In Session Today: Part IV

My outside contact has been invaluable. The frequency has fluctuated over the months. The overall stress of getting a response and my feelings about T's response has improved significantly.

It has been 2 weeks since I posted my in session notes. A work project has kept me very busy. Also, my sessions have been so random, almost incoherent. Thursday 2-22, I basically threw a tantrum (my type of tantrum), sitting on the floor wedged between the couch and the cabinet that holds her printer, barely fitting. I had the picture of the filing cabinet [supportive/bound object from clinic before T moved to private practice] and told her I was mad at her about it and about lots of other things. I told her I didn't want her to look at me. I have been struggling a lot with not feeling like I (Elio). I'm just me - whoever me is. I've had to remind myself that I am Elio even though in my head I'm saying to people not to call me that. It's moved to... ok, I'm supposed to be Elio, I can be Elio... how would Elio handle this, what does Elio like. A funny thing happened when I tried to tell T about not connecting to the name Elio... I said that I am not "birth name". As part of my gender, I legally changed my name about 20 yrs ago. That was weird moment.

I have isolated significantly. So, here is me forcing myself to reengage.

3-1 session:
I got to the office with 7 mins to spare - around back, through the doors, down the stairs, push the button, and into the waiting room. I am the only one in the waiting room. I sit down in the chair I usually use. I pulled up the stone language song on my MP3 player. It wasn't very loud and I thought it wouldn't be easy to share it with you. I checked my phone and it was a different copy and was louder. I thought that would work. I got up and took off my coat and pulled out my notebook and ! book. I sit and wait. I am the only one around and it seems like no one else is in the suite as well. I think about pulling out my blanket. I unzip my backpack and I hear your door open. I zip my backpack up. You came out and said hi, pushed the button and headed back to your office. I followed.

I came in and thought about taking my shoes off and putting my feet up on the couch. I sit my coat on the north side of me, leaving most the couch available so that if we want to put our feet up, it would not be in the way. I sit down and put my note book down. I moved the pillow. I look down and see you are in brown boots; well-worn boots.

I say Hi, you say Hi. Minor pause, then I ask you how you are doing. You think and say you are doing good. You comment on how I don't always ask. I agree I don't. You wonder what it means that I asked this time. I'm thinking that I asked today because I have nothing to talk about. Pause. More said. I say that I didn't want to come today. Not sure if you asked or if I just continued with that I didn't know why. I was thinking that I wanted to leave and felt like I was rocking a little in that impulse. I thought I needed to leave. What would you think if I did leave? More said. I said that earlier in the day I had a moment that I was angry with you; just out of the blue. I said that there had not been much feeling, that sadness would come in for a moment and then back to nothing. Then this anger towards you. I said that there was no reason for the anger. I continued saying that it's not an 'I don't know' why I was mad, there was no reason, I just felt anger. You wonder if the not wanting to come, the sadness, and anger towards you are linked.

I'm looking about the room. Pause. Ok not much going on. I actually think about getting up and going to look at the books on your bookshelf. I ask you if you have anything you want to talk about. You say that you do not want to rob me of my time to bring up anything I want. I say that I don't have anything and that it's been a while since I last asked you if you had anything you wanted to talk about. Pause. Then you said that you did want to ask about the insurances stuff. I said that oh, yeah I heard back from my work insurance and having them cover T was denied. I told you that they used some weird code that was like other medical reasons for why I wanted to see you. I told you that I had wanted to bring you the letter and that I had called to try to get more information regarding the reason for the denial. I said that we could appeal it, though I wasn't sure of the point. You said that you thought my work insurance was my primary because of it being where I worked verse being the dependent on my wife's insurance. I shrugged, I don't know but probably. You said it didn't really matter just that you'd have to bill through mine first then go to my wife's. You said something about my wife's paying the 2 x a week without audit. Last time we talked on this you said something about slowly increasing sessions. I'm in such a weird place - increase to see if that helps bring things back or give up, accept that this is life.

As the topic wound down you said stole a few moments of my time. I shrugged it off and mumbled something about there being lots of time today. Pause. Now what. Hmm I had wanted to play the stone language song again for a little while, so I pull out the phone and start the song. I said, remember this. You said yeah 2 yrs ago. I said almost 2 yrs ago. It was in May/June when I shared it right after your first vacation and then the emergency missed session. We listened to the song, all 5 mins of it. There, another 5 mins spent. Silence, now what?

We talked about a discussion that I had had with a friend a few weeks ago. You asked me what was on my mind about it. I paused then said that I wanted to know why one negative thing can get in so deep and get stuck. You said maybe this, maybe that. You said that maybe it was a way to put up a wall to keep me from having to look at things, an excuse; something we have to navigate around. You pondered if I thought if I could convince my friend, I could convince myself. I told you that I wasn't trying to convince her anymore. You brought up the older boy and talked about him using things like this as a way to create rules, protect, and defend. I think you said something about the net here. You said that you are just guessing, that you don't know, brainstorming. I must have been giving you some type of non-verbal communication of disbelief or something for you to have said that. I think I was yeah yeah'ing you. Not really listening. You asked me what I thought. I said that I think it was because those statements fed into my fears; played into them.

I said the "always asking for stuff from you" and the "drama, that there is always drama and if there isn't something, then I come up with something", that has made it hard for me to talk about anything because what if all this is just life, the human condition. You asked me something. I said that at first, I was able to say that hey, this is therapy. It's about unpacking your drama. You said snapshots, you agreed with my statement about unpacking your drama. You asked about now. I said that what if none of it is real, what if I'm making stuff out of nothing. I teared up when I was saying that. You commented on my tearing up and asked me if I knew where the tears were coming from.

Long pause…. I looked at the floor for a long time. How do I tell you that I don't want to live this life? I look up at you and then down again. I was not grinding my teeth. This was not something that wanted out and I was holding in. This was something that I wanted to say but couldn't get the words out. I looked at you again and again back to the floor. I wanted to be looking in your eyes when I said this. I think I wanted you to see how dead I feel inside, I'm not sure. Maybe I wanted you to see the truth of my statement. Finally you said that this is hard for me to say. I nod. I look up again and start to speak and stop. You laugh and comment on my start, I laugh and say almost. Another short pause. I looked up at you and said that if this is life, I don't want to live it. You wanted to know what the 'this' was. Yep, I felt this was the indirect risk assessment portion of the session. How do you answer this question… 'this'… everything, what you see before you. I made some statement. You asked me to clarify to be specific on the 'this' and something from this new statement I don't remember. How do I explain to you what's going on inside when it's just so dead in there. I tried to explain that I didn't want the human experience anymore, I followed that up with my human experience. You asked me what living was. I didn't have words. Pause.

You were talking, I don't know what you were saying. I went back to my phone and got the song again. I started the song and jumped to the middle. I actually went past where I wanted to be, I found a good spot. You said that is living. I said yes. It I let the song play out until it got really quiet and turns deeper/darker. I said that this is my life. More was said, then you asked if I saw images when I listened to the song. I said yes. You wanted me to describe them. Again words failed me. How do one describe what it is I sense. I said that they are pictures but not pictures. So, I went back to the beginning of the song and started it again. I hummed to it and moved my hand the way the sound moves… a type of conducting in a way, I guess. I stopped humming after the first intro, and continued doing the hand movements for a bit longer. You had a smile on your face - delight(?). I was some embarrassed to show you (show anyone). I think I stopped humming because of being embarrassed. I continued the hand movements because you looked happy. [Afterwards of course I come up with words. I see the sheet music, I see the orchestra/the players and the instruments that make the noise, and I see the movement of the sound.]

When I was done, you said something about it being movement. You pondered what it would be like to draw it. I said I don't draw. I'm thinking - you can't draw what I just did. And yeah what a psychology thing to do, draw and analyze, I don't think so. I did not like this idea at all. I am pretty darn certain that is not what you were getting at, still that is where my head went. You seemed really excited about that idea. You talked about even if it was just scribbles, what colors would I pick… and… yeah, no… I don't like this idea… hmmm colors would I pick?

Somehow, I moved us back to talking about the discussion with friend. You asked me if I was exhausted after that discussion. I pondered that, trying to remember, I think I answered not really. I'm not sure. Thinking about it after, no I was pretty rev'ed from it. I was frustrated and mad. I was also worried and sad. I told you that I'd been talking with her some and she had realized that I was holding back with her. You asked me if I was still talking with another friend. I said that I was but not much last few days. I said that I had not posted on the forum in a long time, that I had not even gone to look at it in several days before today. I said some stuff about nothing I had to say was important, had value, was it really what I was experiencing.

We got back to talking about living and not wanting to feel dead inside. You said that you thought I knew there was more to things; that you thought I experienced them. I remember last year after I was past the worst of it with my arms/chest surgery, there was a period of time (short) where everything felt really good - the end of last April/beginning of May. You said "you go away and you come back". (I don't know where this statement was in this part of the conversation.) I thought about that for a moment, it was an interesting statement, one I think I want to come back to. I said that was a very long time ago. I started crying again during this talk; just a few tears and snobbery.

At one point I also talked about how I wasn't sure about what was in my head was real, if any of it was really important or meant anything. I recalled how hard it had been for me to get to accepting that in therapy all of it is important. And now I'm back to doubting.

I asked please can I have some tissue. You said something about me asking (thanked me?)You got me the tissue and I took one, you said to take as many as I needed. You sat the box on the floor in front of me. That irritated me a little and then I had an inner laugh about me and the battle with the tissue. It didn't bother me to ask this time, I was grateful that you provided, that you gave me some. [FYI PC: based on where I sit, I am unable to reach the tissue and I always have to ask for it. I have ranted to her about always having to ask in my journal but not brought it up in person. This is the first time she's left it within my reach.]

Then you said that you had a question. You asked about when we'd do the puzzle from Christmas. I was thinking that it was your puzzle, you decide when and where you put it together. I said that I had thought that we might do it today because of not having anything to talk about. I shrugged about when we'd do it. Did I say it was up to you? It is, it is your puzzle, not mine. You don't have to wait for us to put it together.

Our time was up. I fumbled some at gathering my stuff and I wasn't sure about telling you I love you. I did not put my stuff in my bag.

me: (tears) I want to come home.

you: you will

me: I want to feel again

you: you will

me: thank you

you: you are welcome… …my joy

me: I love you

you: I know

As I was packing up, I was packing up to leave, I commented about needing to get a bigger backpack if I was going to keep carrying my blanket around. You said maybe it brings comfort. I said something about not pulling it out. You said something about get comfort just from being able to see it, because the zipper was slightly open. That was not intentional; however, I did see it at one of the times I was looking down and couldn't find words. It did bring some comfort seeing it as well as some embarrassment of not getting the zipper all the way closed. I wondered if you thought that was on purpose.

I picked up my bag and went to get up. I noticed it was 6pm on your clocks (which I also know they have ran fast in the past so I wasn't too upset about it). As we were moving to the door, you told me to take care of myself the best I can. See you…. And I said Monday. Out the door, I turned and closed it. I thought about, oh yeah, I had wanted to ask you how late you see people on Tuesdays. I know you sometimes see someone after me on Thursdays. I get done with personal training at 5pm. I thought about opening the door and asking and I remembered how late it was. And I'm still not sure about it.

I was a little lost in my head as I left. I had to think hard about what my next steps were, go down the hallway… oh look someone is here in the waiting area…. Up the stairs.. Keep walking… I worried that I might not have left you enough time between sessions. At the top of the stairs, through the door. I put my coat on and looked for my badge. This took me a while cuz things just weren't working right in my head. When I finally made it to the other door, someone had been sitting on that side of the hallway. I was a bit embarrassed by me taking so long to get sorted. I headed out and walked to the train… to home.

[QUOTE

I have isolated significantly. So, here is me forcing myself to reengage.[/QUOTE]

Elio, I have missed you very much. So glad you are here.

Re email contact. R acknowledges my emails and we discuss in person during the next session.

The other psychiatrist I saw briefly offered out of session contact three days a week 6-10pm.

For me I like the idea of having a safety net in the background. That he's "there" if I need him.

My t said kinda the same thing you wish to hear. He said he understood where my need for his attention comes from and he wishes he could give it to me. It helped explain what was going on with it. He knows I have this deep yearning, and he's weaning me off of it. It is so painful. We talk about the process at times. It's definitely helpful to discuss it

So I told T about how he has hurt me. He said "You're right, I'm tired and irritated lately... My second baby was born at the end of January".

Ooops. I felt like I was slapped.

I mean, I'm glad for him... And I glad he has two boys, because if he had a daughter it would literally kill me. But... I feel like devastated. Now I'm even less important. And I hate myself even more. I should stop seeing him in such a difficult time I guess. He should take care of his wife and babies.

I can't stand it. He's happy, loved, beautiful, with a great job and so on. And I'm a piece of ****.


My jealousy is killing me. I know I'm wrong here. But I just can't. Just can't.

I'm sorry you're feeling this way. I can understand the jealousy. Please don't feel like you should stop seeing him though. It's his choice to come to work and still do his job, despite having a young baby. Talk to him about your feelings of jealousy and also that you shouldn't bother him during this time. And stay safe.

Capgut, I relate to what you say very much. Your T having a second baby DOES impact you, and does suck his attention - it is a stage of life that is often fraught with exhaustion and conflict inside a marriage. It isn't aways( usually) romantic and happily-ever-after; He probably wants to get out of that house and get to work! Even though I know all this too well, I am still jealous of my T's wife. What makes me fee better, is reflecting on how difficult marriage is- long ones- and how much kids vampire energy even while giving joy. I think your T's time with you he will often prefer to the long struggle of meeting babies and wife's needs.I truly do.

Argh, Captgut. That was not a particularly kind or helpful way for him to drop that huge piece of information on you. I have had something similar happen with my T, and I was devastated. I hope you can talk to your T about how you feel about what he said. I have a sense of the intense feelings you're going through right now, and I think it's totally normal that you're reacting this way. I'm guessing your T was trying to validate you feeling upset with him by telling you why he has seemed preoccupied, and I'm sorry that his response was so incredibly destabilizing for you.

My t had his first child this year. I was majorly jealous and I told him. I said it's not fair his baby has great parents and is set up with a good loving family. I was very excited for him though , I know he loves being a dad. But i still want him as MY dad. My dad only

After leaving my keys on the car seat while I went in to a mall in a sketchy area (amazingly, it was not stolen), I went to session and forgot to turn on the recorder. So I don't remember a whole lot, except that my therapist seemed completely normal and warm, like her old self. I think the big difference, to be honest, was my frame of mind.

We worked through a lot of things that have been happening with me. She also cleared up that she would totally visit me in the hospital if that ever happened, that she does do that for people. I had thought, after the incident with the cold last week, that she would not go to a hospital, but she said that's different. So I feel better about that.

Except for being so spacey and forgetful, I was feeling better going in to session as well as leaving. When we wrapped up and I saw that the recorder was off, I said today would have to be a rehearsal for next week, when I bring up the same things again.

As soon as I walked into her office, T immediately apologized for the e-mail issue we had last week and explained that it was totally her misunderstanding and that I had done nothing wrong. That was a huge relief for me and a weight off my shoulders! We talked about a lot of things that I mentioned in my e-mail to her, similar topics to last week–– except this time I got much more emotional. I could feel myself getting angry, and sad, and letting those emotions out vocally instead of just laughing and pushing them aside like I usually do. And probably 2/3rds of the way through the session, my brain just... shut down. I totally couldn't form words or speak in coherent sentences for a good five minutes. T said it was probably because I had such an intense wave of emotion that my amygdala reacted and cut access to the prefrontal cortex. It was so strange to feel so much and have such a physical reaction, because when I'm not in therapy I'm stuck in such an emotionally stunted environment... it was nice to feel, though. T asked me what was going on in my body when my mind turned off, and I said I felt like I might cry but that I didn't want to talk about it or sit with it, and she understood. And I am so grateful for that. It's a process to learn how to feel and let myself be emotional again. Rough day, but I felt good leaving.

Went back, sat down. He commented on how I had my usual sparkling water. I said he had his usual coffee. He asked what I wanted to talk about, and I gave brief update on H's shoulder injury. T seemed concerned and compassionate. I said I had brought the homework from a few weeks ago with the Imago exercise (about stuff from childhood and my caregivers), so maybe we could work on that today? He said OK and went to his filing cabinet to look for the materials.

He got them, went back to his seat. He said the way this worked was he was going to have me read out my responses, then he'd fill them in, sort of "Mad Libs" style (something we both know since we're about the same generation). We went to start, and he said, joking, "OK, give me an adjective." I laughed, and he explained how to do the first part. Basically, I'd listed positive and negative traits of my mother and father and had to pick 2-4 most positive and 2-4 most negative. I read them to him, he wrote some stuff down, said OK.
Then on to next part. In that one, I had a statement of what I wanted most from my parents, about acceptance for who I am, mentioning stuff about mental illness (OCD and anxiety as a kid). He said, "Can I say something like, 'wanted to be accepted as I am, warts and all?' I mean, I know you don't have any warts, but..." I said that was fine.

Next part was sharing childhood memories and the emotions associated with them. I listed various things. When I got to one about my grandmother, I got a bit emotional, saying how we'd been close and she'd passed a few years ago. He said he was sorry. Talked about her a bit. Back to list. For one of them near the end, an emotion I listed was "feeling special."

I forget how this came up, but I mentioned something about generally being a teacher's pet. He said, "Wow, that's really interesting--the last person I did this with, she also mentioned being a teacher's pet, and one of her emotions was 'feeling special.'" I said I thought that was interesting, too. Talked some about how it's like teachers appreciated certain parts of me, that maybe my parents didn't? He seemed to think that made sense.

Then frustrations of childhood and how I dealt with them (an option could be "I didn't react"). Went through all those. Then it was time for him to read stuff back to me. First he did more explanation about the whole Imago thing, how the idea is that we subconsciously look for a mate to figure out childhood stuff. But then we're doing this subconsciously, and our mate has no idea what we're doing, so they don't give us what we're looking for.

So what he read to me was, for example, the stuff I said was negative about my parents, were things I was attracted to or perceived about my partner. It mostly seemed to fit the latter, like I perceived my H to be critical...but maybe he actually isn't? Next part was saying what I try to get them to be (positive traits of parents), like playful/silly, a good confidante. I said that seemed to fit.

Then it said I wanted that "So that I can be accepted and understood for who I am, 'warts and all.'" That part made me pause--it really resonated with me. I asked if this is just about my H, or other relationships in my life. He said could be about anyone. I said it made sense. He said how that seemed to fit why I connected so much with MC, how it seemed he gave me that. I started crying and said yes, many times, and how that's why it was so hard when it felt like he rejected me for my feelings.

He continued on, saying how what I wanted was to feel, "happy, connected, loved, accepted, and special." I said yes... Then it was ways I stop myself from getting that, such as "shutting down" (won't include them all here).

It all really seemed to fit. And it just...I don't know, it was kind of overwhelming how it seemed to go together. Like so much made sense. I said how I assumed this would be a starting point for other discussions, and he agreed. I said I'd have to process it over the next few days.

I knew it was about time to stop and mentioned that. He asked how I was feeling, and I said generally OK but a bit overwhelmed because it was a lot of stuff. He said he was sorry for taking us right to the end like that, how he generally tries to have more time to wrap up. I said it was OK. That it wasn't like I was an emotional wreck (I actually wasn't at all!), those would be more the times when it would be a problem. He said OK.

Got out phones to schedule. He said, "I'm really sorry, I forgot to mention before that I'm out Friday." I said actually he'd mentioned it a couple weeks ago, and it was OK. He said he could offer me Thursday morning. I asked if I could think about it, and he said to just let him know 24 hours ahead, that he wasn't putting anyone else in that spot. (Spoiler alert--I already accepted Thursday session). We scheduled for next Tuesday.

He said he'd make me a copy of what he'd written, did that, and gave it to me. I've looked at it a few times since then--it feels different seeing my feelings in someone else's handwriting. I paid, while discussing the weather, we shook hands (he stood up this time), he said, "Take good care," I said, "You too" and headed out.

Last session before he leaves, sorta. My next session is next week, a few days later than usual, so its on the day he flies out, I thought it was a great idea then but now I am hating it, too long before I can see him again and when I do, he leaves. ugh

Anyway, it was ok, he still was recovering so on meds and not completely with it. sucked but I also understood. Kept it light, I didn't get into any of the deeper stuff I've been emotional about, I usually change my mind when I get there, I just hate emotional stuff so I avoid it as much as I can.

He mentioned how we seem to be at a part of my life where things seem good and I just nodded even though it's not the case.

I'm depressed and I miss him already. Regret not making the most of tonight.

LT-- glad your session went well.

I'm sorry, DP. From reading posts on here, seems like T's don't tend to do so well in sessions when they're sick. Is there any chance of changing your session to your usual day instead of the day he's leaving?

I probably could but I think it would be better for me on that actual day. I have weird issues with jealousy and such so knowing I am the last one he sees before he flies out, is comforting. No one else ever really takes that spot so I'm sure come Monday if I decide I need it instead he could get me in

He did say I can call him for a bit Tues if I need to. I may but idk. I already feel annoying and needy and I hate it.

Today, I basically talked to T about my social anxiety and told him what was going on. I talked about how my H gets stressed when I get "crazy". I take days off because it becomes way too much for me and I need a break to slow my system down. I don't want to feel ashamed of myself or humiliated, but I feel that way. I don't want to stress out H, but it happens. I want to be normal. I feel like I am so angry at all of this. I feel out of control, like how do I handle this expertly?

I felt disconnected from T today for some reason. The session went quickly and almost seems like a blur. I asked for an extra session to help me through all of this. So I see him next Tues. and Wed.

Until then, I am going to employ some kind of strategy to help me through. What? I dont' know. 1) The stay in my room at work strategy.

I don't know if T or anyone knows how painful and terrifying this is because words don't do it justice. I am so angry at this that I am going to get through this just out of spite. I don't care how it is done, even if I have to learn not to care what others think of me. I have some research to do on not caring I guess.

I was worried she'd (1) forget about the emails I sent or (2) be mad about the emails I sent. But neither was true. I started by reporting in what ways I had "pushed my boundaries" over the past week, where here it is good to push myself - so examples include walking the dog. And I reported the ways I had not done this - e.g. not gone with the family to watch movies in a crowded cinema.

Then she asked if I was ready to talk about my emails - talking about the time before or after the attempt or the actual attempt. So I did a bit. I appreciated that she gave me feedback and told me I seemed depressed. I knew I was moving super slowly. I had asked her a while back to tell me when she thinks I am depressed so this helped. On the way out she made sure I was safe. She asked, 'is there anything else I can do?' I said no. Of course the answer is no. She cannot see me more than 1x a week. I can write emails and she responds - I'm still here and not going away. But she doesn't offer phone calls. I am basically stuck with the ickiness of emotions until next Wednesday.

I know I was overwhelmed by negative thoughts from Wed last week through this past weekend. I was taking all my meds then. I got my emotions in control by relying on my ED to get other things in control. By Tuesday I was feeling strong. But I knew I wanted to discuss the attempt in t, so I stopped some of my meds so that I could access those deeper emotions. When she asked in session if I had been taking all my meds, I said yes. I lied because how else can I access those deeper feelings if my meds make them inaccessible?

Just wanted to say that I understand. I feel your words and they resonate. I get the trap that is social anxiety.