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It’s okay not to be okay...

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ButterflyBean

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I don’t mean the title in the cliché way that it might be taken because of the commen saying. I wrote a thread last week about needing reassurance and connection from my therapist, which can be found here: https://www.myptsd.com/threads/what-can-my-therapist-say-do-to-provide-reassurance-connection.86542/

I haven’t received any replies (yet), and my next session is tomorrow. I am physically safe, and self harm is not an issue, but I am quite literally not okay. I don’t know how to express that, or perhaps what’s more important, is that I don’t know how to be okay with my current situation. The fact that I need major surgery is not an issue; I have accepted that. However, I am struggling with the need to express my emotions and feeling safe enough to do so. The specific emotional expression is what I am struggling with; not in the safety/stabilization sense. I have a tendency to engage and logical conversation, and I find it hard to be vulnerable at the same time. I want to find a way to communicate the need for my therapist to sit with me in my pain. Any suggestions would be extremely welcome and helpful.
 
You just have to go through it. It comes out in its own time. I don't know your story so I don't know what it is you need to deal with in therapy but I have found there is a commonality with most of us. When you are feeling really bad, nothing really works. High tide floats all boats. As you feel better you get better. I'm not telling you to 'suck it up.' I'm telling you I see these posts all the time and I answer them the same way. It takes way too damn long to feel better. How much better are you going to feel? Nobody knows that.
I didn't have any choice. I'm going to the therapist today. I don't want to go.
 
I don’t really have anything useful to suggest but thought I’d post just to share that I’m sort of feeling the same way at the moment.

For me, it feels like there are so many stressors right now - work, money, family stuff, some medical stuff, or things being stirred up and shifted around in therapy - and I’m not feeling OK at all.

Like you though, I haven’t been able to express the extent of it to my therapist. Nowhere near! Instead, I think I’ve sort of been packing it all away before I go into sessions (which is probably the opposite of what I should be doing!) For me, I think a big factor in that is that there almost feels like too much to share in a 60 min session once a fortnight. I wouldn’t really know where to start. Everything feels like it would take far too long to get out. And so, in a way, it feels easier to just hold onto it all on my own...even though that isn’t feeling good either. The idea of telling her how I feel at the moment just feels...sort of like I have no idea how I would even begin to go about that.

Do you know what is contributing to your struggle with expressing your emotions with your T?
Is it that there’s something trust/safety being dented with your T somehow?
Or is this a common pattern you have in relationships?
Or that you’re not really sure what exactly to express and how to articulate it?
Or...?

Sorry - I haven’t really got anything useful. But something in your post struck a chord with me so I wanted to just post some support!

ETA: I know it’s a suggestion that gets posted here a lot but I’m wondering if it’s an option to email her in advance of your session to tell her that you’re not feeling ok and to express that you would like her to sit with you in your pain but that you’re really struggling with how to let her know?
 
I know it’s a suggestion that gets posted here a lot but I’m wondering if it’s an option to email her in advance of your session to tell her that you’re not feeling ok
Another one that gets mentioned often - print this thread and just hand it to her when you walk in?

It’s worth trying to articulate how you would know that you were getting what you need. Is it an issue of you letting yourself release the pain (cry?), or is there something you want from your therapist, besides being witness?
 
I think you are falling into the fallacy one must be vulnerable especially during therapy.

You do not need to be vulnerable. You are fine what you feel now.

Even marriages one is not vulnerable every day or minute or month or week.

I think acknowledge you are struggling with something. Acknowledge that. Do not resist that and maybe even write down here again to just see what comes out.

but you do not need your therapist like a water. You lived before and after and you are OK. They are helping you as much as they should by now.
Maybe your body is telling you not to be vulnerable because you need to be ready for a surgery. the body is much smarter than the brain...the logic part anyways.

Feel what comes. Feel it in your body. Touch where it hits or goes or bubbles.

vulnerability has to arise when it needs.

Good luck
 
I emailed my T ahead of session once and said “I will tell you I’m okay when you ask. But I am not ok” and she responded “I’m looking forward to discussing how not ok you are” and that was a turning point for us. Because I walk in there and it’s like a switch- I have to appear ok for her. I can’t help it. She now doesn’t ask how I am. She dives right in. And I’ve been able to let my guard down here and there. Shed some tears. It’s what I needed. And still do. But more often than not I appear extremely ok or even more than ok in that I like to make her laugh (or, rather, humor is a distraction and coping mechanism). Now that she knows that, she pushes me a little harder and makes me get serious and truly does help me carry the pain. It has been a healing experience since I’ve never let anyone in to that level before.
 
It’s worth trying to articulate how you would know that you were getting what you need. Is it an issue of you letting yourself release the pain (cry?), or is there something you want from your therapist, besides being witness?

@joeylittle - Those are two very good things to consider. I had several medical appointments related to my surgery yesterday, and I was extremely overwhelmed by the end. Right now, I am laying in bed thinking about what I want to get out of my therapy session later today. I purposely scheduled one with my EMDR therapist in the hopes of being able to access my feelings and de-escalate a little bit. I do need to release my emotions; I’ve needed to cry for months now, but I also need to feel connected in addition to having a witness. I’m not expecting a magic cure for my anxiety right now, because that is not realistic, but I do want to feel like I’m making the right decision and be at peace. I’m not really sure how I would know that I was getting what I need, both in the hospital, and from my therapists, but you’ve given me something to think about between now and my surgery. I guess my next question is: how do others know that they are getting what they need, particularly from their therapists, not necessarily the therapeutic process itself?

I emailed my T ahead of session once and said “I will tell you I’m okay when you ask. But I am not ok” and she responded “I’m looking forward to discussing how not ok you are” ... She now doesn’t ask how I am. She dives right in.

@NightSky - what an awesome way for your T to respond! Do you mind me asking what that discussion looked like? My therapist asked me what “not okay” looked like and/or meant the other day, and I didn’t know how to respond, other than to repeat that I just wasn’t okay. Also, what do you mean when you say that your T dives right in? Do you mean that she doesn’t let you deflect from your feelings with humor? Just curious because I’m not even at the point where I can release my feelings and feel safe doing so... Maybe I need to think about what it means for me not to be okay. Knowing that might help me figure out what I need from my therapist... but what happens if/when she can’t meet my needs for reasons that I completely agree with and understand? I can’t meet my needs for myself and others can’t meet them for me either, at least not right now…gosh I feel stuck and ashamed for having unmet needs!
 
So, it started a discussion that has been ongoing about how when i walk through her door, I am “on” whether I want to be or not, and appear the same no matter how I’m feeling. And when I leave, that’s when I know how I was feeling in session. When I get in my car sometimes I shake uncontrollably. Sometimes I cry. Sometimes I feel calm and relieved. And I really never know which it’s going to be. We haven’t fixed that yet but she has made a point of reiterating often that the goal is for me to go there in whatever state I’m in and that it’s okay. She has learned to not start sessions with “how are you?” Because I never know how I’m supposed to answer. We have begun a pattern of me writing an email between sessions, and she always jumps into whatever needs to be covered. It helps us get down to business quickly- I hate small talk. I pay way too much for that to be our session. But also when she gets right into it, it creates more time and space for me to ground and settle myself and try to be present. That has resulted in a couple of sessions where I could access emotion. It’s not often, but it has happened a few times and took two and a half years to get there.
As far as unmet needs we have often talked about that. I have expressed frustration with the process of uncovering needs that can’t be met. But when she asked me one time what those needs are, I couldn’t answer her. Uncovering what those needs are and how to meet them is a lot of the work. Don’t feel ashamed about that if you can help it. It’s hard. And you’re doing the work. That’s admirable. It’s nothing to be ashamed of at all. You unearth those needs and from there comes the pain, and it will eventually surface in a way that you can express it and you won’t be alone. You’re not alone. But you can’t force these things. You can just try to put words to your experience. I have told mine that I feel tormented and tired. Tired of working so hard every day to survive when I want to be living. I’ve told her a million times that I want to give up, it’s too much, it’s too hard, it’s too painful, I’m too afraid... I say these things, mostly in writing. To keep sharing with her how I’m really feeling most of the time. Being not ok looks and feels different for different people. You have to identify what you’re feeling and try to put it into words.
 
Here’s the situation: My therapist is on vacation (I see her on Wednesday when she comes back, and I have one more before my surgery). I have surgery in 10 days. Major anxiety (not about the surgery itself but the hospital stay). T texted me yesterday (Thursday) to check in. Very nice of her I know! She said that she is ready to support me even though she’s out of town. I replied and politely said:

“Thank you for checking in with me. It really does mean a lot. I’m doing my best to stay positive”.

Reality: I’m not okay, and I don’t know how to be or what that even looks/feels like. I have a session with my EMDR therapist tomorrow that will hopefully give me access to feelings and such. I want to text my main T again, but I don’t know what to say or what type of response I’m expecting. How would your T respond to the following (or something similar):

“Thank you for extending your support. I’m really struggling with anxiety and not feeling okay. I don’t know how to be or exactly what I’m looking for, but all the XXX is very difficult to handle. I need some help“.

Do you think that would get the point across, or would you say something different? I’m planning on sending it after my session tomorrow if things don’t improve or change… Before she left, she encouraged me to reach out and said that she might be able to make a phone call happen if I needed one. I don’t necessarily want or need one, especially since she’s away, but I’m really struggling with feeling alone etc., and I don’t know how to convey that. I also made some realizations in the last few days that are connected to past discussions we have not touched in a while, although I do think everything is related in one way or another. Any thoughts or suggestions are welcome.
 
I hope you find support and love that you deserve and I am sorry you are going through this.
But, I think this is not fair to the therapist. She has the right to have vacation and honestly there is absolutely nothing she can do from the distance depending where she is. You could call crisis line. This is precisely the purpose for them or you could talk to your EMDR therapist and have her support you.

I think your other therapist is kind enough but sending email like her puts burden on her and that is not fair to anyone who truly want to help you.
 
@grit - thank you for your response; I do appreciate and respect your opinion. However, keep in mind that every therapeutic relationship is different, and while certain boundaries/exceptions may not work for you, they work quite well for others. Furthermore, I did not initiate the contact; my therapist chose to text me on her own accord. I do not expect anything from her while she is on vacation, which is precisely the reason I posted my most recent reply. I do not abuse my ability to contact her between sessions even when she is in town. She encourages me to reach out more often before I reach crisis point. That is the case here. I have to remember that she can manage her own boundaries and choose to respond or not at her convenience. By reaching out during difficult times such as now, I am practicing a skill set designed to meet my unique therapeutic goals. That being said, I understand your perspective completely. What constitutes an “emergency”, or appropriate time to reach out for extra help, is something that often causes constant internal conflict. Again, thank you for your well-taken point of view.
 
I’ve sent my T an “I said I’m ok, but I don’t think I am actually ok” text before. I wasn’t sure what I needed other than the connection that comes from someone else knowing that I was struggling and why. My T responded by checking the supports I had around me and offering to see me within the next 24 hours - which is what I did and was so helpful.

So I guess it depends on what you need from her as opposed to the other supports in your life - what need can she meet that friends, family, your emdr T can’t meet. Given she is on holiday I’d contact her as a very last resort - not because there’s anything wrong with contacting her (she’s given you permission) but because identifying why others can’t meet your need might help identify what that need is more clearly. Once you know what you need, you’ll know whether a quick conversation with her would help.

Do consider though that some of what you’re feeling may be a kind of separation anxiety - she’s away while you’re preparing for something you find very hard going so of course you’re going to feel unsteady and want to touch base with her. And if that’s what it is, that’s ok, sometimes you just need to know she’s still there.

In my case we’d touched on something that no one else in my life knew about, and it felt too raw to start opening up about it to anyone else at that point so I needed her. Other stuff I’ve got friends who know me well enough to support me in, but not this thing at that time.
 
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