Failed Therapy

[in_media_res]

I'm not sure where to turn.

I've had long term issues with depression and self-esteem, since I was a child. I started drinking as a teenager, did so for decades, but have not had alcohol in close to two years. I've been on various courses of antidepressants over 20+ years. At best, they seem to provide some short term relief. But eventually, they always stop helping because while they might help my mood, they don't change how I approach the world or how I think.

A couple of years ago, I started meeting with a therapist to try and address the underlying issues that are driving my emotions. It's helped, in that I've shared a lot of experiences that I'd always kept to myself - which was cathartic - and I've come to understand the mechanisms that are at work in my mind. But for the last six+ months I've been struggling with actually changing how I engage with people - and I keep ending up angry, frustrated, and anxious. I don't understand why I can't, or won't, let these things go.

Yesterday, I met with my therapist. She told me she's terminating therapy. We'll have at least one more session (in three weeks) to talk about where I go next, but she feels she can't help me.

Intellectually, I know that she's probably right. Can't keep doing the same thing and expect different results, and all of that...

But emotionally, I'm a basket case. I'm afraid of what will happen. I'm not sure how I'll go on - for the last few months, even though progress has been slow, I've been able to use my time with her to at least share what I'm feeling and get feedback on how I'm approaching things. Without her, I've got no place and no one where I can work through my fears and frustrations. I feel abandoned. Most of all, I feel like a failure. Like so many other things in my life - self, work, relationships - I can't quite seem to make it to the final goal. I never really close the deal. I'm always living some fraction of my potential.

I feel like I just can't stand it anymore, and that this is just another sign that maybe I don't want to change, or can't. Or that this really is the best I can do. I'm so tired of fighting and struggling.

I was only able to sleep about three hours last night. I've been up since 1:30 am staring at the ceiling. I keep thinking about something Paul said on the podcast recently - about how it's never enough, you don't have enough, you don't do enough, and that really you just don't matter. Feels like the story of my life. And with this, I'm back in it all again. My work wasn't enough. I apparently didn't do enough. I haven't been able to change enough. And I wonder whether any of it matters. Or if I'm just wasting everybody's time.

I'm not sure what question, if any, I'm asking. Maybe whether there is any hope of change when habits, and beliefs, and thoughts are so deeply entrenched.

[manuel_moe_g]

Hello in_media_res, welcome to the forum.

I read your post. I honor your pain and I just want to say the truth, that you don't deserve to endure this suffering.

I am not qualified to give help, but I can say a few things from my own story. Obviously, you are the expert on your own situation.

this is just another sign that maybe I don't want to change, or can't.

One of my own problems is "black or white" thinking - that if I am not working 100% to change a negative thing about myself, then I must not really want to change. But I push back on that kind of "black or white" thinking, because it is not realistic - there are a lot of things in life where it is like hammering against a huge boulder - a tiny crack is growing deep inside the boulder, that crack get a little bit larger with each hammer blow, and eventually there will be a single hammer blow that will make the huge boulder split completely in two perfect halves, but that would have been impossible without all the hammer blows that came before. So a lot of work can show almost no payoff for a long long time, but it is building into a real breakthrough. A lot of difficult things in life work this way.

All the best, we are all cheering for your greatest today and tomorrow.

From this MentalPod board - some places to get help for people with limited resources:

• Help for little or no money
  
• Best Insurance Companies/Types for Mental Health Care
  
• Links for More Mental Health Info/Suicide Hotlines

[in_media_res]

Thank you very much. That's a very helpful way of looking at the situation, and I appreciate your optimism. I guess I wish my therapist felt the same.

This is still very all consuming for me. It's most of what I think about - I keep going back and forth between anger and hurt and failure and confusion. And then I start second-guessing my emotions, devaluing them because in the end it's all just me making everything abut me, and trying to control everything. Which is what I do.

I don't know what I'm trying to say, or if I'm really even trying to say anything. But thanks for listening, and for your support. It helps.

[manuel_moe_g]

I keep going back and forth between anger and hurt and failure and confusion. And then I start second-guessing my emotions, devaluing them because in the end it's all just me making everything abut me, and trying to control everything.

I like this book:

Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy; Steven C. Hayes

I hold my negative emotions like I would hold a crying child, and I accept them, and I lead them by the hand out of this scary dangerous place like a responsible caring adult.

I only emotion I had to "kill" was this feeling: "I shouldn't have to work to improve". This emotion I had to kill and crush it, because it was so tightly linked with falling into a place where suicide was likely.

But all the other emotions I hold tight like I would hold a crying child, and validate them, and lead them by the hand through a path of mature decision making, and let them know that I am protecting them and I will not abandon them.

I don't know if this makes any sense. This is the best way I can communicate where I am at right now.

Please take care, we are all cheering for your very best today and tomorrow!

[in_media_res]

Thanks again. I'm still wrapped up in this; don't have to words to describe it right now. Thank you for the book suggestion - I'll check it out.

[in_media_res]

manuel_moe_g:

Thanks for recommending the book. I've started to work through it, and the first few chapters have been hopeful.

The experience has been deeply painful, and it's kicked off another round of deep depression and anxiety. I'm still sorting out what I'll do next. I try to keep in mind that I'm fortunate to have resources and options, and a family that supports me. I'll be trying to work through the exercises in the book. Im revisiting my foregiveness meditations. I believe I need to continue to work with a therapist, but I'm very confused and concerned about how to move forward. We'll see.

Thank you for responding.

[manuel_moe_g]

Yeah, "Dare I Say It" in this forum encouraged me to restart therapy, and I made the first phone call on Friday. I have some anxiety about it, so I will write down what improvements to myself would really remove a lot of difficulty from my life, ask the therapist to go easy on me with the things I have the least control over, and hold me to a high standard on the things I have the most control over, and I will use past therapist experiences to avoid the feeling of being taken advantage of or being ignored.

want to work on: rage, being "punchy" when human interaction is unwelcome, pushing myself to do a little more work before I collapse

little control over: I have to move slow, I cannot risk giving up because I cannot sustain a faster pace

more control over: meditative times when things in my day slow up

therapist issues: need concrete steps, I want to pick what we work on so use therapist "à la carte", I need a therapist who is secure enough so they don't need to bolster their ego during the session

About forgiveness, "in_media_res": please forgive yourself first, forgive yourself second, forgive yourself third, and the people who did wrong to you have to wait in line. Wait to forgive the baddies until you have several people who see clearly that you _need_ to forgive to move forward toward things that are the very very best for you!

All the best, please take care, we here are all cheering for your very best today and tomorrow!

[diaz]

Hey in_media_res,

Sounds to me like that therapist just wasn't a right fit. It's completely normal to feel abandoned and confused and angry. Some therapists are better than others, and her termination of your therapy probably had more to do with her inability to help you - not your ability to be helped.

I can assure you that you can be helped, you can help yourself and there is hope.

Progress can be - and usually is - agonizingly slow. You may go months without noticeable improvement or change, but if you keep at it something will click every once in a while.

I'm not sure what forms of treatment you are getting now, but I definitely recommend medication in addition to talk therapy. And go to a psychiatrist for meds - not a general practitioner. Finding the right medication(s) can be difficult and complicated, so I would definitely go to someone well trained in psych meds.

Also, in my experience, psychiatrists are often not very good at talk therapy, so leave the meds to them and the talk therapy to a psychologist, social worker, counselor, etc.

If your depression continues to be treatment resistant, ask your psychiatrist about Transcranial Magnetic Stimulation. It's a relatively new form of treatment, and it did wonders for me. Changed my life. It's expensive, but it was worth every penny because now I have my life back.

-D

[in_media_res]

I owe a couple of replies.

@manuel_moe_g -- thanks for your support and kind words. I've been able to make a lot of progress with this -- have been working with a new therapist, and I seem to be making my way through it. I hope you're well.

@diaz -- thanks for the post, I appreciate it. Welcome to the forum. I'm very, very interested in your experiences with TMS. In my case, I was able to work through the actual termination by the therapist fairly quickly -- as you point out, she felt she couldn't help me. The real issues I had, which caused the distress I've been working through, was that she did it in a very hurtful way. She made the decision and told me in the middle of a session, just as I was opening up about something I was struggling with. I freaked, and began to beg her not to end the relationship. She was very dismissive of my pain, and became a little sarcastic. She talked with me about ten minutes on the phone several days after the session, after I'd contacted my psychiatrist telling him I was considering suicide. She blamed me for the failure, said I didn't really want to change. She's never met with me or talked with me since, despite multiple requests to her and my (now former) psychiatrist. It's been a long three months. But, as I mentioned, I'm working through it. But your points are well taken.

My experience with meds is pretty poor. I've tried most of the SSRI's over about 15 years, working with both internists and psychiatrists. They either don't work, or if they do help the effect isn't very long lasting. And I have many problems with side effects. I know in many cases, people have found them to be transformative. But I've refused to take them, and am focusing on therapy, exercise, and mediation as the main treatments. I'm glad they're working for you. And as I say, I'm sure everyone would be very interested in hearing more about TMS.

Thanks.

[diaz]

I'll be blunt. It sounds like your former therapist was a worthless bitch. Let's move on, shall we?

Before I begin, it is possible you may have hypochondriasis, which is a very real illness. Please don't take offense. I only mention this to inform you of other possibilities before you spend tons of money on other treatments.

I have major, unipolar, treatment resistant depression. And that is why I was a prime candidate for TMS. If you have other conditions (bipolar, borderline p.d., etc.) it may complicate things.

Anyway, I tried meds and talk therapy forever - and don't get me wrong, they helped tremendously - but no matter how well I did I would always hit a wall sooner or later. There was always one last hurdle I couldn't quite get over - and it meant the difference between success and failure. TMS finally enabled me to get over that hurdle. I'm not sure how, exactly, but it worked. It stimulated the part of my brain that needed stimulation, and my life has been much better since.