Couch 249: The Self Care Couch

Thanks, Lemon. I think you're right. But I'm struggling knowing Dr. T initially didn't want me to meet with her and that I'm probably going to be extremely limited in how often I can see her going forward. So, if she does really help, it's rather bittersweet.

So I'm pretty sure I'm having a major depressive episode. I haven't been on psych meds for a couple years, but Zoloft helped me before. There's a site where you can provide info about your symptoms and medical history, plus a request for a particular medication (no controlled substances), then they'll send it to the pharmacy (so it's legit medication, and insurance will cover the medication itself). They have apparently already sent it to the pharmacy.

I do think some of this may be hormone-related, as I'm in perimenopause. I was reading on one site how the most common age for women to experience hormone-related major depression is 45-49. I'm right in the middle of that. So maybe that's part of what's going on? Bonus that SSRIs are supposed to help with hot flashes, which have been affecting me lately (my sleep in particular). So, fingers crossed this helps some...

I do wish Dr. T might have registered that this could be a depressive episode, as I've dealt with them before, including earlier on while seeing him...

Glad to hear you're covering all bases, LT.

If there is a hormonal component then it's good to have something else to help.

Thanks, Lost. Sorta wish I'd looked into this more sooner, but at least I'm doing so now.

Please put the stick down, LT.

Isn't there a Self-Criticism Stick checkpoint with every new Couch?

If not, there should be.

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Couch Workout Club day 3

My first time doing the recommended three sets of my core workout exercises, and a 20 minute walk around the block.

Insurance hasn't paid L since June. We really can't afford her without insurance. I wonder if we ran out of sessions? We've had so many since she returned. I'm scared of losing her support.

You still have choice in the matter depending on what she says. You could take a break, see someone new if she wasn’t available.

Random question, but what do you for fun LT?How often do you meet up with your friends? Just to catch up or watch a movie?

Not meant as a criticism, but I feel like you do pour so much energy into therapy and all the subsequent ruptures/ emails.

Maybe that’s what’s triggering the depressive episode. you don’t have any gas left in your tank. I heard someone say depression sounds like deep rest. Perhaps that’s just what you need to lean into right now.

What if you took a break from therapy, spent the money on something else that you enjoyed or a short holiday with nothing but a journal.

I'm sorry that he is causing you to doubt yourself, second guess yourself, and even shame yourself for very natural things (ie: requesting a session with R while he is unavailable). It seems you were taking care of yourself and using your resources. If he has concerns about the dynamic between the three of you then he should've waited to address that later when the "crisis" was over.

I feel that he is really dropping the ball on so many levels. He's put you in a position where you feel that you need to take care of him and his emotions (ie: trying not to upset or anger him in order to keep the relationship intact)- which is not your job and is a pretty f-ed up place for a therapy client to find themselves.

I speak from experience on that one.

For me, that sort of dynamic is familiar and stems from childhood. When it happens again in therapy it's sometimes called an enactment and it can be very damaging for the client. It's the therapist's job to ensure it doesn't happen or to at least be aware of the signs that it may be happening. He seems oblivious and I'm afraid you will be the one to pay the price.

I do go out to eat or to taprooms a couple times a week--usually once with my husband and once or twice myself. I saw a friend for lunch a couple weeks ago. And concerts. Watching baseball or (American) football and doing fantasy teams for both.

But I feel like some of that stuff went away during Covid and never totally came back. Like it seems my H never wants to do much of anything now. D mostly just wants to stay home (then whines that she's bored...), so we can't really go out to eat with her--we used to do that once or twice a week. Some friends seem to have fallen off--especially ones that H knew initially, where we'd get together as a group or couples. He just doesn't seem interested in seeing them now.

So I think some of that is part of it. Though I was pouring a lot of energy into therapy pre-pandemic and doing a lot more stuff...

It doesn't help that this year so far, H had a major surgery (and will have another one in September--both hernia repairs), we had mold remediation, he had Covid in there, and we had cockroach issues. Oh, and he's had a couple rounds of gout. Plus switching rooms around in the house (and still working on going through some of those). It just feels like there's been one thing after another. Aside from the surgeries and remediation, none of them are huge things, but it's more all of it in a row. And Dr. T's move taking up space in there as well.

I do actually plan to go to the beach for a few days next week by myself to recharge a bit. I was going to meet virtually with Dr. T one of those days, but maybe I should just cancel it.

I also had a plan, at one point, to reduce to twice a week and do some other thing on the third day, like a yoga class, say. I've joined a bunch of meetup groups, but have not actually taken part in any of them yet. I should at least do one of the writing ones--I guess writing is another thing I do.

Sorry, that got kinda long! You make some good points.

Ugh, I hope that's not the case, Scarlet. Is there a way to log into your account and see how many you've used? Or could L find out? I actually thought that Obamacare changed it so they can't limit them, but I'm not sure. Maybe it was just that they had to cover them at the same percentage/copay as medical appointments.

It might just be some sort of error or backlog.

Thanks, Lost. I started crying right at the start of the session with R and apologized, then I apologized for two other things, like taking up some of her time with the emails yesterday. She said, "OK, you've said 'I'm sorry' three times in the first minute. You've hit your quota!"

At the end, she also told me I should look in the mirror and say, "I'm not a giant mess. I'm just someone with strong emotions. I'll get through this."

Thanks, Inky. I do wish he'd waited to address the concerns until after the crisis. And he'd never said before it was a problem, so I didn't even consider that it would be, especially because he was off today (along with Monday and Tuesday). R seemed confused by it, too.

It does feel like I need to take care of him at times. Which I shouldn't have to do, like you said. Plus, it's repeating patterns from my past. And it's especially frustrating that in this case, I *was* trying to take care of him by not bothering him in the middle of a move.

Sorry you've experienced that with a T, too...

Interesting you mention enactments, as I was actually saying at the end of session with R that I wondered if some of this with him is an enactment. She was like, "You choose to stay with him, so you must generally get something helpful out of the relationship." I said, "Or I'm a masochist. Or it's an enactment." Unfortunately, we were almost out of time then.

Thanks for sharing about the sorry quota...that was today's laugh.

I like the affirmation she offered.

I hope you can go gently through the rest of your day.

Thanks, Lost. You as well.

R was helpful--we covered a lot of ground. I feel calmer and more settled. May write more about it later--lots to process.

And she suggested I consider doing a DBT group, like others here have before. She said it could help me to have a layer of insulation. Plus hear stories from others who are similar to me in emotional reactions. So I'll look into it again.

The dog is better today - woke me up for his breakfast and ate his pain pill without incident (I hate to take those things for myself, but I really push them down the pets - I don't want them in any pain at all ever), went on our walk, and tried to steal the other dog's snack so I think all is back to mostly normal - he still has to have soft food/snacks. They always want what the other one has.

We ran out of sessions faster than L anticipated because we did SO many extras. She said it should be no problem, she just has to renew. And that they'll retroactively pay her. Phew! That really scared me.

She has to get sessions approved every 3 or 6 months. But yes, you are right, mental health appointment copay has to be the same as medical copay.

Glad to hear your dog's on the mend, SD.

Dogs have a lot in common with small children, I feel.

Scarlet - I'm glad you have an explanation.

LT, I'm glad R was helpful! I'm sure you needed her kindness about now.

I really liked one of my DBT skills group. I think what made the difference is the therapist. I can never remember the exact skills, but the concepts and getting others experience was helpful. I also tried a DBT process group. That was horrible. Everyone was reacting off of each other. Hope you find a good one if you try it out!

Speaking as a creative practitioner, the capacity of the facilitator to hold the space makes a huge difference.

It doesn't sound like the space was held particularly well in that group where everyone was reacting off one another.

One of the things I retained from my Introduction to Therapeutic Writing course was the facilitator's comment 'If you are at all unsure of your own capacity, then don't lead the group.'

I'm glad she'll be able to get more sessions approved!

Thanks, Scarlet! Yes, definitely needed her kindness and warmth.

I didn't realize that there are skills and process groups. I assume the skills one is the first one you'd do? R did suggest looking at reviews for the groups if I opt to do one--I imagine that would mention the facilitator.

I would hope so, LT.

You won't be the only person who would rather know what they're walking into...or Zooming into.

Also glad your dog is better. My guinea pigs are the same in wanting what the other has--I can put down two halves of the same green bell pepper, and they'll sometimes fight over the same half. One will steal it from the other, then she'll steal it back. It's entertaining to watch. Especially when they take the pepper into one of the houses, like, "OK, it's safe in here."