Seeing a new therapist; what does progress mean to you?

Ena

New Here
Hi all. I'm looking forward to my intake appointment with a new therapist next week and would like some input as I'm feeling a little lost.

For some background on my treatment history: I have various sources of trauma (including some major medical life events) and saw a therapist locally for about nine months in the past year. Toward the end I was retraumatized during another medical incident, took a break from therapy for a couple months, and then right before I came back, I had a pretty significant dissociative episode (I think? Still learning what all these things feel like) with a lot of memory loss. I don’t think that’s happened before, not to this extent - it did feel weird and scary. We both realized by then that she wasn’t really equipped to deal with the kind of stuff that’s going on. So she referred me to someone else in the practice who’s equally experienced but also trained in EMDR, and generally probably more suited to my situation. So that’s fine, my previous therapist is great, I’m looking forward to meeting this one as well.

I struggle so much with my memory and cognition. I know I’m not stupid, I just have trouble keeping information in my brain. I also have a lot of fatigue from my chronic illness that makes it difficult for me to keep up new habits, digest new info (and remember that I’ve done so), remember conversations, etc. I do still feel stupid and careless sometimes. Every day feels like some kind of time loop if I don't have my calendar and diary to record what happened the day before. Anyway, all that is to say that my coping strategy is to write down literally everything. My memory is shot when I'm tired or stressed, so I barely remember anything from therapy if I don't write it down. Here's what I've got so far in google docs and in a binder:

- Therapy diary: I add to it before, during, and after a session. So I have a journal of my entire time with my last therapist, for example. Immensely valuable.
- Two-line diary: basically a list of my successes/progress as it happens. I write down when I've journaled, made review sheets on topics that are new to me, had appointments, had hard/necessary conversations that touch on therapy topics, looked up new resources, started reading a new book. Every day feels the same if I can't feel the progress somehow, and with this I can see everything I've managed to do for myself. Feels pretty good.
- Resource lists: all the authors, methods, blogs, websites, communities, youtube channels that I'm referring to. If I didn't keep a list like this I'd forget who everyone but Janina Fisher is.
- Book notes: I type out notes on the books I'm reading, keep transcripts of documentaries, etc. Right now I'm working through Janina Fisher's book (Fragmented Selves).
- Reflections & journals: Handwriting makes my brain work differently so I usually handwrite my reflections on what I'm reading, how it connects to my own life, if anything interesting comes up in my mind when I'm reading. Sometimes it's just "I feel called out" or "did the author read my diary" but it helps me remember what clicks with me.
- Topics: I've been starting to write out "review sheets" like I was back in school, on specific topics like "disenfranchised grief and chronic illness" for example. Summarizing and handwriting helps me incorporate new ideas faster.

There's a little more but that's the gist of it. It might seem very organized, but in reality this is the amount of external assistance I need to make any progress while I'm fatigued, traumatized, disabled at home, frequently dissociating, without a supportive social network, with a partner who also has PTSD. I have a "life binder" because without it I can't remember what breakfast is, how to take care of myself, or which receipts I need for taxes. The moment I try to multitask or tackle two priorities at once, I just zone out and forget what I was doing and then it's two hours later somehow.

That's where I'm coming from: I'd like to hear what anyone else has done to prep for a new therapist, and/or how they approach the everyday parts of incorporating things from therapy. I really do need a lot of structure and I want to get better so badly. But it's hard to picture how to get there without knowing how to navigate all the little things in between. Some feedback would also reduce some stress before the intake appt. Thanks for reading.
 

Sideways

Moderator
I relate to what you've written on so many levels!! I journal - which is to say, I have various diaries and journals that serve different functions, record different things, and have different levels of detail. I also have a "How To..." folder, which is dot points on how to do various things that I routinely forget, which varies in complexity a lot. Because yeah, I can forget pretty much anything, especially when I'm stressed.

More recently I've gotten into using Apps to help with a lot of this stuff. Which streamlined a lot of it. Some of my journalling needs to be handwritten (for the same reason, I'm using diffusion parts of my brain, so it had a different effect on the process), but some of it is quicker if there's an App that is designed specifically for it. Like Moody, which I use to track major daily stressors against function level. Life with a disability!!!

In terms of prepping for a new T, I'd be on the same "I'll need to write anything down that you specifically want me to remember or address". But I've also come to have a small number of questions to better gauge whether we're likely to be well suited - like what treatment approach they use, how much they integrate psychotropcics into their treatment approach, how they feel about DID, and what their typical goals are when working with a client.
 

Ena

New Here
Thanks for the validation on my "write everything" approach! 😅 I'm new to it but so far it's been nothing but positive (as long as everything's in one place). Do you have any other app recommendations or things that worked / didn't work for you?

In terms of prepping for a new T, I'd be on the same "I'll need to write anything down that you specifically want me to remember or address". But I've also come to have a small number of questions to better gauge whether we're likely to be well suited - like what treatment approach they use, how much they integrate psychotropcics into their treatment approach, how they feel about DID, and what their typical goals are when working with a client.

Good suggestions, I'll make sure to let her know how I use writing. I'll also read some more about setting treatment goals so I'm a little more prepared going in. Self-directed therapy isn't my strong suit anymore with the memory impairments going on.
 

Sideways

Moderator
Do you have any other app recommendations or things that worked / didn't work for you?
I use Mood Tools and PTSD Coach to track my mood and ptsd symptoms respectively. I know that there's folks here who use apps for daily task reminders as well (not sure which apps), but my trusty daily diary does the job for me with that.
 

arfie

MyPTSD Pro
i measure my progress in the small victories. the willingness to keep trying is a small victory i celebrate daily. most days.
 

SallyO

New Here
Hi all. I'm looking forward to my intake appointment with a new therapist next week and would like some input as I'm feeling a little lost.

For some background on my treatment history: I have various sources of trauma (including some major medical life events) and saw a therapist locally for about nine months in the past year. Toward the end I was retraumatized during another medical incident, took a break from therapy for a couple months, and then right before I came back, I had a pretty significant dissociative episode (I think? Still learning what all these things feel like) with a lot of memory loss. I don’t think that’s happened before, not to this extent - it did feel weird and scary. We both realized by then that she wasn’t really equipped to deal with the kind of stuff that’s going on. So she referred me to someone else in the practice who’s equally experienced but also trained in EMDR, and generally probably more suited to my situation. So that’s fine, my previous therapist is great, I’m looking forward to meeting this one as well.

I struggle so much with my memory and cognition. I know I’m not stupid, I just have trouble keeping information in my brain. I also have a lot of fatigue from my chronic illness that makes it difficult for me to keep up new habits, digest new info (and remember that I’ve done so), remember conversations, etc. I do still feel stupid and careless sometimes. Every day feels like some kind of time loop if I don't have my calendar and diary to record what happened the day before. Anyway, all that is to say that my coping strategy is to write down literally everything. My memory is shot when I'm tired or stressed, so I barely remember anything from therapy if I don't write it down. Here's what I've got so far in google docs and in a binder:

- Therapy diary: I add to it before, during, and after a session. So I have a journal of my entire time with my last therapist, for example. Immensely valuable.
- Two-line diary: basically a list of my successes/progress as it happens. I write down when I've journaled, made review sheets on topics that are new to me, had appointments, had hard/necessary conversations that touch on therapy topics, looked up new resources, started reading a new book. Every day feels the same if I can't feel the progress somehow, and with this I can see everything I've managed to do for myself. Feels pretty good.
- Resource lists: all the authors, methods, blogs, websites, communities, youtube channels that I'm referring to. If I didn't keep a list like this I'd forget who everyone but Janina Fisher is.
- Book notes: I type out notes on the books I'm reading, keep transcripts of documentaries, etc. Right now I'm working through Janina Fisher's book (Fragmented Selves).
- Reflections & journals: Handwriting makes my brain work differently so I usually handwrite my reflections on what I'm reading, how it connects to my own life, if anything interesting comes up in my mind when I'm reading. Sometimes it's just "I feel called out" or "did the author read my diary" but it helps me remember what clicks with me.
- Topics: I've been starting to write out "review sheets" like I was back in school, on specific topics like "disenfranchised grief and chronic illness" for example. Summarizing and handwriting helps me incorporate new ideas faster.

There's a little more but that's the gist of it. It might seem very organized, but in reality this is the amount of external assistance I need to make any progress while I'm fatigued, traumatized, disabled at home, frequently dissociating, without a supportive social network, with a partner who also has PTSD. I have a "life binder" because without it I can't remember what breakfast is, how to take care of myself, or which receipts I need for taxes. The moment I try to multitask or tackle two priorities at once, I just zone out and forget what I was doing and then it's two hours later somehow.

That's where I'm coming from: I'd like to hear what anyone else has done to prep for a new therapist, and/or how they approach the everyday parts of incorporating things from therapy. I really do need a lot of structure and I want to get better so badly. But it's hard to picture how to get there without knowing how to navigate all the little things in between. Some feedback would also reduce some stress before the intake appt. Thanks for reading.
I have to say I lead the therapy in that I think about what I want to talk about and tell the therapist when I get there. I then keep questioning and asking how I can fix my problem. The key is having the courage to do what they tell you which is the hard, scary and painful work. In group therapy, I notice most people are very resistant to doing the hard work. Then there will be no progress. My one therapist told me I get my monies worth from her. I work them hard! lol
 

Givrali

MyPTSD Pro
I don't. When people say I'm making progress I immediately think they're wrong because I realized my schooling making progress was in reality me fawing in meeting professor expectations.
It's such a strong immediat reject I have hard time to actually believe in factual measurable progress
 

Huxley

Learning
I can completely relate to your approach and think it’s great. I enjoy being organized too.

I think the only idea I can offer would be to remain flexible in what works for you, and flow with whatever makes sense at the time. Sometimes a journal is a list and sometimes it’s a picture, and both are good.

I have had odd reactions from therapists about writing or otherwise recording / referencing things, though, so just make sure your T is supportive of your strategies.
 
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