i've been thinking...
about how my therapist keeps talking about how we are together for a limited time. he said something once that suggested that he thought that i would figure out working with someone else once we finish up together. and i have been thinking about how long... and how expensive... this is going to be.

i function better when i have a good therapy relationship. that isn't unusual, i guess. the majority of people do function better when they have good relationships. people who make them feel cared about etc. someone who they can talk to about what is going on for them. the difficulty with me is that i simply can't get that (in the depth that is needed) outside therapy. because... my need is too great. if i try and get that outside therapy i end up with either someone taking a real parent role with me (which isn't so healthy really) or i end up with someone who is similar to me and we end up clinging to each other (which isn't so healthy really). so... no can do in the real world.

there is a panic / fear though. people leave and there is noone to replace the role they played in my life. and then... i really do start to lose it. psychotic break kind of losing it. just want to be dead kind of losing it. feel like i'm being ripped apart / exploding into fifty million pieces. will it get better over time? i guess it will. i guess it will. but i'm scared to let people in because i'm scared that the more i let them in the more i really won't be able to get through their leaving and come out (relatively unscathed) at the other end.

some people spend a fortune on therapy. i know some professional people who spend most of their salary on their therapist. they are pleased with their therapists, that is true. they are doing some great work, that is true. they have husbands to support them and their family financially, however.

is that... the best i can hope for? for therapy to help me open up such that i might actually be able to marry someone one day? marry someone who will financially support me so that i can do therapy so that i can do work so that i can fund therapy etc etc etc. there are people who are happy with that arrangement. is that what i really want?

i've figured that i don't really want to be an analyst. i think that what that was about was the idea of my being in analysis and... being able to reciprocate in some way. not seeing my analyst for analysis but some kind of loop... where i take someone on and someone takes me on... i don't know what to say. is this the best i can hope for?

therapy takes up considerable amounts of time and energy. after therapy i find it impossible to work where working is reading and writing. if i have seminars or something like that then i can get to those and power through. good distraction. but to put therapy away enough to self direct work? no can do. maybe... i'll get better at that with time, though. i find therapy exhausting. just want to take it easy for the rest of the day. traumatic ruminations / flashbacks too. i guess that gets easier over time. i guess i'm just thinking that there might come a point where i don't have the time / energy for therapy anymore. i don't know. when i don't have therapy... i rail. i surely surely do.

can't win.

something to think about... something to keep thinking about... something that i need right now. but for how long? i'll see, i guess. lets get the thesis done already....

before i had a couple weeks break (i had conference then t took a week for school holidays) my t was asking me a bit about what i wanted to work on and stuff. he kind of set the issue up as a dilemma, however. either we could work on the voices (which i didn't want to do because i don't want to switch and i dont' want to conceptualise things in that way) or we could do trauma work. i think i was meant to pick the first option but instead i picked the second. but the fact is... i'm not really stable enough to do that. my functioning is too fragile. so... what else can we do. i guess that is where the conversation picked up on my return.

he said something about how trauma work probably wasn't something that we could address at present because of how my functioning is important and because how one of my goals is to improve my functioning. i need it to get better than it is at present and i really can't risk it getting any worse at all. i said something about how i didn't know if i ever would be in the place where my functioning could afford to take a dive. i didn't know if i ever would be in the place where i could do trauma work.

so i think that is it. that is where we are at. basically... i'm not well enough to do exploratory therapy. i need supportive therapy. that makes me feel mad, however, because theoretically i REALLY REALLY REALLY REALLY REALLY want to do exploratory therapy. the fact is... i'm too fragile, however. and... that is likely to be my life, i guess. i don't know that i'll ever really be in the position to do exploratory therapy. i remember reading somewhere (Colin Ross, I think) about how he does a bit of a probe to find out whether there are parts. but then how he needs to assess whether the treatment should consist in trying to sort that out or whether the treatment should consist in supportive therapy. some indications include:

- if the person has good coping skills or not (mine are relatively okay but not brilliant it is true)
- if the person is capable of insight / is psychologically minded (i think i am)
- if the person needs to function highly for work

and it is that last one. i do need to function highly. and in virtue of that... i don't know that i ever will be placed to do the exploratory work.

but... maybe the supportive work will strengthen the ego so i can do exploratory work and still function okay. maybe... but... at what cost?

[Caramee]

Wow -- your post gave me so much to think about.

First of all, you should follow whatever your heart desires as far as a career goes, but I do think it is a shame that you do not want to pursue being an analyst because I have read many of your posts, and I am blown away by your analytical mind. You have amazing powers of insight into yourself and a great ability to take psychological literature and research and apply to your situation. I think that is a great gift, to be able to stand outside yourself and be so objective in assessing where you are and how you and your T are interacting. You are incredibly honest with yourself, and that shows great, great maturity. Again, you can use those analytical skills in many other professions, too.

I have run into the same situation with high-functioning vs. trauma work. In my "outer" life I have a high demanding stressful career that I have managed to keep together. However, internally I am quite empty and very depressed from a multitude of past traumas. I have yet to find a pdoc or therapist who will touch that trauma with a 10-foot pole. On pdoc told me that he would love to get his patients with similar backgrounds as high-functioning as I am, so why in the world would I risk that by dredging all that up? It has been very discouraging, as all there is in life is to be able to slap on a fake smile and make money . So, this is all there is? This is the end goal? But no one wants to do the exploratory therapy because of that functioning issue. It's quite a catch-22. I think that many professionals do not want to be responsible for a downturn in functioning.

Supportive therapy is unattractive to me. I guess I think I can maintain status quo on my own. I feel like I'm spinning my wheels. Is that kind of how you feel, like you don't know how long you'll be in that limbo before you can go where you want to go?

You bring up very interesting questions -- I wish I had more insight, but you make perfect sense. Perhaps to be more relevant and useful to your end goal, supportive therapy could be more about exploring why your relationships you describe take on the form they do and how that could improve so you could have more support in place when you do take on trauma work.

The anxiety of your situation is palpable. I am sorry for the bind you're in.

hey. thanks for your response. i guess that in a way i am capable of good insight. i am good at offering explanations. analytically minded explanations. explanations... rationalisations... justifications... what is the difference? emotional connection, i think. i bypass the emotional connection in the present. therapist comments on something i do in the present and i'll launch into a explanation / rationalisation / justification. i think that how it is supposed to go is that i listen to what he has said. then kind of reflect on what i'm doing and take it on board. then feel an emotional response to that (in the present). then communicate that emotional response. then... look at where that emotional response is coming from (stuff in the past). i circumvent the process, however, by interpreting (rationalising / justifying) behaviour rather than allowing myself to have an emotional response there with my therapist in the presence. my ego... is too fragile. i must explain myself to pre-empt his negative assessment of me. to pre-empt the negative judgement and corresponding lecture. though of course he doesn't negatively assess me or lecture me. sigh. there is something to talk about right there. only... i tend not to because i feel too embarrassed. in therapy there is a lot of my defending and skirting around the real (the emotionally charged) issues.

i figure there has to be some kind of balance or middle way between exploratory and supportive therapy. it is like a single dimension and there can be changes over time. i guess that when functioning gets worse... i don't know... people talk about habituation sometimes. talk about how you have to power through the traumatic stuff otherwise if you back off everytime your functioning drops a little then you are reinforcing your aversion of it. i don't know though. folk myth or fact? i don't know. sounds a little like the 'no pain no gain' maxim of folk working out / exercise. maybe things go faster... but you can get the same benefits without pain - can't you?????

tap tap tapping away. i think we tap a little. i sent my t some stuff... poems. deep poems really. touching on some of the trauma. just a little. he hasn't mentioned them. maybe he will, maybe he won't. somehow it helps me to know that he knows even if i can't talk about it yet. i don't know.

[sunrise]

alex, some of the first work I did in therapy with my current T was trauma work. We used EMDR, and it was very helpful to me. I needed to work through some past trauma in order to be able to move forward with problems in my present life. I know there are lots of approaches to trauma, but have you considered EMDR? It is known for being efficient and fast, and perhaps less traumatic itself than "reliving" strategies.

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i function better when i have a good therapy relationship. that isn't unusual, i guess.

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I do too. I am depressed today, woke up with the cloud on me, felt it coming last night. I hate that. I am due to see T today for the first time in 2 weeks, but I don't even want to go. I hate going there under a cloud. On the other hand, I may feel better if I go. The relationship really does help me. What a strange thing to offer clients to make them feel better--a relationship. It's so amorphous.

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people who make them feel cared about etc. someone who they can talk to about what is going on for them. the difficulty with me is that i simply can't get that (in the depth that is needed) outside therapy. because... my need is too great. if i try and get that outside therapy i end up with either someone taking a real parent role with me (which isn't so healthy really) or i end up with someone who is similar to me and we end up clinging to each other (which isn't so healthy really). so... no can do in the real world.

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This sounds like an important thing to target in therapy. You said your T wanted you choose something to work on. How about this?

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some people spend a fortune on therapy. i know some professional people who spend most of their salary on their therapist. they are pleased with their therapists, that is true. they are doing some great work, that is true. they have husbands to support them and their family financially, however.

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I can relate to this. I have been going to see my current therapist for 10 months. He is not cheap and my insurance won't pay for him. I struggle sometimes with what an indulgence therapy is, and I try to keep myself from adding up what I have paid him in the last 10 months. I know it has helped me in many ways, such as moving on with my divorce, which I was profoundly stuck on, and improving my relationships, not to mention the depth work we did, which I found hugely satisfying. Although I work, I know that it is being in a financially secure marriage which allows me to spend so much on therapy. When I am divorced, I don't think I will be able to justify taking the money away from supporting my kids. Am I gonna tell my girls, sorry there is no money for college because mama did therapy? Nope. Priorities.

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i figure there has to be some kind of balance or middle way between exploratory and supportive therapy

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To understand this, I needed to know exactly what supportive therapy is, so I found this definition:

"supportive therapy remains closer to the surface of the patient's issues. Supportive therapy is an approach that is used to relieve immediate distress; to return the person to his or her previous level of functioning; and to strengthen adaptive ways of coping that the individual already possesses in order to prevent further discomfort."

Supportive therapy sounds like what I did pretty much exclusively with my first counselor, who used a CBT approach. This approach did help stabilize me but did not help me move forward or rid me of my depression, although it helped me with some of the symptoms. When I moved on to my current T, I was stable and ready for depth work. We plunged right in. And my depression completely went away. But even though we did depth work, I did (and do) get a lot of support from him too. Our relationship supports me. Now we are doing a lot of nuts and bolts type stuff, so I guess we are back to supportive? But we aren't scared to pepper our sessions with less surface stuff if it comes up. Anyway, I think therapy can definitely be a mix of the two.

alex, I would be interested to know what type of approach your T would like to use in trauma work with you.

first, i think there is nothing wrong with having a therapsit as long as its helpign you develop and grow as a person.

I think that as you a grow and heal, you will find that other people on the outside may fill that role with your therapist and you can do without it. It may be down the line though. EIther way, lean on your T as much as you need it.. i think.

Hey. No, I haven't really looked into EMDR. I'm not sure that it is something that I'd like to do... I'm not sure that my t does it either...

> What a strange thing to offer clients to make them feel better--a relationship. It's so amorphous.

Yes. It is a hard one. I think that different therapists feel quite differently about that. I didn't think that my therapist minded, but I think that he might be starting to feel a little uncomfortable about that now? I'm not sure.

I think that what I want to say to him is... I don't see how we need to have goals in order to make the best use of our time (his words). Life is a journey... His walking with me for a while... That is kind of what I need. A person who has similar (though not exactly identical) values to me. A person who can comiserate with my disapointments and take pride and pleasure in my achievements. A person who can care. Help me feel less alone. Help me feel worthy of love. Help me feel deserving of love. I guess I think that it will generalise to a certain extent. But yeah, might be a long haul kind of thing for me and it might well be true that he can only walk with me for part of the journey.

I'm not sure my need can be targeted directly. I think that for me... It is about experiencing differently. Experiencing caring rather than my rationally trying to convince or persuade myself that I'm deserving. I have this huge discrepancy with what I *know* to be true and what I *feel* to be true. I think that t is trying to get me to feel and to experience and working on changing my feelings and experiencings so they come into line a bit more with my reasonings and knowings. Trying to get in touch with them a little. To express my experiencings and feelings in language and not undermine them with reason or justify them with reason and reinterpret them with reason. To get in touch with them. I guess that I need to really get in touch with them before I can gradually employ reason to help alter them. Maybe... Some of the experiencings / feelings need to be altered by his complementary experiencing / feeling rather than his reasoning too. Trying to get some of that right brain communication going on...

I don't think we are going to be doing traum work in the sense of my relating my past experiences over and over in great amounts of detail. I guess he thought that... Alters would communicate that to him and that I would not remember (hence put it away during the week). But... I'm not gonna do that. They need to gently come up in my consciousness or not at all. They are there (the memories). I email him snippits. We don't talk about it a great deal in session, however. Sometimes I feel like I'll die of shame. Just want to fall through the floorboards. Gently gently gently does it. Transference stuff is coming up. I try and talk about / express some of the hard feelings. It is hard for me, though. Maybe it is that progress is so very much slower than he thought it would be. He was surprised that I seemed to trust him so much so soon. What happens with me though is that as I get more attached... That is when the fear kicks in. The fear is kicking in now. Big time. Fear of him leaving. Fresh in my mind because of the two week break. Bringing back the month break before that. The month break before that. A year block before that. A six month block before that. All the way back to waiting seven years for my dad to come back for me and he didn't. He didn't. People go and my world falls apart. So scared of needing. So scared. So scared of caring and being attached.