I am so depressed he couldn't have connected with me in a deep way anyway. But it was a good session I guess.

We haven't begun any actual schema work yet because of the crisis problems. I am actually a little scared of it. I am worried about it being over too fast. I don't want to be in therapy for a couple of decades, but I would like it to be a couple of years. I want to not have a clock ticking.

I have read that about schema... that the relationship is vital.. how does that come about? What does that even mean? What makes it vital? Like what about it is special or different?

[winterbaby]

awww I didn't mean that the way it sounded. Just concerned that's all as so many people who are substance users truly give up and it pains me to see that. I'll write more about my experience with schema, my laptop battery is dying but I'll write more shortly. I hope you can do some work with him on schemas. It will really help, I am/was the most messed up completely freaked out person you could ever hope to meet. Now I am just moderately so. Kidding here. Keep posting and filling us in on what's going on.

[Hopefull]

I'm glad that you went in to see T today. I am glad that T was there for you. I have a feeling that you will work through the drug issues and get a chance to develop a close working relationship with T.
As for the concept of love, I tried to look it up in two different dictionary a few weeks ago. My sister and I can't seem to express what love is. So, you are not alone in now know what love is.

WHAT drug issues? i don't have any drug issues. SOmeone else made an assumption that isn't correct. I couldn't afford a drug issue if I tried.

I also made an assumption, because of the wording of your original post...drinking to much and using to much...sorry if you were read wrong.

[winterbaby]

Gerber - back to schema now. Well, the therapist usually uses guided imagery to see what kind of schemas you might have. Mine just used a relaxation exercise and I ignored it and of course you are free to do this or not. He eventually figured me out though, it didn't take him too long. Then he educated me about my schemas. The reparenting as they call it, comes along when you are able to trust him (it's a male, right, I can't remember) and build a relationship between the two of you. This means ,the therapist is way more interactive, directive and conversational than probably the norm. He will show he cares by words and actions. Still keeping boundaries of course. But a lot more outward caring than I think the usual type of therapy session. I'm just going on what I've heard about other therapies.

Building a relationship takes time. It doesn't happen usually in one, two or five sessions. It takes time. So give yourself that time. Once you have worked through the issues that you posted about in your original post, you will see how helpful schema is. I think it's for everyone. Not just BPD. It's logical, caring, communicative, and real. The only thing I'm not really into is this inner child stuff. Schema has some of that, some psychodynamic, CBT, gestalt, and inner child work all wrapped up into one package. It's really a great way to learn about yourself and to catch yourself in those all to familiar patterns. I have many patterns and at least now I can see where they are coming from and I can honestly say I've made a lot of positive changes. I hope you can work with him on yours and give it some time.

ah, a week later and in the same place..again...and again.

He hasn't shown any real "outward" caring... verbal or otherwise. i am actually thinking from reading other threads that he shows less overt caring. He's nice, and very talkative/interactive, and generally upbeat...which honestly gets under my skin sometimes. i dunno. SOmedays i think we're going make a good relationship, other days i feel like i need to keep looking. Four months, weekly, and i don't feel very connected or close at all.

i see him tomorrow and i just keep asking myself "what's the point?"

do you have trouble really opening up to people / letting people in? i'm wondering whether you might be holding him at arms length in an attempt to protect yourself. i do that sometimes. with female therapists in particular. my mother was fairly invasive so i have real difficulty opening up to female therapists.

can you tell him that his being upbeat gets under your skin sometimes?

the thing with connection... is that you need to share something that is intimate. to have him receive that kind of communication well leaves one feeling connected and less alone. if you don't share intimate thoughts / feelings etc then it is really hard to feel connected.

that being said, sometimes we simply don't click very well with particular people. they can be lovely, but the connection isn't really there. i had that with the therapist i was seeing before my current therapist. i'd take what i thought was a risk with disclosing a feeling that was hard and instead of acknowledging it (mirroring it) and sympathising / empathising with my feeling that way she moved on in to restructure / change it. that led to a feeling of disconnection and aloneness rather than a feeling of connection and love.

i tend to run too early... i tried to stick it out with her for a while... for maybe 6 months... i kept thinking of splitting because i felt like the risks i took with her weren't well received and most of our communications were disagreeing rather than our being able to connect rationally (which is important to me). i had just started feeling connected with her and then... got a referral to my current therapist. i didn't go back to see her again.

if i'd have stuck it out i think we would have felt more connected over time. if i'd have explained some of this to her i'm sure i would have felt more connected to her over time. i really wanted... a male therapist, however. female stuff is hard. i am quite rejecting 'cause my mother was so invasive. i think there is a lot of work to be done on those issues... but i worried that she wouldn't be able to take some of my intense transferences, too. i worry about that a little with my current therapist but we do seem to understand each other more. she never ever mentioned transference. i mentioned it a bit laterally / abstractly (as i'm prone to do) and she wasn't able to see that i was implying things about our current relationship (whereas my current therapist will ask questions in the attempt to do precisely that).

so... it might be the case that you would find it easier to connect with another therapist... but it can indeed be really very hard to find someone who is a good personality match. it might be... that there is much to be learned in the current situation. what holds you back from taking risks in sharing stuff with him? could you tell him what you have told us?

i am trying to tell him, i feel like i have explained it a number of ways. i thought it was settled a few weeks ago when we nailed down what i needed "trust" to be about... i left on cloud nine b/c i thought he got it. i wonder about looking for someone else..but he does schema and i am intrigued by it's possibilities. There are mostly CBT types around here and so i'd be hard pressed to find much else. I am what CBT calls a "treatment failure." i just don't think that way or something. ANd we do click in so many ways.. so i am loathe to actually leave either.

what is stopping me? hmmm... i'm not sure anything is except a nod from him... if that makes sense. If i were able to be open , warm and caring with people i wouldn't need him. i think i need him to reach out a hand to me.... give me some overt sign that it's safe.

intimate details.. i try, but i can't connect to the feelings, so it's a very bland recitation. As far as that goes i am an open book and i don't keep anything back. I just say "X happened to me at age 11, Y happened at age 15" and so on. i give whatever details i figure are relevant and i openly answer whatever questions he has. i'm not sure what else to do without some guidance from him

hmm. i have trouble with the CBT thing too.

what kind of a hand / overt sign that is safe would help?

is it that you don't find him to be very warm / emotionally responsive?

i'm not sure what he is thinking with respect to not trying to get you to connect emotionally with what has happened to you. maybe he doesn't want to push you before you are ready.

have you tried telling him that you find it hard to emotionally connect with what you are saying? he might be able to help you connect if you tell him that you are ready to try and do that. part of it is about... trying to connect with what you are saying. my t doesn't prompt me very much about my feelings... if i deny them he will likely say 'ok' even though it is obvious to him (and me later) that i was denying what was apparent. dunno...

i think you are right, i think he is trying to hold off from pushing me. i have a lot going on in my life, a lot of difficult garbage that has kept me in crisis, of varying degrees of intensity, for months now. Now that i think of it that way, maybe that is it really... that he doesn't want to shove me at all or i might fall over. hmmm...that leaves a dilemma then doesn't it?

how can i form an emotional bond with him if he has to two-step around me so much?

no, it isn't drugs.. i drink too much occasionally as an escape but i don't drink every day or even every week for that matter. i am going through marital problems.. most likely a divorce. Right now it's a sort-of separation. The issues leading up to this point are very complicated...very complicated. i cannot get too specific in case it is found by my husband... even though the facts would be accurate, it would tear his heart out to see me write it out. i can't do that to him even now. All i can say is that our situation is not a typical breakup... it's tragic and sad... and very difficult. We still love each other but i just can't do it anymore. Life was hell for nearly two years.

So, i am often in a mess emotionally... outside of therapy, but unable to connect to it in therapy. It's often the case that i cannot connect to emotional situations after they have happened. If something by chance overwhelms me and i have an intense emotional rxn, it's like it happened to someone else when it's over.

i don't know quite how to approach this... i hadn't considered that the current crisis situation might be an obstacle....

with my former T, which i saw sporadically for a few months, i bonded instantly because i was in such intense crisis all the time.. i was near a breakdown.. it was like grabbing onto a rescue float. But that all went badly.. when i got to my new T i was a lot more stable and not as eager to grab the float so to speak. i don't know how to break that barrier and get that connection that happened so quickly with the old T. It wasn't anything about him or a better match or anything... it was something about where i was at mentally/emotionally. Do i need to fall down flat on my face before i can let him in? what can i do?

hmm... this has given me a lot to chew on. hmmmm....

and yes, i have been very direct with telling him that i need his help connecting... but i have not said either way about how or when he should do that. i guess he is going by feel.

this puts things in a whole different light. Thank you! i am thinking now that another T would be in the same boat no matter how well we clicked. i do so like this guy. He tells me i am not the freak i think i am.

uh-oh... 12:53pm and haven't taken any of the morning meds yet. oops.

[sunrise]

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gerber said:
i think i need him to reach out a hand to me.... give me some overt sign that it's safe.

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Could you work on exploring in therapy what you need and want from him? This is a great topic and it sounds like it is so on your mind right now. I remember once T asked me what he could do to make it safe for me with him? It meant a lot to me that he asked and was willing to try to accommodate my needs. Also, are you the only one feeling like there is something lacking in your therapeutic relationship? Does he feel things are going along fine? Maybe he sees this slower style of bonding from a number of clients and can help normalize your experience by sharing that with you. Hang in there with this. It is a very good sign you are concerned enough to want to change/improve the relationship.

BTW, CBT also doesn't work for me. Therapy was not that helpful for me until I found a non-CBT therapist, someone with a bigger toolbox who could use the best techniques for me. It seems I often read here that CBT doesn't work for a number of people. I wonder why so many therapists gravitate to it, then? I remember pinksoil saying once that most of the students in her program wanted to do CBT. (Hope I got that right, pink!) Maybe it is just as simple as CBT is the therapy that insurance likes to reimburse for (because it is shorter and not deep work), and the therapists in training are very concerned with the bottom line.

> I often read here that CBT doesn't work for a number of people. I wonder why so many therapists gravitate to it, then? I remember pinksoil saying once that most of the students in her program wanted to do CBT. (Hope I got that right, pink!) Maybe it is just as simple as CBT is the therapy that insurance likes to reimburse for (because it is shorter and not deep work), and the therapists in training are very concerned with the bottom line.

CBT is about the easiest variety of therapy that there is to systematise in such a way that you can ensure that therapists are all doing the same thing (hence the easiest variety of therapy to learn how to practice IMHO). The advantage of that is that it is comparatively easy to test CBT. That means that the majority of psychotherapy studies test CBT so that means that the variety of therapy with the most empirical evidence (arguably) is CBT.

Some clinicians believe that it is unethical to practice anything other than by the book CBT as it is by the book CBT that has been empirically shown to be effective. Practicing anything else is unethical - it is experimenting on clients rather than giving them what is empirically validated as the best treatment.

(Part of this is turf grabbing... They want to promote what they do and part of that often involves attempting to undermine the opposition)

This is severely critiqued by therapists who are not of a CBT mindset. Therapists often point out that brief psychodynamic therapy is about as effective. Some people maintain that theoretical orientation isn't as important as the fit between the clinician and the client and the fit between the client and the theoretical orientation. I think there is a study or two that attempts to show that.

Insurance companies like CBT because it is brief (though some people stay in it for years) and because it has been empirically validated.

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sunrise said:
Could you work on exploring in therapy what you need and want from him? This is a great topic and it sounds like it is so on your mind right now.
Also, are you the only one feeling like there is something lacking in your therapeutic relationship?

Does he feel things are going along fine? Maybe he sees this slower style of bonding ...[/i][/b]

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we have been off and on.. exploring it i mean. That is why i felt i had that wonderful session. And he does think it's going ok.. and part of the slowness is my own doing. i told him explicitly that i wanted things to be slow or i would bolt... but i didn't mean the formation of the relationship, i meant the journey through crapville.

i also hadn't answered alexandra's question about overt signs.. he know i focus on the tone of his voice, and i get a lot from that. i am accutely tuned into to body language, for reasons i'll bring up in another thread later maybe, and it is direct recognition. Like Alexandra said, it's a mirroring in a way. i think he is trying, but we haven't hit the same wavlength yet.

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sunrise said:BTW, CBT also doesn't work for me. Therapy was not that helpful for me until I found a non-CBT therapist, someone with a bigger toolbox who could use the best techniques for me. It seems I often read here that CBT doesn't work for a number of people. I wonder why so many therapists gravitate to it, then? I remember pinksoil saying once that most of the students in her program wanted to do CBT. (Hope I got that right, pink!) Maybe it is just as simple as CBT is the therapy that insurance likes to reimburse for (because it is shorter and not deep work), and the therapists in training are very concerned with the bottom line. /i][/b]

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you're right about the insurance thing, and it's the same reason why T's move to it.. it can be a quick fix to immediate problems without opening up the whole person. So, it's treating the symptom, or immediate issue without addressing the whole picture.. or that's the idea. Many CBT T's do delve further in, and from what i understand they are supposed to superficially look at past history. My old T was a CBT purist and he said outright he didn't feel that PA style did any real good. i am somewhere in between, i have worked hard over several years to explore my own self, and i have had many insights, but have not had them help a lot, or not known what to do with them. i think my former T just didn't want long term relationships with clients, partially because he felt it was a dependency that was unhealthy. His views, not mine.

i tend to think it has to be what works for the client. My T felt the same way even though he does CBT with most clients. i told him how i felt about CBT, and why, and how i felt the many insights i had hadn't connected me with any solutions... many people can adjust once they have an insight but that didn't happen for me. i need something different and so he suggested schema, which i think will become very widely used eventually. It incorporates a lot of CBT ideas but with a dash of other things... and spnds more time working on past issues.

CBT became the grail in a lot of circles because it offered working solutions for people. More people are willing to go into therapy that will take a few months rather than a few years, for financial reasons. So for T's it can be a business decision if nothing else. MAny traditional PA T's are seeing their business dry up somewhat. Years of therapy is expensive.

which reminds me... i bought a card for my T which says "therapy is expensive, popping bubble wrap is cheap.. you choose"

[lauren_helene]

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sunrise said:

BTW, CBT also doesn't work for me. Therapy was not that helpful for me until I found a non-CBT therapist, someone with a bigger toolbox who could use the best techniques for me. It seems I often read here that CBT doesn't work for a number of people. I wonder why so many therapists gravitate to it, then? I remember pinksoil saying once that most of the students in her program wanted to do CBT. (Hope I got that right, pink!) Maybe it is just as simple as CBT is the therapy that insurance likes to reimburse for (because it is shorter and not deep work), and the therapists in training are very concerned with the bottom line.

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I actually read somewhere that insurance companies love short term therapy and yes CBT accomplishes that. My therapist uses this primarily and it didn't work with me.

He adjusted though and I'm glad he did. He did say once that most of his clients respond to it.

[lauren_helene]

Gerber I'm sorry you are having such a hard time. Maybe a new therapist would be best for you that focuses on psychodynamic and not CBT...

Try and find a good fit between you and the therapist and then evaluate with him/her whether he/she can help you.

Take care!

well, i have been thinking a lot about the connection (obviously) and about the things i do/have done which have helped create the current situation. i did ask him to go very slowly and i do have a lot of crisis management stuff we always have to handle. So, when i think about a new T, i think he would have the same trouble. i am planning to stick with this guy for now. He is not pure CBT and doesn't believe there should be such a thing as a purist.

Right now i don't have any insurance to cover anything, so i guess what they think doesn't much matter.