When to Start

[cyanidebreathmint]

Yeah, you're probably right. Yesterday turned out to be a difficult day, although good in the end. But I actually managed to get to a place emotionally where I can contemplate leaving them in the medicine cabinet rather than carting them around. First time in ten weeks. Tossing them may have to wait for another day. But that's another thread.

I'm glad you can think about leaving them at home at least. I'm interested to hear more.

Therapy is important. Hard to write about right now, as I have had some setbacks in that regard that I'm trying to mend. But if your depression stems from how you approach people and the world, I think that's the only way to pick those sorts of issues apart and get past them. This is my biggest criticism of meds (and in particular, with my former psychiatrist) - that somehow taking a pill is going to help undo the situations that have led to pain and fear. That's probably all I can say right now.

It seems like I find out another way I'm fucked up with communication and relationships at least weekly. This is definitely a huge factor for me, and I'm still uncovering more and more. Just today I had a bit of an epiphany about how I carry myself/my demeanor. I am a small person but can be intimidating, and I've heard people tell me they were "scared" of me for years. One woman used the word "shocked" to describe my demeanor. And I always thought it was ludicrous because I think I'm a nice person, and all I'm doing is usually just trying to do my best. But there you go. A million things like this can cause problems without us knowing if we don't have insight into them.

I agree that therapy is important, but I am also frustrated in the process. I want to live my life to some reasonably pleasant standard, not spend the whole thing trying to get better. I need a basic quality of life, you know?

Also, just this week I had an incredibly horrible therapy session that kind of made me step back and question the whole process. What does this woman really know, anyway? Some of the time I can tell she's winging it. Do I need someone more knowledgeable? I don't want to minimize the problems of anyone else, but at the same time I have a number of debilitating issues that need pretty focused attention. I'm not having problems with my relationships, I'm having problems allowing for the possibility of relationships, period. Like, the foundations aren't even there for me, so maybe I need someone more experienced with my particular malfunction(s).

Mindfulness does come from Buddhism. I find the religion itself interesting, although I know next to nothing about it. I'm probably more of a student of buddhist psychology than buddhism, if that makes any sense. I'd like to learn more -- spirituality is an area that's not seen a lot of focus from me, and I think it would be helpful.

I've been able to use mindfulness to help improve how I relate to other people. My upbringing saw a lot of uncertainty. People I care for very deeply, and looked to for support, behaved in unpredictable and often frightening ways. All of that laid down a foundation of fear - you can never be sure how people are going to react to you. Over time, that fear grew to be a defining characteristic of all my relationships. (Paradoxically, the more important the relationship, the worse the fear.) I'd spend huge amounts of time trying to analyze how somebody would react and what they might say or do, was always on the watch to try and gauge how someone was reacting and guessing what they were thinking, trying to figure out how I should respond, what their reaction meant for me, and so on, and so on, and so on. As is probably obvious, it didn't leave a lot of actual time for communication...not to mention coming off as distant, and controlling, and a bit manipulative at times. With mindfulness, I've been able to break some of that behavior. To just sit and listen, and take in what somebody is saying, and then react has been a huge help.

I've also done a lot of work with meditations on forgiveness, acceptance, and letting go. There's a lot of stuff I've drug around for a very long time. And having a structured way to set some of that down has been necessary for me.

I find Buddhism interesting, too. I think I'm gonna dig out my book again and try and let some more sink in. I am incredibly skeptical about religion, so this is a huge challenge for me.

I have, however, seen pretty great improvements with mindfulness practice, even the small bits I've done.

I think our upbringings were fairly similar. I can definitely relate to what you're saying, anyway. I am paralyzed by the mere idea of intimacy. And I do that running through scenarios thing, too. My therapist calls it hypervigilance.

Exercise and nutrition have been doubly important for me...as I mentioned earlier on, while on meds I gained a huge amount of weight. The extra weight fueled an already poor vision of myself. Over a couple of years, I've managed to lose 90 pounds. I feel much better, physically and emotionally, and feel better about myself. A lot of what I read talks about the importance of accepting yourself as you are, but I'll confess that's one thing I've been happy to be able to change. I think it has more practical uses as well - on days when I'm struggling, going and working out can (but doesn't always) help me get out of my head, and it does help my mood.

Exercise definitely can help! I've managed at times to turn it into a punishment for myself, but I need to get back into it in a different mindset because it's a necessity for body and mind. On the same note as the acceptance thing, when I was struggling with weight, and developing an eating disorder, my friend's mother asked me why I was measuring out all of my portions and denying myself nutrition. She asked if I would do that to a child. That really takes you out of the hateful mind when you project your actions toward yourself onto a child. It's a good tool to use. So if you find yourself beating yourself up about the weight, just think if you would ever let someone beat up verbally on a kid like that and know that you're just as valuable and vulnerable and try and give yourself a break.


Thanks for your thoughtful response! I hope you are well!

[in_media_res]

Just a quick note to acknowledge your post -- thank you for the thoughtful reply.

I'd like to try and respond, in particular, to your comments about your experiences in therapy. I've been trying to work through the termination of my relationship with my therapist of two and one-half years. She ended it 11 weeks ago in the middle of a session. It's been emotionally devastating, although I was fortunate to find another person who's been able to help me work with it. And it's been helpful to have conversations with others here. But I'll be completely candid, I struggle with it most days, and cycle through a mix of emotions that range from equanimity and acceptance to pure rage and suicidal despair. It's difficult to talk through, but I'd like to try and talk with others about how they've handled situations like this, and what they do when their relationship with their therapist goes off the rails, for whatever reason.

It's my hope Paul can do one of his podcasts on the topic, perhaps with Dr. Zucker, on what to do.

Will try for more later.

Take care.

[cyanidebreathmint]

Yeah, I think problems with therapists is a very important topic to address. It's tough waters for most of us to navigate. The relationship is inherently fraught with so many layers of tension, I think.

I'm hoping I didn't miss you saying this before, but did your therapist tell you why she was decided to end therapy with you?

Having only been in therapy for 5 months, I can tell you I'd be absolutely wrecked if my therapist did what yours did. I imagine I'd react in the same way you are. I really can't imagine how hard it must be after 2 1/2 years.

I was fairly wrecked after just one bad session!

I think it's an important topic and maybe you should even email Paul about it. Since he's switching therapists right now, it might even be one of the best times for a topic like this on the show.'


I hoe things are going well for you today.

[in_media_res]

...but did your therapist tell you why she was decided to end therapy with you?

She said several things. That's been part of the problem.

I'm not sure I can/should get into it in a lot of detail...still really wrapped up, and I'm struggling just to let it go. So as tempting as it is to run through the story again, it seems wiser to just leave it alone. But having brought it up, let me just say I think it came down to she didn't feel as though she could help me any more. Which I'm not happy about, but was able to accept pretty quickly.

If I try to look at it from her perspective, I don't think she was ever planning to get into a long-term therapy relationship -- I'm not sure why. I've heard from someone else that she did something similar to another patient -- so I get the feeling she's just not into working with people over the longer term. Which is her right. My view of the situation is, naturally, quite different -- I was having difficulty changing, and in the end was greatly pained that she didn't seem able or willing to help me overcome the things in my way. In the end, I suspect she was bored/impatient - one of the things she accused me of was that I was using therapy as an excuse not to change. And that led her to push me away before I was ready, and without any support. She's basically refused to speak with me since the termination, so I'll never know.

A lot of the pain in the termination, in my case, comes from how it was handled. I think it was hurtful in many respects, but I'm sure she doesn't see it that way. I've been working with another therapist to try and get re-started, and one of the things we've been looking at is how this experience is similar to other traumatic events in my life -- which may be creating a reaction on my part that, at least to my former therapist, seems way out of proportion.

The thing that I'd probably find interesting in a discussion of the topic with someone like Dr. Zucker would be an explanation of how terminations -- against a patient's wishes -- should be handled. It would help me to understand whether what happened to me is "normal" practice, or something else.

[cyanidebreathmint]

From what you've said, it sounds like your therapist handled your termination very poorly/unprofessionally. Although I'm sure the way in which she terminated brought up past feelings for you, I'd like to offer you support in simply saying I think anyone would be offended by that and feel a bit lost. I hope things go much better with your new therapist.

[in_media_res]

From what you've said, it sounds like your therapist handled your termination very poorly/unprofessionally.

Thank you very much for your understanding and support. It helps a great deal. It's easy -- at least, it's easy for me -- to assume it's just me, and I'm overreacting. (Or, as my former therapist told my new one that I'm just "taking it personally.") I've had feedback from others, including therapists, and the consensus is that she handled the situation badly. My new therapist has been quite understanding and helpful, and we're working on some different techniques to help me work through it. I'm thankful I have found him and that I have resources and support.

I did send Paul a note with a question for Dr. Zucker on this -- haven't heard back. While my specific situation probably isn't relevant, I do think some discussion around ending therapy and what to do when things seem to go wrong would be of interest and useful to the larger audience.

But with all that said, I feel bad that I seem to have hijacked your thread about when and if to start meds. How is that going for you? Any insights or decisions? It's a difficult topic -- I'm still not taking anything. (at least not for depression -- I dip into my anti-anxiety and sleeping pills from time to time.) I get pushback on that, and I do wonder if I've made the right choice. I'm curious how it's working for you?

[cyanidebreathmint]

Conversations evolve, I rarely feel like it's hijacking. I certainly don't think it is in this case.

I actually think even your specific situation is relevant to the larger population. I really don't think it's very rare, unfortunately. But I am glad you are finding some support now! Again, I don't think you overreacted at all!

I'm not sure I have any new insights or decisions on my situation. I am wary of medication for a variety of reasons. Some of them are informed, some are sort of rebellious and juvenile perhaps. I can be a hypocrite because I do use alcohol in a way that could be labelled abusive or self-medicating. But I feel like I know my relationship with that. I monitor, I navigate it. I'm usually not one to lose control. In the end I simply don't trust drug companies, doctors or therapists enough to put my mental well being in their hands. I've been through a lot and I've pulled myself out of it all time after time with little to no help. So at the moment I've not been brought to my knees by my mental problems, though it's been very fucking close. At the moment, I've been able to manage. But the truth is it's not getting easier.

I don't know, I know it's probably a very common feeling but I don't want my emotional experience to be reduced to a chemical. That would fucking crush me. It would make me feel cheap. It would make me feel mocked and worthless. And if it couldn't crush me because I was on medication, that would bug me. And if it didn't bug me, the me right now is just offended by that.

I'm a very stubborn person. I don't want to need help. I don't want to accept help. I don't want to feel weak. I don't want to need anything at all. And I know this is something I have to work on in life, because it's unrealistic and can even be cruel to others. But right now, in the mood I'm in, I feel like I'd fight it until intervention was required and it was out of my hands. Or I'll fight it until logic prevails and I see nothing has gotten better with non-chemical means over a very long haul. (like one year (since it's been at least 6 before this), and then compromises are likely to happen- like, redefining the acceptable level of change needed to satisfy me)

I try to keep reminding myself of the science behind my malfunctions. But I'm not very satisfied most of the time and I feel we are just on the wrong side of history/ time in this thing. I just want a clear answer, and there is none. And maybe that's a lesson I have to learn, too, I dunno.