Anxiety In Between Contact

[Leah123]

Hello all,

It's been quite a while since I've posted here but I could use some calm and understanding perspective. (Please try and be moderate in your replies, keeping in mind it's a long story and this is just some of it and I really hope you all can help me calm down, not ramp up more, ha.)

Long story short, I've been in therapy 2.5 years, but... in a sense I've gotten a lot more work done than the typical course of therapy perhaps because for the first couple years, we probably met three times per week and emailed in between, and now we're meeting for 1.5 sessions per week with emails in between.

I began therapy because I was having angry outbursts at my kiddo. She's gifted but also seems to have ODD and borderline ADHD with a sleeping disorder, so I was (still kind of am) seriously sleep deprived and stressed. But once we went in, we worked through my behavior and came up with some better strategies. Also, though, just having someone caring to bear with me gave me more emotional capacity to bear with my daughter. I am estranged from both my parents and my step-family, and my grandmothers who I was close too are both gone, so I didn't really have that type of support, and though I'd created a playgroup and other support, there really wasn't/isn't anything like having my therapist to work through all the issues with me.

I was diagnosed early on with PTSD too from abuse, and then we did a lot of trauma work which also helped me be happier and function better as a parent. I'd known I had some of the symptoms all my life, but they'd eased over time and I hadn't really put 2 and 2 together until I began the therapy.

My therapist also inspired me to return to school and I just finished my B.A. degree program which I wasn't able to do originally because of the PTSD. I've just started a part-time job in my new profession which I'm really excited about.

Amidst all of this, I have been working a full time job at 60 hours per week while going to college and doing freelance work in my new field, along with being a mother, wife, volunteer and doing a part time job at my college. So, very busy.

I've relied on my therapist to help me manage my stress as I tackled all these challenges.

It's been really expensive. She's a private practicioner, and we do distance therapy, so in 2.5 years, I have spent a tremendous amount, really. It's as much as one year gross salary for me. At first, I spent a lot on trauma work and processing and working through family conflict, but I also spent a lot on working through ruptures and misunderstandings and misattunements with my therapist. I was triggered by disconnects with her, a "good enough mother" figure in the Donald Winnicott model.

She's really unique to me and in a lot of ways we have a wonderful, healing, supportive relationship, but what's tripping me up is how anxious I feel without her sometimes or when I don't hear back from her. And that sometimes I feel she's tiring of me and overlooks things I've written or isn't as proactive as I'd like, she's encouraging but mostly believes talking everything out is the way through and is a bit short on supports in between, where sometimes, for example, I had to really practically "hollar" at her to get her attention that I needed something to ease the tremendous discomfort of therapy and of in-between sessions, so we finally got me doing a little DBT a while back, which helped. I haven't looked into it lately, but may again. She said a little while ago she was thinking of teaching me Wise Mind, but I already have such a strong sense of it sometimes, it's really only in relation to her that I feel so volatile. Because my mother was abusive and betrayed me, so... I'm sure it's just a constant battle to accept my T relationship for what it is, to let her be my 'good enough mother' and be content and calm and trusting.

I actually decided, after I finished my degree, that I would make this a focus of the thearpy- to work through my feelings of abandonment/anxiety/discomfort so that I could enjoy a more stable relationship with her, or I mean, so that I felt calmer and trusted our relationship more.

I just started that work three weeks ago, when she suddenly had family emergencies and had to cancel two sessions. Then I had a family emergency as well, a dear relative very ill in hospital for a while. At the same time, I was diagnosed with asthma and started prednisone, which turned into a horrible experience to take. My PTSD was really flaring up, exacerbated by the steroid, worse than maybe in 20 years, and I had a very very shaky two weeks, which is just ending. I think I mostly finished withdrawing from the horrid steroid on Sunday.

But this week I've been feeling anxious again between sessions, so anxious that I talked to her (well, wrote) about possibly just quitting. I am so sick of the anxiety and feeling like.... I'd be stronger and calmer without her. :(

Now, for a reality check, I am not dysfunctional without her, I am and always have been (since high school anyway, when things were worst) highly functional. And I don't take any medications.

So, it's not that the anxiety is... hurting me per se, not in a practical way... I do my work, I work on my goals, I parent my daughter, etc. Except I'm more distracted than I would be and last night and right now again I'm having these anxiety attacks and I don't want them!! And of course, if I could just be calm about all this, I'd get more done and feel better.

Part of me says... be patient. We're just diving into this abandonment issue and progress and relief is around the corner. Part of me says no thank you, I've had enough anxiety for one lifetime. And part of me says this one isn't fixable, but I think part of that might have been the prednisone talking because it really put me in a bad emotional state and I have started feeling better since then.

I don't think I really want to quit. I think I am feeling panicky and could use some calm reassurance.

I did think about the cost and worry at it, but I kind of told myself in one sense, if this is my midlife crisis spending, better on therapy than a sportscar. It was extreme spending, but I have cut back my spending on therapy by 70% or so, so I have made gains and while it's still expensive for me... it's not unreasonable at all, whereas the earlier spending was really out of line with my budget. (She has told me that she would see me for free if that was ever necessary, and... I think I do believe her. She is typically very sincere and real with me.)

I hope she's not burning out on me. We have less live session time than we used to, plus all the emergencies and issues of the past couple weeks, and right now, that's hard.

 

[Saint Nik]

Part of me says... be patient. We're just diving into this abandonment issue and progress and relief is around the corner.

Listen more to this part of yourself, it was the first part you typed up too. . .this is definitely intuitive and positive!
But this part:

Part of me says no thank you, I've had enough anxiety for one lifetime. And part of me says this one isn't fixable,

It's just doubt and of course worry. You've been through a lot and this thought is only just that, a thought! But you seemed to clear this thought up with saying:

but I think part of that might have been the prednisone talking because it really put me in a bad emotional state and I have started feeling better since then.

It sounds like you have all the tools and you are coping well.
Honestly, stick with the first thought you had:

Part of me says... be patient.

progress and relief is around the corner.

This message is coming from deep within you. Don't doubt it. :hug:

 

[qwyoey]

I hope you don't mind me asking, but is your therapy open ended or have you sat down and laid out specific goals to work on? I too pay out of pocket for my psychiatrist- 1250 a month. But he's very very firm that we work towards goals and constantly references them in the treatment process. He's also regularly checking with me on what type of outside resources I'm using to cope. He was open in the beginning about the dangers of dependency, and why it can feel comforting at first, but it wouldn't actually help me become a stronger and more independent person, which is one of my personal goals.

My mother was a very violent borderline and bipolar woman, and I devoured everything I could find to help me understand and read an interesting book on treatment. Of course you are talking about your PTSD but as a sufferer myself I saw some parallels in Joel Paris's book "Treatment of Borderline Personality Disorder." It has some great and very interesting things to say about frequency of sessions, and in between contact, and how this can actually cause more problems for some patients in the long run. Not saying that it's a problem for you as I don't know your situation, but I have a close friend who became obsessed with having contact with her college therapist. When he went on break and the center wasn't open she showed up at his house. He was letting her have lots of in between contact and many years later she told me it made it so much harder for her because she looked to him instead of looking for other coping resources. Anyways, the book has some good info, like how even if therapists allow contact in-between sessions, that its good to wait unless you are responding to an emergency so the client has time to reflect instead of depend on you.

I totally understand where you are coming from and hope that you can work through it!

 

[Leah123]

I hope you don't mind me asking, but is your therapy open ended or have you sat down and laid out specifi...

Oh yes, I'm extraordinarily goal oriented. I've achieved a number of goals due to my hard work in therapy, from improving my parenting to creating a better marriage to completing my degree to transitioning into a new career to doing some difficult trauma work and resolving some of those triggers. However, it's a false dichotomy to consider goals are not compatible with ongoing therapy- mine is goal oriented and open ended, best of both worlds. Now that the cost is manageable, it's pretty sustainable and I think if that changed, my therapist would (as she's said she would) offer me an accommodation as I've heavily invested in the therapy. However, I don't anticipate that being necessary, knock on wood I have always supported myself independently. In my therapy, in addition to the concrete goals, an overarching theme is actually becoming less staunchly independent, so my therapist is one of my resources. I do have some others and finally, now that I'm done with college, time to start more of a social life again (it was impossible working 60h a week + university full time + raising my daughter to do more than maintain family relationships and the volunteering).

My goal right now actually, in therapy, as I've resolved the other pressing ones, is to improve my sense of attachment, which probably marks the last phase of trauma work, as this is largely (not completely, but heavily) tied to my mother's abuse and neglect of me. Unfortunately, as we began the work, the universe pretty much seemed to mock the attempt by having me relive some of those experiences, lol, which of course, I will use to illuminate the issue.

In the meantime, while we get started, I am unpleasantly aware of the anxiety.

I talked to her online this morning though and she gave me a good exercise to remember, along with us getting on the same page about what to do next. She says we can make this better. She's been practicing 20+ years, so... here's hoping she knows what sh'es talking about! Ha.

P.S. But to comment directly on your concerns about dependency, I don't believe dependency in itself is harmful at all. *Healthy interdependence* is necessary and can be wonderful, and that's what I'm working on. Obsession is different, so is co-dependency, etc.

 

[qwyoey]

Sounds like you don't really have a reason to quit then if it's on par with your goals.

Re: dependence, it's not something I'm afraid of but I can see how you interpret it as that way. But I'll disagree politely regarding dependence. It can be good ie, depending on my husband, friends, and them on me, but it can also be bad when you don't understand your own strengths and your own anxiety takes over regarding those dependent relationships. Therapy isn't a relationship in the real world like we have with friends where we can give and receive. Obsession is the extreme side of dependency, of course, but all dependency isn't all positive or negative. Everything in moderation.

 

[qwyoey]

There's a good article called "The Darker Side of Therapy, 10 ways to deal with Dependency" I have it bookmarked under my must reads. I do not want to be negative, but it's good to be aware of the pitfalls. A lot of people have anxiety between sessions like you do, and especially healing attachment issues. I always feel better seeing similarities and that the feelins are normal.

 

[Leah123]

Sounds like you don't really have a reason to quit then if it's on par with your goals.

Re: dependence,...

Therapy is a real relationship- in my case, the therapeutic relationship is one of the most powerful. But it is not emotionally reciprocal. All relationships require exchange, in therapy it's just primarily exchanging money I earned from my expertise for her expertise. But beyond the clinical expertise, is something along with it, a genuine caring and mutual respect and appreciation. We both gain from it, but in different ways. In the absence of a mother in my life, my therapist fills the role of Donald Winnicott's "good enough mother" in a limited sense. A corrective experience. I will say my therapy is unusual, I don't believe most people have similar experiences, everyone goes in with varying situations and best outcomes.

Also, my own therapy is very much part of my real world, integrated. I share about my therapy with my husband and a few select others. My therapist is involved indirectly with the rest of my life, she sees my work (I'm a professional writer) and snippets of conversations with those in my life that I share. My therapist and I share lots of things and communicate in the midst of challenges. We do distance therapy, so that includes phone sessions and such, in a fluid fashion. It's a really engaging therapy format.

 

[Leah123]

Regarding the article, I guess I would say, my issue isn't with dependency, it's about being anxious about those I depend on. Because I've been badly burned in the past. So the dependency is fine, and the reaction to it is what I'm working on now, so that I can be relieved of the anxiety around it.

I find her helpful to work with and she can help reset my emotional barometer when I'm very upset, but I'm not dysfunctional without her. I always maintain my work, school, volunteering, family. Not perfectly of course, but... successfully.

 

[Leah123]

I feel for you spending $1250 a month, good help can be so expensive! I was spending a lot more than that at first, too much to keep up with it, but now I am down to about $650 per month, still pricey, but very reasonable given her credentials and the amount of therapy.

 

[qwyoey]

1250 seems reasonable to accomplish my goals. I also wanted to see the best of the best considering both the trauma and TBI. My insurance covers additional neuropsych treatments with my extended team, but talk therapy it doesn't. It's been worth it to go to the top. Luckily I live in the state with the best hospitals and treatment centers. I don't know how people get by in parts of this country and there are no trauma specialists around.