On Shame, Disgust & Guilt (therapy Twice A Week)

[HappyJock]

I recently got this new therapist and I have PTSD. Long ago, I used to go twice a week (for a totally different reason). Now, I'm thinking to myself that I really respond to more intensive counseling better (twice per week). My only issue is bringing it up to my therapist. One part of me tells me "You're stupid, arrogant, weak and should be ashamed. You're not her only patient and you should be fine and learn from what you talk about once a week with her." The other part of me... Well, I just think I've always responded better with twice a week. Rather, that I WOULD respond better with twice a week. But I honestly feel embarrassed to even bring it up. It's a really humiliating feeling for me. Is there anyone that sees their therapist twice a week that has PTSD? On a regular basis, that is -- not "twice a week if needed." I'm really hating myself for even thinking I deserve it or that I even consider it; I also know that I'm the type of person that will NEVER ask for "an extra session if needed." I simply won't. I'm just not that type of adult; and if I schedule therapy twice a week, I think it would already be set and fine -- that even the goal could be to eventually decrease it to eventually once a week.

 

[Deleted member 28403]

There is nothing wrong in wanting to have more from theraphy, if more intense theraphy helps you, you have full right to ask for that.

I'm glad you have a new theraphist, and hopefully this helps you to decide. Sending hugs! :hug:

 

[Casper1018]

I have been in therapy since 1991 and have only done twice a week BC it's what works for me. No shame needed. I hope you can ask your T for the additional session. I am sure she has/had other clients go that often. Good luck!

 

[EveHarrington]

I think many people go to therapy twice a week and there's nothing wrong with it, if that's what you need. I am very for going to therapy as little as needed----the key word being "needed." I think that it's important to learn how to cope on your own, but it's impossible to cope if you don't have a strong foundation. I hope that you ask for the extra session a week. I think it could really propel your healing forward. And then, when you feel a bit more secure/stable, you can try going down to once a week and see how that goes. There's no shame in asking for help. It's actually a sign of strength! Oh, and when I was first diagnosed and quite symptomatic, I went to therapy twice a week. I'm glad that I did.

 

[Leigh925]

I go twice a week for therapy and have for over a year...even better/or worse depending on how you look at it....my sessions are two hours long. So that is four hours of therapy a week.

Sometimes I am embarrassed about it. I did one session a week for the first year but I look back on this last year and see how much improvement I have made and I am grateful my therapist was accommodating when I first asked....I don't know if he realized we would still be doing it this far out but here we are!

This year I went from having five and six nightmares at night to having two to three nightmares a month. The nightmares are not even that scary compared to what I used to have.

I haven't cut in 6 months.

I set boundaries with family members that continued to be harmful for me.

I have been standing up for myself and not blaming myself.

It's been worth every single bit of extra time and money and energy to be where I am today.

 

[Friday]

So far... Everyone I've interviewed with has insisted on 3x a week to start if we're doing more than touching base. And the guy I actually started seeing last year? 120min session 3x per week.

The 120 minute sessions are super normal for me / what any therapist I've actually worked with (not trauma, other stuff) has nearly always ended up switching me to. When I work? I work. Okay! Let's bust this out! LOL. So that part didn't make me blink. It was the 3x per week thing that had me all :eek: ((And is a big part of why Im not in therapy. It was logistically impossible for me to get to, much less pay, for 2 hours 3x per week.))

If you think about it, though? PTSD is something that's -very normally- treated on an inpatient, partial hospitalization, & intensive-outpatient basis.

Inpatient = 24/7 for 1 month or longer
PHP = 8-12 hours a day, 5 days a week, for 6 weeks or longer
IOP = 4 hours a day, 5 days a week, for 6 weeks or longer

So 2-3 sessions a week? Peanuts in comparison.

 

[Suzetig]

I started out weekly bit sessions were between 90 mins to 120 mins depending on how I was doing. I then asked for additional time if I needed it - which was a huge learning for me in asking someone for help when I needed it.

If you think you need twice a week, ask and see. Your T may not have space in their schedule or may have concerns about dependency etc but you won't know if you don't ask. No need to feel bad or stupid asking for support, but I know it goes that way sometimes.

 

[Queen Boudica]

I would love to ask for more than 1 session a week and I tend to get 50 minute sessions which are just too short, when he has run over, which sometimes he does when he doesn't have another client, then just an extra 15 minutes makes a difference. 1 week seems an eternity. I can never cover all the stuff I need to and therapy just seems piece meal. (But I do have a lot of complications in my life). Like you I just cannot ask. My psychologist is very booked out and yes, since I already go weekly and feel like that is terrible I am so dependent and yes he will think I have dependency issues already then I can't ask. But the biggest problem is how much it all costs.

However I do think that more than weekly is much better for therapy and would produce much better results. I watch girl interrupted how luxurious 3 therapy sessions a week.

If you can afford it I would ask. Explain how you feel that it would benefit you and you could discuss if there is any issues about dependency.

I used to feel incredibly guilty about going weekly, in fact at beginning because my psychologist was so booked out my appointments were all over the place. Then after a whole load of dilemma and procrastinating, at the end of the year I said "I want weekly sessions" after the end of a particularly frustrating session, I just had to say it. And he said that is fine. And I book him for the whole year virtually. In fact last year he went away for 5 weeks and I told them no way I could last for that long and he offered me a substitute therapist and boy was I glad I did that because things went completely crazy across that period. If I had the money I would ask for 2 sessions a week, although yes I do worry he will think I am too dependent. He did say something about trying to increase the gap to every 10 days because of the expense, I said No way, I still need weekly. And I have been going over 4 years now, in fact coming up to 5 years and I have had all these guilt issues and shame about needing all those years, but now I am a member of a campaign to increase medicare funded therapy sessions, I talk with a whole load of therapists and also sufferers who are also therapists and they say it takes years, some of them 10 years just to get stable to do DBT. So there is no need to feel shame or guilt. The shame or guilt is coming from the policy makers who are trying to say people can get better in minimal sessions, so they can cut spending, which any psychologist will tell you is absolute crap. One week can feel like a lifetime, when you go through what we do; as I said I really would like more or at least longer sessions and I think it would have helped with the relationship as that gap is just too long for me.

I think good trauma therapists know that you need a lot of time so they would not think anything wrong of you asking for more sessions in a week. See every time I summed up the courage and asked, it was fine and I have been SO GLAD I did ask because it has made a difference. Maybe you could email, or write it down so it would be less confrontational to ask?

 

[barefoot]

I started off doing an hour a week. I then had a period quite early on when I wasn't doing very well and ended up taking three months off work. During that time, at my therapist's recommendation, I started going twice a week - I kept my regular one hour slot and added a two hour session earlier in the week. For the past year I've done one two-hour session per week. I'm about to reduce the session time to 90 minutes to see how that goes.

So, it's whatever you feel you need - and that will very possibly change at various points as you feel you need more/less support.

Do ask for what you need - as others have said, asking for what we need (not just with our therapists) is something many of us find really difficult. So if you can ask, but also tell her what impact asking has on you (the feelings of shame etc - which I identify with too) I think you could have a really useful conversation around that as you explore it together.

I hope you are able to ask and that she is able to accommodate your request.

 

[Justmehere]

I had therapy 5 times a week 1 hour a day for two months when i got really really destabilized. I have also done specialized inpatient care, partial hospitalization and had group therapy as an outpatient. I did it twice a week for a year, and other times it has varied all over the place. I now go once a week for 90 minutes.

 

[Neverthesame]

My rule of thumb when debating with myself about something, is to listen to the voice that has my best interest in mind.

The other one will always try to self sabotage you. While sometimes it's tempting to listen to it, to allow yourself to take the easy way out.

Think of it this way, if you needed directions somewhere. Two people walk up to you, one smiles, says something like "don't feel bad, that place is hard to find on a good day. Here's where to go".

The other person frowns at you and says "how stupid are you? Everyone knows where that is." Points in the wrong direction and says "go that way far enough and even you can find it." Then proceeds to extinguish his cigarette in your coffee. As a final act of rudeness leaves you with this piece of advice "next time buy a f*cking map."

Which one do you think you should listen to?

The internal voice that we have, which used to be there as our internal critic. Depression turns it into a twisted abusive self-deprecation. No longer a voice used to challenge ourselves to improve upon the areas of our lives we feel needs improvement. But now only serves as a means to reinforce the distorted negative view we impose upon ourselves.

Not sure if this is what you were asking, but that's what I got from your question.

My advice would be to listen to the voice which is trying to lead you down the road to recovery. Not the one that wants to leave you stranded beside it.

 

[Tinyflame]

Wow @Neverthesame , good (& powerful :wideeyed: ) analogy. :wideeyed: Thank you. :hug: