Couch 249: The Self Care Couch

We're 102 here. 103 tomorrow. I'm grateful there's a little park/garden right outside my patio so we get a cool breeze and some shade from the trees. It's still too hot for me, but at least I can be outside a little bit.

The summer where I am has been unbearable but if it was 102 and 103 I wouldn’t even be able to stick my head out the door.

Like 40 years ago i was at the san diego zoo and it was 104 and i was pretty healthy racewalking n stuff and i was like, you people go ahead, i am going to lie down on a bench in the shade and eat ice cream. It seemed the only rational option, in a very serious life-preserving way! You know, that weird sense of watching yourself from the outside.

It's been hot and humid where I am, too, though more high 90s than breaking 100. I'm at the beach now by myself for a few days, and it's cooler here. Though, of course, humid, as I'm right by a giant body (actually, two bodies) of water. I think the next two days will be OK, then it will be raining. Hoping it won't be too bad for driving home Wednesday or Thursday (unsure which day). Note that I'm not close enough to the hurricane that it would be affecting the weather here, at least not till the end of the week.

LT-In these parts we call the beach areas “Down The Shore”.
Jersey person #1. What are your plans this weekend?
Jersey person #2. Going down the shore a few days.

Anyways at the shore due to the ocean breeze it’s normally about 5-10 degrees cooler. Still humid but a tad cooler.

Similar, but here, it's "down the ocean."

“We accept the love, we think we deserve”.

I appreciate this Lemon. Thank you.

It is swampy here - but really hot and humid is normal for us. The hardest part is that my elderly dogs want to go for a walk at 4pm when it is at its hottest and I keep telling them it is not good for them -but they don't believe me so we take a hot and exceptionally slow plod to the park, I carry water for them, and we only go about a mile (they are now senior dogs with arthritis- they get 2 or three walks a day for 1 or two miles each walk depending on how they are feeling on any given day - we used to take 1 or two long walks a day but now I have to walk them and then go do my own real walk without them) and then they come home, get their pain pills, and sleep on the a/c vents

A friend brought over fresh corn, tomatoes, and other veg from his parents' garden. We are stuffed from eating a lot of tomato and corn salad = it is so delicious when made with great veg -and this is some of the best corn I have had in a very long time.

In the PNW we often say we're going to the coast.
PNW person #1. What are your plans this weekend?
PNW person #2. Going to the coast for a few days.

I know it might seem scary to you but you can find a group where you pay each week. Most meet once a week for 2 hours. I really does take at least 6 months to get through the entire book. It is divided into 4 sections with different skill types for each. Mindfulness is done throughout while you spend 2 months each on the remaining 3 sections.

Sorry if this sounds bad, but you spend 3x a week in therapy for years but you seem hesitant about a 6 month commitment for something that can teach you the skills to improve your life. Yes, you can put it off but why? I don't expect you to answer, but are you afraid of getting better and being able to live a more stress free life? I know some people are, just something to think about.

You can also buy the Marcia Linehan book ahead of time and get an idea of what you will learn. It really is quite good. If worse comes to worse and you feel you really can't handle it, then quit. It wouldn't hurt to give it a try though.

This DBT workbook is what all my therapists have used.
Amazon.com

Couch Workout Club Day 8

Three sets of my core workout exercises.

LT-

FWIW I have to say I agree with zoiecat. A group would be a commitment for sure, but you could see life changing benefits.

It doesn't seem you've made any progress with Dr. T in the area of healthy emotional regulation and ability to sit with your feelings. Those hard feelings will always come and go for all of us. We are just human. And sure, we need support from others- but as adults if we can't sit with our own painful feelings and begin to metabolize them in the moment we will always truly struggle.

Dr. T has potentially hindered your ability to sit with hard feelings by seeing you three times a week for years. You have become dependent and feel terrified of sitting with hard feelings on your own. This is potentially very harmful to you and will get worse without some intervention. Much like a drug dependence (and constant validation/comfort is a drug as far as the brain is concerned) you will have to struggle to get back on your own two feet but you can do it.

Therapeutic support is one thing. But a competent and supportive therapist knows when to gently step back and encourage a client to have more autonomy and independence. Dr. T appears to do the opposite. Have you ever researched DPD Dependent Personality Disorder (DPD) - Dependent Personality Disorder (DPD) - Merck Manual Professional Edition Does this resonate?

Do you feel Dr. has encouraged you to truly increase your tolerance threshold?? IMO If he had I think the HE would encourage you to titrate down on sessions. HE would strongly encourage a DBT group. Sure, it would be hard at first but as a therapist he can support you through the transition to twice or once a week. He could support you in attending a group. That's literally his job. But he doesn't seem interested in doing it. Ask yourself why. And remember that he profits financially from your unusually high session frequency. I'm not suggesting that is his conscious motivation, but it's something to keep in mind.

Who is truly benefitting from this set up of 3 times a week for over 4 years?? You or him? If you stay with him you may have to really advocate for yourself by telling him you think you may need to reduce sessions and you know it will be hard because you've now grown very dependent.

Edited to add- this is obv just my own opinion and if none of it resonates with you then please disregard. But listen to your gut and ask yourself some hard questions. Advocate for yourself the same way you advocate for your child- even when it's challenging and requires making changes.

The killer cat brought a dead rat to the porch this morning. Usually we just have mice but this year the rain and flooding has brought out more creatures and we have a few hen houses in the neighborhood that also attract. I am glad he doesn't really seem to eat them because I know people put out poison too. My two useless dogs just go out and sniff and back away - they are completely domesticated beasts who mostly prefer their meat cooked by humans. My friend has a lab who gave itself pancreatitis about 15 times because it was always eating dead squirrels and anything else he could find

Ick. I'm glad I just own prey animals and not predators.

Thanks, Zoie.

To clarify, my concern about the 6-month commitment was if it didn't feel like the right fit. If I were financially locked in, like if I had to pay or commit up front. it was a therapist or p-doc, if I went a few times (or even just once, like I did with a p-doc who was proud that he did not use a computer--in 2017) and it didn't feel right, I could end. I could end with Dr. T at any time, for example, and it's not like I'd still owe him money for future sessions. It's not that I'm unwilling to do 6 months in general. I just don't want to be stuck paying if it wasn't working out.

I did meet (virtually) with Dr. T this morning, and he seemed pleasantly surprised that I'm willing to consider DBT groups at all (I really think I've mentioned them to him before?). I asked if he knew of any (rather than picking a random one online). He said a client has one he likes, that he could find out what group it is. (Is that an issue if it's another client? I know some T's also run DBT groups, and I assume that's fine if it's mutual clients in the groups.)

Interestingly, Dr. T said he's done the DBT workbooks a few times for himself, to better learn to cope with things. I asked if I was in a group and needed more help with the skills, could he and I discuss them some? He said yes, though he only knows them as a user, not an instructor.

I also brought up CBT (which I know is different), as I know he uses some of that in general, saying maybe he could use with me more. He said he already incorporates it, which I guess I didn't realize? I said the same for mindfulness (I don't think he incorporates that with me as much, but it's stuff he lists on his website as a methodology he uses).

So, I'm trying to use more tools. And am looking into the groups.

Thanks, Inky. See my response to Zoie about the DBT group aspect.

I do feel I've made some progress with Dr. T in sitting with feelings (with last week being an exception). I'm much less likely to jump to emailing him now than I was, even if it doesn't seem that way on here. it's something he recently commented on. Or if there's a conflict, not feeling I need to schedule an immediate session. Same with my H--if we have a conflict, I'm less likely to feel the need to settle it immediately and realize maybe we need to each take a step back and talk about it later. Or I won't immediately assume he's upset with me and will clarify with him whether it's me or something else (it's usually not just about me or even about me at all).

Again, that's probably less obvious from reading posts on here as I'm less likely to post if it's like "hey, I'm handling this situation well!"

It does feel like Dr. T doesn't step back as often as maybe he should--maybe tied to his concerns about hurting me (paternal countertransference, maybe?). I don't know. Even though a couple months ago, we had a discussion where he said it can be more caring ultimately, in a parent role, to leave me (proverbially) on the ledge at times for me to find my way back in instead of his helping me in.

Thanks for sharing about the dependent personality disorder. Parts of it ring true (like "These patients consider themselves inferior and tend to belittle their abilities; they take any criticism or disapproval as proof of their incompetence, further undermining their confidence."). But I also lived by myself for 5 years in my early 20s and did pretty well (and miss that at times...). I don't think I was overly dependent on anyone at that time either. So I don't know? He seems to think borderline...

I do agree in part that Dr. T hasn't done enough to increase my tolerance threshold. When I talked about DBT groups today, though, he seemed pleasantly surprised that I was considering it. He probably figured I'd be upset if he mentioned it. The thing is, sometimes I'm upset at a suggestion in the moment, then think about it more and figure it could be a good idea.

He also said this morning how he's thought multiple times that he wished I was seeing a psychiatrist regularly again, but I think he only actually brought that up once, maybe a couple years ago? Granted, in the moment, I was upset about it. But if he keeps thinking it but doesn't say it, for fear of upsetting me, how does that help me? Sometimes, I might need the nudge.

I do know he's fine with the idea of my reducing sessions, but wants me to do that on my own terms. So I don't think he'd push me to stay with three at all. Plus, I pay a slightly (by $30) reduced rate, so if he got someone in the third slot at his full fee, he'd make an extra $120/month. Though I guess maybe a reduced fee is better if he doesn't have to shop for clients, and it's rare that I cancel.

You're right that I do need to advocate for myself. Like I do for D.

So pleased that you're speaking up for yourself, LT.

I picture SD's dogs holding out for smoked meat on rye with brown mustard.