In Session Today: Part VI

In the (as then unknown) final session. Her: "I want to stay with you. I am here."

In the final email. Her: "I know this is unexpected. I am sorry to tell you in this way."

Liar.

Therapy went as well as it could go with me being sleep deprived and super hangry. There was a bad joke I made she seemed to just ignore. A word vomit question and then conversation about the current events. Basically I felt weird but it was probably just me. I came home and ate some soup and I'll probably forget about her and the session in a few hours.

I met with this therapist today. My "current" one was not there. This therapist was super pissed my therapist cancelled on me when I was already there and she was even more upset that I thought I did something wrong.

She's a big LBTQ ally. Shes about 15 years older then me. A great age. I did not find her physically attractive which is good. She is very honest and open. She does emails although I learned my lesson from my transference T about those. I did agree to work with her. Although I'm still on guard because of all the other times I've gotten hurt. She was understanding though and showed zero judgement. A bit of a blank slate but an honest one. She seemed super eager to work with me. It went well. I am not feeling good physically so I have to do a bit of fact checking but yeah she wasn't creepy or a bigot or unproffesional like the others.

Therapy went well. I like her although I do sense a tiny bit of fakeness but just a little. She shares the same poltical views and beliefs that I do which is a big deal. There was a slight scheduling issue at the end. I had set up an appointment with her for next week and then when we walked up to meet my mom my mom reminded me I had a doctors apppointment that day. Which we had already rescheuled. I see so many doctors I can't keep track. I felt like my therapist was a bit annoyed. Shes going to email me another time. She said absoultly go ahead and email her about how my new med is like. So yeah overall it went good today.

T yesterday. We'd met Sunday (weird schedule this week), but he'd had to switch to virtual at the last minute (not Covid-related), which upset me, so a good part of Sunday's session was spent on that. I felt rather unsettled after that session, so I asked if we could meet Monday instead of Tuesday.

I said I hated how I reacted so strongly to things like last-minute changes to virtual. That I wanted to just be fine with it. But because it does affect me, then we have to spend time talking about that, so it's time I can't spend talking about other stuff. And I feel like things keep happening.

Me (through tears): "It just feels like any time I start to feel safe or secure with you, something happens." Dr. T: "Switching to virtual makes you feel less secure?" Me: "Yes. I'm not sure why. I think because when it's a last-minute change, it's hard to trust that it won't keep happening. Because back pre-pandemic, that would have been a cancellation. But you never cancelled. So now that it's happened a couple times, plus your having to work from home a couple days next week, without saying why for any of them. I mean, I know, you have the right to privacy and all that. But...it just worries me, of course in part because of ex-MC."

Dr. T: "If there was anything going on that I thought could affect our work together, more than one session, even if it was like a 10% chance, I would tell you. I may not give you any specifics, but I would let you know it was going on." Me: "OK, that helps to know." Dr. T: "Did ex-MC not do that?" Me: "No, he just kept canceling." Dr. T: "He should have said something." (This was before I knew what was going on with his sick wife, obviously.)

He said, "It feels like the only way I could make this better for you is to not ever go on vacation or take a day off." Me: "But I understand you deserve to go on vacation." Dr. T: "I know--you make it very clear whenever you mention it. And I believe you. But I can tell you wished I wouldn't go. It's like you're speaking from your head, but your heart feels something else." Me: "Yes. This will sound cliched, but it feels like I'm a little kid clinging to her mother's leg at daycare drop-off." Dr. T: "That's exactly the sense I get. But I mean I don't know how to help you with it other than to not go." Me: "But I also know you need breaks to be a better therapist."

Dr. T: "You're right. I went for months without a vacation. And I don't think I've told you this before. But I do feel that I haven't been as good of a therapist." (I was unsure what to say to that, as I actually felt like he'd been a better T to me since the pandemic.)

He also said that it has felt like I've been pushing him more lately. Me: "What do you mean? Can you tell me how you were experiencing that? I honestly want to understand." He mentioned about my pushing more for in person, being bothered by virtual, etc., but didn't really give specific examples.

I said how it felt like things had gone generally smoothly while we were only virtual, just a couple minor conflicts. But that we've had considerably more conflicts/ruptures since we've been back in person. To the point that I wondered if maybe I should just switch back to virtual. Dr. T: "You mean like just do virtual for the next 6 weeks, with the weird schedule?" Me (crying): "Yeah...but no, I don't really want that."

I said how it felt like all the conflicts had something to do with in-person vs. virtual. I mentioned the texting thing in that (where I sent brief texts before session to confirm in-person, and he was originally fine with it, then told me it had become irritating).

We talked about that more. He said how he found it very difficult to reassure me then. It seemed like everything he tried didn't help me feel better, and he wasn't sure what else to say to let me know that it wasn't a big deal to him at all. I said, "Maybe I just needed you to say, 'everything is OK'--wait, I think you did say that, and I guess it didn't help."

I said how when my brain goes in a certain direction, it's difficult to turn it off. Dr. T: "Are you aware of when that's happening?" Me: "Yes, but I'm still not sure how to stop it." Dr. T: "So it's difficult for things to penetrate at that time, like to get beyond the intellectual and into the heart?" Me: "Yes, exactly."

Me (crying): "I wish I could just be OK with this, with your going on vacation or switching to virtual or whatever. I wish I could just trust that I'll be OK, that I'll get through it, that things will be OK here." Dr. T: "I think that's basically the definition of secure attachment." Me: "That's part of what's so hard for me--I'll start to think I'm securely attached, then some small thing happens, and I'll realize I'm not."

He said for now, maybe it's partly about just accepting that the next 6 weeks or so would be difficult for me. That I'll struggle with it.

He also said something that's sticking with me: To try to think of the relationship like climate as opposed to weather. How there might be a storm in there, but the overall climate stays the same.

I said I felt good about our conversation and asked if he felt OK about it, too. He said he did, adding that he wondered if this could have a therapy grenade effect (where it feels fine in the moment but is upsetting later when I think about it). That I was welcome to email if it did (I haven't, though I typed up a few thoughts in Drafts).

The thing that stuck out to me is he seemed to be trying very hard to understand, both what I was feeling and how to help me. And he wasn't at all defensive. It felt like we were both very open and honest with each other.

Today went ok. I was so checked out and tired to the point I was basically dissociated the whole time. I'm not totally sure whats up. I feel kinda bad for not putting in the effort I should have. We talked about my dysphoria mainly. She said I had the perfect body type for a guy because of my broad shoulders and thats why stores like Hollister were good for me to shop at. Idk. I don't really like comments about my appeareance. I was just out of it the whole time and I still feel out of. Like I swear she switched offices but she said she didn't. But I don't know if I'm having a complete head **** or if shes gas lighting me because I swear we werent in the same office last time. She asked me on our way out if I had eaten anything today and I said not really and she told me I should. I did eat a bit after but I'm not very hungry. I did find out the thing I did eat that made me sick I'm highly senstive to. So I wasn't mucking around for no reason today. She swears like in F bombs which I don't always like and I was talking about urinary rentention and she told me to stick my finger up my you know what to massage the area. Like dude that word causes dysphoria. But eh I think it was just me today being too senstive.

I do not like your T(s) commenting so much on your appearance/body type. It really screams bad therapist-ing on my part.

A lot of people comment on my body type and appearance and the way the way I dress, whether they should or not. My pdoc told me I looked great after all my surgeries and my weight loss and I've had coworkers ask how much I weigh. Its annoying but at least my therapist wasn't being creepy about it the way some other people have.

That bothers me as well. In part because I don't think they would make that sort of comment to someone who is not trans. Though I'd be bothered about them talking about my appearance in general (whether saying something positive or negative), unless maybe if it was something that I brought up.

I think of once, early on in seeing my T, when I talked about the amount of beer I was drinking at the time. He replied, "How do you stay so skinny?" (Beer is pretty high in calories.) I didn't say anything at the time, but it bothered me. (Also, I'm not skinny!) He hasn't said anything about my appearance in years (I'd call him out on it at this point if he did). But a couple years ago, he did describe a former (female) client once in rather unflattering terms. I told him that did bother me, and he apologized. Hasn't done it since.

I once had a kid say to me in 6th grade "Mountaindewed you eat so fast but you are so skinny!" Like is that supposed to be a compliment or something?

Had a good session today, I mentioned to my Therapist that the Mother of a former Therapist of mine either worked there in the past or still works there now, although she declined to say anything else.

I feel bad that I didn't seem to put in the effort today. I was hungover from taking my melatonin too late and also my stomach and anxiety were off this morning so I needed some zofran and valium and stuff to calm it which helped my stomach and anxiety but didn't help me being hungover. We talked about stuff but I was just so out of it I felt like I could barely get my words out. She said she saw me at the grocery store and it took her a minute to recgonize me and she said she thought I was just some dude shopping. Man I hate running into people I know and a therapist would be on the top of that list. She said it was on Monday but I think she has either her days or her stores confused. But basically I feel like I'm making all my progress on my own outside of sessions and then just shooting the breeze with her while strungover on meds when I'm in sessions.

Therapy went pretty well last night. I wish it would have lasted longer--it was about 50 minutes...but it was one of those times where I could have kept on talking.


I feel fragile and stuff. It is hard coming out of IP and straight back into regular life. I don't know if I explained that well enough to T.


And I am struggling with a lot of shame and disappointment and embarrassment about having to go to the hospital again. I know I shouldn't feel this way but I do.

Had a pretty good session with my Therapist today, looking forward to next week.

Had an abriviated but good session today, we talked about many different things.

I had probably my best session today with her. As we were walking to her office she said she had been thinking about me last week and wondering how I was doing. We talked about my vacation and I was honest with her that I slept about 12 hours each night and brought my own food to eat but that I did participate with my family and they noticed a difference in me. We talked about my name change and I told her how it went and I told her about the super nice secuirty guard who gendered me correctly but called me "buddy" she said "you look so young you look like you could be a teenager. You don't look like you are almost 30." I talked about my pdoc appointment next week and how at one of them he told me the Ukraine war was possibly the end of the world. She was really pissed about that and said he shouldn't be saying that. She said he sounded like a jerk. I told her I was so focused on the Ukraine war but that stuff like Monkeypox and Polio werent bothering me and I said I think its because of my pdoc and she said "yeah it sounds like thats what happened." So she basically thinks my pdoc tramatized me. I mentioned transference T a bit but not a lot. Just that I had a therapist who sometimes would take her bad days out on me and then the next week say "it wasn't you, it was me." I then said that I gave that therapist a Iot of credit because she was the first one I came out to and she gave me the resources I needed and she helped me out that summer during covid when I had no idea what was going on" I didn't mention much else about her. So yeah today was pretty good and I was focused.

Today’s session began with a recap of my medical procedure. R understood my frustration at the lack of explanation, and I thanked her for understanding why I got in touch.

‘I knew from your email it was something you struggle with. How are you feeling now?’

We talked about it some more, especially the fact that I had essentially chosen to have it done.

‘Can I hear a very faint “I’m proud of myself.”?’

‘Maybe. I think I am proud of the way I handled it.’

I explained that having something physical going on puts me in a different mental space. ‘So I wasn’t really able to access the space I needed to be in to do that [work on the support system diagram]. The day I sat down to work on it more, I received an email from one of my favourite grief coaches. He’s gradually stepping away from social media, and moving his video content to a platform that nobody’s ever heard of.’

This led to a conversation about the importance of access within my support system. In order to feel like someone is there, I have to be able to reach out to them.

‘If somebody’s in my support system, and I know that they have something going on, I’m less likely to reach out to them.’

I spoke about how I wasn’t aware of the sheer number of roles Steve seemed to fill for me until I did the support system diagram.

‘There was a lot wrapped up in your loss of Steve.’ R went on to list many things we had spoken about. She then asked me how I felt when looking at the diagram.

‘Most people wouldn’t need to do something like this to know who their people are.’

‘You’d be surprised. What are S.L. specific spaces?’

‘Suicide loss…’

I then read an excerpt from last night’s journal entry in which I talked about some of my difficulties with a specific space.

‘Even though I’ve spent the last 14 months adapting, I still feel out of place in those spaces. Steve was my friend, and there are many people grieving inner circle losses.’

‘Try not to minimise your grief over Steve.’

I went on to explain that the purpose of the support system diagram was to help me update the Wellness Plan I made in 2017. R said she hadn’t come across a Wellness Plan before, so I said I’d show her next week.

When we spoke about my medical procedure, I remarked that everyone present had said ‘Well done.’ – ‘I didn’t do anything.’

‘Sometimes well done doesn’t mean well done for doing something.’

‘This is new information for me.’

‘Well, that’s my gift to you.’

Our breathing focused on releasing any tension that had built up in relation to my medical procedure, or anything else.

Had a good session today, for some reason I keep bringing up old Therapists of mine which she says is OK.

She chewed me out a bit today. Not in like an angry way. More like in a frustrated way. She just had a slight tone. She told me I look a bit too thin and I am eating way too few calories. She looked up a calorie caluclation thing on a mayo clinic site and said according to my age height and weight I need to be eating 2050 calories. I haven't been losing any weight recently so its just how my weights been distributing so its not really anything I've been doing weight wise. I do know I've been eating too few calories but its been due to both medical and pysch meds I'm on. They make me not hungry. Anyways besides that we talked about my possible nut and egg allergies and what could have possibly triggered them. She thinks it could be transition or surgery related and I was wondering the same thing. We also talked about my pdoc appointment tommorow and she is glad my mom is coming in with me. Which makes me a bit nervous she thinks he is going to yell at me again. I had some head **** brain zap episode thing 5 minutes before the end of the session and my voice was cracking and I was having trouble getting my words out. I think it was just from not sleeping well and talking for 40 minutes. I guess today went decent overall.

Of course the first thing she brought up was my weight. I said I was eating 1600 calories. She said thats not enough. I said I was literally trying really hard. I then had to explain it was not intentional and I was eating entire jars of apple sauces and table spoons of peanut butter. She thought the entire jars of apple sauce was interesting. Then I mentioned the other stuff I've been eating and she layed off. I said my size did bother me and I didn't want my coworkers to start gossiping about me being this small 30 year old guy. Especially when I look like a teenager. Then we had to have that whole talk about guys come in many shapes and sizes that I have had a number of time with people. I told her the stuff my last therapist had said about my appeareance and how it bothered me. I told her I wasn't trying to throw her under the bus but it just bothered me. My T's eyes flared up and chewed the other one out some more. She said "I was so pissed at her about what she did and I feel very protective of you." Ehhhh. Not sure how I feel about that comment. Makes me feel like shes bordering on countertransference. After that we just talked some more about my worries. She said it seems like I have a lot. I told her I didn't take my prestiq since it makes me tired. She said at the end to keep emailing her because she loves reading my emails... so I guess today went well. When I got home I realized I had barely eaten today so it was probably more that then anxiety.