Tag Archive: therapist


Stumbled upon this article from the BBC News website, which shares the results of this study in The Lancet.

I was somewhat surprised to read that there hadn’t already been a definitive study (if this could be called definitive?) about the efficacy of CBT (cognitive-behavioral therapy).  It’s been around for a while now.

“Before this study, no evidence from large-scale randomised controlled trials was available for the effectiveness of augmentation of antidepressant medication with CBT as a next-step for patients whose depression has not responded to pharmacotherapy. Our study has provided robust evidence that CBT as an adjunct to usual care that includes antidepressants is an effective treatment, reducing depressive symptoms in this population.”

I’ve been in and out of “talk therapy” for well over a decade, though I’m not sure how much of it was CBT.  I honestly don’t know enough about the history and development of psychotherapy, or even what different forms of therapy are commonly in use these days.  All my therapists have been more or less the same, so I’m guessing it has all been CBT.  No Freudian psychoanalysis, anyway.

Details aside, I can honestly say it has been extremely helpful for me.  Obviously it hasn’t “cured me” — I don’t think what I’ve got can really be “cured” — but having someone to talk to about whatever’s going on in my life has helped me make important decisions, take myself more seriously (in a good way) and, most importantly, kept me working on myself.

The thing about medication, great a boon as it has been to me through the years, is that it doesn’t encourage active participation in the growth process.  For someone like me, who probably has something of a chemical imbalance but also a fair amount of non-genetic emotional/psychological dysfunction, staying actively involved in my own treatment is crucial.

That’s not to say that I think I would achieve the same results if I were to sit and talk to myself or journal or something for an hour once every few weeks.  That certainly helps too, but having an appointment, having to go, having someone with notes who looks back and says “last time you expressed such-and-such a feeling,” keeping far better track of things than I could even if I cared to, makes it feel more substantive, somehow.  I don’t want to say I spend my $60 copay JUST so I can feel my treatment is more “real,” but there is something to that.  Plus, if I’m financially liable I’m much more likely to keep with it (tell that to the running shoes I bought last month… but that’s a different story).  It’s far too easy to “not feel like” meditating or reading another chapter or just practicing a little awareness.  Which is why I haven’t really done much meditating the last few months… so maintaining contact with a therapist is important.  It keeps me present, keeps me from being able to ignore or pretend.

I guess that makes me one of the 46% of people (as reported in the study) who respond positively to CBT.  I wonder, with no small amount of sympathy, what the remaining 54% do?

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Treading cautiously

I’m attempting to gauge whether I’m on a New Man high or if I’m genuinely feeling better these days.  It’s really hard to tell.  On the one hand, I am feeling better these days.  Tonight I’m cooking a big pot of vegetable stew, which will be the base for a pot pie with a pumpkin biscuit topping instead of the standard pot pie pastry (courtesy of Fatfree Vegan).  I have a small glass of red wine (courtesy of Trader Joe’s) and I’m clean, having showered after I got home from work.  The stew smells marvelous!  The seitan has to simmer another 15 minutes and then I make the pumpkin biscuits.

What struck me about this moment, and the reason I thought to write about it at all, is how seemingly carefree and mellow I feel.  It’s sad that I’ve come to distrust that sort of feeling, but my experience with this sort of not-depressed feeling is that I do something or say something or something and I end up looking back at this little euphoric moment with disgust.  It’s a strange conflict within me, trying to enjoy and appreciate this positive flow of emotion but at the same time trying not to buy into it too much — like I think it’s a con or something.  And my distrust is valid, I think.  It’s more than a little suspicious that I am feeling more positive, more motivated, less self-critical, at a time when I’ve been on a few dates with a guy I’ve been crushing on and who hasn’t disappointed me yet.  So you see, I can’t entirely trust myself in these matters.  I suppose that’s where meditation helps.

I guess what my concern is is that I feel quite strongly that an individual’s happiness is not solely contingent on the presence of an intimate relationship in their life.  I mean, sure, it probably helps, but I know that I have a lot of issues still to deal with, and I don’t want to see myself laying those aside because of some illusion of contentedness that is a natural byproduct of New Man high.  (I guess he’ll be NM from now on, eh?)

The mind is so complicated.  I guess I can vent some of this out on my therapist this Thursday, too.  But I was telling mom — it’s so funny — my therapist asks me if I’m seeing anyone every time we meet.  I guess it’s not that farfetched, but every time she asks I’m a little amused and a little annoyed.  After all, being in a relationship is not going to solve my problems!  But she knows I struggle with feelings of loneliness, of disconnectedness, so I guess she thinks having someone near my life could potentially be beneficial.  I guess that’s what it is.  So I won’t be annoyed anymore when she asks.  And of course, this time I’ll have a different answer for her.  Watch her fall out of her chair when I tell her I asked him out! (she won’t, but she’ll be absolutely thrilled)

So that’s where I am now.  At this moment content, warm, hopeful and suspicious.  I’m afraid to let go of the suspicion.  I suppose that’s the last little piece of self-protection.  The author of “The Untethered Soul” would tell me to “just let it go…. open my heart… relax and release.”  Maybe I should try that, pain be damned.  We’ll see.  Maybe after another glass of wine.

Therapy

Just a few notes for myself.  Things to discuss at therapy:

– realization of my fear of committing to life
– increasing social isolation
– projects/hobbies (attempting to address the above)

[5/22] So I had a phone conversation just now (lunch break) with a woman who was diagnosed with herpes in February.  I didn’t ask which kind she has; I assumed HSV-2.  She is completely devastated.  I mean I felt like crap and I still have moments when I just don’t want to think about it, but it’s torturing her in a way that I think only my depression has done.  And I realize, I don’t have it all that bad.  Not only do I have the more common form of the virus, I also don’t care about getting married and having children.  This woman is in her early 30s and does want to get married and have kids.  So even though she’s with someone all she can think about is how impossible it will be for her to have the life she wants because no one will want to be with her.

It’s things like this that make me want even more strongly to “come out” as it were and start working to destigmatize this disease.  People shouldn’t have to feel so hopeless and disgusting over a virus that is NOT life-threatening and really doesn’t even change our daily lives in any way.  Of course no one would CHOOSE to get infected.  But at the end of the day, it’s not that big of a deal.

And as I say this it makes me feel worse and worse about NG.  I still haven’t told him.  [5/23] In my mind this makes me a reprehensible person which is probably contributing not insignificantly to my recent (+/- 3 weeks) mood slump.  I told my therapist this yesterday and she didn’t totally berate me which was good.  But I haven’t told her that we have in fact been in contact with each other’s genitals.  So basically, that thing I swore I’d never do again?  I did it again.  I don’t know what I’m going to do.  I have seriously considered breaking up with him instead of telling him.  So here’s to me and my high moral standards. *sigh*  I’m trying not to give myself too much flack about it but it genuinely does upset me to discover that I’m so much of a coward.  Especially since I KNOW that it’s not that big of a deal and that odds are pretty good that he already has it.

And part of me is still rationalizing: If the general populace doesn’t equate cold sores with herpes and the virus I have is the cold sore virus I have just as much right to pretend I don’t have herpes as that 75% of the population has to pretend they don’t have herpes.  Except of course most people, I think, don’t even realize it is a form of herpes, so it’s considerably different from my situation, where I know damn well it’s herpes.  *misery*

Why I stay indoors

I just got rejected.

Not really.  Not in reality.  But in my head, it feels like rejection.

Basically, I had told New Friend (a while back) that I would be interested in pursuing a “more-than-friends” type dealie if he was.  Honestly, I didn’t feel anything for him at the time and I still don’t now.  In fact, were it not for the couple of things we have in common we probably would not hang out at all.  If he gets a girlfriend to spend lots of time with, I’m off the hook.  What I mean is, I don’t think we really enjoy each other’s company that much.  He’s horrible for conversation, which is one thing I absolutely must have, and his taste in movies is mediocre at best.  I’m not saying all these things just to make myself feel better — though it is helping — these are things I have been aware of all along.  But because being around a single man who is moderately attractive kind of stirred up some of my hormones, I made that declaration back when.  I have many times wished to rescind it.  Actually every time we hang out I think, “man, would it be rude to take it back?”

Today he texted me and said “blah blah blah, you said you were interested back when, I value you as a good friend” (what? if we’re good friends he’s seriously hurting for actual good friends) “so I want to let you know I met this girl, yadda yadda.”  The good thing is, it gave me the opportunity to say, “nono, you misunderstood. it’s ok. srsly.”  The bad thing is, my body is shaking (only a little) and I feel a bit like crying.  I feel rejected.

What do I do with this?  I know it’s irrational, I know I didn’t even want him.  So I don’t really understand why my brain is creating these unhappy responses.  I DO NOT want to talk with my therapist about this.  I suppose it’s not really worth it for me to keep paying her if I don’t feel comfortable talking about things like this.  The things that illustrate some of my core dysfunctions.  I think it’s not so much that I don’t feel comfortable talking with her about it.  I don’t want to. I don’t want to develop an action plan.  I just want a hug.  I want a friend, dammit!

I guess maybe that’s part of it.  I knew NF and I weren’t compatible, that I don’t even really like his company all that much, but if he were interested in me that would be at least something.  It would have meant I was valuable to at least one person other than my mom.  Valuable enough to call up and say “hey, let’s hang out” every now and then.

I’m a little fucked up today anyway because I forgot to take my meds yesterday. Woke up depressed.  Had breakfast, took meds.  Started to feel a bit better.  Cried a bit. Felt a bit better.  Then I started to feel dizzy and nauseous.  Haven’t gotten a thing done today because I ended up having to lie down for a bit.  When I woke up I felt like a had a brick in my stomach.  Still do.  Did I mention I’ve been shitting weeks’ worth of feces this weekend?  Let’s hear it for chronic constipation.  But I felt a little better emotionally, at least.  Then NF sent me that text and I’m…. well, not back where I was, but still.

I think I can’t really trust my reaction today.  Emotions started off wrong, body’s all fucked up.  I’ll try to reanalyze tomorrow.  Today I just want a fucking hug.

I got a little short with my therapist last Thursday because it felt like she was pushing me to be less introverted, which is a little silly since introverted is what I am no matter how you slice it.  Working my way through last week’s Sunday NY Times (which, incidentally, was my last of the 12 weeks I got in the Groupon deal) on Saturday I read an opinion piece about shyness being an evolutionary trait — sometimes holding back really does keep us safe.  Interesting thought.  But the article also talked about how shyness and introversion are so often diagnosed as “Social Anxiety” (a disorder invented in the DSM III) and sufferers are medicated in order to keep those tendencies at bay.  And don’t get me wrong, my depression is significantly more manageable due to the 150mg Effexor I take each morning.  And because the depression isn’t as bad, my shyness is not quite as crippling as it used to be.  But to be honest I value my introversion.  I like to go out, hang out with friends, hear a concert every now and then.  But my week is soo much better if I get at least one day on the weekend to spend at home with very little company, running errands, beholden to none.  It was very affirming to see that opinion piece shortly after leaving therapy with that feeling of “is she trying to suggest that there is something wrong with being introverted?”

Figured I would track down the link for posterity’s sake.  It was: Is Shyness an Evolutionary Tactic? by Susan Cain.

All this being said, I did go out to the Double Door last night by myself to see a local band I enjoy.  When I got there the band hadn’t started yet so I did feel kind of awkward, wandering around by myself.  But once the band started playing it didn’t matter — in fact it was almost better to be alone, because there was no one trying to talk to me over the sound system.  I hate straining to hear, and I hate having to yell to be heard.  So it was just me and the band.  Awesome.  Of course when I tell Hannelore (my therapist) this next Thursday I’m sure she will be delighted.  I don’t think she realizes, though, that you can’t push me to do anything.  You can suggest it, and maybe a while later I’ll consider giving it a try, but it’s always going to be in my own time, on my own terms.  I’m just that stubborn.  But I recognize it and I know that if I’m patient and just think about it for a little while, I may grow comfortable with an idea and try it out.

Next on the list is the swimming lessons.  Since I’m not paying rent I don’t have to worry about needing that 80 bux to pay for vitals like groceries or utilities.  I just have to remember to make the call or drop by the Aquatic Center.  There’s a class starting the 11th or 18th I think; I’d like to get into that one if possible.

Anyway, it feels like I’m definitely on a positive track right now.  I even cleaned the kitchen while my mom is out of town!  I’m not holding my breath, because the cycle always bottoms out eventually, but for now I’m just gonna ride it.

Whining (just a bit)

I think I am on the verge of some major changes in my life & lifestyle and I have literally NO ONE to talk with.  I’m considering sending V an e-mail begging her to call me just so I can run my thoughts by a rational, caring person.  Mom is out of town (but I’d rather not get into these things with her anyway).

Some things keep coming up in therapy that it is getting harder and harder for me to ignore.  The fact that I have actually been willing to talk about them with even my therapist is a huge step, but because I am talking about them it is impossible for me to pretend they aren’t issues that need addressing.  I’ll be honest, this is pretty agonizing.  I feel like I’m about to burst and the one friend I have in this town that I feel I can be “real” with and who will understand what’s going on is still in several levels of denial herself and can’t be counted on to be consistently “real” with me.  And I’m not gonna show my heart to someone if I can’t be sure they will at least be level with me.

Fuck it, I’m sending that e-mail.

Bit of a downward turn

There are some things I have noticed over the course of this week that have me a little disheartened.  In the first place and most prominent (to me) is how fragile my psyche is, how susceptible to sudden change.  For example, I have almost cried at least once every day on the way to work and once on the way home, brought on by some story or other on NPR.

Second is the constant shivering, which may have little to do with withdrawal and lots to do with a climate in transition and the fact that it’s either too cold or too hot both at work and at home.  Regardless, my spine aches from being constantly tense and shivery.

Third is the sick feeling which, while not incapacitating by any stretch, has prevented me from taking my vitamins nearly every morning this week.  I have just felt too sick to my stomach to take any pills.  I can eat alright, but by the time I remember to take anything it’s been too long since I ate and I don’t trust that I won’t vomit it right back up.  It’s a feeling I associate with stress, which is only fair, as I guess my body is probably pretty stressed out.

I feel like I have gained some weight over the last few months and that brings me down a bit as well.

I do have this feeling that so much of my physical and emotional issues are built up in my abdomen.  I suffer from chronic constipation, cramping/spasms, sour stomach, often connected with emotional stress in my life.  I have never exercised, yet I am not in bad shape overall.  Except my abdomen.  It’s like this big ugly blob that is a physical manifestation of everything in my life that I can’t control or can’t seem to get right, or just seems too hard to fix.  I often imagine ripping it off, like pulling a wedge from an orange.  As though such a violent action would solve the underlying issues.

I remember what fat looks like from doing dissections in school; I have especially vivid memories of giving a frog a liposuction, essentially.  I don’t want to talk about it too much because the person I am now can’t bear the thought of dissection, and remembering being that person who could do such a thing has me tearing up.  But the fat, the fat is what I remember, and so I can very easily imagine what this belly of mine looks like under the skin.  It is vile and disgusting and I hate it.

 

What all this boils down to is that my behavior is leaning towards depressed, which, as I noted in the opening paragraph, is really disheartening.

 

I do have to give myself some credit, though!  I have made it through this whole week on no medication whatsoever and have had to rely on my own power to steer myself away from the kinds of unproductive negative thinking that is so easy to fall into.

When I told my therapist (brand new, only 4 sessions in) on Wednesday that I had gone off the medication (to be fair, I did tell her about my plan when I began seeing her) she seemed… concerned, I might say.  I suppose it does seem a little odd to decide almost simultaneously that going back to therapy and going off medication were both good ideas I wanted to pursue immediately.

Ohh my, I am feeling so sleepy.  And I kind of want to cry because this is obviously going to be much harder than I thought at first.  And I want to cry because I keep shivering and it’s frustrating that I can’t seem to stop!!  And I want to stop being able to smell myself when I sit indian-style because it makes me nervous, like there’s something irreversibly wrong with my body.

 

Sit and meditate, do some deep breathing, and see if that helps.

“Normal” trauma

Just to keep up with the days, it’s Day 22 of Effexor Detox.

I had an experience of what I would call “normal” trauma last weekend.  I got depressed, like I usually do on the weekends, and ended up telling BF in a very tearful conversation that I thought maybe we weren’t good together.  It was weird and awkward and I felt awful about it because I really, really upset him.  And myself.

We’re OK now, and seem to be addressing some of our “issues,” but I keep thinking about it..  It’s the first real “fight”-type thing we’ve had in ages.  Well, it wasn’t really a fight, it was more like  a day of sadness and uncertainty.  But for years it seems we’ve lived pretty harmoniously, which sometimes I think is a sign that we’re doing something wrong.  But often I just think it means that everyone ELSE is doing it wrong.

I do think we’re kind of an odd couple.  We have both been pretty detached from people in general, and yet we manage to care for each other a great deal.  Not to turn this into a big mushy piece of tripe, but I do feel pretty good about “us.”

Anyway, after going through almost a whole roll of toilet paper (using as tissue for our tears and runny noses) we declared a truce, had one shaky day after that and are doing pretty good now.  We are trying to be more open with each other and more present for each other.  So yay!

 

So the holidays are coming up and I have “Joy to the World” stuck in my head… I think I always get it in my head around this time, because the cold weather reminds me of dad singing this counter-tune-thing during the chorus.  I loved the way it sounded, even though the song was never a favorite of mine.  I wonder where he learned it, or if anyone else has heard anything like it.  It was always something unique to my father, so with him gone I feel like I will never hear it again.  I treasure the memory of hearing him sing.

Boring Post

Detox is still going fairly well.    No new or interesting details to add on that.

 

I saw a therapist for the first time on Wednesday after work.  It was… weird.  I forgot how awkward the first couple of sessions can be.  But she was attentive, and despite the fact that when I started talking I felt like I really had no cause to be there she seemed to take me seriously.  So that’s a good sign.

 

Three people where I work got laid off on Thursday, right around lunch time.  One of them I had been expecting, but three in one day really kind of shocked me.  It was rough on the office manager, who had to do the actual laying-off. Of course it was rough on the people who suddenly don’t have jobs.  I couldn’t stop thinking about it on the drive home that day.

 

This is a boring post.  Blah.