In Session Today: Part V

Thanks for sharing LT. I really like your write-ups. I wish I had even half the memory of my sessions as you have of yours. I barely remember two or three things. I liked the cat socks part. I had a former PDOC who used to wear "funky" socks and I thought it was fun. My former T never wore funky socks, and probably didn't even own any, but as I usually have trouble making eye contact at least for parts of it, I look at feet a lot. Plus I used to sell shoes so I guess that's part of it! Kit

I enjoyed the write up, and the cards-table communication between you and T.

Second session with L. The first session wasn't worth discussing.

She asked if I could sign a release for her to get Pollyanna's files on me. "Isn't the release I gave him sufficient?"
"Oh, I didn't know that you'd signed a release. I'll call him."

We reviewed the goals that we'd discussed in our first session:
1. Reduce negative cognitions
2. Process childhood trauma
3. Examine how attachment issues influence my relationships
4. Deal with infertility stuff

What did I want to start with? What felt pressing? I shrugged my shoulders. I was very anxious. She asked me how EMDR processing had gone with Pollyanna. I told her about the day where I sent him the nasty email after processing, and it bothered me for several days after. She talked a bit about how the way she does EMDR is different somehow to Pollyanna, so that shouldn't happen to the same degree, "but I can't say that with certainty, of course."

She asked what it looks like when I get in that emotional place. I told her it is like I'm shut down and that the emotions take over. She clarified a bit what I meant, and I started discussing the prefrontal cortex (because this is who I am as a human being apparently).

This led to a conversation about the idea of wise mind. She actually had a white board and drew out a Venn diagram to discuss the whole thing with me. It was hard not to internally critique the way she was teaching it to me; I needed the lesson to be scaffolded. But more frustrating than that was how foreign the concept seemed to me. How much I was struggling with it, how stupid I felt, and how not Pollyanna L is.

Something we kept coming back to in the conversation was how I suppress my emotions, and I felt myself doing that as we spoke. I wanted to run out of the office and cry. I was holding back tears.

There was a lull in the conversation at this point; likely I was dissociating or too wrapped up in my emotions. "What kind of thoughts are you having right now?"

"In this moment? I don't want to be here, and I feel stupid that I'm getting upset over a f****** Venn diagram."

She responded with how it's important to work at my pace, and how it seemed like I needed to work on or reinforce some soothing techniques before we try to do heavy lifting. Like with Pollyanna, we would need to build trust.

It was toward the end of session at this point. She wants me to fill out a DBT diary card to track my moods this week. I've been booted from vacation, so I decided to turn the whole thing into a mini project and bought my first bullet journal after I left.

As we were wrapping up, she said that if I wanted to email her between sessions I could. She wouldn't always reply to content, but she'd at least acknowledge receipt. And we confirmed my standing appointment going forward: Tuesdays after work.

You have big, important therapeutic goals. I'm in awe of them in writing all together like that.

But Venn diagrams, to me, sometimes try to make sense of something that is non sensible, at least in the present moment in its application. Just because you can draw two overlapping circles doesn't mean that their intersection (in application) works in real life.

My kid had a therapist for awhile who liked to jump up and write things on the whiteboard. He hated it; I thought it was kind of cool but also that writing words like "balance" didn't really make more of a difference in just saying them. "It's like he's a teacher," my kid said, which is probably more revealing of how he feels about teachers than anything else.

I like learning new concepts or greater nuance about things I know a little about, as it helps me learn about myself. Learning has definitely been a part of my therapy. What's often painful for me about learning is the neighborhood where I think you are, which is when things don't make sense to me. I feel like I can deal with anything, as long as it makes sense and I can understand it. About myself I can usually get to self understanding, about other people or events, not so much. I've had to give up on the fantasy that everything makes sense if you just understand the world people are operating within.

I realised that not hurting myself is directly because of my OH and if left alone things might be different. Then I was sad because why can't I ever feel worthy without some else's approval?

T yesterday. The classical music was really loud in the waiting room, so when he retrieved me I said they had the music turned up to 11 today. He went to fix it while I went back and sat down. He came back, we discussed what might have happened with the music (maybe one of other practitioners). Then he said, "Hello." Me: "Hello." We ended up discussing football and other sports for a bit as I internally debated whether to tell him about a dream I'd had involving him the night before that was somewhat intimate. But seeing him and talking made me feel nervous about sharing it.

I said I was considering what to talk about. He asked if I felt we were done with our discussion last session about H. Me: "About the possible autism or sex stuff?" T: "The first one." Me: "No I don't think we're done talking about it." T: "I actually expected to get an email from you after session." Me: "I thought about it, then figured I'd be seeing you today, so I didn't." T smiled. Me: "See? Progress!" T agreed.

I talked about a date night Friday where I felt like I was being oddly quiet and like I was trying to analyze H. And that I'd looked up info online and tried taking a few quizzes on his behalf, but wasn't sure how to answer parts. T: "That's exactly what I was afraid you would do." (I wanted to be like, "So why did you suggest that to me?" but resisted.) I said how in one quiz, an awful lot of the stuff seemed to apply to me. So then yesterday I found this post on women with Asperger's, listing some common traits, and an excessive number of them applied to me, so went down a bit of a rabbit hole." T: "LT, you're not on the spectrum." Me: "Yeah, my friend said the same. And that the list was BS." T: "She's right."

Me: "OK that makes me feel better. She also asked me why it would matter if I was." T: "I'm not sure how I feel about that question." Me: "What do you mean? I just said I thought it would help explain me more. She asked that about H, too." T: "Well, I tend to feel that the more information you have, the better. Like they say, knowledge is power." I said I did see why she asked me the question, like what was I trying to get out of it. And he seemed to understand more.

I said how one thing the quizzes ask about is stuff related to sensory processing disorder. And that I'd realized I had some of that when I was researching stuff about D. How I'm really sensitive to bright lights, certain sounds, certain food textures (part of why I'm a vegetarian), and certain smells. Me: "Like the smell of fish really bothers me. Or frying butter, like if H is making pancakes. If I smell that, it makes me feel really sick and get anxious." T: "Frying butter--I've never heard that one before!" Me: "Oh great..." T: "Yep, that's a new one. I've heard cooking grease." Me: "Well, you've learned something today!"

I said something else that came up in there is executive function issues. I mentioned a few things, like trouble paying bills on time, not being able to get organized or keep house clean, etc. T said that could just be an effect of anxiety, having trouble focusing. I said maybe, but it seemed like so many things I ticked off. I have lots of trouble filling out forms, always afraid I'll mess up (T said could be fear of people being mad at me). And how I can try different methods, like making lists, putting alerts on my calendar, etc. But none of those things work. I forget if it was those examples or something else I said. But then T said: "OK, that's not anxiety, that's executive functioning stuff." Me: "Like an executive functioning disorder?" T: "'Disorder' seems like such a sad word." Me: "Uh, OK, executive functioning issues?"

We talked about how many people have trouble with those things. And how my mom made it seem like there was something terribly wrong with people like that, such as my aunt, who could never pay bills on time. I said it made me feel like there was something horribly wrong with me that I couldn't seem to do things like that, to get organized.

H came up again, and I said I didn't really know how I could figure it out. T was saying that he can generally tell within a half hour of talking to someone if they're on the spectrum. I said I wished we could come up with some excuse to have H come in for a session with me, and then T could kind of evaluate him while he's talking. Me: "But...I guess that would be kind of unethical, like no informed consent." T agreed that it's not the best way to handle it. He said if we were in marriage counseling again, could be a place to address it. He said he supposed I could possibly ask ex-MC what he thought. I said he was likely to dismiss it, how he also met our D at one point (full session) and didn't think she was. T: "Yeah, and he doesn't tend to like putting labels on things either."

I agreed and said how once I'd gotten upset with ex-MC because we were talking about, I think, whether D might have ADHD in addition to autism. And ex-MC had said generally people don't have multiple diagnoses, that one thing explains it. And I had said, "So are you saying someone can't have OCD, generalized anxiety, and recurrent major depressive disorder?" (referring to my diagnoses). I forget what he'd said. But yesterday T said how he completely disagreed with that, how in the DSM V, under each diagnosis, there's a section on comorbidities (conditions that tend to occur along with that condition). Note: I do not plan to ask ex-MC if he thinks H could be on the spectrum.

I forget how we ended up on this topic--maybe because of New Year's?--but talked about changes I wanted to make. And I brought up drinking again. Talked some about how to set attainable goals, breaking them down into smaller parts. He gave example of, you wouldn't want to just say "I'm going to eat healthier" because it's too broad. But to start with little things like "I'm going to stop eating candy." Or "I'm going to eat two cups of vegetables a day." He said that I should make the goals like what they have on an IEP (individualized education plan, which my D has for school), where it says "75-80% of the time, the child will meet x goal." I said that was a good way to think about it. That I shouldn't expect to meet goal all the time because then I'm kinda setting myself up for failure. He agreed.

Talked a bit more specifically about numbers, way I could set goals, some of which we've discussed before, but helps to discuss again. He asked reasons why I wanted to cut back, and I said health and also to set better example for D. And also financial. And that I'd lose a bit of weight, so we were discussing how many calories are in beer. He said it also has no nutritional value. I said I think Guinness has iron. T: "Is that the dark one?" I kinda laughed (since it's pretty popular) and said, "Yes. H drinks it but I don't like it." I also was talking about calories in, say, a double IPA, and he looked puzzled and was like, "What's that? An IPA in a big glass?" I said no, just one (India pale ale, hoppy beer) that's higher alcohol, like 8% (compared with, say, Miller lite at 4.5%).

At the end of that conversation, I joked, "Hey, maybe I could take up crack to stop drinking!" T: "Well, it doesn't have any calories!" I like that we can joke about things like that. I said maybe I could think about the goals thing over the next few days and discuss more Thursday.

Was time to stop. Confirmed Thursday, T looked at his phone and said, "We're back to a regular schedule next week!" Schedule the following Monday/Thursday. He was asking about New Year's plans as I went over to pay, mentioned going out with the same couple we've seen past few years, that it would be fairly low-key. T: "So probably no bail bonds needed?" Me: "No, I don't think so!" Paid, shook hands as he said, "Have a good New Year's Eve." Me: "You too." (no "take care" this time).

Trigger Warning about SH/SI/SA.....

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Saw T today after our week and half break. I had talked to him over the phone on Sunday so he already knew about Hs grandmother dying and that we went to her funeral. T asked how it was going and I told him it was all crap, crap and more crap. He asked me to explain further what I meant, so I told him about what happened on New Year's Eve with H and I drinking and Told him that I had stayed up until 5am that night afterwards and SH because I was so upset at myself. Told him I went and got it checked out at urgent care yesterday and they just glued it together. He asked me if it was around the same area I usually do it at and I told him yes. He also askes me how it was feeling today and if the spots ever bother me. I told him the only one that's ever really bothered me was my ankle. He asked what the doctor had to say about it, and I said he told me to read a Western philosophy book about how other religions view suffering. T corrected me and said it was probably Eastern philosophy and I agreed. I told him that I didn't tell the doctor the whole story about the SH and that I just got drunk and SHed. T made a comment about how the doctor had to have seen the other scars given the location, and I said Yes he did but that I didn't explain the situation surrounding everything. Told T that the Dr sent me on my way. Told him that the only reason I went to that urgent care was because the last time I was there for SH was in 2016 so I figured they wouldn't send me to the ER like the last urgent care did. After talking about that part T asked me what led me to take out the anger on myself about what H had done. That was a really difficult talk because I mentioned my SI. I'm not sure if what I said worried him but he mentioned words like life threatening and how he worried that if H does it again that I'll act on those thoughts.

We talked about other options that I have like kicking H out and why I feel like SI is an easier solution. We basically spent the entire session on talking about that incident, how I am blaming myself, and options. I was surprised to see that we didn't end until 5 till when usually he stops right at 10 till...almost to the dot. After he told me that we'd have to stop there for today, he said that he didn't know if he had mentioned it yet but he has availability tomorrow if I wanted to come in since we didn't get our Monday session or if I just wanted to wait until Friday. I told him yes, I'd definitely want to come in so we scheduled that and I left.

Good luck!

I had a T session yesterday. I was sitting in the waiting room, and I realized it was 15 minutes past when the session was supposed to start and 15 minutes before the office staff leaves for the night. I thought if she hadn't shown up by the time the office staff left, I would leave too. I see my T at an office where there is a bunch of T's and PDOCs and they share an office and office staff. My T works late though so usually she is the only T there after 7 PM and that is when the office staff leaves. So eventually T came to get me, before the office staff left, and she asked how my Christmas was. I said, "Good." Kind of shrugged. I wasn't there to talk about my Christmas per se. When we got to her office she wanted to know how the hallucinations were, particularly the auditory hallucinations, so I told her that I had heard voices but not that frequently since I had last seen her, but that I had more trouble with visual hallucinations in the past month. So we talked about that and about what I "see" and whether or not it scares me. I told her that it had been (trigger for mention of SH) she seemed pleased that it wasn't too frequent. I forgot to tell her that I was upset about it, because I feel sort of defeated by it. We talked a little about why I did it, and I explained I have been feeling more depressed and how it helps lift my mood for a while. We talked about the Christmas and New Years breaks and how I do better when there is a routine and how I need to plan things next time to help me not get so depressed. We talked about (mention of Christian religion) We talked about my depression and my former T and how I miss her and how it was worse over the holiday. She asked me if I had been in contact with my former T which made me feel weird. Like I was betraying new T if I had been in contact with former T. I told her that I had emailed former T at the beginning of December and had texted her Merry Christmas with a picture of my kitty on Christmas Day and had received a text back the next day saying that former T had a good Christmas and kitty was growing. We talked about the progression of former T's illness and the T that I saw during the summer that did CBT Therapy and how it didn't really work for me because I don't have a lot of negative self talk for one, and two, being on an anti-psychotic is a very powerful sedating sort of medication so my mind usually feels blank and I have trouble recalling my thoughts. And new T said yes, she didn't think CBT would be very helpful for me. We talked about why I thought I was depressed and I couldn't really say. So it was time to go and I was putting on my jacket and she said next time we would try some eye movement technique. And I couldn't really think at the time, but I wanted to ask her if it was EMDR or something else because I think you have to be thinking about something troubling you to do EMDR. But I just said, It might not work, and she said, it might. And we left it at that. Kit

The therapist retrieved me. She asked how I was. I said I was grumpy. The therapist said she was feeling a bit grumpy, too. She said I was the first person to actually show up for my appointment today. This surprised me and I made some comment about rudeness. She said thank you and agreed. We sat in silence. I complained about how my sister didn't come to stay with me since she was off work, and that she had instead stayed home to enjoy her roommate's guest dog.

We sat in silence.

The therapist finally asked me what I wanted to talk about today. I decided against anything major. I told her I want to make C let me get the ear piercings that I want. We talked about that a little. The therapist said maybe I'd be allowed to do this since I'd been helping out with stuff and had stopped doing a central problem behavior. I didn't say anything, which I guess made her suspicious. She asked for confirmation that I had been behaving. I said kind of.

She seized on that and questioned me until I admitted that I had been engaging in part of the problem behavior, though not the worst part. The rest of the session was spent on this issue, with the therapist repeating her typical refrain that we need to figure out a better way for me to manage my anger.

I told T that needing reassurance as we enter some hard things is part of who I am. She told me that she wouldn't always reassure me the way I wanted. I said this felt hard to talk about and she replies boundaries always are, as soon as boundaries were mentioned I floated off in my brain somewhere and it was time to go.

T didnt so anything wrong but I had a childish impulse to throw her "you are enough" rock on the floor. I wanted to tell her just to eff right off. I'm not sure what all of this means. I'm sure it's fine but I stress ate half a pint of ice cream anyway.

Feelings suck

AND she inadvertantly called me dumb.

*sigh* I'm sure I'm just getting angry to avoid talking about things I need to talk about

Can you say, "I want to throw this rock on the floor"?

Yes and she would respond nicely I'm sure. It only increases the urge lol

We arranged session times for the rest of the month.

Me: "That's 7 sessions in one month"
Her: "I know"
Me: "Will you be able to stand it?"
Her: "I don't know, we will have to wait and see"
Me: ...
Her: "See you next week"

She is a very rude old woman.

T yesterday. I was really nervous because a few days ago, his wife's post showed up in a Facebook group I'm in (related to kids with special needs). I'd emailed T about seeing the post and said how I hadn't clicked on her profile. His response praised me for my restraint, how he really appreciated that I hadn't clicked on her profile or looked at her past posts in the group. I initially just thanked him for understanding, but then yesterday, I felt this overwhelming guilt because I *had* looked at her past posts in the group. So I'd emailed T admitting that and asking him to please not terminate me. He replied last night saying we could discuss today and "Of course I'm not terminating you." Which made me feel a bit better.

Though I still felt nervous for session. In part because he tends to share what he's feeling about things I say or do--he says to help me understand how other people in my outside life might be reacting to me. So I worried what he'd say about this, even if he wasn't going to terminate. So I had trouble looking at him as he retrieved me and when I first sat down. I thanked him for email reply the night before. T: "I was hoping you'd be able to get some sleep." Me: "Well, I got some but was still awake a lot." T: "I'm sorry."

Me (crying a bit): "I feel almost like I should apologize for my email to you--it probably seemed so pathetic. I just had sort of this meltdown yesterday. Your first email to me, you were just praising me so much for my restraint, and I didn't deserve that. I just got consumed by guilt. You gave me much more credit than I deserved. You thought I was better than I am, and I couldn't deal with that." T: "It's OK, you didn't really do anything wrong."

Me: "But I feel like I did. And that email I sent you, I know it was coming from a very young place. It was like...OK I feel this is an extreme comparison because my parents never did this, but the best way to describe it is:

I know that probably seems like a screwed-up thing to joke about, but I think it helped kinda break the ice and make me feel less scared.

Me: "I guess in a way, it's like something got put right in my lap" (referring to his wife's post). T: "I agree." Me: "But I feel like I should have been able to put it to the side and walk away from it." T: "It would have taken Herculean strength to have done that. I probably would have done the same thing in your position." Me: "OK, thanks, that makes me feel better." T: "And people, including my wife, should realize that nothing they post online is truly private." Me: "Well, this was in a closed group, so not totally public, but yeah I understand what you mean."

Me: "Also I was honest with you that I didn't click on her profile. I'm worried you won't believe that." T: "I believe you." Me: "OK, good. I mean, I don't even know if there would have been anything in there to see, or if she had most set to private." T: "I don't know. I'm not on Facebook." Me: "I know, you've said that. I also worried you wouldn't believe that I got the notification in the group, that I didn't go looking for it. But I checked, and I've been in the group 3 years." T: "I believed your account of what happened." Me: "OK, good."

T: "Just so you know, my wife decided to leave the group." He said he'd just told her that a client had seen a post. I made sure he hadn't said anything identifying about me, and he confirmed he hadn't and wouldn't. I said I was wondering if he would have told her to block me. T: "No, I couldn't do that." Me: "Because it would require revealing my name and that I'm a client?" T: "Exactly." I said I felt kinda bad if his wife had to leave a group she was involved in because of me. He said she told him that she wasn't really that active in the group anymore, so she just opted to leave. That I don't need to worry about it.

I saw we had 20 minutes left and suddenly started sobbing. Me: "So I know you probably have anger or frustration to express to me. I don't want you to do that in the last 5 minutes of session. So, just go ahead and have at me, lay it on me." T: "But I'm not angry with you." Me: "You're not?" T: "No. I have no reason to be. And I think you've beat yourself up enough already." Me: "Yeah...OK, good." He said he wished he hadn't seen what I had, but wasn't angry about it.

Me: "Do you want me to share what I saw?" T: "You don't need to tell me. Most of the posts were older, like from a few years ago, right?" Me: "Yes, so I know, any information might not still apply. And like, if certain diets or supplements were tried, that could have been for multiple reasons, like allergies or something. OK, I guess that gives a suggestion of something I read. I mean, some of it was just things she'd shared from other groups, so no information there. But if you want me to be specific about what I read, I can." T: "Why don't you just see how you feel going forward?" Me: "Like if I think something could be affecting our relationship, then I could share it?" T: "Exactly." Me: "OK."

I did say how I'd been worried before talking about certain possible treatments for my D, worrying he'd think they were kooky or something. Then I saw his wife was in a biomedical treatment group. That if I'd realized they supported that beore, then I'd have felt more comfortable talking about it. T: "Didn't you realize by my comments about it that I was OK with it?" Me: "I guess, eventually. But at first I was concerned. Like this was a case where having a bit of information would have helped me."

T said how some of this is about protecting his son's privacy. I said it's not like I'm going to tell people about his son. T: "Well, you already have." (referencing a few people I talk to from PC nonanonymously). Me: "OK, good point, but the chance of any of those people having anything to do with your son is extremely slim." T: "You never know." Me: "True." T: "I do choose to have his picture on my desk, so clients see that I have a son. And that he's 11. And that he needs glasses." Me: "But he could just be wearing glasses for the look." T: "Well, that would say something about him, too!"

He said whatever is shared in therapy is mine to do what I want with. I could share all kinds of negative things about him, give him a 1-star review on Yelp if I want. Me: "I kinda doubt people trust Yelp for therapy reviews..." He said how he has to hold my confidentiality, but I have no similar obligation to him.

He said again the thing about what I thought about his son felt to me like a connection between us. I said yes. And that I struggle with the therapeutic relationship at times because it's so one-sided, it's unnatural. T agreed that it's not a natural relationship, but said it's important for it to be that way to keep the focus on me and my issues. How, if I know too much about his son, that I'll feel I should ask about him, and that takes the focus off of me.

T: "I'm just going to use a random example. Say, I get migraines." Me: "I do too, I mean, I don't know that you do, you're just using an example." T: "Right, but if I tell you I get migraines, then you might feel obligated to ask how I'm feeling. You're a nice person and if you don't ask, you might worry I'm thinking, 'What a b****, she's not even asking how I'm feeling?'" Me: "But if I get migraines, too, then it might be easier for me to talk about them, knowing you have them." T: "But me talking for 20 minutes about my migraines isn't going to help you. I can talk about yours and support you with that whether I get them or not. I hope you don't end up getting a migraine from this..."

Me: "Me, too. OK, I see. But I know you said before that I can't care about you because I don't really know you. Yet I feel that I can care about you in terms of what I do know of you, of who you are to me." T: "Yes, I agree with that." Me: "OK, good."

We were almost out of time. I started crying again. Pointing to him, then to myself, I said, "So, we're OK, right?" T: "Yes, we're OK." Me: "Good. I think so, too. I was just really worried that I'd messed things up." T: "You didn't." Me: "OK. Thanks for understanding."

Confirmed Monday and Thursday, and went over to pay. Shook hands and he said, "Have a good weekend." Me: "Thanks, you too." T: "Take care." Me: "you too."

LT--I'm glad T session went so well and that he was understanding and not hurt or mad. I didn't think you did anything wrong and it sounds like he doesn't think so either. Well done! Kit

Thanks, Kit! I think I was mainly worried because we'd just recently had the conversation about his son and he was saying how what ex-T had said might no longer be accurate. And then I saw previous postings by his wife that suggested how, at least at one time in the not-too-distant past (like a few years), it may have been accurate (based on what his wife had posted and what I know about biomedical treatments for autism and other conditions). So I felt I had violated a particularly touchy area for him. But like you and he said, I didn't really do anything wrong. If his wife posts in groups like that, there's always a chance a client could see it (including a particularly curious client like me...) I really appreciated how he handled it.

That was a touching session write up, LT. He handled it really well, and seemed to zero in on how scared you felt. He seemed to give more ground to your bond- that you can care about him .

Yeah, I feel like he's understanding and becoming more comfortable with it lately. I think he now understands that he may need to take a different approach with me than with most of his other clients. He's seen what helps me and what hurts me and is adjusting accordingly. I feel that's a sign of a good T.