[arielawhile]

Hi everyone! I wondered if anyone has experienced what I can best describe as a therapy hangover. Like I go to therapy, have a decent session. But when I leave, I suddenly feel...jittery, anxious, a sudden and/or urgent need to contact my therapist, weird, any or all of those things. Usually, I leave therapy feeling fine. But the last couple of sessions...

My session, itself, is usually unremarkable. Some humor. Some awkward bits. Nothing devastating. My therapist and I have good rapport. Maybe I have a small case of "I should haves," after session, but it's nothing major. Still I end up feeling so restless and...

What does it mean? Time to wind up therapy? Something is going haywire within therapy? Or I've become too dependent on therapy? (And yes, I'm going to ask my therapist, but that's in a week, and I'm resisting the urge to email.)

Thanks!

[Xynesthesia2]

Originally Posted by arielawhile

Hi everyone! I wondered if anyone has experienced what I can best describe as a therapy hangover. Like I go to therapy, have a decent session. But when I leave, I suddenly feel...jittery, anxious, a sudden and/or urgent need to contact my therapist, weird, any or all of those things. Usually, I leave therapy feeling fine.

I experienced similar a few times and my sessions were also usually nothing really hard. I wondered what caused those states and the closest correlate I could come up with was that it happened when I felt dissatisfied with the session, sometimes because I was hiding/avoiding something, I just would have liked to continue the conversation with the T, or felt that the T was not engaged enough. I often did email the T but it didn't really help (whether they responded or not), the feelings just went away after a few hours.

[Lilly2]

Sometimes I'd have those "therapy hangovers."

It would usually occur under two conditions, maybe more:

1. If the session dealt with tough trauma issues and/or "me" issues.

or

2. If the session felt unproductive, dissatisfying, or harmful.

Under the first condition, I'd ruminate about what I shared, what I should have shared, what I felt I should not have shared, what the therapist thought, what the therapist is going to do next week, and why the therapist brought it up during the last half or quarter of our session, which didn't give me enough time to process that with her/him to begin with. I felt like such sessions should allow enough time and room to process, and such sessions should be planned well ahead of time. Some T's will allow for a double-session or time-and-a-half session in order to go through a series of trauma processing. It may cost more, but it's better than experiencing a therapy hangover. And then there are times when the therapist would have non-trauma-related issues brought up, such as when you're working on changing a behavior pattern, or when you're dealing with an interpersonal conflict. In those cases, it may not be traumatic, but a lot of what is processed requires time to unravel. Leaving the session too abruptly may cause this. Again, better planning and forewarning on the part of the T should have been in order. Overall, there should be a tapering down during the last 10 to 15 minutes of the session, where reflections about the session could be made, and where affirmations and goals for the week could be discussed. Therapy isn't easy when you're dealing with life-changing strategies, and even identity-changing ones. It's not healthy for anyone to leave a person hanging without some beneficial closure at the end of the session, meeting, etc. The end-of-session process should allow time to debrief and room to feel safe before leaving. Why leave the T's office upset, shaken, wet from tears, or "retraumatized"? That's like a friend bringing up a bunch of horrible things and then saying, okay, gotta go, seeya next week! Would you want to see a friend like that again? No. Or, if a boss calls you in, tells you all the crappy things that have happened, or all the crappy things that you've done, and then says, I've gotta go, got another meeting, see you next week for our one-on-one. Would you feel comfortable working for a boss like that, who wraps things up in a de facto manner without first considering what his/her words would mean to you, to your production, to his/her business? No! In the same vein, T's should not wrap up their sessions with trauma or life-chaning processing. There needs to be a period of time to debrief, not the 5-minute: Well, we've got 5 minutes left, tell me how you're feeling speech. 5 minutes is NOT enough time to debrief. Asking for what you need in therapy is your right and your boundary.

In the second point I made, I feel therapy hangovers whenever I have felt that the session wasn't productive. Maybe the T was late, too preoccupied with answering phone calls, or inconsistent from what was discussed the previous week. Maybe you feel disconnected from last week's session and had spent the entire session talking about everything other than what you wanted to talk about. Maybe you experienced a rupture in treatment and left feeling misunderstood, hurt, mistreated, etc. Maybe you were actually emotionally, physically, and/or sexually abused by the T. In any of the given scenarios above, you may feel therapy hangovers - the kind that makes you afraid to return to therapy, or the kind that keeps you ruminating about what the therapist was doing and why, or the kind that distresses you for the entire week because you have issues that you weren't able to deal with but wanted to. Either way, these are things that should be discussed openly in treatment and with a trusted therapist. There should be ground rules, expectations constantly revisited, goals clearly explained, accountability clearly laid out, patient rights clearly agreed upon, boundaries set from the client as well as from the T, and more. If the T is able to set those ground rules up in the beginning, and then revisit them once a month, give or take, then ruptures could be handled more smoothly, safety could be established, expectations could be met and adequately understood, etc.

Feeling icky, anxious, nervous, scared, retraumatized, depressed, or any other strongly negative emotion and/or thought pattern is not what should be happening at the end of every session.

I had a good trauma and dissociation therapist while inpatient who told me to request any T I speak with before to allow me time to debrief at the end - at least 10 minutes, if not 15. He allowed me to speak about the session we had that day, time to consider what homework I could do to make progress out of our session over the week (or over the night, since I saw him every day), and time to answer two questions at the end of every session we had: (1) What are 3 affirmations I can say about myself (e.g., "I am strong," "I am courageous," and "I am working hard toward my recovery") and (2) What are 3 positive goals I will do when I get home tonight (not for the week, but for that night, such as "I will watch a favorite show" and "I will burn some incense to make my house smell nice" and "I will go for a short walk after I eat a healthy dinner"). Leaving with a good debriefing coupled with three affirmations and three goals for the night helped me to refocus on the positives every time I left the T's office. It's a suggestion you all can make to your T's.

[LonesomeTonight]

I've had something similar. Sometimes I realized it was that I wanted to share something during session but didn't. And then I had to wait till the next session. Other times, I felt I revealed too much and felt exposed, which could make me feel the desire to check in with my T to make sure all is OK. And other times, I felt really connected to T (or ex-marriage counselor), which led to the urge to wanting to reach out to them. And I guess other times, I've just felt totally wiped out, like I used up all my brain power and emotion on the session and want to just curl up and go to sleep, or at least not do work or talk to anyone else.

[SlumberKitty]

I usually feel like I need time to decompress and sort things out in my head. Sometimes I'm activated and I'm triggered and I need time to self-comfort. Other times I'm just drained and I need time to sleep or just relax. I usually feel sort of dissociated and foggy and kind of spacey and out of it.

[*Beth*]

I'm pretty sure that I know what you mean. I'm always open with my therapist; more than anything, it seems to me that the "50 minute hour" is never long enough. Whoever came up with that, well, someone should change it. Even a full 60 minutes would be better for both therapist and client.

I am very fond of my therapist and will remain in therapy with her. My only complaint is about her memory. She sometimes forgets that we decided to talk about a particular subject during a session. Then I am in session wondering why she doesn't pick up where we left off. I don't usually say anything, only because there are always other subjects to discuss.

Another issue that causes me to feel anxious and ruminate after therapy is that my T has forgotten my age twice. Two times over the course of our therapy she has asked if I'm such-and-such an age yet. I do look somewhat younger than I am, but geez. I always have to remind her that I am 56 years old. It's annoying to me, and even hurtful.

Do you feel that you need to go more deeply into an issue(s)? I think that bringing the discomfort up with her is an excellent idea.

[arielawhile]

Thank you all for your thoughtful replies! They’ve given me a lot to mull over. Lilly, I love your idea of positive goals and will implement those. At least they should add something fun to my day. It’s also weirdly helpful to know I’m not alone. Maybe it’s problematic that sometimes we’ve stopped when I’m a little emotional? Not like retraumatized. Just a little discomposed. He goes a little over with me (55 min is a norm) so I don’t know what to do about managing time/flow better? Part of this was we had a lot to cover this session, but this has been an issue in the past. Something for us to discuss again. And there was an issue that maybe I felt too awkward to explore as honestly as I’d wish. But aren’t there always? (Ok. Maybe not. Hopefully I’ll get there!)

[nottrustin]

I have for a few reason: it was an emotional appointment and I froze during it, I didnt really talk about anything even remotely important as, or I told her something that I regretted. Occasionally I say something that while in the appointment felt appropriate, however, after leaving I overthink things and fear I came across wrong or that she will judge me.

With the exception of when I feel like I wasted the appointment. I usually try to deal with it on my own for a day or two. If I cant then I will reach out to her.

[maybeblue]

I've had this a lot. Sometimes it even happens when I think it has been a good session. Maybe it's because it's sort of the highlight of my week? So even if it is good and productive, I'm a little let down because it's over. When it is bad, as it is sometimes for whatever reason, it's worse. Sometimes I think I really need something else in my life to look forward to. This week I have a colonoscopy to look forward to, but somehow it just isn't the same.

[autonoe]

I had this experience pretty much every session during the last few months I saw my ex-therapist. I would leave feeling relieved that it was over, and but feeling anxious and dreading the following week. Looking back on it, I was afraid to say the things I needed to say, and the last few months were unproductive because of it. I developed a fear of breaking down in therapy and it kept me from touching the subjects I needed to. I would find myself putting on an act during each session, even if it was just to make myself seem "okay." It's one of the reasons I'm no longer seeing my ex-therapist.

[Xynesthesia2]

I'm glad this thread has been posted because the stories about how people felt uneasy after unproductive sessions really resonates with me. I actually consider more or less my whole therapy unproductive, and that was why I decided not to pursue it any longer in the end. Like stated by others, I regard this unproductive nature to my own patterns of not using therapy in a really therapeutic way. I used it more as a distraction from what I really needed to work on. It may have worked better with a T who really challenge and call me out on my BS and avoidance, but I did not get lucky to have one of those and then decided not to look for more. I found many other things that help resolve the issues I was avoiding, where I don't have the same attitude/behavior, and they pretty quickly turned out quite productive and satisfying - no uneasy, anxious feelings and a sense of wasting resources with those and most of them are actually free (peer support groups, working more closely with colleagues to achieve a better work discipline, better nutrition, sleep and general self-care for anxiety). But my issues are not trauma-related or anything hard to talk about that would require a high sense of safety and expertise. They are issues with motivation, discipline and some poor habits - these are all things that cannot be improved just by thinking, support and talking, I've done that for years and that was exactly the problem that fed the avoidance. They require strategy and hardcore lifestyle changes and no one else can do those for me. In fact, therapists ways of validating my poor habits and trying to make them look not as bad just added to the problem as well, it was enabling. Of course it feels unproductive then!

[*Beth*]

Originally Posted by Xynesthesia2

I'm glad this thread has been posted because the stories about how people felt uneasy after unproductive sessions really resonates with me. I actually consider more or less my whole therapy unproductive, and that was why I decided not to pursue it any longer in the end. Like stated by others, I regard this unproductive nature to my own patterns of not using therapy in a really therapeutic way. I used it more as a distraction from what I really needed to work on. It may have worked better with a T who really challenge and call me out on my BS and avoidance, but I did not get lucky to have one of those and then decided not to look for more. I found many other things that help resolve the issues I was avoiding, where I don't have the same attitude/behavior, and they pretty quickly turned out quite productive and satisfying - no uneasy, anxious feelings and a sense of wasting resources with those and most of them are actually free (peer support groups, working more closely with colleagues to achieve a better work discipline, better nutrition, sleep and general self-care for anxiety). But my issues are not trauma-related or anything hard to talk about that would require a high sense of safety and expertise. They are issues with motivation, discipline and some poor habits - these are all things that cannot be improved just by thinking, support and talking, I've done that for years and that was exactly the problem that fed the avoidance. They require strategy and hardcore lifestyle changes and no one else can do those for me. In fact, therapists ways of validating my poor habits and trying to make them look not as bad just added to the problem as well, it was enabling. Of course it feels unproductive then!

My husband had exactly the same issue. He also feels that therapy enables him, rather than motivating him. He also stopped going.

[kaleidoscopeheart]

I definitely know that feeling. I started journaling about my sessions and that helps me decompress and process anything and everything from the session. Sometimes even the ones I felt were unproductive have nuggets that I can take and use in my growth.

[arielawhile]

Just a followup on my initial post. I brought up my therapy hangover in session and asked what his take was, and he...well...he punted. The old, "I can't tell you what I think. What do you make of it?" spiel. And he showed such little curiosity and willingness to explore what was happening and maybe felt a little defensive to me? (Or maybe I was reading that because I'm hypersensitive to inflicting hurt.) Anyway, it was all very disappointing. I'm starting to wonder if therapy will ever be super helpful for me. Like many of you here, I'm a product of childhood neglect/abuse, and the trauma runs pretty deep. I'm very high functioning, upbeat, social, etc. in real life, but clearly, have major gaps internally that I'd hoped therapy would help bridge. Maybe they're unbridgeable? Anyway, don't mean to be a downer! Just wanted to update (because I love reading updates on others' posts), and thank everyone again. All of your responses were much more helpful than my therapist's!

[Xynesthesia2]

That complete lack of insight and curiosity would bother me as well. If you feel that you don't get much out of therapy, maybe take a break and see how it goes. I never believe that therapy should make a client chronically frustrated and dissatisfied, that healing inevitable goes through intense and lasting upset. Occasionally, sure, but if there is nothing else coming out of it, then I would definitely question whether it is worth spending my money and time in that way. I think there are many avenues and possible resources to investigate and heal from trauma and psychological injuries and therapy is only one. Much like there can often be a variety of treatments for a physical illness - some may works better than others, depending on individual variables. I am not discouraging you from exploring therapy further, just something to consider before doing more of the same and eventually finding it wasted energy.