Twice a week?

[Sandstone]

I've been seeing this T weekly for six months or so, funded by the NHS after a years-long fight. Today she told me that we now have funding for twice weekly, if I want.

I'm completely torn. On the one hand, I think we could move on faster that way, which has to be a big motivation. If I lived closer then I would do it straight away. But it is such a long journey. Today every thing ran perfectly and the round trip was five and half hours. Usually it is at least 30 minutes longer. It can't be made any shorter, unless I drive and experience has shown that to be unsafe after therapy. So for practical purposes, once I've allowed for a bit of a flop when I get home, that is a whole day gone. I've been home for 20 minutes now and my head is still echoing with the noise of the bus.

I do volunteer work, at home, for one day a week. Weekends I regard as time for my husband and grandchildren. I had been setting myself a goal to start going out more this year, but it feels as though I wouldn't get enough down time if I did that and two days therapy. I wonder if that is an illusion though? We've also just applied to foster dogs, and that requires me to be at home most of the day when one is here.

Which bits of recovery do you think I should prioritise - therapy sessions, peaceful decompressing, going out, feeling useful?

 

[UnicornSightings]

5 and a half hours of travel?! Omg! There’s no way you can drive home? Why not? Can you just spend some time at the end grounding yourself? What is the travel time driving? Can you take Uber or something? I’m assing you’re taking the bus or something and making multiple connections so if it isn’t that far I’d be working at finding a way to drive it safely as a goal in therapy and then do twice a week. That’s a good deal if it’s free damn.

 

[Freida]

T#1 is 30 minutes away so that one is easy.T#2 --- yea. I leave at 230 and get home at 730 and have to ride the bus both ways for part of it and drive the other part Yeap - it sucks up most of my time. It is worth it because the appointment runs 1.5 hours -maybe that's an option for you? I also use noise cancelling headphones on the bus which are a godsend. They are really spendy but I got mine at a pawn shop so they only cost about $50.

Twice a week is good for moving forward but its also exhausting.

 

[EveHarrington]

How long do you have NHS approval for therapy?

 

[Deleted member 44579]

Hi @Sandstone how about one trip to her and the second session via e-mail or facetime?.. Or a phone call?

I think because it's such a long................. Drive its up you. Happiness is extremely important... And if doing those other things is your happiness.. I wouldn't give it up.

Also maybe if you wish try on extra session a month for one or two months to see how it feels?..

Im sorry whatever happened to you.. Did... Therapy will help greatly.... Take care...

 

[Deleted member 44579]

I'm sorry for whatever happened to you.. Therapy.. Sorry my texting is letting me down tonight

 

[barefoot]

Great that they have upped your funding so can increase the level of support that they can provide for you - I know you had to fight so hard and for so long to get any access.

Also understand your dilemma - the long trips, the having other things to fit into the week, your desire/need for downtime to be built into each week etc.

I did twice a week for a few months fairly early on and have quite a long journey time on public transport to get to sessions too (though not as long as yours) So, for me, that was really a full two days out of my week. I found it quite all-encompassing because of all the processing in between too. I found it hard to switch off from thinking about therapy. But I do think it helped with building a relationship with my therapist
Also, I didn’t have a whole lot of other stuff going on in my life at that point as I was off work and not socialising. So, for me, I guess I chose the opportunity to spend more time in therapy to try to give that a focused boost.

Do you know what the likely timeframe is for getting your first foster dog? If that’s some way off, could you perhaps try the increased sessions to see how it goes/feels?

If it’s too much/too exhausting/too all-encompassing you can drop back to weekly again.

If you try it and twice a week feels fine but then you need to be around at home more for the dogs, maybe you will have to drop the second session at that point but you may have had a period of useful accelerated work.

I guess, unless you have a strong feeling about what you want to prioritise of those areas you have listed, it will probably just be a case of try it and see - and know that you can always go back to once a week at any point if you want to.

 

[Friday]

Oddly enough, or not, when I was in 2x a week therapy i found my recovery time drastically shortened. To the point that I was losing far less time to therapy, even going more often.

In part, just nature of the beast. Stuff that was brought up during 1x got to be settled during 2x. It also highlighted exactly what was hard (because it was the stuff that wasn’t settling). Also, in part, a learned thing. As I learned that all the big bag that came up during 1x would be sorted in 2x? It came out lesss. Then there was just the practice of it. By doing things more often I got better at self regulating both before and after.

It took about a month and a half or so for that to kick in.

 

[Sandstone]

How long do you have NHS approval for therapy?

That is a really sensible question that I wish you hadn't asked me. I have no idea. These decisions go on without me, and with no consistent logic. The option of twice a week was a complete surprise. I know it is equally possible that I could be surprised at any time by their total removal, as has happened before with both support worker and psychiatrist. So the logical response would be to grab what is offered now with both hands.

Can you take Uber or something?

noise cancelling headphones

The practical solutions - other forms of transport don't look possible. A taxi would be £70+, and the Community Transport would be £50+. The bus is free for me, but an irregular timetable and winding through rural villages make the journey so long. I do use headphones when I can, but hyper-vigilance requires that I be aware of my surroundings. Working on it!

There’s no way you can drive home? Why not?

By doing things more often I got better at self regulating both before and after.

I've used the car as a self-destructive tool in the past after therapy and risked others lives as well as my own in the process. I'm not keen to take that risk until I've done enough work to be sure I won't do it again. The regulation thing is hard because I am so hidden from myself, I don't always know how bad things are. I've come out of a session thinking things were OK, only to crash a few minutes later.Again, working on it.

Nowadays I drive once a month, four miles each way. I'm still aware of how confused I get at busy junctions, and that my attention isn't always as it should be. I know I couldn't drive into the city where T is, but I will look at using the Park and Ride. That would cut the journey time, and give me longer to realise how I am before I get in the car. Not sure what I'd do if I realised things were bad, though.
Part of the point of dog fostering was that I'd need to lengthen the times I drive, but it would be on wholly rural roads, not the dual carriageway to the city.
For now, I think I have to assume driving to T is out. Or, just possibly, to do a trial of driving to the Park and Ride.

Twice a week is good for moving forward but its also exhausting.

hard to switch off from thinking about therapy. But I do think it helped with building a relationship with my therapist

I was seeing it as a way to cut down overall time spent in therapy. From what T said, I think she was thinking more about the relationship, and she doubted it would reduce time. I'm not very interested in the relationship - which probably indicates that I need that sort of therapy.
There are often threads here about needing to see T more often for support, but I have no idea how that sort of therapy relationship works.
I do know that the day after therapy I need to spend hours thinking and writing, and have already had to remind myself today that this isn't wasted time. But I want to use time for other things too. I think I go on working on therapy stuff in a lot of my time anyway.

doing those other things is your happiness.. I wouldn't give it up.

desire/need for downtime to be built into each week

Therapy can't be my whole life. Yet it should enable me to have a more complete life in the future. I can't work out the balance.

It is worth it because the appointment runs 1.5 hours -maybe that's an option for you?

That was a possibility. With another T I had two hour sessions. Looking back I'm not sure we covered much more each time than I do now in an hour, but it might be worth a try. I'm often aware of more to say than there is time for.
We also discussed other forms of contact, but she feels the need to be face to face.
I thought of twice a week when I don't have a dog and once when I do, but assumed she wouldn't want that as her income wouldn't be consistent, but she was happy with that possibility. It may be worth a trial.

I didn’t have a whole lot of other stuff going on in my life at that point as I was off work and not socialising. So, for me, I guess I chose the opportunity to spend more time in therapy to try to give that a focused boost.

know that you can always go back to once a week at any point if you want to.

I'm off work, and only socialise with OH's family, mainly impromptu. I'm only beginning to feel glimmer of possibility of going to other semi-social things, but I want to encourage that, not risk snuffing it out. I still find it so hard to do anything, but maybe more structure in the week would push me to use my time more effectively.

I wonder what it would feel like to drop back down to one session. Would I feel it was failure? Would I feel I was insulting her? Would the nascent desire to put other things into my life still be there?

 

[joeylittle]

I think you are considering all your travel options really well - and, just extending the session time might be a great approach.

Is there anything interesting/good to do in the city where T is? Wondering about your desire to commit to getting out and doing more, if you did have two sessions in a week, perhaps before one of them you could plan to go early (?) and do a recreational-type thing (?) out there?

I've had 2 a week off and on for the last few years. Occasionally 3 a week for short periods, but I equate that to doing a kind of mini outpatient program, and have to have little to no other stuff I need to show up for. Otherwise 2, so long as I'm able to. It drops down to one when I'm traveling for work, which is about half the year, all told.

When I'm doing two, generally one of the sessions is dedicated to trauma processing, and the other is dedicated to talking about all that trauma processing. If there are day-to-day problems I'm having, we will use those as the last 30 minutes of the first session, or 45 minutes of the second session, as a way to transition out of dealing with the stuff from my past. My sessions are 1.5-2 hours long. We went to 90 minutes shortly after starting trauma work, just because (for me) all by itself, it takes around an hour to get anything done, and I can't just walk in, plop down, get to it, be done, leave. I need 10-15 minutes at the top just to review what we are going to be doing, and time at the end to turn back into a present day person.

It doesn't always work - sometimes I end up leaving the session still feeling much worse off than when I started it, and exhausted, and lose the rest of the day. When I'm in therapy and also needing to keep up with life more than that, it always comes down to being very diligent about using a chunk of the session time to decompress, so I can walk out the door and function again. And some weeks, there are too many things going on with other aspects of my symptoms, and we just need to do those.

This is all just to say - if you add more time, you also can think about what you would like to do with that time that would be complementary to the work you are doing now, but perhaps focuses on a different angle. You don't just need to double exactly what you are doing right now, especially if it's going to be nothing but exhausting, mentally. And the easiest way to start could be to talk to her about doubling the session time as it is, and see if that extra time becomes useful. You'd probably know after two sessions, how you felt about it. And could always switch back.

 

[Freida]

When I'm doing two, generally one of the sessions is dedicated to trauma processing, and the other is dedicated to talking about all that trauma processing.

This is me!

 

[barefoot]

Is there anything interesting/good to do in the city where T is? Wondering about your desire to commit to getting out and doing more, if you did have two sessions in a week, perhaps before one of them you could plan to go early (?) and do a recreational-type thing (?) out there?

I was thinking this too. I have to schlep into London for therapy and, while I don't turn therapy days into major sight seeing trips and I don't schedule things for after session, I do often head in earlier and do something with that time in the city. That might be go for a walk, have lunch or a cup of tea with a London-based friend, get my hair cut, find a nice cafe to journal in. These are things I like doing and that relax me a bit before sessions. Are there things that you could do before your session that tick your "going out" or even your "peaceful decompressing" box? I guess it depends mainly on whats around near your therapist and also what time your session is.

generally one of the sessions is dedicated to trauma processing, and the other is dedicated to talking about all that trauma processing

Yes, same here. When I was doing twice a week, the first session of the week was 2 hours long and the second one was one hour long. I tended to use them differently. The first, longer session of the week we would tend to dive into harder stuff. Being two hours, it gave me a chance to warm up and get going, then dive into the gloop, then hopefully have time at the end for grounding before I left. The second session of the week would often be lighter - and often focused on whatever had come up since the last session (in terms of what had come out of my reflections/processing etc)

maybe more structure in the week would push me to use my time more effectively.

Although I said before that it had felt quite all-encompassing, simply because things were getting churned up there twice a week instead of only once, I did actually quite like the structure and routine of it. It meant that, on those two days, I had a real sense of purpose. And, yes, it means that you have to manage your time well on the non-therapy days if there are other things you want/need to build into your week.