29 April 2008

Therapy

I'm meeting with my therapist/social worker again today. I think this will be the fifth time I've seen her.

I'm finding the meetings helpful, but for the last couple, I've left with the feeling that I could have gotten more out of the session. I'm usually tired when I'm there (hell, I'm always tired), and because my sessions come in the middle of a work day, I find that I don't make or have the time to think about what I want to cover until I'm on my way there. So then I get there, and we chat, and it's good, but I feel like it takes most of our time for my brain to really get going, and I often think of things I wish I'd said when I'm on my way to the car or back at work.

Never having done this therapy thing until now, I'm wondering how it works for most people. For those of you who have done this before, do you go to your appointment with specific things on your mind to discuss? Does the therapist come up with topics? Is it a combination?

Also, I had expected "homework" of some kind: coping strategies to try, things to think about. I got that the first week, but haven't since. (I also haven't asked for it.) Is it common to get "assignments," or did I make that up?

Regarding what to discuss, I also often feel like I don't know what I want to discuss. While I feel a fair amount of generalized frustration and sadness with my life, it's hard for me to think of how to turn that into a discussion. Ideas?

24 comments:

Megan said...

4 years into therapy with a really good therapist, it still take a few minutes of idle chatter to get me going. I guess it's just the way my brain works; I have to slow down a bit before the deep stuff can bubble up.

Also, some of the most profound things come up during the moments of chit-chat.

Kirsten said...

I am a psychologist, so I can give you the other perspective. I usually talk to my clients about whatever is on their minds, and frequently I have issues from the last session I want to follow up with. I routinely give "homework" assignments, though if it gets to feel like drudgery to the client, I discontinue. Some clients come with written lists of things they want to discuss, others come with just free association. With griefwork, I usually go with helping the client with the "new normal."

Good luck!
--Kirsten

Anonymous said...

I think that you tell your therapist/social worker exactly what you've written here. Who better to answer your questions about therapy than your therapist?

Best wishes, always.

Jen said...

dude.. i'm the queen of psychotherapy.. at least from the patient perspective. my psychologist almost always asks me at some point during the hour "what do you want to walk away from this time with.." and sometimes i don't have an answer. i've been seeing him for a year and i'd say that it varies depending on how i'm doing on the particular day that i see him.

yesterday i had an appointment and it went well and i cried a little, but i basically talked about how positive things were (i even mentioned you.. *laff*.. told him how i called you all by myself and didn't break).. but then i have a bad day/minute/moment and i think "god.. i wish i was talking to ken now".

having gone through some pretty extreme counseling, i am used to homework.. and at the beginning i got it regularly.. i'd be happy to fill you in on some of the things that have worked for me so maybe you can go in and talk about your goals. it's really good to set goals when you're in therapy.. half of the time is spent figuring out what the heck your goal is.. then you can dig into it and when you meet your goal it's like crossing a finish line (like me picking up the phone and calling you even though i knew you were busy with picking up your parents)...

griefwork is tough.. it's strange, but that's 80% of what my post partum depression baggage was about. i was dealing with this incredible emotional loss that didn't jive with the fact that my dreams had come true and i had a beautiful and healthy baby. i'm way open about my experiences, so feel free to ask anything. i had to learn how to get through the day while feeling the loss, but accepting it for what it is.. and letting myself feel the pain and realize that it was ok and then i had to learn how to fit the "new me" into "the old world"..

nutty..

anyway.. i go into some of my therapy sessions with a list.. i go into others with no clue of what i want to talk about. the biggest thing for me is that there is no judgement.. i can go in and there is this person who is not part of my life and i can literally say anything to him. it's when i open up and have word-vomit that the really profound things happen.. *laff*

god.. i'm jabby today...

Anonymous said...

I've been in therapy every week for almost 2 years with the same therapist for depression and anxiety.

When I started I was very results-oriented, but she was less so. We first had to really get to the bottom of what my feelings were and where they came from. Once we figure that out by just talking and her getting to know me (mostly things that made me feel anxious and depressed), then we could focus more on behavioral issues. I could say "I dislike that I [blank]." And [blank] is "am overly sensitive," "have trouble getting close to people," etc.

Obviously our situations are a lot different because our needs for therapy or different, but you say that you are unhappy basically all the time. I know that this is because you are grieving for your husband, but maybe there are also other reasons? Maybe you can talk to your therapist about when you feel unhappy and you can be mindful of your feelings and jot down in your planner or on a note pad things that pop into your head about what you would like to talk about. That's what works for me, so that's the best advice (hopefully not assvice) that I can give you.

I know it's hard, but seeing a therapist more frequently helps. I used to see my old therapist 2x a month and it wasn't enough.

best wishes.

sappho said...

i think one of the hardest things about therapy is the fact that it is an ongoing process. because it's process-oriented, there are plateaus, fits and starts, noticeable changes, and sometimes nothing.

i'm finding that experiencing all parts of it can be a really interesting learning process. it's tough, because i'm goal-oriented. i like schedules. i like results. therapy is kind of like that but it's a lot more intangible and it takes up a hell of a lot more time.

i usually have things in my head that i want to talk about, kind of a list of things that happened between the time i last saw my therapist and the current meeting. i usually talk about how i handled, or didn't handle things, how that made me feel, what i was having problems doing and what i may have achieved.

i had homework in the beginning, but i'm in a transitory phase before i start another workbook. right now, i just cherish the fact that i have a place to go where i can say anything and someone will listen and respond. it's a very unique space, and one that in my experience doesn't exist anywhere else.

it takes time to build trust with a therapist. my beginning with mine was rocky but it has improved greatly and i'm glad i stuck with it.

good luck snick. xo

moo said...

Therapy (and therapists) are meant to be a reflection of what is inside of you. They aren't supposed to have answers and aren't supposed to be teachers, but guides as you navigate the waters of your life. If you feel like you aren't getting what you need, tell your therapist! A good therapist will work with THAT and help you find what you are looking for.

But therapy, like life, is what you make of it. What you put in is what you get out. Perhaps your dissatisfaction comes from (and I'm WAY out on a limb here) being afraid to really say what you want to say? Something to explore, at any rate.

Anonymous said...

As another psychologist I would only comment that the previous posts have ALL been right on! Therapy is a process, and does take time to establish a rapport, and for your therapist to really get to know you. Give it time.

That being said, it is also a great idea to let her know exactly what you wrote in your post. It is possible that a part of you is fearful of going too much deeper, but that you know instinctively it might benefit you. By discussing this very issue, you might be able to learn something more about yourself. it may also just be hard for you to let yourself relax given that you know that you have to return to work. Talk with her about that too.

Good luck, and be gentle on yourself. Therapy can be a bizzare expereince, and some weeks may feel more productive than others. Try taking a slightly longer term perspective, like "do I see progress in a months time?". Let your therapist know how you are feeling.

Good luck-L

Anonymous said...

the best trick to effective therapy: tape record each session. listen to it 3 times (i know its a lot to ask!).
the first time you'll hear yourself and make judgements.
the second time you'll hear your therapist and what they were trying to say.
the third time you'll start to hear yourself, your patterns, and you'll learn.
6 months of therapy on tape beats 3 years of therapy in an office!

Anonymous said...

you sounded less frustrated when you were using the time with her to tap into something deeper (the madalas, for example). you could ask her to keep the brain dump time of your session to a reasonable limit (don't erase it entirely), and spend at least part of each session doing imagery, drawing from a deep place, and the like. also, as you know, it sometimes takes a series of seemingly mundane moments to have one that feels powerful and meaningful, and you can't force those. but you can set your intentions and manage your time, in combination with letting yourselves be guided by the process.

Jennifer said...

I usually come in all ticked off about something-or-other from week to week, so mostly we deal with that. If I don't come in with anything specific, she might come up with something.

I get "homework" once in awhile, but it is kind of spur of the moment and she doesn't "check" my homework to see if I've done it. And sometimes it's just "go have fun."

Rose said...

Can you schedule your therapy sessions at the end of the work day or just before lunch? It provides time to reflect and recover from the epiphanies and emotions. (I also needed time to splash cold water on my puffy eyes and fix my makeup.) It does help to have quiet time before having to be "on" again at work.

Maybe your therapist is cautious about adding homework because it'll burden your already-crowded radar screen.

Sam said...

My shrink told me to make a list of things I want to discuss as they come up so I don't forget and get angry with myself. So I have a mini-notepad (get it? shrink. mini. get it?) that I write stuff down on through the week.

Sometimes he gives me stuff to do; sometimes he doesn't. He's had me write down all the things about my family who died that I'm scared I'll forget. That was my best homework

OTRgirl said...

I've done various levels of family, individual and couple therapy. In the midst of my grieving time, I just needed a place where it could all be about me and my sadness--with no guilt for not listening in return. I think all the points about discussing goals and what you posted with your therapist are great.

Off topic: when Jrex came home, I was watching Idol. He joined me as he ate leftovers. When I declared that Jason needs to get kicked off the island after tonight, he looked over at me and said, "What have you done with my wife? Who ARE you?" To which I naturally responded, "What? This is all Snickollet's fault, not mine! I never would have gone down this road without her influence." By the end of the show, who was jumping in with snide remarks and judgmental opinions? Oh yeah! You've corrupted our whole household.

You should be proud.

Shiela said...

i agree with everyone else here .. and will second anon's comment about telling your therapist exactly what you wrote here. you'd be surprised at how much that can help.

i usually start with kind of a brain dump and then realize that this is about ME .. and that usually gets me to stop the dump and start to really examine what's going on.

caramama said...

Since there are different types of therapy and therapists, I would definitely talk to yours about how you are feeling and what you want to get out of it. In my first session with mine, I flat out asked her what this was going to do for me, i.e. were we just going to talk about my feelings and past or were we going to develop tools to help me deal with the PPD or what? She said that some therapists delve into the past and how that affects you now, but she leans more to working on changing habits and thought patterns. And she really did.

My sessions were a combination of things I had been thinking about that I wanted to discuss and things that just came out. Also, I found that when I was just feeling an emotion that was upsetting, she would keep asking me to give examples of when I felt like that and we'd talk through what was going on by using the example. Then she would offer me different ways to think about things or tools to help in similar situations or when I felt like that in general. She didn't give assignments, but ideas that I could take or leave.

So, there's my experience. I found my therapist so incredibly helpful. But it did take time and not ever session was perfect, you know? Anyway, good luck with yours!

Amy said...

I agree with all. Especially the comment wondering if you can schedule your visits after work so if you get emotional (cry) you won't feel you have to hold back for the sake of the co-workers.

I would think ONE of the best things a therapist can do is be a safe person for you to say whatever the heck you want. Safe..

buddha_girl said...

1. I think you should share this list with your counselor.

2. I liked homework when I needed focus. Once I walked out of her office, I would feel flighty about putting new skills into place unless I had been given an "assignment." Ask for it. Perhaps she thinks you're overwhelmed and don't want homework.

3. Some days I just wanted to shoot the shit with my chick. Other days, I needed her to guide me. I found that the better she knew me, the more apt she was to innately realize what I needed in case I didn't make my needs known.

Jan said...

Wow! I just needed to let you know that I really admire you. How tough life is for you. My experience with counseling is that you have to be comfortable with your counselor/therapist. Sometimes it takes a while to find a good match. As far as homework goes, I guess it depends on if it feels like you are accomplishing anything with/without it.

MLE said...

I saw a wonderful therapist for several years. For me it was not so much of having an agenda as it was the occassional epiphany over something that should have seemed obvious.

An open mind and a desire to heal are the only things you need to bring to your sessions.

Abacaxi Mamao said...

I have found it very helpful to journal the night before I go to therapy, to help me think about what's on my mind, and also to journal immediately after therapy, before I go back to work. I have a flexible enough work schedule that I can usually do the latter, and not enough self-discipline (at all!) to do the former.

And I second/third/whatever everyone's suggestions to share this post with your therapist.

Abacaxi Mamao said...

P.S. I have been in therapy for about ten years now, since I was 18, with a variety of different therapists. It did sometimes take a few tries to get a good fit, but I've also been able to tell a therapist when I wanted/needed something about therapy to be different. That was very empowering.

masteroftheuniverse said...

I went to one grief session, stayed 15 minutes, and left. It wasn't for me. Maybe they have value for some, but I didn't perceive any value from that session. I've found out that my best way with dealing with grief is to go out back to our beach and do a couple of hours of surfing. It doesn't matter if the waves are big, small, choppy, blownout. Surfing puts a smile on my face for a couple of hours and makes me feel human again.

Again,
My Condolences.

Jeff

WiseOne said...

I can't imagine the life you are living right now. I can only imagine having my life derailed from anything close to what I was expecting. I admire you for putting one foot in front of the other every day and moving forward.
But, back to the question. I would recommend going to http://www.goodtherapy.org and looking through some of their blog posts. You will find many written on grief, which may give you a some ideas of things you'd like to talk about with your therapist.
I personally feel that therapy is such an individual pursuit that you can't really say that something is right or wrong (as long as it's ethical). If you are benefiting from the sessions, I wouldn't worry about whether or not you are "doing therapy" the right way. I'll be thinking about you and wishing you well!