What should I tell the counselor?

Every Monday this psychologist from my health care provider calls me to check in and see if I have done CBT activities. This week my goals were to step up my half marathon training and look for a job. Mostly what I did was stay in bed.

I feel like telling her that she should not bother calling me anymore. That I know all I need to do is look for work.

I actually feel guilty when she calls. I don't feel like I can tell the truth. The truth is I am swirling in the darkness. I did send her emails to this effect.

Maybe this is a technique counselors use. That is, not really taking too much about the fact I am still extremely depressed.I don't know because I have never experienced suicidal ideation until this year.

When I am positive and upbeat this seems to "please" the counselor. But when I have had a bad week she makes me feel I have somehow failed her. I HATE this dynamic.

I wonder if I should tell her what I am think about hating these check in calls because I am not progressing.

Sometimes, it just takes a while before we are ready to talk about our stuff. We sort of have to "warm up" to it. It helps when we go more often but most of us can't afford this. Be forgiving of yourself about this. You are not harming anyone and you will tell her more when you are ready.

She just calls to "check in" on the phone so it is not like therapy. I don't know what the hell it is. Maybe she does it because I called my health provider's crisis line after hours and said I had suicidal ideation. That got reported to their behavioral health unit and she started calling me. If I see her in person my copay would be $160 -- I can't afford that -- but when she calls it is free. She also invites me to email her any time.

But nothing is changing. I feel like I almost want to lie to her just to keep things going but not have to deal with the whole feeling of failure which is the last thing I need at this time.

I will probably tell her the truth today.

Yeah, deeper stuff...but CBT is "short term" -- who knows...maybe today she will tell me I have used up my phone chat quota.

I can relate to your feelings I know it's hard, but telling her the truth really is the best solution.. and sharing how you feel about this whole situation. It's not easy, but I think it will be worth it.

Meh. I can almost hear her pouting over the phone if I did not do what I said I would do. I feel crappy guilty and stupid for spending the week in bed. I feel guilty as all heck. I am afraid to go for another job because I got fired from the last one. She will just use CBT which is aversion therapy and just tell me - again - that I have to get out there. I am so down and out. She's kind of a butt kicker.

The psychologist said I was trying to control the anxiety by staying frozen and not doing anything. She said this actually feeds the anxiety and increases it. Her "homework" was once again to start looking for a job even though it made me feel anxious, and to get out of my apartment every single day. She also mentioned buspirone but I don't want to go the medication route especially because I read that some people have increased anxiety on buspirone. No thanks.

I think looking for a job and getting outside every day are good suggestions from her. What do you think though? Does her "homework" align with your personal goals? It's always best if you and your therapist are on the same page.

Yes. The goals are fine. I guess I don't understand all the anxiety. She said it is building up because I am feeding it by staying isolated. I have to trust her. You see, it is more about the management of anxiety. That's my problem, not the goals. I took diazepam on and off for over 20 years to manage my anxiety but now they won't prescribe it. So it feels really weird and it is frightening for me to not be able to just pop a diazepam. I was one of those people who always carried them with me. I also hid stashes all over the house so I wouldn't run out. I think this was...addictive type behavior. She's trying to teach me coping skills and that's good but I am also kind of freaking out. I am sorry. Really sorry, guys.

Personally I am shocked at these goals. Seems like a case of biting off more than one can chew to me. Is this her gauge of what is possible for you to accomplish or is she herself motivated by pressure to get you back to work. Is this reasonable? Doesn't sound like it to me. I can see talking about returning to work but I see this as being more of a goal to seek out upon completion of the therapy program. I've taken CBT and that doesn't sound like a realistic, measurable, and incremental goal to me; unless you are nearing completion of the therapy. Just how far are you through it? This really troubles me. On the other hand, if she does consider this doable I want to extend to you my hugs of celebration as this would indicate a significant improvement.

It is not really a program. She is a psychologist from my health care provider who calls me once a week. She is too expensive for me to see in person...$160 per visit, but the phone calls are free.

She feels that working will get me out and I won't be isolated anymore.

I guess she sees it as a life goal. It is needed for my survival. So whether or not I am capable of it is not up for discussion. I kind of feel like I am handicapped by not feeling very strong mentally but I guess I can hide it.

I don't know if she thinks this will make me happy or less stressed. If she does then I think she is a bit deluded about my so called recovery.

I don't think working is going to solve my problems. I probably won't be able to get a great job to start...and the lower the job level the more stressful it is.

On the other hand...I see it as a first step...to escape isolation.

Work has never been the most important thing in my life. More important is getting out in nature, doing art, appreciating other cultures, volunteering for a good cause, friendships, travel, exercise, and spirituality.

I would like to get some of those things back. The psychologist calls me and we talk about CBT skills and managing my anxiety. Right now my anxiety has been through the roof. I really don't know what is worse...depression or anxiety.

I think my main goal might be to accept that I have a very stressful life and it will probably remain so until I am dead. Along the way I still might like to have a few enjoyable experiences. So whatever I do to get out of isolation is good.

Thank you for caring. You are a sweetheart!

I'm sorry you don't have enough money for therapy. Gettign out every day to me seems something manageable, but finding an actual job isn't an easy task in my opinion. Have you tried some self-help books, perhaps?

Is this Wellbutrin. This is not an SSRI but it still has been known to cause increased anxiety. I am one such example. I ended up in hospital with such a bad panic attack I thought I was having heart attack. I think you are wise to avoid it.

I was urged to go to group therapy for along time...and kept refusing...then one of my therapists that I trusted kept after me so much....I finally said..."FINE, I will go...I just won't talk."......Then my therapist said something that really stuck in my mind....

"Therapy DOES NOT work if you don't participate.".......

Be honest with your therapist...it is your opportunity to let every little thing fall out of you....if you feel like she whines...tell her....if you feel guilted....tell her....LAY IT OUT THERE...JUST AS IT IS...for you...how you experience her phone calls...what you need....participate in your therapy...if you don't tell her what and how you feel or think...the most important part of YOUR therapy is missing.....

I too have no insurance....yet asked...one of my therapists traded sessions with me...to watch her cat and water her garden when she went out of town....it is really so frustrating when we can't get what we need because we do not have funding....yet it seems to me....though I don't know this....that the therapist is willing to work with you through phone calls...because SHE IS calling you......so tell her what you are feeling and thinking...use that phone call....AS therapy....

Just my opinion....and worth as they say....2 cents....

I hope you can feel more peaceful....

Thank you. This was amazing advice. Excellent advice. I obviously feel fear around being honest. Also, she is calling me and is from my health care provider and the calls are free. But if I saw her in person I could not afford it. So it is nice of her and I should participate more. Yes. And try to be more honest. I don't do well in therapy, I guess. But I think I will give a go at what you suggest.

I have had some bad experiences bartering for therapy.

Long ago I was working as a fine arts photographer among other things and I had little money so the therapist said let's trade photos for sessions. So we did that for about six months. I would bring in a photo a session. I was preparing for a big photo exhibit so I had a lot of nice work at the time. I decided to move to another state so we finished up. Later I received a bill in the mail from him for something like $1,400! I never paid it and it never went to a collection agency or anything. But it really peeved me. We had made an agreement and yes it was just a verbal agreement.

Later I traded one session with a psychologist for doing some yard work for her. Her soil in the yard was like cement and I injured my foot spading the soil (plantar fascitis) and it took about a year to heal! And her one session was a joke! Not remotely helpful. So that was the end of bartering for therapy for me.

I think you respond better to what you "can" do rather than what you can't do. Being fired from a job can bring on a lot of negative, hurt, and along with that anxiety. This is especially true when one enjoyed their work. From what I have read the other thing that created a very unsettled feeling in you was how your work environment "changed" too.

Going out to look for work can bring on a lot of anxiety, especially when one is older. I also think that because of how much technology has changed the work environment, it can be very intimidating going out in the working environment that really has gone through a lot of changes. If I combine that with where you live and how cold it is where you are right now, I would not want to leave my home either.

I think that taking a time out and thinking about what you want, something that you could actually see yourself doing at this point in your life, is wiser than going out without having that good idea of what you can see yourself doing. Sometimes what can help is going to a job fair to walk around and see what the current job market is about.

One of the things that stood out to me about you is how you were so good taking care of your mother. I am wondering if you might be good at working along the lines of a visiting home care person. I am talking about an individual who goes to homes of individuals who are "there" mentally but just can't do all the things they used to do and get lonely. I am thinking that you would fair better where you are in a "guiding" position where your efforts add to the quality of the other person's life.

I have noticed that a lot of millennials have their elderly parents living with them or may even be trying to help their parents live at home as long as possible and they need someone to spend time with that parent so they can work and not have to worry.

It's important that you realize that you are not without abilities and talents. Anxiety has a lot to do with pushing self towards something you don't want to do and often can bring on some kind of reminder of whatever you experienced that "changed" how you lived your life.

Thank you for this.

It's 75 degrees and sunny where I am.

I appreciate the comments. My original post was about how to communicate with my therapist.

Ok, it's freezing where I am, I somehow thought you lived someplace where it's very cold right now.

I was thinking about how you described how you are feeling and how your therapist calling you to make sure you are up and out may not be helping. I would not appreciate a therapist checking in with me in a way that feels like she/he is pushing me. I think what works best is helping someone get "motivated" so they "want" to engage themselves.

I am suicidally depressed. I am not even motivated to live so of course looking for a job is going to overwhelm me.

The point is I have to work and whatever mountain I need to climb I have to do it. I cannot afford hand holding. I now think the therapist is doing the right thing.

If you work out or vent frustrations, sometimes you recognize what is helping as you have stated in the above quote.

I am sorry but I don't understand. I am sorry in general but I am having a hard day. I think the "plan" is a good one and I am frustrated I cannot do such a simple thing. That is...the two simple things such as train for a running race and start looking for a job. She didn't say have an interview lined up by next week. She just said start looking. I also talked to her about motivation. In CBT therapy she said generally it starts with trying to get the person moving (behavior) rather than cognition (motivation) --- so yeah,I guess we did discuss this a little. It feels a little backwards. However, if someone said I could come ride their Arabian for an hour I would probably be out of bed like five minutes ago. I am one messed up cookie.

LOL, I wish you lived closer to come ride my arab.

I can see why you would think that a little backwards. Did you ever hear the saying, "change a thought move a muscle?". I guess what your therapist is doing is getting you to move a muscle so you can change your thoughts, maybe that works better for depression.

I have been a messed up cookie too so I understand.

I might as well get up and get going. It doesn't matter if I am sitting at home or out working I will probably still be depressed and anxious. In fact, I have always worked through depressions except for this last one. As I stated earlier I have never had suicidal ideation until this year. I just think that's a sign of a more severe, intractable depression.

Have you ever heard, "RIde an arab change your mood and muscle?" Just looking at those guys with their beautiful faces can lift one's mood.

Are you in the US? There are many other resources to help you here. It seems like who you have is not a good fit. You may need a different type of therapy.

The fit is perfect. It's normal to have these kinds of feelings. (i.e. wanting to progress at a faster rate) Talking with others and getting their feedback here has been a big help.

Some may not have access to a bunch of resources, especially in the US. If you read enough on Psych Central that becomes pretty obvious. Just saying we need to be very careful with advising people to switch therapists when we don't know their full story. Unless, of course, there is some obvious abusive situation being talked about. That certainly is not the case here.