therapythoughts

I feel like I'm possibly gonna get flak/slammed/value-signalled so here's a BIG TW for sensitivity to grey-area actions by health professionals 🙃

Here we go - thankful for Dude even though sometimes, I can't believe what just happened. Haha.

This week I had therapy - it was a 10.30am appt, but past 10.45am when he got to me (part and parcel when you're not first in the queue - first slot was 9am)

Dude is like, "I have someone after you - but it's ok, we started late, we can do full 45 mins"

So we take 45 minutes, do imagery rescripting (and I'm close to tearssss. I hate it this much lol it's so far the only therapy mode that makes me cry .. Dude is like "issokay! there's tissue ☺️ | Me: 🤨😒😏), blah blah blah.

Then he's like, "so ... how should I say this - how's the job search?"

Me: ... .. !!! Omg I kinda semi-anticipated this like then what do I say, and what if you're judging me ..

Dude: no, just an update! For update purposes, no judgment 😬☺️

Me: ... k. Um nothing yet 🙃

...

At the end of the slot,

Dude: blah blah blah we started late this appointment is rushed - I will put in a different charge code ☺️
Me: !!! !! ! This is gonna be on me (remember what happened the last time), so .. 😳🙈 | ("the last time", got found out and almost had to pay 😳)
Dude: nope this is on me 😌
Me: The last time ...! It became "my fault" and I almost had to pay 😳🙃
Dude: ... that wasn't me, that was the counter 😌

OKAY it's true 😂 "The last time", counter staff billed me a more discounted rate for a couple of slots 😂 He found out .. we made a mutual agreement to keep hushed. 🙃

The point of this extra long story is ... the "different charge code" ... is the remote appointment/teletherapy item for billing.

I saved 40% of my bill 🙃😬🎉

#MentalHealth #SocialAnxiety #Anxiety #therapythoughts

This is why you shouldn't be ambiguous in therapy (I think it was just a misunderstanding/unclear communication but lolololol oops 😒😬)

[on schema therapy/trauma therapy, 03Nov]

Dude: well I do think letter-writing might work, as a gentler form of schema therapy. & you like writing/are comfortable with it, aren't you?

Me: Yepperrrrrs.

Dude: Okay, then as discussed - write a letter to your younger self based on what we discussed today ..

[30Nov]

Dude: so did you do it? What have you got ..

Me: I could read it? In extracts if you're concerned it's a bit long?

Me: "& denying your Sadness will just teach you never to cry ... which is an insane logic that you're going to internalise. ... and you don't have an answer. It's just, Wrong, to you. Like shame. Like childishness. Like .. failure. Crying is the sound, feel, taste, and shape, of failure."

Dude: How was the whole experience for you - what was therapeutic about talking to your younger self about it?

Me: Don't know - I think it was helpful to erm, put my thoughts into words though. Like I never could put precise words to why crying is bad. But now I think I've got it - "Like shame. Like childishness. Like .. failure. Crying is the sound, feel, taste, and shape, of failure."

Dude: ... .. . [I swear he had the "this is not what I intended" look on his face]

🤔🙃😬 oops I'm sorry! 😆🤣

I think he's concerned that I'm just reinforcing wrong messages to myself in writing 🥴 But at the same time, see - he didn't clarify again, tsk 🙃

Based on personal past experience of actual imagery rescripting, you're supposed to rewrite the memory to make it safe - and the way I was taught it with a previous psych [intern] was to introduce a safe/comfy person on the scene. Lol. So had I kept this in mind intentionally, I would have written something like "Crying is the sound, feel, taste, and shape, of failure ... so you think. But at some point, you will meet P, a safe person, who will help you realise that's not necessarily true .."

Or something like that 🙃😬😂

But it's okay - I told him, perhaps we can just get the shape of my shame/sadness first, and reshape it later. He also said, I could add new reflections or additional recollections later on/over time, which is helpful too. So for now, we're good. As in even if we're working on the assumption of no prior knowledge of imagery rescripting, I think it can still work, just a few more interim steps to start.

BUT STILL P. Ohmygoodness. 😒😂😒😂😒😂🤦‍♀️

But overall. I'm thankful for less threatening, slower paced options in the direction of what's helpful. Hahaha. I do think schema therapy is a bit more targeted to personal trauma and less .. like ... blind behaviour correction lol.

But 🤦‍♀️🤦‍♂️- this is classssic "but you didn't teach me, Y U no teach me" - thankfully, issssokay, managed to figure. Tsk 🙃 & I'll be writing my next letter for therapy homework with imagery rescripting processes in mind 😆

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Dear P,

I did my homework! For the second month in a row 🤓 You'll see. [Finally, but I'm not sure this is the context we, or mostly you, had in mind when hoping for me to do my therapy homework regularly hahahah 🙃]

I don't know if this is a good thing at all, I don't know what this means - that I'm becoming More Problematic to have More Problems to write about? That I've Always Been Problematic and am growing an awareness of my Problematic-ness? That I'm growing increasingly insecure and unable to trust the world so things become More Problem-ly? Which is totally in line with the survey thing I did that time, when you gave me the "🤔🧐 why your score drop, hahaha issit unemployment, huh" because one of them scores dropped.(🤷‍♀️)

(I believe therapy is meant to make me better, not worse. So I'm sorry 🙃 It's not you, I definitely appreciate the greater clarity in scaffolding therapy tasks & clarity in communication. Sometimes I really and truly believe all these in part results from me deciding on my own accord to increase my Sertraline. 🙃 Hahaha my psychiatrist still doesn't know, I _think_ my meds should be enough nonetheless 🤞🏻)

& sometimes I wonder what you'll think of me if this job hunt goes on, prolonged. I didn't get the job opportunity I was telling you about last month, I'm hopeful (but also cynical/scarred by prior experience with healthtech excolleague dude) for this other opportunity I interviewed for last week. Which they haven't got back to me, but friend who put us in touch says they're really busy.

I appreciate all you've tried (lol we tried and failed but I can't believe you pushed for it) to help me get a lower fee, and at present - I'm thankful for your suggestion of spacing appts out a bit more. But .. in current situation, I'm not really sure the difference 4 weeks vs 6 weeks makes? I mean, forreals, it's not like I'll have money 2 weeks after the planned May appt, if I continue to be stuck on the job hunt like that. Y'know?

&yes, at some point in the past couple of weeks, I considered taking a therapy break to save money - to cancel the May appt (I haven't, cos I'm too scared to commit to it haha.) - & by now, the concern of financial prudence is real, and far outweighs anything my friend said the other time, upsetting as it was.

(Because therapy is 10x the cost of a movie ticket - and life is scary without any incoming income halp)

how now?

Sorry,
Me.

#CheckInWithMe #Anxiety #SocialAnxiety #Employment #MentalHealth #Selfesteem [pre] #therapythoughts

Me: Hi. The good news is, I did my therapy homework 🤓😌 The bad news is, that means I had a crappy encounter, enough to note it down 🙃

So I told P all about the job interview and the things my friend said abt skills & cutting down on therapy (wh0t, if only she knew the difference 3 years of therapy made to our mutual friend's brother - which she doesn't, cos I don't think she knows friend's brother and idk if friend told her) .. so then like, we ended up talking abt (1) me needing to develop self assurance (pulls hair out, it was already This difficult to develop self-assertiveness and I just got here, x years later) & (2) progress of therapy. Also because it's been 5-6 months since I last did some form that we've been using to track my progress (it's the one measuring self hatred x self assurance x inadequacy), so I did it again and we chatted abt my progress/scores.

Then he's like, "so how do you think you've progressed?"

Me: I mean like, I actually talk to you now, okay 🙃 [It's true. I used to write stuff on post-its when I was in the shuttle bus, when he was interning at the university centre 🙃] and ... I think at the very least - I know it sounds crazy - I don't ask my friends if they're still my friends, cos I'm unemployed 🙃😌

👆🏻 ya, clearly I used to be A Lot Worse. Psychiatrist would say the same about my used-to-be-worse -ness 🙃

I think he also wanted me to make some comparisons between 2015 (when he was interning) till now, vs 2019 (reacquainting as full-fledged) till now. I think minimally from 2019 till now I've learnt to communicate for what I need, at least in therapy. Like show me how to fill this worksheet. Give me an example/template. Do we have a concrete measure to track progress (that's where the form comes in, but my scores fluctuate. He said some score dipped and he wondered if it was cos of unemployment) 🤔🙃🤷‍♀️

He finally realised it made more sense to print extra copies (actually I just need one main to write, one spare as photocopy-copy, if needed) of thought diary template for me, which is helpful - I told him the episode with friend was two-fold, employment x MH. I only filled the thought diary template for employment, MH was discussed in session.

I dunno, feels like we're slowly but surely getting somewhere and possibly making stretch goals without a behaviour/exposure hierarchy and that makes me SO PLEASED - I hate behaviour exposure hierarchies yuck. I guess, USD 2.2k [ish, minimum, cumulative] has been worth it? 🙃

* I pay ~ $110.25 USD (converted) as a private-paying patient cos I wanted This Dude. It has recently increased circa las month to ~ $116.90 USD so yes, it is my Expensive Conversation. 🙃 ... that doesn't mean anyone's entitled to asking me to cut it out!!!

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Made it for a 9am appt at 8:57 am & before P, officially my accomplishment of the week.

We talked about work shame, Christianity & therapy, & ... one last thing I forgot 🙃

Pretty proud of myself HAHA. Eg, I think impressed him when I told him that in current scope of WFH pandemic life, I created imaginary 15-min work boundaries (lol I don't always need them. But saying "I'll call you in 15mins" sets the leeway on me & communicates a "not immediately pls!" Sometimes I drink water/refill coffee/eat snack/pee ... y'know 😂 It's not always cus I have urgent work things!) - he was like, WAIT SAY THAT AGAIN. 😂

Also wrt work, explained the "if I can't personally resolve this within an hour, don't call me" logic I've since agreed upon [with myself which I thankfully haven't needed to use], I think he was impressed too. Dora is impressive for once, huh. 😂

Talked abt my previous horror work experience with now-fired middle manager colleague, P asked if I thought it was a hierarchy/rank thing or just the dude as an individual - could be both/ either, IDK but to be fair my bosses always text before calling if they wanna discuss/brief me (panicking on me wrt client b different though 🙃, but when they're rational, they text first - phew.)

In the middle of these things (while he's looking so pleased & idk, having a super-pleased-mutual-win moment HAH) .. I proceed to tell him abt deciding to increase my Sertraline by myself 🙃 ("I thought abt this & what my doc would potentially say - since it was quite likely she might possibly ask me to up a dose, figured to try 🙃") -- but also explained that in view of this, I can't really explain whether I'm getting better @ thought-processing, or it's the dose. IDK - could be either, neither, both. So I said, thankful for conversations & answers today but I can't put a factor to why, sorry 🙃

wrt Christianity & therapy, he was like "Uhhh if you want specifically Christian-based CBT I'm not trained .." (Me: nah, I'm just saying I've read articles abt CBT from Christian perspective before!), & "professional angle or Christian? Professionally, any therapist is supposed to be able to engage using the client's faith & from Christian perspective - it's a tool? Like vaccines, right?" (Me: ikr I don't understand the anti-vaccine Christian crowd either ..) - explained the context of convo with friend & I was like "in that logic, Christians might as well not be anything cus you could then argue that as a copywriter in education marketing, I'll probably feed corporate greed/tuition industry competitiveness, etc." 😒🙄

Still not feeling fab, might be a combi of things - why do I feel like something's up with my nose somewhere & somewhat/that feeling of general nasal passage malaise - I don't know how else to describe hahaha sorry 🙃 but in general, ughhh. I definitely feel like something in my ENT passages is screwed up - or feels like it. 🙃😒

#CheckInWithMe #mentalhealth #therapythoughts #Anxiety #SocialAnxiety

I asked for the call, I got the call (thank you P, you are the bestestttt. You may not be the most experienced per se or the most accomplished - you have, after all, only been in this for 5 years and not 50 - but the amount of empathy you have and the way you do the best you can to care, is something I'll never take for granted and am always thankful for)

Me: /walks in/ | /sits/ | /stares/
P: ? Why, what's up. [pause] Did you write me a note?
Me: ... no, I really didn't!

😏 so perceptive by now 🤪😂

I ENDED UP CRYING IN THE LAST 15MINS OVER .. NONSENSE.

As in,

Me: I know we talk abt this like every freaking alternate month and I'm terribly sorry but it's .. Real. Like part of the reason I'm this obsessed abt therapy homework, and the guilt for not finishing it - its like being the worst student in class -- will that make me your worst client?

... ya, we really do. Mainly cause I'm insecure like that, I wish I was better than this. Like we've already been acquainted for this long (almost 2.5 years full-fledged) & back then, even on first meeting when he was a student intern he already was explicitly clear on boundaries - I will be interning here from X date to Y date. ... so there really is no reason to freak out, rationally. But I'm crazy insecure, because of ... every Other MH Experience. Which is the worst part cos I know it isn't his fault/problem at all 😏😒

Meanwhile,

He: 😂😅 You know what, tbh not everyone does their homework too, actually many of my other clients don't - it's helpful, but sometimes life gets busy and we can't help it/it's not ideal, but that's just how things are .. its meant to help you think about things, which we can always talk about in convo anyway.

Me: :") (I'm super gross I know but I really looked at him like a tear-stained child ...)

Meanwhile, inspired by a convo I had with a friend from church: what's your perspective on having a therapist/psychologist with the same religious faith, but in a secular therapy context? (That's us rn, which I'm thankful for - skills and rapport came first but shared Christian faith was def the cherry on top)

Tldr, my friend from church was trying to say that behaviour changes are only addressing symptom and not cause, only God changes hearts. Which is true, but well - I think therapy is a God-given gift. & having a Christian psychologist in a secular therapy setting is exactly how I like it rn. Went to counselling at a faith-based counselling centre before this (long ago), she got me to memorize the gospel of John ... what. (Me: so R U able to do it yourself, tbh ...)

Anyway - yeah my personal take is only the gospel can address the issues of the heart, but secular therapy in the right perspective/lenses can be extremely beneficial! (which is also why I think a Christian perspective/psychologist in secular setting is great/works best for me) - thoughts?

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So my psychologist (the Dude, P) gave me this worksheet for the past couple of sessions - [https://www.cci.health.wa.gov.au/~/media/CCI/Consumer-Modules/Improving-Self-Esteem/Improving-Self-Esteem---05---Negative-Self-Evaluations.pdf]

The first time, I wrote abt some incident at work ... that turned out not-so-bad. Then he said, ok, go try the reverse - now imagine the outcome wasn't the positive one, how would you complete this instead?

So I did.

So we talked about both versions of potential outcomes - and realised that the concerns I had abt the incident (neutral) were at first, about anxiety. But if I screwed the work task up, the reactions are more about shame (P: see, it's kinda similar but different, do you see that? | Me: oh .. yeah ...)

As we are going over this and coming to conclude the similar-but-different in shame vs anxiety, this happens-

Me: /beginning to shrink back in chair because we were reviewing the worksheet/
Dude: 😅
Me: 🤨🧐
Dude: I can feel it coming ... are you triggered by this 😬 U anxious - is it?
Me: ... This feels like some kind of draft 3 for a writing assignment, can you not 😩😩😩

🤦‍♀️ I don't know who is worse at keeping a poker face, me or him 😑🤨🤔😒 But is this what 10 months (intern) & 2 1/4 months (full-fledged) of rapport does to you? 🤪 (yes the 😑 is mutual and real lolssss)

We also reviewed some survey we did in the beginning of the year- 6 months on. I can't remember what it's called, but essentially it was a teeny step forward in some ways, but a teeny step back in others. 🤔🙃🤪 oh 😬😬😬

We left the session with (the usual) wrap-up, which for some reason I found myself stuck(!!!! IDK what happened to me 🤦‍♀️, possible that I was panicking cus I had a short window to eat lunch x get myself to braces appt in the same hosp) and he was like, that's ok, we can use the metric (Me: !!?!!! Ok I have NO idea what you're talking about 😑 but sure! | Dude: I used it before, long ago when I was interning ...) - so yeah it was this sheet called the Session Rating Scale.

Essentially its really nifty cos (for the longest time), I grew to internalise it as my framework for broad, open-ended questions about therapy. Like how helpful they are in terms of being heard, therapeutic progress, etc. & I'm thankful it scaffolds things to help me organize myself.

But .. part of me felt a tinge of ... am I losing my skills/abilities in something I initially grew to be able to do? (I didn't dare to articulate this 😩) Cus it's like taking away scaffolds/guidance for a long long time then putting yourself back on them, ahhh 😩😩😩

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therapists in the media: that must be really hard, huh.

P, my real life therapist who is absolutely the best but also sometimes weird as crap: 😑😑😑 stop reading so much Facebook!!!!

Me: 😌 IT WAS MONDAY-TUESDAY INSTINCTIVE ... sorry!!! 🤪

^ when I explained MH conditions vs highschool murder.

It was hard to go for therapy today. Not so much for the events that happened - I know I've been looking forward to this since Monday. But with my busy week, the perceptions of lived MH experience in the past week (and a half), my eyes on my phone because I told my boss I was gonna submit stuff today -- I was like [in the therapy room] - "um so I'm kinda feeling kinda guilty for being here and I'm kinda scared my boss might call, I'll put my phone on the table so I can eyeball it ok ..."

But yes I also said that I didn't do therapy homework. Because even if I take the "improve myself"/"level up" perspective and not the "people-please my therapist" perspective .. sometimes people are too damn tired to level up.

Spent the most part of the appt being all upset abt MH and work and how I was questioning what it meant to be an employee with lived MH experience, with him telling me about balancing my values/asserting boundaries/etc etc which are all good and true (and maybe I need someone to tell me it so I can chew on it) ...

15mins to the end (wow, not a great time to crumble, gdjob) I was trembling and my hands were numb (ok might have flailed too many times too but 🙃) and I crumbled in tears, because -

"YOU KNOW. It's like if being a good worker is giving your 100%, and say lived experience of a MH condition limits you to maybe 80%. ... in light of all of these I feel like I've to prove myself, that I'm more than this. That I have to be 110%" ⬅️ I truly feel this btw. That's probably partly why I'm the happy, cheerful, young and bubbly employee kinda persona in office but ...

ANYWAY. So I scored a follow-up call on his non-clinic day. After-care follow-up service is great (😂 toldcha he's great) but it makes me wonder if I'm that bad he needs to schedule in extra time like that. Or that I completely wasted time crying so he needs outside time to Actually Talk Things on agenda. ... and stuff -- am I overthinking this? 🙃

spoiler: my boss didn't call. phew 😂😅 AND after taking time out (like half an hour travel + 45mins appt + half hour/40mins? juggling work x lunch) ... still finished it and submitted at 3pm. & boss decided it was substantial enough that it didn't need to be enhanced so YAYYY -- I told him I'd submit all-in by end of day, both parts. Then he said just submit the first part, if it's good enough we don't need to enhance with the 2nd part. Which he decided we didn't have to. YAYYY.

The busy continues (for the next couple of weeks I reckon), but at least I don't have anything due tomorrow yayyy.

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