Three times a week

After several months of sporadically adding a third session as our schedules allowed, my therapist and I finally found a standing weekly slot for a third appointment, and it feels like a much bigger deal than I thought it would--maybe something about seeing all those appointments stretching out for months on my calendar, maybe I'm just feeling weird about being someone who goes to therapy this much every week (even though I think it's a good idea and I've been going three times a week about half the time since February or March). Either way, yikes.

My therapist did specifically say he thinks this is going to heighten my general ambivalence about therapy, and increase the ways that ambivalence shows up in the transference. Which is interesting and terrifying at the same time. Therapy is so bizarre. How is it possible to be this eager about something and this put off by it all at once?

I have no clue; but 3 times a week did change things for me. It brought ambivalence and hate/anger to what was a mostly loving state. The missing/needing feelings also changed from a longing to a more manageable need/want place.

I've been going twice a week for a year now, and I sometimes feel sort of guilty about that, and that I need to start going less often. At the same time, I don't want to (and am somewhat scared to decrease to, say, once a week.) So I understand the mixed emotions. I hope it helps you.

I definitely experienced that change to needing/wanting being more manageable when I went from once to twice a week, so it'll be interesting to see what happens this time. We've already been dealing with a ton of ambivalence, so an increase in that would (will) be quite something.

Understand that feeling. My T said we were just getting into stuff when it was time to end the session. So he extended session to an hour and a half. That worked better. Welcome to the forum.

Thank you! I really empathize with that. I've been going twice a week for about a year and a half, and at first I felt really guilty about it--like I was cheating someone else by taking up two slots, wasting my therapist's time, and wasting money that I wouldn't need to spend if only I could somehow magically deal with everything myself, without therapy (or at least with less therapy).

I think that guilt finally decreased over time as I realized how much more useful material I was able to address by going more frequently, but it took a while and obviously I still have a lot of ambivalence about therapy in general. Honestly I think a lot of people would be better off with twice a week and might realize that if they gave it a try, and I wish it were an option for more people--I've gotten so much further and been able to open up so much more than I think I would have at once a week. Why do you feel like you should be going less often?

I'm realizing that part of it for me is knowing some people think going to therapy three times a week must mean someone is really ill, or going through a crisis, or otherwise dealing with something terrible. And I'm not--I'm doing well overall, no catastrophes.

Interesting, glad that worked better for you. I don't think my therapist would ever be up for that, but I could imagine it being helpful. Actually, he did mention the fact that we've been going over time nearly every session as something he thinks is a sign that more sessions would be beneficial.

I started going twice a week early on with my current T about a year ago. Now I'm going every day Mon- Fri unless one of us has a schedule change. I am ambivalent about it, too. On one hand I like it but the other I feel guilty that the time isn't spent with another client.

That's really great. And very relatable. I've had the same thought about taking up time that could be spent with another client. Especially since I know my therapist isn't taking new clients right now, so the slot I'm taking up could go to someone who's currently stuck looking for a therapist. On the other hand, as my therapist has pointed out, he gets to decide how to spend his time.

This is interesting. I’m curious how going 3x/week would heighten ambivalence. I’ve never heard that before and am wondering why that is.

Ambivalence about therapy has been a frequent theme within therapy for me--I often feel guilty about going, or like it's self-indulgent, or like it's selfish to take time away from my work responsibilities to go to therapy. Or like there's something wrong with my seeking help or relying on my therapist in any way. I suspect that he's right that going more often will bring those up even more (it has in the past to a certain extent). So I don't think it was a general statement about increased session frequency heightening ambivalence, just an observation that he expects this particular theme and issue to intensify for me as therapy gets more intense.

Got it. I’ve had tremendous ambivalence from day one for many of the reasons you stated. Not sure it increased when I went from once to twice/week though.

That's really interesting. For me I think the ambivalence flares really obviously when I'm initially discussing adding extra sessions or increasing frequency, then shows up in different ways once things are actually happening.

Is it important for you to figure out why you have this ambivalence? I didn’t expect to have it when I started therapy because it was my choice to start therapy, but it has been incredibly strong. For me it may be some guilt about setting time aside for myself and allowing myself to be the center of attention which can feel really self-indulgent. It sounds like that might be at least partly what is happening with you. I’m curious how the ambivalence shows up for you.

I expected the ambivalence--I've been in therapy multiple times and have been deeply ambivalent about it every single time--but didn't anticipate how it would show up this time around. With my first good therapy experience, I spent the first 6 months berating the whole concept of therapy nearly every session, before grudgingly settling into things. With every subsequent therapist, I spent more or less the whole time wondering if going was helpful or worth it, being unsure if the therapist was competent (made more complicated by the fact that several ultimately really weren't) or a good fit, and having a lot of trouble justifying the time and money involved.

With this therapist, I'm very sure that he's competent and helpful, to an extent that is really strange and unusual for me. I've only seriously contemplated quitting once in 2.5+ years, I never cancel sessions or consider canceling unless there's a clear and unavoidable work conflict, and I've made therapy a high priority in my life in some concrete ways.

So the usual ways I express ambivalence aren't happening. Instead, I show up to my session and my mind goes blank. Or I'm struck with a sense of terror that makes it impossible to speak. Or I silently berate myself for only having unimportant, trivial things to say. Or feel guilty that I'm taking my therapist's time away from patients who are more deserving, or for taking my time and attention away from my patients.

I seek out extra sessions, but then when I get there I start berating myself for being needy, and for not being able to resolve my issues on my own. I get into issues I've never addressed before, and then have to contend with an aggressive backlash of feeling like I've committed a terrible crime by inflicting those conversations on my therapist. So really that's the crux of it: realizing my therapist is helpful and trustworthy is terrifying, because it brings up all of my fear and ambivalence around the idea of ever relying on other people. It brings up every way I was taught from childhood onward that burdening someone with my feelings is grotesque and unacceptable.

I should add that all of this is stuff I feel like I'm working through in productive ways, and my therapist has been incredibly supportive and reassuring about how difficult it is for me to open up. It's pretty amazing, at the same time as it keeps being extremely challenging in new and unexpected ways.

Sorry to seem dense, but are you able to explain how you are able to work through this is productive ways? I feel like I’ve been ambivalent for quite a while and although my therapist is supportive I’m not sure that we’re doing anything to “work through it.”

Have you or your therapist had any thoughts about what's behind the ambivalence for you?

Part of working through it has been working around it--finding ways to talk and stay engaged in therapy on the whole in spite of it. Part of that work has been respecting it, and recognizing that the limits set by that ambivalence are there for a reason. Which doesn't mean those limits are a permanent fixture, only that it's not healthy (most of the time) to try to just pretend they're not there.

Part of working through the ambivalence has been talking about what other things it brings up for me, and tracing some of that back to older experiences and childhood. So recognizing that there are significant reasons I have so much trouble relying on people, and exploring the difficult experiences that underlie those reasons.

Some of it has been just working on letting my therapist in on what's going on when I get stuck. Either in the moment or after the fact. Talking about the specific thoughts and feelings that come up, and letting those be a part of the picture. Which has yielded some interesting insights into what's actually going on and what feelings are being evoked, rather than just the cognitive side.

An update--going three times a week has been really incredibly helpful. It's difficult at times, both in terms of the amount of time and energy it takes, and in terms of the intensity of emotions it can stir up. But it is really amazing how good it is to be able to get into so much depth and detail, and work through so many things as they come up. And having the solidity of three regular appointments feels very different than the sporadic 2-3 I was doing before.

I'm really lucky, and I wish this type of therapy weren't so unusual. Everyone who wants to should be able to try this. I hope I'm able to stick with it and see this through.

I hope it helps you, too. And y'know, right now, in this space my head is in, if I could afford it, I would go 3 times a week.

seems like everybody here uses private therapies or terrific health insurance. Most MH consumers are lucky if they see their pdoc once every month and many check in every 6 wks for a medcvheck.

I see my therapist 3 times a week, but insurance only pays for one of those. I'm seeing a psychologist, though, not a psychiatrist for meds.

The norm in my country is weekly if you are unstable and then maintenance at 2 weekly to monthly intervals I have never heard of anyone see a T more than once a week.

Yes, I'm definitely aware of how lucky I am to be able to access this. I was on the less lucky end of things for quite some time, where I could only afford therapy every two weeks at most. Or the time period when the only psychiatrist I found who took my insurance would only see me every 6 months for 15 minutes. It seems incomprehensible by comparison that now I see my therapist this often, and it's hard not to feel guilty about it at times. I also worry my luck will run out and my insurance will stop covering it, but I'll cross that bridge if/when I get to it.

It shouldn't be this rare though. This type of therapy is far more helpful for me than previous therapy experiences have been, and I wish it was available to everyone for whom it would be helpful.

The norm in my area is weekly. Twice weekly is unusual but not completely unheard of, and more than that seems very rare. I don't actually know anyone else in real life who does three or more sessions a week. Unless you count my therapist, who I believe sees his own therapist three or four times a week.

But then it's not like anyone I know (besides my partner) knows I go to therapy this often either. So for all I know I do know others, but none of us are talking about it.