rehashing therapy in therapy; thanking T; what's next?

Tonight was my first individual session in a while. T talked a lot. I listened. He gave me food to eat and water to drink. This is the first time we have eaten together. He typed an email for me on his laptop while I watched him. At close range. That felt good. I couldn't seem to follow through on any topic, and I feel almost apologetic about that. All I can deal with in therapy right now is the divorce and it's actually going OK so not too much angst to deal with. At least for today. T said someone told him once that going through a divorce is like having a second fulltime job.

I had this urge to rehash our therapy history together. Does anyone ever do that in therapy? I wanted to look back over the months at what we had done. Our history. I looked back a little over our 2 months of couples sessions together (they're over now) and did some reflecting, but it was disjointed. I wanted to look back over my months of individual therapy too. I wanted to see sense there, and abstract meaning from it all, and discern paths and direction. And see if it all makes sense now that I am where I am. Is this an odd impulse? Do you reflect back like that? Do you ever feel your T knew all along where you were going even if you didn't? I don't know if mine did, but I would like to get his spin on our early months of therapy, before going to couples. What did he think we were doing? (Will he even remember what we did, amongst the competing memories of all his other clients?)

Why do I want to do this? Is it a way of starting to say I am done and good-bye?

I also had a strong impulse to thank T for all his help. I think I managed to do that a little in regard to the couples therapy. But what I really want to do is thank him for all his help in individual. He has really saved my life. And I want him to know that.

But mostly he just talked. And I flitted around. And he tried to deal with my fears about an upcoming scary event next week (his composing and sending the email in my presence was to help allay one of my fears). I thanked him for sending the email, but that was really all I was able to thank him directly for.

I think I shouldn't take my med right before therapy. It makes me really up and kind of bouncing off the walls. Flit. Flit. Flit. T may think he is talking to a different person. Hard to be reflective under the influence. Does anyone here tell your T if you are on meds? I haven't mentioned this to mine. I kind of feel like a failure because I started taking this anxiolytic about 5 weeks ago. It's kind of embarrassing to me I sought out medication for anxiety. Is this the sort of thing to share with your T? Or would he just not care (i.e. that is the doctor's domain)? I almost feel like I owe him some sort of explanation for my uncharacteristic behavior in session.

As you can tell from this post, I am still flitting around.

> I am still flitting around



Sorry. I couldn't seem to get a flitting smily to appear.

I'd tell him about the meds. Its your therapy after all.

Oh my! Yes indeed talk about your meds and when to take them regarding therapy! (((hugs))) I wonder why you haven't, and I hope it isn't because you're ashamed to be taking meds.

Reviewing progress in therapy is a good way to be sure you're on track for what you want therapy to help you with, imo. It can also be closure for one part of the journey when another path is about to be taken.

TC!

sky, I can see from what you wrote that reviewing therapy could be helpful and not necessarily meaning I am gearing up to stop. I guess I have been pondering why I want to review therapy in therapy and why I want to thank T. Does it mean I am getting ready to stop therapy? You reassured me that is not necessarily true. Thank you.

I would like to hear from others on whether you thank your Ts in session, and if so, why? And how they react. And if you review therapy in therapy.

(I'm thinking now I probably shouldn't have posted about my anti-anxiety med in the same post as it could distract people. Sky, I haven't told my T I am taking a drug because I don't want my husband to know--I have my reasons--and most of my sessions with T since I began taking the drug have been couples sessions. Last night was my first chance, and I didn't do it. I do find it a little embarrassing.)

I think it is good to reflect on therapy. Last week when I saw T - I don't remember the topic we were talking about, but he flipped back in my file and looked at his notes and said - you were here last year on this day, he also said I think there was a whole ton of denial there last year. Then he said that he was going to go back and read over the last year. It was very encouraging the way he said it. I think sometimes we don't see the progress we have made and even T can forget just where we were at. - As we contine to progress they look at what we are doing and how we are progressing and T brings about so many changes we tend to forget just exactly where we were. I think it can be very encouraging and validating.

As for the meds you should tell T. My T actually suggested that I ask my GP for X and X and if my GP needed to talk to him - he would be happy to. My T also asks about other meds I take for health issues. I struggle with taking care of myself and it can be very dangerous when I don't take them. I spent a week in ICU last Oct because I hadn't been taking them. He also has suggested things like fish oil when I didn't want to take an anti depressant. Although medication is not their thing they are knowledgeable in that area and defintely know when we need something. One time I wanted to up my Zoloft and my T said that I shouldn't - that if I did I would be a little to happy and I needed to feel some of what I was feeling. He thought my dose was optimal - anyhow just my opinion.

Every time I go to a session, it begins like this: I walk in, sit down, pay him, and sign my name in the chart. I look back at all those signatures; almost two years of signatures.... and I often think back about all the stuff that has gone on between all of those times that I have signed my name. I remember my 1st session... I told him I just needed a little therapy for my generalized anxiety, that's all... HA! I remember when admitting that I was mad at him was the absolute most horrific thing I could imagine... the time a single tear slid down my cheek... the first time I called between sessions... and relate that to where I am now. I think it is natural when we reach a certain point in therapy, to look back. I think this is because when we are in the moment of therapy, it is often difficult to look around and see where we are. However, once we do reach a certain level of self-awareness and understanding, we are able to take a step back and see how we have gotten to where we are.... and be so appreciative of the T who has helped us to get there. So no, I don't think it is indicative of you wanting to end therapy. I just think you may have reached a milestone-type thingy in therapy, where you are able to step outside of your treatment and look at where you've gotten. And how you've gotten there.

As for the meds? Well, you weren't ready to tell him. That's ok. You'll be ready soon. Then you can add that to your therapy montage.

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sunrise said:
Tonight was my first individual session in a while. T talked a lot. I listened. He gave me food to eat and water to drink. This is the first time we have eaten together.

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Aw, your first meal

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sunrise said:
He typed an email for me on his laptop while I watched him. At close range. That felt good.

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I know what you mean. I once did biofeedback in T's office and we sat pretty close together as he explained what to do and then explained the results. I felt like I was home

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sunrise said:
T said someone told him once that going through a divorce is like having a second fulltime job.

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I agree, smart man I've been through one myself.

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sunrise said:
I had this urge to rehash our therapy history together. Does anyone ever do that in therapy? I wanted to look back over the months at what we had done. Our history.

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Sometimes I'll make comments about when I first saw him over a year ago or I'll say wow the fog has lifted on x,y,z why didn't I see that in the beginning but it is so clear now?

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sunrise said:
Do you reflect back like that? Do you ever feel your T knew all along where you were going even if you didn't?

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I definitely feel like the majority of time he knew where I was going. I say majority because when I first started seeing him after he did all the testing, he told me my depression would lift in weeks rather than months.

I can admit that this upset me when he said it. I thought uh-oh I better not even bother. I'll never meet the deadline In fact, one day I should tell him that saying this to me in the beginning made me feel like such a failure as each week passed and I was still sitting there. Then again, he was talking about CBT his specialty and I had no idea that therapy even had different methods let alone how long therapy takes.

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sunrise said:
Why do I want to do this? Is it a way of starting to say I am done and good-bye?

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That may or may not be the case. See how you feel next time and decide on that.

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sunrise said:
I also had a strong impulse to thank T for all his help. I think I managed to do that a little in regard to the couples therapy. But what I really want to do is thank him for all his help in individual. He has really saved my life. And I want him to know that.

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I have told T several times the very same thing. I think we have moments in therapy that provide some clarity on where we started and where we are now. I've done this a few times, and I'm not feeling ready to graduate.

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sunrise said:
I think I shouldn't take my med right before therapy. It makes me really up and kind of bouncing off the walls. Flit. Flit. Flit. T may think he is talking to a different person. Hard to be reflective under the influence. Does anyone here tell your T if you are on meds? I haven't mentioned this to mine.

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Actually, I'm surprised he isn't involved in the decision or at least knows about it. He has never asked you that? Although, I'm not sure if you went to see him initially for a problem that required medication.

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sunrise said:
I kind of feel like a failure because I started taking this anxiolytic about 5 weeks ago. It's kind of embarrassing to me I sought out medication for anxiety. Is this the sort of thing to share with your T? Or would he just not care (i.e. that is the doctor's domain)? I almost feel like I owe him some sort of explanation for my uncharacteristic behavior in session.

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Stop that right now You are not a failure for calming symptoms you are having. This is why I think you should tell him what you are taking and why. He can help you with what you are feeling about taking meds.

It seems as if you and T have a very comfy relationship so it shouldn't be hard to tell him this at all... hugs!

Thanks purplemoon, pinksoil, and almedafan. It's good to hear about reflecting on therapy in therapy from you all. And that it doesn't necessarily mean I want to end therapy. Because I've been wondering. I had this huge goal in my life that I have worked on for almost 2 years now, and I reached it. And now what? I just had not visualized the phase I am in now at all. We started to talk about that in therapy yesterday. T had me look even farther ahead in the future and visualize that and then start to look back to now and visualize how what I do now will get me to then. But we didn't get far...

I am actually curious in another way to discuss my past therapy with T. Because I wonder how much he remembers and it seems that what he does remember will in some way be what was memorable/significant to him. I am really curious now what he will remember! (I don't believe he keeps notes on my sessions so it will just be what is in his brain.)

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almeda24fan said:
Aw, your first meal

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I know, it was so significant, lol. I was thrilled by it. It is one more thing we have shared.

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pinksoil said:
However, once we do reach a certain level of self-awareness and understanding, we are able to take a step back and see how we have gotten to where we are.... and be so appreciative of the T who has helped us to get there. So no, I don't think it is indicative of you wanting to end therapy. I just think you may have reached a milestone-type thingy in therapy, where you are able to step outside of your treatment and look at where you've gotten.

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I think I am there. WOW!!!

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pinksoil said:
As for the meds? Well, you weren't ready to tell him. That's ok. You'll be ready soon.

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I really like how you put that, pinksoil. I think that is true. On the meds topic, I am the person who is always so proud that I didn't take anti-depressants to fight my depression. It has been like a badge of honor for me. I beat depression with psychotherapy alone. So it makes me seem like a complete hypocrit to myself to now be taking an anti-anxiety med. But it just got to be too much for me, very painful and anxious time (divorce), with lots of negative emotions zinging around our house. I just needed something to help me get through this time. So I went over "to the dark side" lol and got a prescription from my GP. (What' s ironic is that the med I got does not help at all with anxiety but has these other effects I really like.)

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almedafan wrote:
Actually, I'm surprised he isn't involved in the decision or at least knows about it. He has never asked you that? Although, I'm not sure if you went to see him initially for a problem that required medication.

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almedafan, IMO, many conditions/problems for which people take psychotropic meds do not "require" meds. But that is just my own personal bent. Ever since my previous T, who was strongly against meds, I have felt that meds are my decision and not a topic I want to discuss in therapy. I need to decide myself whether to seek meds, not because a T is for or against them. It is just such a charged topic and no one is free of bias, so I prefer to make up my own mind without consulting therapists. Now that I'm actually taking a med, however, I would consider telling my T, as what's done is done. The slippery slope, etc. (I did tell my T ages ago that my husband takes anti-depressants, and I was pleased with his neutral response.)

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sunrise said:

I think that is true. On the meds topic, I am the person who is always so proud that I didn't take anti-depressants to fight my depression. It has been like a badge of honor for me. I beat depression with psychotherapy alone. So it makes me seem like a complete hypocrit to myself to now be taking an anti-anxiety med. But it just got to be too much for me, very painful and anxious time (divorce), with lots of negative emotions zinging around our house. I just needed something to help me get through this time. So I went over "to the dark side" lol and got a prescription from my GP. (What' s ironic is that the med I got does not help at all with anxiety but has these other effects I really like.)

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I would never judge you for your stance on taking meds. In fact, I have an aunt that swears up and down that my ADD is made up so drug companies can make money. So I hear this stuff a lot. It a personal choice and you made yours but give yourself permission to make a different choice too.

You are not a hypocrite, you did what you felt you needed to. That's a good thing.

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almedafan wrote:
Actually, I'm surprised he isn't involved in the decision or at least knows about it. He has never asked you that? Although, I'm not sure if you went to see him initially for a problem that required medication.

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almedafan, IMO, many conditions problems for which people take psychotropic meds do not "require" meds.

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Actually, I don't disagree with this statement about depression meds being handed out like candy basically. I won't babble too much about this but since we are on the topic, doctors should focus on what medical conditions can mirror depression like hypothyroidism, run some blood work perhaps and rule some conditions out. I'll stop here because I don't want to offend anyone for their choice. But I understand what you are saying.

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sunrise said:
I need to decide myself whether to seek meds, not because a T is for or against them. It is just such a charged topic and no one is free of bias, so I prefer to make up my own mind without consulting therapists.

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Of course you need to decided for yourself You've been with him so long and trust him so I jumped in the wrong direction with my comment. Now that I have more information I understand. Have you told your current T how staunch against meds you are? If so, is this why you feel hypocritical now for taking them?

These are questions for you to think about not to answer to me by the way. I'll share something with you. I used to agree with my Aunt about ADD...jokes on me I guess I understand feeling hypocritical but what I explained to her was that I allowed to many other opinions from those who do not at least possess a medical degree and some knowledge on the subject.

In other words, I included myself in that and I gave myself permission to change my mind having more information.

Does this make sense?

((Sunny))

You must be relieved to be back in your individual sessions.
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Does anyone here tell your T if you are on meds?

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Not only does T know I am on meds, but he was helpful in making the decision in the first place.

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Do you reflect back like that? Do you ever feel your T knew all along where you were going even if you didn't?

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I do reflect ocassionally, but mostly try to stay in the here and now. I remember saying to T, "Well, when I first started coming here I thought...." and we both laughed together.

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Why do I want to do this? Is it a way of starting to say I am done and good-bye?

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It sounds to me like maybe you are trying to reconnect, not say goodbye. What do you think?

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I think I shouldn't take my med right before therapy

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I remember feelnig very heavy and tired one day in therapy and saying to T that I thought it was due to my change of meds and he looked at me and said, "I don't think it has anything to do with the medication."

Could you be flitting for any other reason?

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I couldn't seem to follow through on any topic,

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To me, this sounds more like therapy than having a plan and going ahead with all the pieces nicely laid out. Maybe your subconscious couldn't tell you what it needed to say.

Well, it sounds to me like your therapy is ready to take a deeper turn now that the divorce discussions are moving away. And is also sounds like you and T have a great relationship to do that work. This happened with me after dealing with the initial famly crisis that brought me there in the first pace, and it has been very dynamic recently.

Good luck.

long post/reflection on meds ahead...

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almeda24fan said:
I would never judge you for your stance on taking meds. In fact, I have an aunt that swears up and down that my ADD is made up so drug companies can make money.

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I want to be clear that this is not my belief at all. I believe that meds can help many conditions. But just because I think that there are non-pharmaceutical interventions that can help as well, does not mean I believe that the conditions do not exist.

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almeda24fan said:
Actually, I don't disagree with this statement about depression meds being handed out like candy basically.

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I just want to clarify that I never said this, and I do not believe this. My one experience going to a doctor and asking for a psychotropic med (for anxiety, not depression) was not like this. I told her my symptoms, felt she carefully considered them, we discussed them, she suggested several meds, and I chose the one that was most acceptable to me. I never felt like my prescription was handed out like candy, and I guess I expect that other doctors also take similar care with their patients. But maybe you have had a different experience.

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almeda24fan wrote:
Have you told your current T how staunch against meds you are?

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I am not staunchly against meds. For example, I routinely take antibiotics to combat a chronic infection I have. Modern drugs can be amazing. True, I gave birth to two babies with no painkillers or anaesthesia... But seriously, the whole AD med thing with me traces back to my first session with my first counselor, when I was in crisis and devastated in my personal life, had been depressed for at least several years, and was at the point of not functioning. I asked her about anti-depressants, and she was very judgemental and negative about them, and basically didn't want to work with me if I was going to take them. I felt really cowed by her response. It had taken just about all I had to arrange this appointment with her and drag myself to her office, so I was not able to dissent and just agreed to try psychotherapy only. Well, she was pretty much plain vanilla CBT (although I didn't know what that was at the time) and went after the symptoms of my depression rather than the root causes. And dealing with some of my symptoms, by fighting hard to get more sleep, building support systems, and relieving some of the dissonance in my life, did help me feel better, and I am grateful to her for that, but it didn't cure my depression. After 6 months of working with her, following all her advice, and still being depressed, she says to me one day that she thinks I should try anti-depressants. I was very angry about that. She tells me when I really was desperate that she won't work with me if I take ADs, then when I am somewhat better and not in such great need, she says go take them? I felt like, where was this suggestion when I really needed it??? I felt like some lab rat in pain that she had experimented on and only after her CBT-only experiment went awry was she willing to consider meds. I can be very stubborn, and there was no way I was going to take ADs after she said that. I was committed to not using meds because of her, and I did not understand how she could so nonchalantly reverse her strongly held philosophy on this. She gave me the name of a pdoc on a piece of paper, I took the paper and thanked her but never said I would go see this person, and then we never mentioned it again. Eventually I stopped seeing her, took a break from therapy, and then found my current T when I was ready to resume. Within about a month or two of starting to see him, my depression was cured. He was willing to work with the root causes of my depression (for example by using techniques such as EMDR) and so we were able to make rapid progress. (((((hugs))))) for my T. (When I think back on that, I see it is no wonder how strongly attached I am to him since he helped me step out from under this depression cloud that had hovered over me for years. When someone does that for you, you just want to lick their feet. )

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almeda24fan wrote:
doctors should focus on what medical conditions can mirror depression like hypothyroidism, run some blood work perhaps and rule some conditions out. I'll stop here because I don't want to offend anyone for their choice. But I understand what you are saying.

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My own belief is that all of depression is biochemical. I don't understand when people say some depression is situational and some is biochemical. One day I went to see my current T and told him I had been depressed the last week (we all have our relapses), and he asked, did I think it was hormonal, biochemical, or situational? I looked at him, the rational/analytical scientist/biochemist looking at the touchy-feely therapist (probably like how can you say such a dumb thing, lol) and said, "all depression is biochemical." He thought about that for a few moments and said "you're right." (I never understood what was his point in trying to distinguish these 3 "types" of depression anyway.) Hormones are biochemical molecules, so too much or too little of certain ones can certainly affect our mood and cause depression. In our lives we have situations that make us depressed (perhaps a hopeless, failing marriage, the death of a child, anger and grief that has been repressed for years, etc.) but they make us depressed via bio-molecules in our brains. That's how our mood is determined. Sure, we can mess with our neurotransmitter levels by taking drugs, but we can also deal, in therapy, with some of the root causes of those levels of molecules in our brains. This is what I chose to do. So yes, of course, it's all biochemical, but I can and did work on changing my biochemistry through other means besides drugs. I know this doesn't work for everyone. (Now if I had a genetic mutation/variation that made my serotonin transporter extremely efficient, for example, the therapy approach would probably never be sufficient and taking an SSRI would be very, very helpful. Someday in the not too distant future we will all know what genetic variations we carry, and choosing the most effective treatments for many conditions will be a lot easier.)

For those interested in the brain and addiction, there's quite a good article in the July 16 edition of Time Magazine, and it has some great graphics on neurotransmitter action in our brains (focusing on the dopamine neurotransmitter):

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sister said:
It sounds to me like maybe you are trying to reconnect, not say goodbye. What do you think?

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I think your posts are always very insightful, sister, and I think your suggestion has some truth in it.

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sister said:
Could you be flitting for any other reason?... Well, it sounds to me like your therapy is ready to take a deeper turn now that the divorce discussions are moving away.

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I do think my med is causing some of the flitting, but maybe not all. It really acts as a stimulant and can make me kind of "jangly" at times, unable to sit still, rather impatient, etc. Unfortunately, that happened in therapy last time. But I do feel a little at sea in therapy, I think, because in my life right now I am so fixated on the divorce. It is a huge deal for me, and I need support from T on this right now and in the future. But through couples therapy, I have resolved some of the high-stress problems with my husband, which is paving the way for an amicable divorce, so I am currently feeling pretty good about this, although I'm aware rough times may be on the horizon as we get into the legal nitty gritty. On the one hand, I want to "get on with therapy" with T and not focus on the divorce, because I have other important issues I would like to work on. But on the other hand, I feel unable to do that right now, because the divorce is so all-consuming. It takes all my energy. So maybe in therapy, I flit about, wanting to deal with non-divorce stuff, but being unable to. Like a butterfly unable to alight for more than a few seconds on any one perch. It is just not the right time for that. I know that. T knows that. He has alluded to our future in therapy and what we might work on, but that time is not now. As a result, I am not seeing him every week right now. It is a bit frustrating for me to go there and not be able to dive into non-divorce stuff. So for now, I am seeing him just every other week or less, depending on whether the session is individual or couples.

I was just trying to be helpful Sunrise as you've been to me in the past with my questions.

Good night everyone!

I am so sorry, almedafan! I kind of went "over the top" with my drugs post. It's an important topic to me and I guess I became worried my views might be misinterpreted--I know many here on PC take psychotropic meds and I never want my views to make it seem like I am disapproving of that. Some of my brain dump on that topic just kind of got triggered by your post. Sorry! Your posts have always been helpful. Because of this interchange, I have thought even more about the drug question in the last day and decided I'm done experimenting with meds. I'm going to stop them. I will wait until after a significant event coming up for me later this week so I don't accidentally destabilize in the middle of that by stopping, and then I plan to quit. It's been interesting to be on meds, and in some ways I have liked it, but I need to do this myself. I worry about the longterm effects, both physiological and psychological. I have already seen behavioral changes in me I do not like. In my case, I don't believe the benefits are outweighing the negatives.

It's okay Sunny Somehow we managed to trigger each other and all we were doing was typing and trying to make sense on what we wanted to communicate.

If we had been verbally talking, I wouldn't have misinterpreted anything I'm sure.