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When is the end of the therapy?

Thread starter #1
I'm in my 16th year of therapy. I wish I were joking - it's been one damned long haul.

Last year, I thought I was done with mental health therapy. My therapist thought I was too. However, when I tore the cartilage around both of my hip sockets and landed in physical therapy a few months later, my physical therapist insisted that my anxiety level was severely increasing my pain and repeatedly suggested I get back into therapy. It took me a while to find a therapist but I eventually did restart therapy.

More recently, it seems that my doctor isn't so sure about my fibromyalgia dx and sent me to treatment for myofascial pain syndrome. This woman must be a damned genius. I had never heard of the condition before but am quite certain she is correct. With that, certainly anxiety can increase pain, be it fibromyalgia pain or myofascial pain BUT the treatment I was getting was only increasing my pain: orders to do 30 lunges, squats, wall-sits, 45 minutes in the pool and so on, each day with multiple injuries, arthritis and whatnot. The myofascial therapist appeared shocked to find out that I was actually strength training through all of this last winter rather than recuperating. The daily level 7 pain I experienced during all of this did not improve my anxiety.

Of course, any time I see a doc and say I have anxiety they immediately want to know if I have a therapist, as if this is the cure for anxiety.

So far, I have seen my new therapist 4 times. Each time he has told me that it sounds like I am doing everything I need to be doing -- of course I am -- I am a therapy professional by now!

I don't have a problem with the guy but is my insurance just paying this guy to hang out with me once a week and if so, why?

It honestly doesn't bother me to be in therapy but I can't help but feel like I ought to be done by now. Yes, I still have anxiety and I may always have anxiety - does this mean I need a therapist?

I feel like I don't. I feel like I get what is going on and am dealing with it. I have symptoms - they may never go away - but I do what I can do pretty consistently and I live a pretty damned healthy lifestyle, too.

Just curious if anyone has any thoughts on this.
 
#3
Can’t think of the Exact book by the meditation guy john Kabat zhan or something and he wrote full catastrophic living. But he worked in pain management then brought meditation into his hospital setting with great results. I can manage a lot more pain from doing some of it. I actually wish I was more faithful to it because when I was doing the minimal I was much calmer. Pain is very draining. Tapping also works to reduce anxiety and pain. I have a condition that causes muscle spasms.
 
Thread starter #4
Do you still have stuff you want to improve on? Like even shit you don't think is fixable right now. I think it depends on what therapy you've had in the past compared to now. Like what are you aiming for with current T?
Thank you for helping me to think this through. I started with this therapist for the purpose of doing EMDR treatment. Then I moved out of state. He has stated that he thinks we can do EMDR via telehealth but says it is not ideal. It may be time to look for a local EMDR therapist and drop the talk therapy altogether which sort of shifts my point to this: I think I have talked talk therapy to death. Maybe I do just need to try different treatments because I feel like I have spent the last 5 years trying to develop healthy coping skills that I already have.

Can’t think of the Exact book by the meditation guy john Kabat zhan or something and he wrote full catastrophic living. But he worked in pain management then brought meditation into his hospital setting with great results. I can manage a lot more pain from doing some of it. I actually wish I was more faithful to it because when I was doing the minimal I was much calmer. Pain is very draining. Tapping also works to reduce anxiety and pain. I have a condition that causes muscle spasms.
My sister reminds me to mediate regularly. I will admit that I have been very lax about it even though I know I need to. I also have frequent muscle spasms and I know that meditation helps with the pain. I remember hearing about tapping and maybe even doing it but don't remember much about it. It appears that YouTube has some information on it. I will look into it further. Thanks for your input!
 
#5
Yeah.... I am nearing 20 years of therapy now... Depending on how you count... Do the initial years of searching for a useful T but only getting duds that made things worse count as therapy? :P

Anyway, I consider my trauma therapy phase to be over now. I've worked through childhood trauma to the point where it feels "done".

I think I'm going to do long-term maintenaince therapy tho. It's what I'm doing now.

Because, with childhood trauma, my internal and external support system isn't "what it should be" and probably never will be fully.

So I'll have phases in life where I'm cruising along, or where it's moderately bumpy and I'm coping.

But I think "major life events" are always going to throw me for a spin, cos they set off PTSD parts of my brain again.

So I think in calm phases, I can see my therapist once every 2 or 3 months. But in phases where I'm struggling cos of overwhelming life events (like now) I can bump that up to fortnightly or weekly.

And I think/ assume that's how it's going to be long-term.

So I think it's possible to be finished with one phase of therapy (trauma therapy) and then just sort of do after-care (maintenance therapy).

If you think of other serious illnesses, say cancer, or addictions, people will get intensive treatment for those conditions... and once they are in remission, they still get "after-care" and long-term stabilising maintenance treatment to make sure those conditions don't flare up again/ come out of remission.

For me, going to maintenance sessions is an investment... Better to keep T up to date on what's going on and vaguely check in to see if things are "fine".... Rather than have no therapy and then when a major life stressor occurs to have to scramble to set up therapy sessions again, in a crisis.
 
Thread starter #6
So I think in calm phases, I can see my therapist once every 2 or 3 months.
This is another part of what I think I am having a problem with. My new therapist seemed to just assume I would need weekly therapy or maybe he was just planning on feeling it out. I was seeing my old therapist once every month or two. While it was nice to have the extra support while transitioning from Portland to New Mexico, over the last six weeks or so, we are here now and I've actually been pretty busy lately. The last two weeks it's been hard to be available for that appointment.

I definitely do see your point about having an established therapist available for when major life events happen. That's something I hadn't thought much about. I guess with a few decades of regularly occurring traumas behind me, I figure I can handle just about anything. BUT I didn't "handle" a lot of things - just survived them.

Thanks @Sophy (in lockdown) - I think a little less frequent therapy would help me feel a little less like I am wasting my time and my therapist's time.
 
#7
I have gotten to a point where I rarely get anxiety. I have some little anti-anxiety pills, if I need them, but I only take them at bedtime. I don't have anxiety then, they just help make me tired enough to sleep.

I rarely get anxiety during the day. If I do, it is about the kinds of things that make most people anxious, like having to deal with a government agency.

I still do therapy, every two to three weeks. I feel better just having someone who listens to me, because I have to listen to people on my job, which can be difficult.
 
#8
My opinion since I’m in my sixties is probably therapy won’t end, maybe just do different kinds ? I’ve always been in therapy more or less, it just was 40 years of trying to remember what I was trying to talk about. Then humpty dumpy fell and it’s been 10 years or so. How am I now? Not sure. CSA and repressed memories. IDK if others are different or other kinds of trauma are different.
 

grit

MyPTSD Pro
#9
I think it is good to compare where you were then, where you are now, and where you think you may be another five yrs or one yr or two months, and pinpoint the value it serves for you. I think no one would do something that long (even something as challenging as therapy) if it was not beneficial to a point because also the process has active element like paying a cost so it is not something done unconsciously.

I find when I start to talk about how I would face a traumatic situation today in therapy, it alerts me that my protection parts are operating; otherwise, why do I need to focus a future traumatic event that has not happened yet? There is no logic to it.

So I wonder if you have a pattern of asking this question every few years or so and if this means something else is coming up and you have not process what that is yet and it has nothing to do with leaving therapy or not but maybe anxiety increasing or something else?

Again, without knowing your life story and basing this comment in my own jumble of things, I would say, for me at least, I would probably stop going to therapy after couple more years because I have a lot of support outside and I am truly learning a lot about me and how my traumatic childhood impacts me today and how to manage it or accept it. My energy level (ptsd cup) is increasing and I feel someday I could be better off more spending time with others rather than in therapy (time, energy and cost) ...but as of today, I do not know when exactly but I know it is not today. But also again, it is not something I consider today unless reminded.
 
#10
The question of how long I’d been in therapy never occurred to me until I started spending time here. Makes sense. PTSD isn’t somehing you’re born with that’s going to be there for the rest of forever in exactly the same way.

But I think of life as art to be perfected... not work to be accomplished.

Shrug. How much work do I have to do? When will I be done? When I’m dead. And in the interim... I’m going to have a helluva lot of teachers. Some will be the people I’m just lucky enough to stumble across. Others will be those I deliberately seek out to teach me something. The way I operate? Is very top down. When I want to know something I seek out the experts in their field. Becuase those are the people I WANT to learn from. The best of the best, the passionate, the people who truly love what they do, and excel at it. Because the best most amazing people? Are just people. Same as the mediocre and miserable. So if I’m targeting someone to learn from? That’s where I set my sights. As high as possible. <grin> And that way? I’m not depending on luck to get me where I want to go, but can simply be grateful for luck adding things to my path & people to stumble over.

If I want to learn about archeology? I talk to archeologists. If I want to learn about martial arts? I find a master. I want to learn to shoot? I find a sniper. If I want to learn about psych? I find a therapist. Et cetera.

How long will I be with ANY of these people? Until I learn what I need & want to know.

Everything else is bonus.

***
Back to specifics? I think the first time I talked to a therapist I was 10. (Not about PTSD & trauma; I’m not clairvoyant, and that hadn’t happened, yet ;)). I’m 40 now... so does that mean I’ve been in therapy for 30 years? Pfft. Hardly. Same as I haven’t been in school for 17 years, although I started when my son was 2mo old. Nor speech therapy for 35 years, nor physical therapy for 25 years. Sometimes I’ve been in school/therapy, sometimes I haven’t.

Similarly? I worked with my first trauma-therapist more in 3 months, than I have with my second in 2 years. (Pretty sure, my maths are a bit iffy. 3x12=32 & 12x2=24. So, yep. Saw the first bloke more in 3mo than the second in 24mo. Even though I forgot to double the first set of numbers for 120 minute appointments rather than 50 minute appointments). I’ve just never related to attempting to quantify quality/the experiential parts of life. I can understand inherent curiosity of timelines (what’s this going to look like, roughly? Are we talking 2 days or 2 decades? Give me a rough overview! :D) But that’s all there is. Because mileage varies. Rather a lot. ((Do I want a degree in archeology, or an interesting afternoon? Do I want to train 16 hours a day for the Olympics, or a twice a week workout?))
 
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