I’m not sure I even want to get better

Has anyone else ever felt like this? I’m afraid my therapist is going to get sick of this attitude and abandon me.

First I need to put out there that I have never felt what you are feeling. I have always felt very driven to find healing come hell or high water.

If I told my T I wasn’t sure I even wanted to get better I am 100% sure my T would not abandon me. He would have more reason than ever to hold on for me until we got through this. Now, if I was telling him this through behaviors he may confront me on the behaviors. If I could have the courage to tell him he would feel both very sad and very excited. He would want to know why I wasn’t sure I wanted to get better, the why would be really important for him to understand. Am I more comfortable being depressed? Is there benefits to being depressed for me? Do I think I don’t deserve better? Am I scared because better is unknown and new? Am I just not ready yet?
My T would welcome the question and stay by me. I hope your T will do the same.

Yes and according to my T it is very common. I felt like it because I was afraid of having to let go of her (she has assured me many times that that doesn't have to happen - she won't stop seeing me just because I feel better) and also afraid of letting go of my past and my emotions. It is common for people to want to hang on to difficult emotions and experiences because they don't know who they will be without them. It's like having to recreate ourselves new - and change is scary for people. I don't know if any of this fits, and there are countless other reasons for not wanting to get better, but I'm sure your T will have come across this before. Try to talk about it and explore the possible reasons.

I have never not wanted to get better but I have and currently am afraid of getting better only because it is new to me. Change is scary.
I do know that my T would and will refer me if I am not improving and am not willing to committ to getting better.

He always says that if there iscno improvement within a year then it is his ethical duty to refer me because he is obviously not helping me. While he says this does not apply to me because he always sees me working hard to get better; he also explains that the no progress rule is mainly aimed at his BPD vlients and those that just come in every week to blow off steam or talk about their week fir support because he says those clients are not getting any better.

In a sense, yes. It was more about not wanting to change certain things rather than not get better.

This is quite embarrassing-but I actually liked being dependent on him for a period of time. Child parts that were frozen in time wanted to be present and remain present. Changing meant they would sort of dissolve, integrate. It was a loss, for sure. Sometimes I wonder if I was better off having those child parts emerge from time to time, but they are gone now. I wasn't able to express myself while growing up, so I still struggle with the loss sometimes.

No I am very motivated to get rid of this anxiety and I don’t feel like she’s going to abandon me. I was thinking of moving 3 hours away anyways to be closer to family and that’s much more important to me.

Are you sure it’s you not wanting to get better? Do you enjoy feeling how you are? If no, then I think you want to get better. The path might scare you and be difficult but that’s different than not wanting to get better. #beenthere

I think that change can be scary in general, even if it's for the better. So it makes sense to me that you're scared to get better. Maybe this could be something to bring up with your T? Is it possible you feel you don't deserve to be better? Like you don't deserve to have a happy, fulfilling life? Just a thought, because I've had those feelings at times.


I've found I tend to struggle when my T will comment on an improvement in me. I don't think I realized that until he brought it up. I haven't quite figured out what that's about (especially considering I got upset with ex-T when she suggested I had *not* improved as much as I should have), but I think it can be a fairly common reaction.

I have felt this way several times. For me, it has been an unfortunate symptom of a deep, hopeless depression, not about me as a person and what I actually wanted. But I could only see that in hindsight. When you're in the thick of it, it can feel like it's very true that you don't really want to get better. (Your depression is a dirty, dirty liar, FYI.)

You don't want to get better? What is it that you like about "being sick"? What is it about now that you prefer over "being better"?

Thank you so much everyone for your thoughts. I really appreciate y’all so so much.

I think that “being sick” means that people have to reckon with my pain. It means that I don’t have to pretend to be okay. It means that people are gentle with me (sometimes, at least). It means that people see and understand how much harder it is for me to get through life and work compared to people who aren’t sick. It means I can curl up and give up. It means that I deserve care from people.

I’m not saying that these things are right or logical, but it’s how things feel right now.

I'm not sure where to put this, but I have been thinking about your T and what might be happening here. Is he the uber-intellectual academic type? I recall you reading scholarly articles he referenced, and it seems like he is sharing some of the theory he subscribes to in terms of why he thinks your treatment should proceed in a certain way. I have heard people on PC reference "supportive therapy" before in contrast to something that is more insight-driven. I know that my T sometimes can't find the right balance between comfort/containment and pushing me forward. Is there some kind of conflict around this type of thing with him? He seems like he wants you to get better, but maybe you feel on some level like he is pushing you too hard and you're reacting to that?

I am, perpetually, all about the warm fuzzy therapeutic relationship. The mirroring makes me feel like I'm okay, which makes it easier to tell myself that I'm okay and actually believe it when I am distressed. I am wondering whether you have it in your head that being ill makes you bad, which makes you feel bad about yourself and more ill, which just causes you to spiral down?

EM, I think you're right on the money as usual. He is very much an academic; just finished writing his first book and sometimes sends me psychoanalytic articles to read (the last one was Fairbairn's "Endopsychic structure considered in terms of object-relationships"). (To be fair, I have an interest in psychoanalytic theory.)

I've been asking him for comfort and containment (literally using those two words over and over again) for weeks now. He seems to struggle to provide those things, or maybe I struggle to feel those things from him. Either way, I end up feeling deprived, bereft.

I think he needs to back off and provide a safe holding environment until I can manage to get a little stronger. He thinks we need to push through and do the work so I can feel better.

I think your conclusion is insightful. Having knowledge is one thing; applying it appropriately is quite another.

Hope you get the containment that you need until you get stronger.

I do like Fairbairn.

Im starting to think, its not about being a better version of where i am now, because thats built on a false premise, a false self. I need a whole new chassis. Detroit metaphor. Sometimes when they did the summer model changeover, the factories would close for 3 weeks, or 3 months, depending on how big a difference the new model year car was from the previous year. A headlight and taillight change would be 3 weeks; a chassis change - longer shorter etc - 3 months.

Last night i poured mac n cheese over some steamed cauliflower - not mixed together. It looked beautiful. But it was completely different from how i ever had it before. I was like, where did THAT come from?

Eta - my point is - this is after leaving ten years of supportive therapy. I couldnt do this while i was still seeing him. And i couldnt do it right after i left. You are trying to heal a huge wound. IME, this is not acknowledged in common therapy. Its starting to be, in CEN. Is he up on that?

I'm not sure if this is the same thing but sometimes I am ambivalent about stopping SH. I want to, but part of me doesn't want to. Part of me is afraid to give it up because it's the coping mechanism that has always worked, but if you ask me what my goal is for therapy, it's always ending SH (among other things). I don't know what the ambivalence is about....

DBT also sees suicidal thoughts as a misguided coping mechanism (not unlike self-harm or substance misuse), which I find oddly reassuring. You are likely resorting to thoughts of ending your life as a way to calm your distress by imagining what it would be like to not be in pain. It would probably be safer and less scary to have other coping thoughts and strategies instead, but being suicidal (and trying like hell not to act on it) kind of makes sense when you see it in that light...

Ah, yeah, this makes total sense. I like reading about psychology and therapy, and my T sometimes suggests things or discusses things, and we nerd out together in a minor way, but most of the actual change comes from a completely different emotional place. I am usually using the theory to try to reassure myself cognitively that the scary new feelings are normal. It seems like maybe you are connecting intellectually but he is missing you emotionally (sometimes anyway, and maybe particularly when you feel especially vulnerable?). It is possible that he doesn't know what he doesn't know -- like a musician who reads music beautifully but doesn't feel the music in their soul.

This may seem a crazy question - but is it possible your chosen profession has anything to do with this? Like - do you really want to practice medicine but can't quit or change because of time, debt, perceived loss of status, how it would look, pressure to keep doing it etc?
I see this with law students/brand new lawyers a lot. The practice of law is not what they expected or enjoy but they can't figure out how not to do - and they go through a lot of angst - some get hospitalized or super psych drugged up just to get through the day. It takes a lot of support and encouragement from us to help them see that stopping is not a failure and that going through life hating what you do is a bad way to live. There are a lot of things one can do with a law degree or medical degree besides practice law or medicine. And it is not a failure to stop.
Just throwing it out there as a thought.

Not crazy. Huh. I hadn't thought of it like that. This all started while I was in med school, so I guess time-wise it's not impossible.

I do love the practice of medicine (though not the 80h/week thing that is required in residency), but the idea of making a mistake and causing someone permanent harm scares the bejesus out of me. So I dunno.

I'll have to think about that.

He's said before that he's not a "naturally nurturing" person, and when I've asked him for comfort or containment in the past he's often said that it needs to happen spontaneously, that he can't just conjure it up. He also worries that too much active comforting on his part might be too "activating" for me (I think he means in an attachment sort of way). It's maddening.

Earlier today I sent him an email that included this: "I might be imagining it, but it seems to me like we’re having something of a tussle wherein what I want is comfort/containment and what you want is for us to push through this difficult material so that I can start feeling better. Does that ring true to you?"

I'm hoping he and I can use this as a jumping-off point to discuss this difference in what I need and what he's providing. I really hope he can figure out how to get his nurture on because I really feel that's what I need.

That sounds like a really good email. And makes me think of some stuff with my T, where he's said he's not "warm and fuzzy." Lately, since I've returned from the brief termination, he's seemed more comforting, but I'm scared that's going to go away, which is part of what came up today in session. I feel I've made more progress during the past few months when he's seemed a bit more nurturing. But I'm almost afraid to call attention to it, because then he might be like, "Wait, what am I doing? Must pull away!" Honestly, the realization that he's apparently still married (wearing wedding ring again after like 9 months) threw me for a loop, like in the sense of maybe he was being more caring because he was lonely or something.

But I digress. I hope your T can understand that he needs to provide the support and containment for you to face the more difficult stuff and move forward. How it's not either/or, but both together. Hugs...

I think of my T as having multiple facets/parts, and there is definitely a nerdy psychologist part and a mother part and a bossy businesslady part and probably a few more. It seems like maybe your T doesn't have the parental side to himself (or it's very underdeveloped), and it's good that he seems to know that about himself. I can see where he would feel like he can't conjure up comfort if he isn't feeling it because then it would likely seem forced and awkward to both of you.

As a parent myself, I think that comfort/containment urge comes from feeling empathy and a deep connection to this little creature in distress. My toddler's catastrophes rarely seem that upsetting to me, but I have this thing inside me that pulls me toward her and makes me want to lend her some of my stability and okay-ness and to hold her until she feels better, if I can. To me, that's pretty similar to what happens in the therapy sessions that have the biggest emotional impact, even though the two situations look quite different on the surface. But the therapist has to be ready to go there on a fairly intense emotional/relational level, and this just might not be that guy.

There are probably people who can heal more through insight, and my experience of therapy is likely not typical. It just seems like you're reaching for something that he can't provide, and the longing and emptiness you feel are reactivating intense responses that likely have roots in childhood trauma. I don't know what the solution is, but I hope you can find some solace in the idea that I see your pain and I think it is understandable and valid.

Loved EM's post.

Me too.

It reminds me of Winnicott’s image of soothing a child with an earache by holding her—you can’t make the earache go away but you can offer a comforting presence.