[susannahsays]

I'm feeling really hopeless. Had a rupture with the therapist last Thursday. She told me I needed to "take responsibility" and try harder to be functional. I found that really offensive because I feel like I'm trying as hard as I can. Every day lately has been a monumental struggle. My goal is primarily to get through it without harming myself in some way and without doing anything to make my life worse. When I feel able, I do the things she thinks I'd be doing daily if I was actually trying hard. And she hadn't even asked if I'd made progress on anything before telling me it wasn't enough.

Anyway, I left the appointment 26 minutes in because being criticized for being depressed and not acting as if I'm fine isn't helpful. She wouldn't call it criticizing, but that's just her being in denial. Telling someone they aren't taking responsibility and they're choosing to be this way is an inherently critical statement.

Had an appointment with my psychiatrist today and now I feel kind of ganged up on. She didn't say the same things as the therapist and I didn't find it offensive, but it does leave me feeling completely helpless because the take-away is the same. I have to somehow be ok when I'm not. I say that's the message because I can't do what they ask when feeling the way I do now. Ergo I must somehow make myself ok.

All this makes me feel like there isn't really a point to seeing the therapist and psychiatrist. It's not that I think they are just withholding help from me. I don't think they can help me and they don't think they can help me, either. They've both said as much.

The reason I want to quit is so that at least I won't have to deal with the pressure of their expectations. Expectations that I can't fulfill 90% of the time. It just feels bad because they're asking for things well beyond my capacity. I don't want to subject myself to a situation where I already know I won't succeed. It's not going to help my mental health.

Plus, now psychiatrist is going to talk to therapist. I can't do anything about the narrative they've created, but it only harms me to hear about it.

Unfortunately, I can't just go off my psychotropic meds.

I don't really know what to do. I smiled and agreed with my psychiatrist but in my head I was thinking that it's just completely hopeless and no, there's nothing I can do in therapy that will have any impact on my inability to just be better. Apparently I'm supposed to "take responsibility" which translates to fundamentally altering reality. Instructions on how to perform this magic weren't included.

The therapist said if I think I will eventually kms, I probably will. Does that mean when people commit suicide, it's because they just didn't try hard enough or take responsibility? That seems harsh.

When they say I have to do all these things in order to feel better, all I'm really hearing is I'm not going to feel better. Knowing what I know, there's no other conclusion I can reach. I can't do more than I'm doing and I won't get better if I don't do more. It logically follows that I won't get better.

Anyway, I wish I could just drop them both. I feel helpless and hopeless enough as it is without also feeling criticized for being unable to "take responsibility" or make things better before feeling better. I'm not criticizing them for not helping. I understand they have a limited capacity to change anything. I just wish there was more comprehension that I have a limited capacity as well. And when you push people beyond their capacity, there are always consequences. For every action there is an equal and opposite reaction. Some people take up drinking or drugs. Other people suppress until they can't take it anymore and fall apart, destroying their lives. And of course some people just exit life.

This post isn't an attack on my therapist or psychiatrist, so I'd appreciate responses avoid taking a defensive stance on their behalf. I don't need to be educated about the limits of treatment. I don't need to be told they can't do the work for me. I don't need to hear anything about the therapist never trying harder than the client. I know all that and repeating it just perpetuates the fallacy that unlike them, I can always do more. This post isn't about placing blame somewhere, apart from not placing it all on me for not being superhuman.

I would appreciate responses of commiseration. Encouragement that doesn't insinuate I just need to try harder is also welcome.

[ScarletPimpernel]

I do have empathy for you. From what I've read, to me it sounds actually like you're trying really hard especially given your emotional/mental state right now. It sucks when people don't understand, can't empathize, and put too high of expectations on you. You know yourself best, not some doctor. If you're trying, you're trying.

L's only expectations of me is to show up, come as I am, be open and honest, and keep trying. We also have the agreements that I don't harm myself, we have at least one closure session, and she doesn't abandon me. With my PCP, our only goal right now is to quit smoking. Diet and exercise and picking we can deal with after I'm able to fully quit nicotine (which won't probably happen until next year). My Pdoc...well her only goal for me is to go back to college. But I just don't pay that much attention to her anyways. My dentist just wants me to brush my teeth. :/ And none of my doctors harp on me about my weight.

You should be able to set your own honest goals. If getting up and taking a shower is your goal for the day, then you succeeded! Taking out one bag of trash, sitting outside for 10mins, making a nutritious meal, going to an appointment, even getting out of bed can be great goals! Especially if you're in a deep depression.

I've had doctors who expect too much or didn't trust my knowledge of myself (ex-T). It sucks! I don't have any advice for you other than to be patient and good to yourself, give yourself credit for all the big and little steps you take, and hang in there.

[susannahsays]

Thanks, Scarlet.

[unaluna]

I feel like i dont understand what it is to have a clean, safe, happy home. Thats 3 different things. I get "safe" by paying a high rent in a town with good public transportation and other amenities. But that choice was kinda unconscious, and made geez 30-some years ago, altho i have re-made it a few times (moving away and back).

But clean, happy? Not really on the watsisnames list of 6 or 7 things. These things werent given to me, werent taught to me. Just like safe really wasnt. I feel like im trying to adjust to an alien environment. These suggestions might work for earthlings, but i aint from around here.

[LonesomeTonight]

I'm sorry your T and psychiatrist are being like this. My therapist realized at one point that pushing me just makes me withdraw more and/or feel awful about myself if I don't do what is expected of me, whether from him, my parents, etc. (stuff dating back to childhood). So he stopped pushing. He might mention something briefly, like, "You know exercise could help with that. That's all I'm going to say." Or when I was having agoraphobia issues (which have come and gone during the pandemic), he might ask if I went anywhere or went outside, but wouldn't push me to do that. He trusts that I know what I need to do (a bunch of other stuff in there, too), and his pushing me isn't going to help and is more likely to backfire.

Do you think your therapist and p-doc could be willing to try something like that? To back off a bit? If you say you know what you should be doing, but that their pushing does not help you and in fact could have the opposite effect. And is making you want to leave therapy.

I also get the sense they may not understand what depression can truly be like. Where you know you should do something, and maybe you want to, but you just can't. I'm sure you've tried explaining it, but maybe try to go into what goes on in your head when you want to do something but just can't? To just let them know that you're doing all that you can manage right now. The fact that you're managing to not harm yourself or not doing anything to make it worse *is* an accomplishment in itself.

Also, I've had the experience of feeling ganged up on by my ex-p-doc and ex-T/ex-MC. And it sucked. Where ex-p-doc said they wanted to put me in an intensive outpatient program, we were going to have some conference call about it, and I freaked out, because it felt like they were all ganging up on me (turned out that she hadn't even talked to either of them about it yet, and they disagreed with her). Would you consider revoking their ability to speak with each other? You should have the right to do that at any time, even if they're at the same practice.

And could you consider looking for a different therapist and psychiatrist?

[Etcetera1]

I'm really sorry. I quit therapy before where it felt harmful, I think you have the right to do that if you feel the need for it. I think where she said that about suicide was really really unprofessional and unempathetic and harsh, yes.

In general, what I honestly think is that while therapy may help some, it can also be harmful, and even though all the psychoeducation is important, there are other things too, e.g. sometimes it's just the external situation that needs changed, rather than you having to try so much to "fix" yourself. That was an example only, it could be other things too, the point is that a lot of the time the solution isn't actually about "fixing" yourself.

And I've been there before where I was so low I couldn't do things even though I wanted to. The solution, ironically enough, was to just wait, like I was getting to do things really really gradually and not pushing myself anymore with expectations, let alone expectations on the timeline of how much or how fast I should be able to be doing things.

So I actually had to learn to hold myself less responsible. Getting free of being/feeling overly responsible. It helped a LOT. Because overresponsibility also contributed to feeling low. Maybe that's what you would need too, ie. feel less responsible, I don't know.

I wish you much luck with all this!!

[susannahsays]

Thanks, LT. I don't think I'm the best communicator about what it's like to be me, if I'm honest. Like I've only recently realized how terrible I am at identifying my own feelings. "Bad" isn't really an emotion. For example, I'm terrible at separating anxiety from all the other "bad" feelings. And since I don't realize I'm feeling anxious, it's kind of hard to do anything about it. Then I start overthinking and panicking because I don't know what I'm feeling except that it doesn't feel good. I think sometimes even when I try to identify what I'm feeling, I get it wrong because it's like I only understand what a certain feeling is like theoretically. I'm not saying I don't experience other feelings, but it's all very nebulous and hard to pin down. And when I slap a label on the bad feeling and it's not accurate, that just leads to feeling unreal like I'm performing. I start questioning if I'm actually feeling anything or if I've confused how I think I ought to feel with actually feeling. I spend so much time feigning the emotions I think I'm supposed to feel that stuff blurs together and I become hopelessly confused.

I kind of forget where I was going with all that.

I don't think the therapist/psychiatrist are the problem here, so not really looking to switch. Or at least their perspective is not what's preventing me from getting better although I might find it unhelpful and unrealistic, plus rude/offensive in the way the therapist stated it. Whatever they say, however they say it, would all still come down to not having a way to help me when I'm unable to do more to help myself.

[ScarletPimpernel]

Off topic a little...When I first started to try to identify my feelings, I learned that analogies helped. I still use them currently. For example, just last night in my email to her, I said I feel like a child on the playground needing to come back to check that mommy's still there before going back to playing.

Also L is very good at mirroring, so she helps me figure out what I'm feeling.

Maybe you can tell your T and Pdoc that you struggle with identifying emotions? And if they could help by mirroring or analogies?

It's okay to struggle with it and it's okay to ask for help.

[SummerTime12]

That type of response would definitely make me feel helpless too. I’ve heard similar from a therapist in the past and it really upset me and made me feel terrible about myself. I’m sorry they took that kind of damaging approach. And it doesn’t make sense either. If they are treating you for depression (I thought that’s what you said but apologies if I’m wrong) and then say “no, you are not allowed to have debilitating symptoms of depression,” then why are they treating you? You wouldn’t need treatment if your symptoms weren’t impacting you in some way.
Also FWIW, regarding the whole “the therapist should never work harder than the client” common belief, I think therapists can sometimes use this to be dismissive and pressure clients to try to do more than they are capable of at the time. The client just showing up might actually be a much greater effort than whatever the therapist had to do to plan and interact with the client that day. It’s all relative.

Sent from my iPhone using Tapatalk

[susannahsays]

Originally Posted by Etcetera1

And I've been there before where I was so low I couldn't do things even though I wanted to. The solution, ironically enough, was to just wait, like I was getting to do things really really gradually and not pushing myself anymore with expectations, let alone expectations on the timeline of how much or how fast I should be able to be doing things.

So I actually had to learn to hold myself less responsible. Getting free of being/feeling overly responsible. It helped a LOT. Because overresponsibility also contributed to feeling low. Maybe that's what you would need too, ie. feel less responsible, I don't know.

I wish you much luck with all this!!

Thanks Etcetera, I couldn't agree more with all this. It's been hard to be less critical of myself over the years. For example, there's a time when I would have described myself as just lazy. And that really wasn't being fair to myself. But I did that because I felt judged by others. It was a sort of fawning, Stockholm syndrome like thing where I felt compelled to align myself with the idea that I have some sort of personality flaw (e.g. laziness) that is to blame. And since I can't have power that I don't, I always ended up feeling like my suffering was all my fault because I could change it if I really wanted to.

Now that I've changed my thinking, it feels like I'm getting pulled back into negative self talk and cognitive distortions by the therapist/psychiatrist. Or I'm not getting pulled back but only because I reject their assumptions.

It also drives me a bit nuts to think now they will interpret any improvement I make in the future as me finally "taking responsibility" when it's actually just the typical fluctuations of depression. This idea really bothers me.

[susannahsays]

Originally Posted by SummerTime12

And it doesn’t make sense either. If they are treating you for depression (I thought that’s what you said but apologies if I’m wrong) and then say “no, you are not allowed to have debilitating symptoms of depression,” then why are they treating you? You wouldn’t need treatment if your symptoms weren’t impacting you in some way.

Exactly! The message feels really dissonant with how things actually work. Like the therapist literally told me that the fact I can do certain things in one context or at one time in my life means I have equal capability at all times. I couldn't even formulate a response to that when she said it because it was like she said 2 + 2 = 5.

Originally Posted by SummerTime12

The client just showing up might actually be a much greater effort than whatever the therapist had to do to plan and interact with the client that day. It’s all relative.

I couldn't agree more.

[susannahsays]

Originally Posted by ScarletPimpernel

Off topic a little...When I first started to try to identify my feelings, I learned that analogies helped. I still use them currently. For example, just last night in my email to her, I said I feel like a child on the playground needing to come back to check that mommy's still there before going back to playing.

Also L is very good at mirroring, so she helps me figure out what I'm feeling.

Maybe you can tell your T and Pdoc that you struggle with identifying emotions? And if they could help by mirroring or analogies?

It's okay to struggle with it and it's okay to ask for help.

Thanks, I'll see if I can give analogies a try.

I don't know if the therapist is good at mirroring. It probably wouldn't do me any good if she was since I'm not sure my emotions come across. Except anger. I'm good at that. And sometimes disgust shows on my face if somebody says something I think is stupid. I know this from seeing myself in meetings on zoom.

ETA - Recently I've been sending her memes about what's going on with me. I guess maybe memes could give me some clues to my emotions.

[Etcetera1]

Originally Posted by susannahsays

Thanks Etcetera, I couldn't agree more with all this. It's been hard to be less critical of myself over the years. For example, there's a time when I would have described myself as just lazy. And that really wasn't being fair to myself. But I did that because I felt judged by others. It was a sort of fawning, Stockholm syndrome like thing where I felt compelled to align myself with the idea that I have some sort of personality flaw (e.g. laziness) that is to blame. And since I can't have power that I don't, I always ended up feeling like my suffering was all my fault because I could change it if I really wanted to.

Now that I've changed my thinking, it feels like I'm getting pulled back into negative self talk and cognitive distortions by the therapist/psychiatrist. Or I'm not getting pulled back but only because I reject their assumptions.

It also drives me a bit nuts to think now they will interpret any improvement I make in the future as me finally "taking responsibility" when it's actually just the typical fluctuations of depression. This idea really bothers me.

Yeah that's totally not cool that they are pulling you low rather than building you up. OK so this may be simple but important....Existing methods of analysing and evaluating objective feedback for the successful continuation of therapy are based on this simple idea, that the client regularly leaving the therapy session in a worse - or unimproved - state is very wrong and should never be ignored.

When I read about this, I felt totally validated in that it's OK to want to leave a therapist and seek another option if I find they just make me feel worse, or making me low, or I'm simply not seeing my symptoms getting better, so I'm posting it for you too, maybe it will help some. I mean if you have to fight their stuff to avoid getting low and having more symptoms, that sounds the same issue to me. Even if you are able to fight back in your mind, it's still a waste of energy and not helpful for you to feel obligated to go back to this therapist.

Just my thoughts of course, hope it helps in some way.

Originally Posted by susannahsays

Thanks, LT. I don't think I'm the best communicator about what it's like to be me, if I'm honest. Like I've only recently realized how terrible I am at identifying my own feelings. "Bad" isn't really an emotion. For example, I'm terrible at separating anxiety from all the other "bad" feelings. And since I don't realize I'm feeling anxious, it's kind of hard to do anything about it. Then I start overthinking and panicking because I don't know what I'm feeling except that it doesn't feel good. I think sometimes even when I try to identify what I'm feeling, I get it wrong because it's like I only understand what a certain feeling is like theoretically. I'm not saying I don't experience other feelings, but it's all very nebulous and hard to pin down. And when I slap a label on the bad feeling and it's not accurate, that just leads to feeling unreal like I'm performing. I start questioning if I'm actually feeling anything or if I've confused how I think I ought to feel with actually feeling. I spend so much time feigning the emotions I think I'm supposed to feel that stuff blurs together and I become hopelessly confused.

I kind of forget where I was going with all that.

That issue is very familiar to me. I learned to just wait and try to tune into the feeling later again to try and see it better. Repeating that a few times before I could identify the particular feeling a bit more closely. And so on. I did also give up on expecting too much from myself (theme sound familiar yet? ), in this area. I mean.... if my negative emotions are by default like "mad, sad, bad", so be it. Sometimes they do become more differentiated feelings and then I try to do the above process.

Also I've given up on trying to be different from what I really am like, i.e yeah when I may not be able to realise that I might be feeling e.g. anxiety, it's just because I simply am not actually feeling it in that particular moment. Like maybe it's there somewhere, sure, but like my brain is still in control enough of it for now, so why should I concern myself about it. What I'm trying to do instead is just try and be more aware of initial signs of the emotion (e.g. anxiety) coming up in situations when I decide it actually would be important to be aware of it.

I don't try to overfocus on my feelings anymore in general as I tried too hard, forced it too much and so it made me lose myself too much. Instead of learning about my feelings at a more natural pace, ie. a pace more natural for me. I find most therapists don't understand that, of course.

[Just42dayK]

I can relate to hopelessness, depression and being told to work harder in the midst of it all. My mother would tell me that I need to push myself. Struggling with depression forever, just recently for the first time I was at a place where I thought oh this is what people can do, pull themselves up. To this day she does not understand my depression and how it is a rare privilege and level of well being to be able to do what she demanded. That's tough but to be told that by trained professionals who are paid to get it is terrible. Sometimes I think people do that as a way to blame the victim because they can't, don't know how or refuse to do what is needed to help and or tolerate another suffering.

Sorry you are going through this and others understand. "Pull yourself up by your bootstraps" assumes you even have shoes.

[susannahsays]

I don't feel like going to my session tomorrow. I feel like I'm in trouble.

[Rive.]

Sometimes Ts do more harm than good. They get defensive or angry and plonk the 'blame' right onto the client's lap..

I am sorry there is no recognition or validation for how much you are trying. That is painful

[susannahsays]

Thanks Rive. Hopefully the therapist and I will be able to come to a better understanding tomorrow. As she likes to say/threaten, "we have a lot to talk about."

[LonesomeTonight]

Hope it goes well tomorrow, or at least that she's more understanding.

[Pinny]

I hope the session goes as well as possible!

[ScarletPimpernel]

Originally Posted by susannahsays

Thanks, I'll see if I can give analogies a try.

I don't know if the therapist is good at mirroring. It probably wouldn't do me any good if she was since I'm not sure my emotions come across. Except anger. I'm good at that. And sometimes disgust shows on my face if somebody says something I think is stupid. I know this from seeing myself in meetings on zoom.

ETA - Recently I've been sending her memes about what's going on with me. I guess maybe memes could give me some clues to my emotions.

Memes work! As does art, music, poems, etc. You can always use other's words to describe what you're going through.

And I hope your session goes well too.

[susannahsays]

My session seemed to go fine and I accepted her apology. I am realizing that I didn't actually address everything with her. We didn't really talk about it at all except for her doing what I knew she would do and saying she didn't mean to be critical. I think maybe she thinks being critical is always outright malicious. I stand by my opinion that her statement about taking responsibility is inherently critical, but we may be working with different definitions. At least she didn't say she was sorry I felt that way, which is what really drives me nuts.

I guess I still did have my say about everything she did that made me mad since I sent her a link to this post. So probably not necessary to dissect it further.

She talked to my psychiatrist who is apparently concerned or something because I seem to be doing worse, especially in comparison to before I started working with the therapist. Which was like yeah duh. Everything got bad when I moved away for school and then got even worse due to the pandemic. And then lately I think it's been worse due to a combination of a depressive episode and not having much to do at work yet having to account for how I spend my day.

She seemed shocked that my psychiatrist said I had developed something about driving. My psychiatrist described this as a fear but I feel like it's more a very strong aversion. I don't feel fearful that something bad is going to happen when I drive beyond the unpleasantness of being stuck in the car and how much I hate that. Leaving the house feels like more of a fear because I mostly feel anxiety rather than dread.

But the point is I've mentioned how much I don't want to drive and the lengths I go to avoid it plenty of times. Maybe I wasn't clear how much I hate it.

Anyway, I don't know what all they gossiped about. I say gossiped because I've gotten into the habit of describing things in ways to provoke the therapist. I wondered if she told my psychiatrist that I stormed out of the session, figuratively, and was angry. I didn't ask though because I don't think I want to know if she told her that. Feels embarrassing even though I don't think my behavior was wrong.

Also the psychiatrist described my job before I went to school in a way that made the therapist describe it as "prestigious." I didn't really know what to say to that. The pay definitely wasn't what I'd expect from a "prestigious" posting. But there was a lot of responsibility. Maybe that's what she meant?

The therapist really has a hard time pronouncing the psychiatrist's name. Today she butchered it several different ways which made me feel fortunate the worst she's ever called me is Suzanne.

[Jelzig65]

Just to mention my daughter is autistic and her Psychologist who has a specialty in Aspergers, just told her to get over her social anxiety and get out there and join the world so to speak. Some professionas are just winging it I believe and can be hurtful. Give yourself that break. I know that feeling when you say, you feel like you are in trouble, its confusing, because its unlikely you have done anything wrong. If they walked a mile in your shoes, they wouldnt say some to the things they can and do.