Couch 249: The Self Care Couch

What are your goals for therapy in general?

Three times a week is very intense, more common in traditional psychoanalysis or psychodynamic.Unless you are in an active crisis mode, you need to see that you already are capable of dealing with your emotions.

I do think session reduction would be beneficial and teach you resilience, but also confidence in yourself .

You can learn some aspects of DBT like grounding and self soothing techniques on YouTube too instead of waiting to start a class.

You just need to start building up your window of tolerance to distress, before emailing him. This is not impossible.

Would you deny me the only pleasure remaining in my pitiful life?

If it helps, LT, I went from 3 to two sessions last fall. I'm not going to say there aren't times I miss the third session, but overall it's been ok. And I have really no outside support system that I can fall back on. I think you could be fine with it after an adjustment period. It seems like there's been a lot of conflict lately between you two. Maybe a little more space between sessions would actually help your relationship.

Thanks, Jersey. I do think I'm probably keeping my Monday appointment now (we had a brief email exchange). But I was having a similar thought about dropping at least to twice a week for now (I generally go three times--was working on reducing at one point, then life stuff happened), then maybe one sometime in the future. What you mention is part of it, but his not being particularly available lately made me realize that I've become dependent on his availability. And I don't want to be that way.

One part of the exchange (just one email each--well, aside from a thanks email from me) was also about working on other ways to help me cope with strong emotions. Which is something I'd realized on my own (as I'd tried many things that weren't working), but he also mentioned. So we're going to talk about that. It could involve, say, my going to a DBT group and/or focusing on other methods.

Maybe in some way, this whole experience will ultimately help me to move forward and become better at coping on my own and with the support of those in my outside life (though I did get lots of support on here and from a couple friends this past week). Like it's serving as a wake-up call that relying on him (and R) is not a long-term, fail-proof strategy.

The DBT group may help with some coping skills and a big part of DBT is emotion regulation. I don’t know if you recall I did a group while in therapy but the group I did was led by a psychologist and I didn’t finish the whole thing (it was 9 months long). I didn’t have the money for both that and therapy. The group for me felt very controlling but it was just probably that particular group.

I didn’t realize you were seeing Dr. T 3 times a week. I thought it was twice and anything beyond that was just an extra session. That is a lot. You really have no time in-between sessions to try to let your mind rest a little.

Thanks, LT.

I wish to heck that I was more able to deal with these things.
I suppose I would be if I felt more stable.

Can somebody please tell me that now is not the time to figure out how to deal with my overflowing Gmail inbox?

LT, has he explained his clinical reasoning for establishing a pattern of working thrice weekly? I know you have requested it because you have felt the need for it but presumably he has clinical decisions behind it too as it has significant implications for your work and the relationship. It might be worth considering his reasoning when/if you are reducing.

Thanks, NP. It helps to know that you've mostly managed OK with the change. Out of curiosity, what days do you have sessions?

Has anyone got any experience of magic mushrooms? A friend has given me some to try, I have never had them before and am a bit anxious about how they might activate delusions/psychosis. I have smoked a lot of weed at various points in life but not for many years. I am wondering how the highs compare.

"He found that if he ever mentioned reducing sessions, even saying to let him know when I'm ready (as I'd said I eventually wanted to reduce), I'd get really emotional. So I think he learned to not bring it up because he didn't want to upset me (he just chooses to upset me in other ways!)"

I think this is a huge problem - I don't think this is the way to view this. He might have mistakenly added to the problem by not wanting you to get upset (and the idea has seemed to cause you to spiral for whatever reason) -but it isn't him that is upsetting - you are choosing (perhaps not consciously) to become upset - he is not doing it to you. I would not give him that power over you. Adults act and other adults respond in various ways and both are on each actor.

Way to go, Una!