Couch 231: Live Long and Prosper!

I feel like I want to cry but I don't cry.

Thanks for your response, EM. I’m a bit confused, though — which sorts of moments are outside the window of tolerance, the ones where I’m all frustrated and about to cry and just frustrated AF, or the post-“I love you” flabbergast?

It was really interesting (at least to me haha); my response to him saying that was an immediate interruption in the circling bad thoughts and a sense of calm and groundedness. It shook me out of a state of abandonment panic that I wasn’t even really aware I was in.

I think earlier in the therapy, him saying that might have been overstimulating — probably would have scared me (d/t trauma hx involving my dad) or made me overly joyful (d/t countertransferential stuff about wanting him to care about me). But now it’s just like, yeah I know he loves me. I love him. It’s all good. It was nice of him to say it, and it was useful of him to say it in that moment because it interrupted a spiral of panic about abandonment. But I don’t feel the way I would have about it a few years ago. Does that make any sense?

Anyone ever just feel emotionally exhausted? I think that is how I am feeling. It makes me feel physically tired too but I think I am just emotionally exhausted....drained.

Absolutely, Kit. You're managing a lot right now, and it is perfectly understandable. (Might be a good starting point with IOP T, which would provoke a useful conversation.)

HUGS

Thank you Lost, that's a good idea.

Today in awkward therapy moments. Dr. T: "How are your anxiety medications working for you right now?" Me: "Um...actually I'm not currently on any anxiety medications. I mean, I'm taking magnesium and some other supplements but not anything prescription. I was on Zoloft but I stopped that a while ago because I didn't think it was helping. I'm pretty sure I told you?" Dr. T: "You probably did. I haven't looked at that section in your chart for a long time."

Me: "OK, I mean, maybe I should get back on something." Dr. T: "I wasn't trying to say that, I was just wondering." Me: "OK. I mean, I probably should contact Dr. S..." Dr. T: "Only if you want to. I'm not trying to pressure you to do that, I was just curious." Me: "OK. Maybe I'll call her Monday."

Note to anyone reading this and wondering: I have tried a long list of psych meds over the years, most having side effects that canceled out any benefit or made things worse (for example, Prozac really helped depression but sent my anxiety through the roof; Cymbalta and Effexor at different times made me much worse psychologically, etc. etc.). Zoloft helped somewhat for a fairly long time, but then kind of stopped. I'm generally very sensitive to meds, so that makes it more difficult. I took the Genesight DNA test at one point, but don't think the results were all that accurate (as some it said were fine/relatively safe for me...weren't and vice versa).

I definitely understand this and am feeling a bit of it right now myself... I'm not sure if it shows itself this way in you, too, but part of it for me is that seemingly minor things can really set me off, either crying or sometimes snapping at people. Things that wouldn't normally affect me much. Plus just physical exhaustion.

Random thing first: I really appreciate the phrase "post-“I love you” flabbergast."

And I know I'm not EM, but I think it's good that you're reacting the way you are, both now a bit after the fact and in the moment. It suggests a level of trust in him that you can immediately calm when he says that. And that you're seeing it as just part of the relationship.

I assume you mean that a few years ago, it would have felt like a much bigger deal, him saying it?

Also, hm, maybe this can be a sort of lesson for him for the future, where if you start spiraling, he can know how to stop it? Not even to necessarily say the L-word, but just some sort of reassurance.

I hope it goes well, Kit. Try not to put so much pressure on yourself for the session. If you don't remember everything, it's OK.

Hahaaa, thanks LT — I actually meant to ask you and the other grammar folk about the optimal arrangement of punctuation there

Yeah, a few years ago it would have been a huge deal — I would have been both utterly terrified and utterly delighted, and it would’ve thrown me for a double-barrel tailspin.

He actually did say to me that if I need to hear that he has positive feelings towards me, I can tell him that. I’m not sure what to make of that given that in the past he has been extremely reticent to reassure me… we’ll see how this shakes out.

Oh sorry, I meant the part where you're frustrated and overwhelmed. I tend to have changes in posture when this happens, like my shoulders get all hunched up and my entire body tenses. That's a sign that I'm kind of psychologically overheating and not really able to do "the work." It happened recently, which I guess is why it was on my mind.

Oh, and Dr. T was right--the insurance company is denying my neck (C-spine) MRI, saying I need 6 weeks of conservative treatment first and also an x-ray before they'll do it. Just heard from the imaging place, and they're faxing the orthopedist. She said I should call there Monday to see what to do. So perhaps it will be physical therapy or a chiropractor (or massage therapist? apparently there are different types, also per Dr. T--one advantage of having a sports psychologist as my therapist) for me.

I'm sorry your MRI got denied LT. It seems like insurance companies are always doing that nowadays.

Individual therapy with IOP T went okay. We discussed what happened last week and this week since she's seen me in detail, of course paying special attention to when I relapsed including the two hours before I relapsed. I've never had a T be that precise with it and want to know that kind of detail. Of course you wanted to see the wounds. I knew this would happen! I feel vulnerable and unprotected now that I showed you. I'm sure that I could have refused but IDK what kind of trouble I would be in if I refused and I am a people pleaser so I showed you. I never feel like it's bad enough. I know now that I should have done more. Of course she kept her response very clinical and gave me some advice on cleaning and taking care of the wounds which I know I just haven't given a flying **** about.


We talked about the verbal warning I got from R about the relapse and how next time it would be a written warning. And how that scares me enough that I don't think there will be a next time while I am in this program. Can't say about afterwards, but while I am in this program I have to abstain because I don't want another consequence. I forget the word she used, it wasn't protective factor but it was something like that. Like the consequence is a positive reinforcement or some such nonsense. The homework she gave me was hard but I did it and sent it back to her via email and she said, Well done and went on to say a few words about it. That was nice.

We talked about perfectionism and self care. And of course about the hallucinations. I don't know why she is more worried about the SH than she is the hallucinations. For me it is the other way around. She asked me if she was being empathetic enough and I told her she was doing a good job. She told me I'm delightful. That was kind. I told her that S is tough, the IOP therapist I have tonight. She's intense and she's tough. She doesn't put up with anything. I'm a bit scared of S actually and I know that her session will be intense.


We talked about shame. That was hard. I kind of feel myself getting attached to this T even after only two sessions. I'm like don't attach! You only have maybe a few sessions with her. She's just short term! I really wanted to hug her which was impossible as we were on Zoom and she was at her house and I was at work. But I had that urge to hug her. Odd.


I guess it was a good session. I feel overwhelmed and a bit shaky. HUGS would be great if anyone wants to give me one. Kit

Thanks, Kit. From what I'm reading, x-rays can show a fair amount, and they freak me out a lot less than an MRI, so maybe it's a good thing in a way?

Hugs to you, Kit. Sounds like a really intense session. I think the concern about the wounds and care is somewhat common--I had a pdoc who was like that at one point, where it seemed very clinical.


I hope the IOP goes well tonight and isn't too overwhelming.

Hugs Lemoncake - ditto what Kit said you are absolutely not a ****up you are a sensitive, warm, loving, and caring person of much value. I'm so sorry you're going through all of this.

Big hugs, Kit. That does sound like an intense session. Shame has been a big topic for me in my therapy. Sometimes it can feel very overwhelming.

Sorry your MRI got denied, LT. But it sounds like from what you had also said that it might be a bit of a blessing in disguise? Maybe the treatment will help? I know it's different but physical therapy has really helped with my shoulder a lot. Shoulder pain hasn't woken me up at night since I started doing the exercises. It still gets a little sore from time to time, but nothing like the blinding pain that woke me up at night before I had it x-rayed and went to PT.

Thanks, Artie. I was actually surprised in the appointment when he went right to the MRI. I guess H had an MRI of his shoulder first, but PT really helped him with that, too.


My neck issues are really affecting my sleep as well, so anything they could do to help would be good. I'm glad your shoulder pain has gotten better!