Is It Time for a Change in Therapy?

<font color="green"> Because of my childhood abuse I used pins to make myself bleed, a drop or three was enough in the beginning. While I moved into needing to see more blood I never really started cutting until I was in therapy. I suppose I felt safe to use the cutting with a therapist to catch me if I fell. I never cut a lot or often but quickly began to crave the release it gave and slight high I felt when I cut. The cutting also helped with my flashbacks. I could stop one dead in its track with it.

Now comes the trying to stop and it is hard. I learned that I was willing to be hurt in different ways if the cutting was not allowable. Worse yet, I tend to claw myself in my sleep sometimes drawing blood. But I have not cut for about 4 months, and the scratching or clawing is waning too. However, anytime I feel anger I feel like I deserve to be punished. See after being assaulted by my godparents for around 3 years I went back to living with my mother who taught me that I am not allowed to even look angry. So I turn it all again me. I have started to learn to be anger with the right person but I have a long way to go with this.

Because I have depression and PTSD, I have been seeing a therapist for 4 years. I made a lot of progress but until I saw a psychiatrist, I was not stable but crashing regularly. Now on Lexapro and Wellbutrin I am reasonably stable. However, this doctor feels I have poor boundaries and am too dependent on my therapist. I admit I love her; she has been a substitute mother for me. I would be such a mess without her. So what does the psychiatrist want to do? He wants me to do DBT, a six-month course during which I cannot see my therapist.

I am literally scared spitless of doing this training and losing my therapist for six months. Even worse, in my mind right now is that the training may make it so I can leave therapy earlier. She has been my support and is the first woman I trust to accept me. There is still in my heart the fear that if anyone knowing the ‘whole’ story would despise me. I know in my head that I was not to blame but I still feel like there had to be a reason for me to have been abused in so many ways by so many people. First, my mother tried to kill me then my godparents used me for sex; my stepfather molested me and my mother used verbal emotional mental and physical abuse against me. It is small wonder that I feel like I am without value and soiled.

Well this is becoming a book instead of a post so I need to bring it to an end. I am afraid to try this DBT training but I can see that I am too dependent on my therapist and need to get unstuck with the anger and abandonment issues. I just don’t know how to do this or if I should do it.
</font>

What does your therapist say about it? Before you decide anything, maybe you could ask your therapist and your doctor to talk to each other and see what they agree on, and/or arrange a meeting with you and both of them to decide where to go from this point. Most of the DBT groups that I have heard of are to supplement individual therapy, not replace it, and the skills are really good, but your therapist would need to back up the DBT skills and work as a team with the group therapist and your doctor. Any time you have more than one professional on your team, they need to communicate with each other so that they ensure they are working together and not against each other.

It sounds like you have come a long way. It's hard to accept that your anger is justifyable and acceptable, and that you are allowed to be angry. Feeling responsible for what is done to you seems to go along with the territory and may serve a purpose for you, although I am sure you would not hold another child to blame if those things were done to them, right?

Letting go of someone who has supported and helped you, and has been a person you can trust, might be the hardest part of therapy. Although I have left or been terminated by several therapists, I never quite had that kind of relationship with them. One of them was hard to let go of. I can't imagine letting go of the therapist I have now though (couldn't with the last one either though, and I got through that once he was replaced). I am told that when you are ready to leave therapy it won't be as hard, but I think some might have a different take on that too.

I hope this helps you.

Rap

If this was me and I had to make the choice between a therapist that I have connected with or trying something new with a psychiatrist I choose the therapist any day.

So what you depend on your therapist to be there for you. Thats part of the therapists juob to be there when you need them.

Not angry at you. I had a DHS caseworker that tried to claim I was Too dependant on SKR. One month she sent SKR to the ethics board for seeing me too much and then the next moth she sent her in for not seeing me enough.

the ethics board sided with SKR and I. The bottom line is that each therapist gears the clients sessions based on what that client needs. Yes the client must do the work but how often and when they see their clients is up to them and the client. If the client needs to see their therapist every day and has the money (cash, credit insurance whatever) the client and therapist can do so.

At one point SKR and I were seeing each other weekly and calls every night either to her or to her voicemail. why because that is what we needed to do to make it through the night.

Other times we didn't have any face to face sessions just my dropping off my journals and artwork and projects so that she could monitor when I needed to see her face to face.

Other times I saw her bimonthly and monthly.

My schedule with LL varies, sometimes weekly sometimes bi monthly.

It don't matter to me who says I have to do things this way or that with my therapist. only LL and I have a right to decide what and how we do during my sessions. I also take into consideration the supervisors suggestions because E is the back up for me if LL is unavailable.

No one elses opinions matter - not her co -workers. My family physician (who prescribes my medications when needed.) even stays out of what and how LL and I do my sessions.

that DHS caseworker also tried to have me court mandated to see a psychiatrist besides my therapist.

To me its kind of overkill and too many hands stirring the stew to have both a psychiatrist and a therapist. Family physicains are capable of prescribing all the same medications as a psychiatrist.

And the court agreed. there was no reason for me to see a psychiatrist for medication needs and therapy needs when my theraipst and I have connected and were getting things done and family physicians have the same requirements for dispensing a full range of medications the psychiatrists do.

So given a choice trusted and connected therapist or unconnected and untrusted psychiatrist - therapist hands down.

if you want to do a different form of therapy your therapist can do that with you just like the psychiatrist can.

The only difference that I have found so far between a licensed therapist and a licensed psychiatrist is that the psychiatrist went to (physical) medical school besides studying psychology.

<font color="green"> Coming back to this because I so want to cut.

Thank you Myself and Rapunzel for your input. I talked with my therapist about it all and in the end she said if I was able to continue not to cut and was not ready to try the DBT stuff it was ok but I had to stand up to the psychiatrist about it. I have to have psychiatrist because my gp had tried everything he knew to do and with me still cutting [at that time] he felt I needed someone more aware of the choices for medications for mental health issues. I did talk to him and he agreed that I could decide for myself and since I was not cutting, he was not too concerned.

Problem is that I have used other ways to si – scratching, picking, and causing bruises and such. My therapist knows but seems willing to let those go by for now. However, they are not enough; I want to cut. I want the whole of what cutting gave me. At the same time I do not want to give into cutting. It has been a very long time since I cut last, well, long for me, six months.

I want to cut cos things are hard; my son had to leave the area cos his ex was trying to destroy him. I can’t have my granddaughter much – she is with her mother and her mother’s mother neither of which are worth much. With school starting, my kids are having some big struggles. My husband seems to be going thru a hugely negative time still and I am so tired of it all.

However, for me the capper is that these two doctors both want to talk to each other and I said, "Sure, go for it." but it has not happened yet. The suspense is killing me. The longer I wait the more I want to cut. I don’t know if there is anything anyone can suggest now but I hope that venting will help.
</font>

You're welcome and glad you were able to talk to your therapist.

I know. its been a year and 6 months on monday since the last time I cut and the urges are still there. And the urges may always be there. kind of like a drug addict or alcoholic alawys has that urge to use drugs and alcohol. It took time to become adicted and it became habit for years to run to alcohol and drugs and getting those feelings that the alcolhol and drugs give so it takes drug addicts and alcoholics years of fighting those urges and craving for it.

Self injury is the same thing a person running to a harmful "crutch" in times of trouble, and it took time to develop that crutch and the habit was being done over a span of years. so its going to take a span of years to get rid of the urges and cravings. and just like with drugs and alcohol each time a person uses appropiate coping tools to solve the problem completely instead of the "crutch" to get temporary relief each time they fight the cravings are urges they get that much stronger.

from your post -

"I want to cut cos things are hard; my son had to leave the area cos his ex was trying to destroy him. I can’t have my granddaughter much – she is with her mother and her mother’s mother neither of which are worth much. With school starting, my kids are having some big struggles. My husband seems to be going thru a hugely negative time still and I am so tired of it all"

and

"these two doctors both want to talk to each other and I said, "Sure, go for it." but it has not happened yet. The suspense is killing me. The longer I wait the more I want to cut"

throw what YOU would get for relief by cutting to the side for a moment and look at the situations not from the emotional point of view but from logic -

Son moved out of the area. OK is your cutting yourself going to change the fact that your son moved out of the area? No its already happened he moved. now throw the idea of cutting out and look logically at options -

In todays world most familys are spread from coast to coast even in different countries. how do these people whos families are scattered?

you can still call your son
you can make plans with your son to meet somewhere for a meal, something to drink and spend some time together
and you can invite son over for meals and spend some time with him at your home.

How about every time you feel like cutting because you miss your son you put some money aside for or go buy something that he would like.

You cant see your granddaughter as much as you want. Again is your cutting going to change this situation? no so now how do other families do it when their grandchildren live in other states, or countries?

You can call your granddaugher
you can write to your grand daugher
you can invite the mom and or the childs other grandmother over for dinner you may not like the childs mother but by being polite and doing this you will also be able to see and interact with the grandaugher.
You can invite the mother, or other grandmother out to luch or shopping for the child.

I right now have no contact with my 13 year old child. I cant call him and I cant see him until his therapist says he is ready and visitation can be done safely concerning his violence. But I send him cards, clothing, books,and so on. One thing I do is every time I want to cut because he isnt here I put money aside for something for him.

Your kids are having a hard time in school. Is your giving in to the urges going to change their school experiences? no. But what will?

You can contact the teachers and arrange for spare sets of books so you can follow along and help the children with School work,
you can sit down with the children individually and ask how their day went and when they tell you about a problem instead of you leaving the conversation upset and trying to figure out what to do about the problem ask the child how they would like to solve the problem. Children are great at solving their own school problems if you give them the chance and be there to brainstorm ideas with them.

Your doctors taking too long to be in contact. is your cutting going to change that? no doctors are busy. Bothe medical and mental doctors usually only have about 5 minuted between clients so they don't always have the time and sometimes forget in the seeing of so many clients. So what can you do?

Make yourself memorable in an appropiate way. Drop off a card to each of them thanking them for the extra time they are taking to help you with this problem. Doctors rarely get thanked in cards, flowers and so on especially when the help has not been completed yet. Not only will you catch them off guard but you will also be supplying them with a very visual reminder of what they committed theirself to helpig you with and how.

I have court reviews on my sons and my DHS case and I know that the review boards see lots of parents, foster parents, lawyers, therapists and so on but may times I have been told I stand out with the review boards, lawyers and so on. this is because I give them a visual reminder by writing up a report about my side of the case. the parents with children in care rarely attend the review hearing. I make a point of appearing at every review even though it is not manditory. The first review I went to they called my sons last name and I went into the review room and sat down right at one end of the table so that no one could look around the room without seeing me. they went around the room for introductions and they came to me and I said my name is and I am (sons name) mother. pens got dropped, chairs got shuffled. Chins got rubbed. then when the review board because I was directly across the table from the main board member I was asked to go first. They expected a very short request of I want my child to come home like other parents, what they got instead was a summary of why my child was in care and my side of the case. I spaced off during this but when I was done I heard The review board member ask my lawyer if he had anything to add and he smiled and said no I think she covered this meeting very well. the lawyer rep for my son looked at me and said not only did I cover my side but had included what was being done for my son and she was very impressed. From that day on even if I was out in public I got smiles of recognition from those community member who had been on the review board. They now knew me and would not forget me and what my son and I need in the shuffle of the crowded system of temporary foster care.

Be memorable - don't do something they expect from you - cutting. Do something they don't expect - your expressing your appreciation and thanks in a way they would not expect for all the extra time they are taking. I would not be surprised if right after recieving your shocking them that they get on the ball and talk together.

as for the urges and cravings they are going to be there a while. You're right theres nothing that anyone can say that will take them away. when they happen for me I put it all into my artwork, and physical activities, and yes if it gets to the point where even those dont work I di diffuse it with a less severe form of self injury.

Not everyone can go cold turkey after self injury behavior. I have been self injuring since I was about 10 - 15. somewhere in there so instead of going cold turkey I work on the more severe and work my way to less severe when it comes to stopping self injury behavior.

give it some more time until the cravings and urges arent so strong on a daily basis then when you are ready pick another self injury behavior to work on. You will get there.

Hang in there

Your husband has a negative outlook right now. Is your cutting going to change him? No only he can change him. so what can you do?

you can plan a special meal.
you can have the kids spend a night with friends so that you and husband have time just to be together alone doing something - watch tv, go to a movie, rent a movie, with no kids in the house the activites are limitless.

I would try to think of my own alternative therapy for a month or two if I wanted to try things more on my "own" instead of being so dependent on my therapist. I'd pick a longish period just past what I thought would be easy enough for me and try something I was interested in but found challenging that I was wondering might work (tai chi, yoga, a class of some sort or quick work with another therapist or maybe even online therapy? http://www.metanoia.org ) Maybe just find a good workbook like Lorraine Bell's Managing Intense Emotions and Overcoming Self-Destructive Habits: http://www.amazon.com/Managing-Inten...dp/1583919155/ You could do something like get the book, figure out how long you wanted to take to work through it and then you could write a "report" to share with your therapist when you saw her again. This would show everyone, especially yourself that you were working hard on your problems in your way and were "in charge."