[Tuttapizza]

Dear All,

I'd like to hear from those who managed to improve significantly with therapy.
What were/are your problems? What type of therapy did you use? How did you manage to make it work?

Some of you know that I tried psychodynamic therapy for about 7 months to deal with anxiety, insomnia, depression and some mildly obsessive behavior. I can say for me it was only partly a success in the sense that it allowed me to "deflame" my latest deep depressive episode in about 4-5 sessions, but I do not seem to be able to use therapy for much more than that and I am therefore about to interrupt it. I do not feel more resilient or immune to depression and anxiety than I was before, in fact I sort of feel more vulnerable now that I am more aware of some of the causes from my upbringing (or lack of it).

I'd like to try something different in order to truly get better and live life.

I have chronic Generalised Anxiety Disorder and chronic severe generalised Social Anxiety Disorder (think traits of Avoidant Personality Disorder) due to a difficult upbringing and young adulthood. I also self harm and have chronic passive suicidal ideation.

I did about 30 sessions of standard Cognitive Behavioural Therapy (Not Trauma focused CBT which is different) and am on psych meds but did not see much improvement while I understood intellectually that many of my fears were irrational and that I have a lot of cognitive distortions, I could not change my beliefs because they're really strong emotional beliefs.

I have improved dramatically in therapy with my current therapist who utilises a blend of Acceptance and Commitment Therapy, and Schema Focused Therapy with some light Dialectical Behaviour Therapy. We're around 70 sessions in and we're working on breaking ingrained patterns of behaviour, processing painful memories and rescripting them, and working on changing my core emotional beliefs.

My partner, therapist and healthy friends (the first healthy friends in my life) have remarked repeatedly that I am a transformed person. I function at a much higher level at my job (which now requires a lot more social interaction, more people skills and responsibility than I first started 6 years ago) and in my personal life. I go several months without self harm. I eat regularly and no longer starve myself. I occasionally socialise with friends. Suicidal thoughts occur way less often and episodes are much milder. I no longer get hit in the home.

How I used to be:
I used to be unable to look at people's faces and went around staring at the floor. I would often be too frightened to speak in a group or 1 on 1 with bosses. Making a phone call required at least half an hour of screwing up my courage. Small talk stressed me out.

I couldn't go anywhere out of my tiny "Safe zones" and "safe public transport routes" alone. I couldn't go into stores on my own and going with a familiar person brought intense anxiety. I had no friends or acquaintances. I clung to my partner whom I met online and even though he was the safest person whom I trusted most in the world, I trembled like a leaf when we hugged each other or held hands. I was a recluse outside if work. I self harmed easily 3x a day. I had a lot of chronic passive suicidal ideation. Eating meals regularly was a struggle, same for basic oral hygiene and I would go two or three weeks without showering since I lacked the energy.

While I held a job, colleagues commented behind my back and to my face that I looked like "a terrified mouse", that I am "stupid" and disheveled and unkempt. They would laugh at me and call me "cave woman" and some really homophobic slurs. Some "friends" would do things like pinch the nerve point in the back of my neck "for fun", push me physically around, belittle me verbally, invade my personal space, scare me by trying to sneak up on me to startle me because I'd a strong startle response and hyperviligence.

I also regularly experienced violence in the home from a parent despite me being an adult , and the other parent would blame me. I had no clue then that this was illegal and wrong and that I had options. Leaving was inconceivable as I lacked supportive friends or relatives and the violence was normal to me and I had no hope in my life.

[stopdog]

Does it have to be therapy? I found exercising, yoga, meditation and qigong to be much much more useful to me than therapy ever ever was.

[InnerPeace111]

I wholeheartedly agree with stopdog’s suggestions of exercise, yoga, meditation, and qigong. I would also add Reiki to the list. If you like to read books, you could try anything written by Pema Chodron. I also like Flourish by Martin Seligman — he provides some practical activities for increasing happiness/well-being such as the “what went well” exercise, the three good things exercise, and the kindness exercise.

I have found that for myself, anyway, it’s not so much about improving or becoming stronger but more about liking and enjoying the person I am becoming no matter what is happening in therapy or in my life.

ETA: My life is far more about setting goals, discovering new things, living according to my values, and enjoying the person I am becoming as opposed to curing/eliminating my depression and anxiety which I don’t really believe is possible.

[ChickenNoodleSoup]

I have borderline personality disorder. The main issues for me are extreme fears that everyone in my life will leave me, very sudden and strong mood swings and suicidal ideation/self harm and intrusive memories/flashbacks from various trauma.

My therapy is mostly psychodynamic, plus some CBT and DBT.

I'm still in therapy, but so far I've seen improvements in: being able to say what I want, say no to things, have my own boundaries, feel like I don't need to rely on other people constantly. I learned tools to deal with my mood swings, and I self harm less, most of the time. Currently I'm working more on how to not be stuck in trauma responses all the time.

I've so far been in therapy for 1.5 years. I think I still have quite some time in therapy before I can say that the things I'd like to improve have improved enough. I do not expect to ever not feel this way anymore, to be 'healed'. For me it's more of a reduction of symptoms to a manageable level.

I think how well therapy works depends on various factors. On the one hand there's the actual issue. For example you say you struggle with anxiety, insomnia and depression. Some people might already feel it's enough to have 10 sessions of CBT where they learn how to influence their feelings more. And after that they might not have any symptoms at all anymore. Some people might feel this way because they were abused for years, they might take longer to recover, and recovery might look more like being able to deal with the feelings than to just not have them.
It might also depend on the exact type of therapy you do, the therapist and how long you go to therapy for.

I agree with other people that if you feel that therapy doesn't help you the way you'd like it to, it's worth looking into other options. Some people like to deal with their issues by talking to someone. But others can find more use in sports, art or some other form of occupation.

[LostOnTheTrail]

'Some people might feel this way because they were abused for years, they might take longer to recover, and recovery might look more like being able to deal with the feelings than to just not have them.'

Thanks, ChickenNoodleSoup - that's a heaping helping of validation for me.

Emotional abuse is my core issue, I think. I've seen some improvement by being able to talk it out, but I have distanced myself from my feelings significantly in order to cope. Trying to learn to let them back in is hard.

[ElectricManatee]

I have had a good amount of success with turning things around during this current stint of therapy. I have been in therapy on and off since I was 16. During my time with different therapists, I learned some good things but never really got to the root of my problems. I didn't even know what the root was -- I actually sort of thought I had a "chemical imbalance" and was unfixable. I have had depression on and off (but mostly on) since I was about 13 with some anxiety issues mixed in. I met the criteria for persistent depressive disorder and have had periods of major depression too.

This current bit of therapy has been much more intense, both emotionally and in terms of session frequency (twice a week instead of weekly or every other week). My T mostly uses a relational therapy approach, so she is very comfortable talking about the therapeutic relationship (when I want to go there) and with helping me deal with current relationships and form new ones. (She has other skills too, but the relational ones are what I value the most.) I actually saw her for a while for other stuff before we decided it made sense to dig into the deep, core stuff.

For me, it has been very enlightening to build a strong relationship with my therapist and then be able to deconstruct the relationship and examine all of the assumptions I make about how other people feel about me and to really explore how I feel about myself. I had/have a lot of negative perceptions of myself (and low self-esteem in general), and my T has gradually become someone I trust to see me clearly and then to help me see myself more clearly. Over and over I have said that I think people see me a certain way (nearly always judgmental or bad) and she has shared whatever reaction she has had (generally positive or neutral). Slowly this has allowed me to let go of some pretty nasty distorted thinking and to recognize that I need to distance myself from the people (family members) who do feel that way about me and treat me accordingly.

I had to learn to open up and be really vulnerable and honest, even when it was painful or embarrassing to do so. Obviously this is risky and intense stuff, so it was really important for there to be a good "fit" personality-wise between my T and me. Plus I need somebody well-trained and with good boundaries or else none of this would be safe. She helped me tear down a lot of my defenses, and now I'm slowly rebuilding with her guidance. I feel like I will always carry parts of her with me, and those parts will serve me better in life than some of the more negative things my parents instilled in me. I can definitely see a difference in my ability to enjoy life and relationships and to make new friends and try new things. It doesn't take nearly as much effort to be happy anymore.