Drinks + therapy???

I wrestle with medicating before session too.

I think what it's come down to right now (for me) is that my anxiety/dissociation level is SO HIGH sometimes that I'm not sure there is even any point to the session. I mean, if I'm am curled in a ball in the corner of the couch, hiding my head in my arms, not talking....am I accomplishing anything?

If I take my anti-anxiety med, it feels like the "adult" me is more able to be there and to process stuff. That's where I'm at today. But I can still see both sides of the issue.

Scared Sad... There is no doubt in my mind that if I told my T about taking or wanting to take medication before therapy...she would have accepted and dealt with this issue appropriately. I don't think she would have been outwardly upset with me. I judge myself much more harshly than she does.

Your comments were good because they reminded me that what I choose to do affects me not her.

This is where I was last session...only I can't honestly claim that my anxiety is this disabling. For me even at its worst...I can still manage to function. My tolerance for being uncomfortable has always been limited.

Last week something happened that made me feel the pressing need to revisit an issue that I tend to ...talk around. I felt like I could no longer afford to delay. I set the session agenda via email and thought I would be OK with it. I was wrong! My session was scheduled for the afternoon. As the day progressed... I could feel my anxiety building and I was afraid that if it continued to build that I would not be able to have a productive session. I could not afford to waste the session choking on the knot in my throat and defensively shutting down. If this happened I would then have to wait two more weeks to try again.

The medication either though its pharmacological action or maybe just though a placebo effect, helped me get through the session. It did not totally block my symptoms, I was still aware of my anxiety and didn't alter my perception or cause me to disclose more deep dark secrets. It just chilled me out a bit, kept my heart from racing, the knot in my throat manageable, and maybe lowered my risk of having a stroke. For me I don't regret taking the medication...I think it was a sound decision at the time.

I guess what is bothering me a bit now is... why I avoided telling my T about taking it? No matter what my rationale for taking the medication was... I didn't tell my T ... because I did not want her to know how stressed I really was about that session. Maybe because I was embarrassed by how much the topic was still affecting me, maybe I thought I was cheating some how, maybe I worried about her disapproval. But when I really think about it...I think I was afraid that I would lose it during the session. I was afraid to let her know I was struggling with self control. I think I was afraid that she would detect my vulnerability and attack it. I know this fear is unfounded.

I should not be still hiding this at this point.

Chaotic -

You are where you are. There is no "should" about where you are. You did what you needed to do to get through the session, you didn't break any laws or go out and get drunk, or whatever. You took a medication for the very reason it was intended.

Maybe next session you can talk to her about your discomfort about not letting her know you had taken the medication last session?

You know, my last session I took my klonopin before I went- I don't usualy do that. And he actually left me a message commenting on how "adult" I was during the session. I admit I did feel a little funny - since he didn't know I was on the klonopin - so does the "adultness" count as being real??

T wants me to take anti-anxiety meds VERY MUCH, so I'm sure he wouldn't have had any problem with me taking it. I just wonder how "real" the session was, you know? But like I said before, at least we were able to do some work, instead of me cowering in fear.

Hum.

YES, I totally get this. For me I am trying to learn to lower my guard and get comfortable with showing people more of me. I don't know if taking the medication really hides anything, but it makes me wonder if it just enables me to keep my inner turmoil at bay. Sometimes I wish I could just take a major muscle relaxant or something and just let myself go. Like Sunrise said, hiding can be so tiring. But I can't seem to figure out how to be any other way.

My therapist says he won't treat me unless I'm on medication. I guess I'm too emotional without it and can't deal with issues.

This is such an interesting thread, I just had to add my 2 cents.

My T actually called my pdoc to see if he would give me a script for therapy-anxiety. He would only give me klonopin, which isn't working real well and he has now referred me to someone who may be more open about prescribing something else (e.g., xanax). I've been seeing T for almost 2 years and still can't open up much.

Also, I live in a state where one can get a legal prescription for marijuana, which T suggested I do (I've been a stoner since the 70s and have used continuously anyway, so the script just makes it safer for me and allows me to grow). And, there is scientific evidence of marijauna's medical benefits, particularly for pain and nausea, which my T is aware of. He IS trying to get me cut down, however and to try safer means of ingestion. I always use it before sessions, or I dont' talk at all. T knows this.

Concerning alcohol, I don't see much difference between that and taking a tranq., at least for some people. I don't advocate it, but just enough to loosen up may be helpful for some people. I wouldn't keep it a secret from my T though. In grad school, whenever my friend or I had to present a colloquium in front of the most intimidating faculty I have ever known, we always had 2 drinks at the bar across the street first. Both of us performed well that way, although we didn't always remember much of the acutal experience!

Yes, there was a time when it was thought that LSD might be useful in therapy and some government-funded studies were conducted in virtual secret until after the fact. Having experimented with LSD in the 70s, I agree with another poster, who said s/he could not see how it could possibly be useful in therapy. LSD produces hallucinations and distorts reality totally - that's why it's called "tripping" - you get away from reality without leaving home!

I don't have any real words of wisdom. And, I certainly have no right to judge anyone . Probably the most important thing would be to discuss whatever med you're taking, with your T.

Thanks for the great discussion, everyone!

Foreverlost,

Sounds like you experimented with this concept at one point. As I read your post I couldn't help imagining myself tripping in therapy. LOL Not sure that would help my anxiety... In my case the ugly couch might try and eat me or something...
I also remember that pot never had a sedative effect on me...I seem to remember a few bouts of paranoia....and of course the munchies...again this would not be conducive to therapy.

Sometimes I wonder if what I really need is to stop being an ****-retentive mature adult and return briefly to these carefree days where I just said.. "$*#& it " and went on a wild ride for a while.

Hmmmm! Maybe you're on to something here. Seriously.

When I first started therapy I frequently wondered... why the heck am I having problems now in my 40's. I have been through stressful changing times before...never seemed to have developed an "adjustment disorder". Then I realize...I had some other coping mechanisms back then. Not sure if they were healthy or not but they must have worked. Maybe what I need is a trip to Vegas. What happens in Vegas stays in Vegas, right!

chaotic,

I never smoked pot before work, because of the paranoia thing. But the munchies go away after about 20 years And I know it helps with therapy!

Please know I'm not advocating anything for anyone else, just a different perspective. My personality does not change with either anti-anxiety meds or my herbal rememdy!

I forgot to mention, Chaotic, that different strains of marijuana produce different effects, from anti-anxiety to cerebral stimulation. One thing legalization has allowed is that you can obtain the best strain for your particular needs.

I find it awful that anyone would consider doing drugs or drinking alcohol before therapy. I really do. The beauty of therapy is the authenticity. Therapy is amazing because even if you sit there lying your *** off-- you are still going to have to deal with it, and eventually process it, in the present moment. Perhaps if you are seriously considering using a substance before session (or if you already do) you should ask yourself what it is that you are so afraid of in there... rather than convincing yourself that it "helps" or enhances the process.

And no, I'm not talking about your regular psychiatric meds.

There are many responses I could make here, but I'll limit it to the main point: I think people who are considering using a substance before session are in many cases already trying very hard to process what is causing them so much anxiety about the situation. Less judgment, and more compassion is, I think, a good thing. And processing these decisions with your T is probably a good thing, too.

Isn't self harm as numbing as using a substance? Isn't so beautifully authentic then is it?

Pinksoil,

You're entitled to your opinion, but the distinction between psych. meds and prescribed mariijuana or even unprescribed marijuana or alcohol is not as black and white to me.

Some of us are trying very hard, but find it extremely difficult to trust/talk in therapy. I can't afford spending all that money just to sit there. If something helps me open up, it does not mean I am not myself. This is the first time in over 50 years of living that I've been able to talk even a little to any psych. professional, because my T is not so judgmental about such things.

People are not all the same and what works for each of us is not always the same either.

This belief is what made me look for this old thread this week. The whole reason I am struggling with this issue is that ... I caved in before my last therapy session and MEDICATED! Aside from this I AVOIDED disclosing this to my T. Now in hindsight I am :

WOW! great point too.

I was certainly in a situation where my anxiety was escalating and if I did not intervene (in someway) I felt like I would not be able to share what I wanted to share. In this case did the medication make me more or less authentic?

I took a very small amount of valium before seeing my T and I normally dont talk much but I talked more easily to her,I was much more relaxed.

I think foreverlost's comments along with some of my fantasy comments may have changed the tone of this thread. Which I for one think is GREAT!

I am struggling with this issue and need to see arguments on both sides.

When I read foreverlost's comments I did not see them as advocating going to therapy high as a kite. Key things that stuck out where:

What I find interesting is that the mention of LSD, marijuana, and alcohol seem to elicit a negative response, even though the intent behind their use is the same as with more conventional prescriptions.

I don't think I am abnormal for looking for ways to reduce my anxiety during difficult therapy sessions. For me the intensity of having someone's undivided attention is just overwhelming at times. At this point I think my decision to take a prescribed medication (as prescribed) was a good decision. The other decisions I made that week may not have been in my best interest. 1) I chose to turn up the heat on MYSELF by sending my T a message before my session saying...I want to go "HERE". I thought I was ready for this discussion but....apparently I might not have been, then again... maybe I never will be without medicating. 2) When I took the medication and then during the fallout following the session...I chose not to disclose to my T that I felt the need to take medication.

What I do next... I haven't decided. I think to medicate or not to medicate is completely my decision (or any patients decision for that matter). I also think since my medication does not alter my personality at all (just lowers my HR and BP somewhat), I don't think it is unethical or inappropriate for me not to fill-in my T. HOWEVER... discussing the fact that I am still having MAJOR anxiety symptoms when anticipating a conversation on a particular topic, is likely VERY important to my overall therapy.

Yes, the alcohol v. Rx comparison was discussed extensively a few pages back (with people similarly divided in their views). It's puzzling to me, too.

As for if/when to tell your T that you have medicated before session, that is, as you rightly say, up to you. My thoughts are that it is probably a good idea when you are ready. I say that because isn't a main purpose of therapy to learn from and reflect upon your feelings and actions? And to do it with the assistance of someone who is trained in these things? If you never bring it up, you lose the opportunity to have their help in learning from and reflecting on it. That said, I think there is the risk that the disclosure may turn the discussion from the topic you really want to explore (which was the reason you resorted to medicating in the first place) to discussion of medicating. So you might want to adjust your timing of the disclosure to avoid that. Just my thoughts.

I also think that medicating enough to calm down and discuss something that you want to discuss can be like a first step. Not the ultimate goal, but a step on the way to being able to discuss it unaided. That's how it worked for me anyway. My anxiety has decreased enough that I don't personally feel the need to take substances to counter it anymore (I still have pre-therapy anxiety/jitters pretty regularly, it's just not so intense).

I agree. I think I have made some progress in getting a handle on my anxiety and tolerating the discomfort of discussing very personal information with another person. I have only medicated before therapy 2x. I've been doing really well lately unaided. When I asked my doctor for the Rx, just knowing that I had something to take if I needed was enough. But for me I think I also need to allow myself to take it and not feel guilty about taking it too.

Honestly, if I choose to disclose during this weeks session (that I took medication last session) it is not going to be a big deal to my T. I don't think she cares either way as long as I am not totally out of it during our session. I think it is ME who is really upset that I had trouble and took medication. Just like it was me to elevated the intensity of the session--I pushed myself over the edge.

I agree that they are quite similar-- but I was talking about substance use as being a purposeful behavior in order to enhance a session.

Yes they are quite similar aren't they.