Ask Lemmy

For therapy to work for you, you have to show up for it in a big way. Therapy is work. Not only is it work, but you have to be ready to work, which often includes letting go of your ego and admitting to yourself what patterns you engage in that aren't serving you well. While advice giving can occasionally play a small role in therapy, it is not therapy.

Counterintuitively, many people are really, really attached to their negative patterns that perpetuate feelings of anxiety or depression. They may say they're unhappy, but they aren't ready to do anything different to change that.

Maybe take a look at yourself and try to gauge your own readiness for change. If you're not ready to acknowledge that you yourself play a huge role in how you feel, therapy will not be productive. If you're expecting a therapist to do the work for you, therapy will not be productive. If you're not ready to do work to break out of patterns in your life outside of therapy, therapy will not be productive.

The first therapist I saw happened to be really good, or maybe I was really ready to hear her, possibly both. One thing she mentioned and really affected me at the time: observing how I expressed how guilty I felt about how mad I was about XYZ, that often the “secondary” feelings (guilt) give us more trouble than the primary feeling (anger). This helped me start to drill down into what my actual feeling/reaction to XYZ was, and I could feel less plagued/affected by the guilt/shame/whatev that had been drilled into my head over time (by mom, teachers, whomever).

I went to one therapist in my late 20s for about 6 months, then in mid/late 30s spoke with 2 different psychiatrists and 2 different talk therapists / social workers, plus have experienced 3 different couples counselors (oh joy). Some are not a good fit. I recommend trying someone for a few sessions — at least 3 — and then allowing yourself to try a different person. They will not be offended!

I'm not a bad person for saying no and my intrusive thoughts do not define me.

That's actually solid advice tho. Not for your whole life, but everyone seems to pretend none of their emotions come from sleeping like a meth addict. Only when they're at absolute crash exhaustion and never at a repeating time.

then again, there's a lot of doctors out there who will tell you to just have better vibes so who am I to judge?

The 3 basics are always the same: regular sleep, regular eating, regular exercise. If these things don't work, the rest gets infinitely harder.

For me personally: try to get a feel where my personal limits are, and act on them. That often means taking a step back, leaving a social situation and not feel bad about it; canceling appointments if they would be too much for me, even if i miss out on stuff (like not using cards for the theater even if i paid for them). Telling myself that I have innate worth regardless of what i do or not do; internalizing that being pensioned doesn't make me worth less than when i worked. Accepting that my issues will never be gone, and that i can only work on fixing my reactions and reducing the time to counteract.

Currently i am failing at literally everything except that i still tell myself that i am worthy of a fulfilling life.

Validating that I was being abused. Everybody else either didn’t want to talk about it, told me I was the problem, or justified it. I had become self-destructive because I didn’t know what I was. Was I crazy? I was pretty sure i was the victim, but maybe I had brought it on myself. Maybe it was in my head. Maybe what was happening was normal and my expectations were off. Being told what was happening was indeed what I thought was going on and to build a support network to get out was life-changing. I mean, I’m still a fucking mess, but less of one. Probably need to fix my sleep schedule.

Ground yourself. No not in the childcare and electrical sense

So I have mild PTSD and I was advised to, when feeling like everything was spiraling, to immediately focus on something like the weight and feel of my boots or the feeling of the seat under my butt.

Not me but someone close to me:

• There is a difference between "ready for therapy" and "ready for change". Some people will sit in therapy for years but never see much progress because they are so stuck in doing or thinking something that holds them back.
• Your therapist will tell you things that don't make sense to you. Listen to them anyway. If they tell you something that seems impossible, don't ignore it, ask how you can do that. If they tell you something that seems useless, try it anyway, then report back if it doesn't work and be open for an explanation for why it didn't work.
• Be brutally honest. Your therapist won't be able to help you unless you tell them exactly how bad your situation is. If you spend 90% of your day in bed and tell your therapist you're doing okay, they won't be able to correctly identify what kind of help you need.
• It is completely normal to miss some of your goals. Therapy takes time and nobody will judge you if you take longer than others. Figuring out how much you should push yourself and when you need a break is hard. Either way, don't be angry at yourself when something doesn't work out. As long as you tried, you're fine.
• Most of your problems are in your head. That doesn't mean they aren't real. It doesn't mean they don't hurt. It doesn't mean they aren't difficult to overcome. It just means that the only person who can solve them is you. A therapist can explain how to solve them but they can't change your thoughts or your habits.

Stop blaming yourself when other people are horrible to you.

Nobody in my life had ever suggested that before. It changed my life and I'm much happier.

My therapist doesn't really give me advice. She has a certain way of talking, looking at me, having a certain body language that either provokes me or inspires me - or my subconsciousness - to come up with alternate solutions, ways of thinking, behaviors and whatnot. Only when I'm apathetic, catatonic, having a panic attack or otherwise incapacitated does she actively provide concrete advice.

At first, I wanted to punch her in her above-it-all stuck up face, but two years later, I'm so grateful for her and her methodology. She has helped me developed my introspective skills. She has helped me heighten my senses so that I can feel such small changes in my mood that I otherwise wouldn't have been able to notice.

With that out of the way, these are some of the most miraculous moments that I have had with her:

1. we were in the midst of recreating a traumatic episode from my childhood. My mind - but really I, myself - was there and then. Just as I finished reliving the moment of abuse and I was crying to the point of hyperventilation, I heard my therapist's voice saying, extremely quietly and gently, although not whispering: "if I would've been there, I would've said, that *** (the abusive action) is not okay." This was so healing. All my life (30+ years), I had carried the burden of believing that I am stupid, ugly and worthless because of this episode. This is the first time anybody told me otherwise.
2. she helped me visualize and understand that my childhood trauma is a constant/static element, which is not changeable, and that my current health is made up of variables/dynamic elements, which are changeable. This was such a eureka moment, because it made me realize, that I should work on stopping fighting the child in within. He, my history, is not "the enemy". What I want to change is how I feel about or relate to him in the present and future.

Here’s my take: therapy only works if you give yourself over to it. That is to say, you have to be committed to take the advice that your therapist gives you, regardless of whether or not you (in the moment) believe it or not*.

You also have the right, and expectation, to push back. But, you have to do it in good faith. If you do the work, and take their advice, and it genuinely isn’t working for you no matter ho hard you try, tell them it isn’t working and what you’ve done.

I’ve been in therapy for almost 3 years now. It’s done wonders. But it’s been a long, difficult, and often painful journey. My therapist and I have had our moments. It happens. But we both kept at it, and I actually feel like a “normal” person for once.

Also: if you genuinely feel like you’re not connecting with your therapist, then don’t be shy about it. Let them know, and go find someone else. Don’t settle for someone just because you think you can’t do better or that you don’t deserve better.

* Obviously don’t do anything that would cause you or others harm.

First she is a safe place where I'm not only encouraged to share vulnerable things, it's where hiding things is actively against the effort. Frees me, mentally, to actually speak.

Second, she's really good at gently nudging me out of my loops. I've contemplated my issues to hell, back, and again. She's really good at finding me an off ramp.

Finally, after I was sexually assaulted, she's been unquantifiable helpful. She answered honestly about things such as police reports and what I could expect (my case was unlikely to get the time of day, which I expected), strategies to address my recurring problems, and just being a decent human that judges me far less harshly than myself.

None. I was the one usually giving motivational thoughts and words Then J. showed up. J was an abused woman, about age 26, burned with kerosene on her chest.. ☹️

I learned something that day, things could be way worse.

I hope J. is doing good these days..

Narcissists will never voluntarily do therapy. The brain is a simple organ. It only learns new things by being surprised, when something unexpected happens. This has to be repeated over and over again to have an effect.

I'd recommend you take a look at schema therapy and mention it because I recognise the emotional state that comes across in what you post. Schema therapy would talk about this as "angry child mode". Which is not intended to invalidate the very real reasons you have to be angry. It becomes a prison, isolation yourself from different parts that exist within you that could otherwise work in your favour to help you achieve what you want or better advocate for your needs.

Without the support of someone who knows what they're doing that angry child mode is a never-ending pit of despair and source of guilt.

Short answer: Try medication (which worked)

Long answer:

I have clinically diagnosed depression, Major Depressive Disorder. Known it from first year of college, symptoms started way earlier probably around middle school

Psychologist from a few years ago recommended me to read the Feeling Good Handbook. I ended up reading the entire thing end-to-end... Most of it I don't really recall anymore at this point. But the book did mention about how there are two gold-standard forms of therapy: "talk-therapy" (usually what psychologists do, most popular one I think is CBT), and antidepressants/medication. And the people who respond most effectively to these two options are almost anti-correlative with each other

It turned out I was among the smaller group of people who don't respond very well (if at all) to talk therapy, but respond very well to medication. I was quite mentally against antidepressants up until that point, but I decided to just bite the bullet and give it a shot... So I talked with my psychologist, who then connected me with a psychiatrist who helped me get a prescription for Fluoxetine (Prozac) and monitored my progress every 2-3 months. It was basically a miracle drug for me. MDD can't be cured, but me taking prescribed antidepressants, along with me getting adopted by two cats at that time, almost "cured" my depression for good. I was on a very low dose too, only 10-20 mg/d

But to echo what others have said. Therapy is work. I was very committed to finding an intervention. Even though CBT didn't work very well I still managed to visit my psychologist every month and self-reflect afterwards, and that continued several years onwards even when most of my symptoms were greatly reduced after medication. No one forced me to read through a several hundred page book either, or to overcome my mental barrier of taking medication... I chose to partake these actions on my own

But yeah I think therapy does work if one is willing to put the effort into it

"Cognitive Behavioral Approaches are the most effective means of recognizing negative patterns in real world scenarios and correcting those behaviors is a matter of will and repetition"

And, she was right, as far as I was concerned. I'm not 'fixed', but I can tell when my own patterns have kicked in and I'm in a spiraling loop, and the tools/knowledge of kicking that loop with new actions in an attempt to break the pattern has been really helpful.

The most important thing I learned were strategies to handle the panic attacks. The knowledge of flooding the brain with physiological responses through focus on sensations and objects within my immediate vicinity has been instrumental in grounding me to the present. The panic attack still comes, but it's not as long and I'm not left exhausted, sweaty, and emotionally dead as often as I was.

The mumbo jumbo softer side (I went to school for psych, my BA says I get to say this) of Psych is really good for a lot of things. The practical side of Psychology is really good for most if not all people.

Learned to recognize and preempt shame spirals before they dragged me down into depression. Made a world of difference.

Helpful.