Lifer versus lifeboat therapy: when is it enough?


I think therapy as a term can be a very diffuse topic: is it to manage and recover from a single critical event? Does it open other cans of worms, whether they be traumas, or attachment? Does it unearth cognitive distortions and long-held beliefs that affect crises management, decision making, and interpretation? What about related relevant areas, like self-esteem, self-worth, and self-compassion? And then the journey from surviving to thriving, as @brat17 said ? But also all of it within it's context, like other crises or abuse, grief and loss (as @ladee said), pain management, insomnia, etc. and just regular 'other' conditions and abilities/ disabilities. So there's processing of traumas, current situations, future dreams or thoughts or goals or fears, and all life throws at us.

So I would guess that what is grounding and regulating, that which stabilizes or gently pushes or pulls towards growth and peace and happiness, or opens new ways to look at one's self (and the past) is a good thing. However that looks for you. Even the awareness that things don't have to be black or white in terms of choices or options can be indicative of a lot of growth that probably was years in the making.

Just an aside, I realized something strange about myself, some of which i knew, some which I didn't. I think (for me) it comes naturally to want to solve or think my way to a solution. But the thinking itself if left to only my own devices frequently digs me deeper in. So, for example, I always thought SI needed to be put in the 'non option' list. The more I'd think about it, the more of an obvious option it seemed. Then I thought recently, what are non-options? For example, going and eating the neighbour's dog, or going to my workplace naked. Etc. (Anything ridiculous or humorus or gross- but SI is pretty gross and violent, too.) And I remembered being told ( not just for me, but for anyone) years ago, "You can't do it!" Now I try to think of it solely from that basis, I "can't", just as I couldn't do those other things. (Technically I could, but I wouldn't. Because just as it makes sense to not do those things, without thinking more about it I have to trust that would make sense too. But that has taken me years to understand). So, long story short, I think learning or coping or eradicating/ replacing unhealthy or unhelpful beliefs and ways of existing do come through life. But they most come from where you can be both honest and it's safe to be honest at the same time, and where there is wisdom and support. Which actually, is pretty rare.
I don't know if the dog is off my "non options list" menu....while a last choice....if it's the dog or going will prayed over, thanked, prepared, and eaten. LOL If the Jamestown colonists did it during the starving time, I'd do it too!


@grit My God (offered humbly) you nailed it for my insides at this moment. I woke up from a nap with SI looming over the very ideology that you mentioned as acceptance of my situation or outcome is not the same for me as approval of my situation or outcome.

My attachment to the my Dr. psychoanalyst who majored in neuroscience and of course trauma, is a woven codependence on mentoring, emotional affirmation that has aided me from radical risk taking leaps without having strong family support. I like to say clinical relationships allow a form of equality or interdependence, however, in Western Dr/patient relationship culture theme... that is impossible nor deemed ethical to extend friendship outside the boundaries of designated therapy time. Thus... therapy is a form of real time practice for future self Interactions.

Therefore, I personally find such a long term clinical relationship a form of codependence from my side of the fence. I have become afraid during the vacuum of Covid ( lack of social interaction) to let go of the clinical validation, ect for self awareness as well as self esteem while making critical moves forward in a family dynamic. My fear ie: my attachment in many philosophies or storylines (even Star Wars think baby Yoda lol) can prevent actually autonomy development.

So the crux for me perhaps is am I strong enough in this moment to travel the journey through self affirmation and awareness alone realizing my clinical scale grades offer full blown PTSD symptoms as daily course?

@Survivor3 You are very encouraging and I thank you for adding your thoughts for consideration.

@Rosebud ...You offered a really honest reflection on a heavy subject, I appreciated your take immensely. SI thoughts are not my immediate go-to place but is a infrequent visitor of many of us with PTSD (so the test scale is added to the regime of questions during my major, major episodes for everyone’s protection).You handle the subject matter in a solid way! I normally skirt it as much as possible out of shame perhaps. Hence considering leaving therapy carefully, you know? Thanks for your thoughts.
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I feel for you and I really hear your intelligence while healing a trauma. thank you for having this post and I will sit on the side and enjoy as more thoughts and comments come in. Thank you again and I hope my long thoughts did not derail the conversation from your exploration of trying to sift through stay in therapy or take a break or in between. There are a lot of value to when two people sit together that are also extremely positive, healing and life affirming. Basically what we do here in this website.
First off i like your lifeboat reference. I was talking to one of my T's Monday, i have been in T for 2 years including an intensive outpatient program, and 2 weeks of inpatient while i was in limbo on the between i dont want to live vs i want to die. I hit the ER before i crossed the line.

Anyways for about 2 years i have been in discovery of myself and symptoms etc and just staying alive. Now after Monday that T has a much better idea of where to 'start'

I personally am staying in therapy. I recently transitioned out of the military and have switched to VA therapists. So far they have been good. One thing i had for tue last six months was a regular telephonic check-in with a psych nurse. We would do the depression and as needed suicde risk questionairs along with a short talk through and any make notes of things for the therapists. I startes once a week until i was seen by a T then we changed the time between calls to 2-3 weeks, eventually once a month. There are times that call was just what i needed.

I would recommend keeping a T even if it is once a week/month/etc. You never know when you might need that lifeboat or life preserver and having a T that already knows you and your issues in my opinion is the way to go.


@Spokesperson brave Although there are currently political pro’s and con’s over this sentence (coming up) please note, I feel compelled out of respect- so thank you, for your service and braving the cost of doing so. Two years of therapy is a solid block of dedication and self resolve. Thank you for opening concerning your T journey.

I am certainly going to proceed with caution and will take your suggestion under advisement. Thanks so much for posting.


My questions to you are as follows:
*when do you personally consider taking a break from therapy
* is it perhaps not as wise to do during this time of pandemic
*have you regretted the lack emotional available support
I take a break when it's interfering with my ability to function. And for me, taking a break is the best thing I've ever done. I took one over the last couple or three months, and I feel better and function better than I do when I'm in therapy.

I went back yesterday, and I think I regret it. I have NO emotional support but I realized that paying someone to sit and nod every now and then is really a waste of money. So I'm getting my primary support from my cats and I've decided to live like I want to regardless of how wrong or antisocial people think it is.


Thank you for chiming in a valuable point of view @whiteraven. May I ask for clarity sake as well as real interest- when you offer you get ”NO emotional support” (for which my heart aches btw) are you referring to your therapist or as a whole?

I am glad to learn however, that an break may be refreshing at times! Good for you and your independence!💪🏼


when you offer you get ”NO emotional support” (for which my heart aches btw) are you referring to your therapist or as a whole?
I meant it as a whole.

I guess that's not entirely accurate, though. I mean, I do get support from my mom - she is 86 and we never had an emotionally close relationship, but I think that's maybe getting better. She just doesn't know about a lot of what I deal with.

I have felt like an obligation to my T.


@whiteraven Thank you for the your vulnerability in sharing. I hope you consider asking your T if s/he sees you as an obligation as this ‘feeling’ might stand in the way of any solid decision to continue or take a break, ect. Matter of fact, I will now ask mine for this clarity because there is that undercurrent of self-imposed isolation sometimes within PTSD.

This concept needs to be explored to decide lifer or lifeboat therapy as well. So I want you to know that I am sad for your posted lack of support and will embrace our commonality with respect. Thank you again: you helped me.


I hope you consider asking your T if s/he sees you as an obligation as this ‘feeling’ might stand in the way of any solid decision to continue or take a break, ect.
Pretty sure he would not admit it if he did. Do you think your T would tell you if s/he felt you were just an obligation? I can't imagine any good therapist telling their client that.

I suspect part of my belief in that is the depression, but he has also said some things that lead me to believe he feels that way. I did take a break - a few months - and last week was my first back with him. I really think I need to stop altogether for a while. I think things would be much better.


I can understand the feelings of being an obligation, or perhaps rather a burden.

But I was thinking of something, and more readings the posts. First of all, I sometimes wonder why people (in general, society) , have what seems such a narrow focus on the ways things need to be done- judgement from it's wrong to eat dessert first, to 'this' is right or 'this' is wrong. I think if it's not harmful to anyone, perhaps a person's 'this' is exactly what they need, or how they are wired. No one knows another's context, and it's (to me) most relevant of all that (all) people thrive, and are happy and peaceful. Perhaps (the 2nd part I thought of from the posts), is questioning why it's a question to leave or stay: is it fear of dependence (and shame or guilt at that)? Is it fear of disclosure? Is it being sick of addressing trauma(s), or close to not having any need to? Or conversely, too close to the core of them? Is it financial? Is it self-blame that you need it? Do you feel defined by it, and judge yourself? Etc. (The possibilities are endless). (As an aside, it seems to be to me in life, from what I've seen of thousands of people, if you've been fiercely independent at some point you have to be dependent; if you've been dependent, independence is forced upon you. It's like it can't be avoided as some lesson to learn, or accept. But equally, interdependence, when safe, is actually healthy. And accepting help is a hard thing to do, or feel 'worthy' of, often.)

ETA, so I guess my thought is, maybe the answer to your question, actually is what is behind questioning it? (Rather than stay, or go, or something in-between.)

JMHO, but I think all people would get farther dropping 'shoulds' and just doing what's self-actualizing, +/or good for their heart, and true to their own nature. I know I'm the worst offender too, but in some ways doing things for my own good is harder than ignoring them or even trying.

Best wishes with whatever you decide! 🤗
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