Why Would T Ask Me To Go In More Often?

[wolfie205]

My T thinks that it would be better if I go in to see her more often. I mean she said I always have a choice and if I didn't want to, that was ok but she really thought it would help if I came in more often. It made me wonder if she thought things were getting worse again because I was really starting to feel better. Either that or she just wanted me to finish my therapy soon and kick me out the door.

We've been doing Cognitive-Behavioral Therapy, which has worked but only to a certain extent. We've focused on trying to get me stable and we've never once talked about the trauma. She doesn't even know what it is, although I think she probably has some kind of idea since they say people who have gone through it usually present with the same set of symptoms.

I think she knows that some parts of the therapy isn't really helping so she said I don't have to do it anymore. She said I could just go in and talk to her about what's been going on. She wanted me to schedule weekly sessions for the entire month which was odd since I usually only see her like twice a month and sometimes we have long breaks in between.

I don't even know if she really thinks my symptoms are getting worse or if she just wants me to open up about my trauma.

It's not that I don't want to tell her, I just don't know if she wants to hear it or if she's ever going to ask me. And with Cognitive-Behavioral Therapy, sometimes it feels like it's too structured for me to share anything else...

 

[Cwolf220]

I do CPT which I believe is similar but my therapist and I have been in the trenches together over the past year. Meaning, she is amazing and allowed me to feel ok telling her some awful things I have never told anyone. We have gone through real memories, recurring nightmares, etc.

I typically go for an hour each and every week. Stress gets worse on weeks where topics are rough, but she's just always there. She definitely does require me to talk about things as much as I can- but it made me feel a thousand times better because she said, look- this is a safe place, no one else has to know, and you can stop keeping secrets.

No more giant burden on me because someone else knew, did not judge me for it and assured me I was innocent and certainly not insane. It somehow relieves that pressure valve and lightens everything. I'd say from personal experience, if you are unable to communicate the real issues haunting you- maybe there's a problem. Just my unprofessional suggestion.

 

[Nebulustrix]

There are any number of possible reasons your therapist wants to see you more frequently, but the ultimate goal should be finding a frequency that is most helpful for you. Typically, therapy is most helpful if you are seeing the therapist at least once a week, but the best frequency can vary with each individual.

I personally think that only seeing your therapist a couple times a month will be very ineffective, unless you are good at self-regulating. You don't necessarily have to talk specifically about the trauma with your therapist for the therapy to be successful, as your therapist could also be striving to help you develop techniques for handling your stressors on your own as they arise.

My therapist, for example, focused heavily on my writing as this was obviously my most effective, natural, self-coping mechanism. I didn't have to tell her about the initial trauma, because I wrote it. And then I discussed with her the current situations that I was having difficulty coping with - like how things my family would do would cause flashbacks and give me anxiety. Or an episode I'd have where I'd react irrationally to something someone would say or do, because it was a trigger that took me right back to my terror. Or the nightmares that kept me from sleeping.

I rarely shared with her specifically what I had been through, but I told her what I was dealing with now, because of what I had been through. Then she helped me recognize my triggers and come up with grounding techniques and alternative thought processes to cope with the triggers and lessen my adverse reactions. It's easier to apply such techniques, get feedback and make little tweaks to improve effectiveness when meeting with a therapist more often - a couple times a month leaves too much time between visits.

 

[Candleflames]

There's lots of reasons to up how often you go in. She might be recognizing that you are ready to really confront things or she might think you need some additional support or some other reason. There really isn't one size fits all schedule, but weekly is pretty standard.

I see my regular T twice a week as I have gotten quite emotionally unstable at times. At first I felt like it was yet another sign of how broken I was. So I asked him why the twice a week. The answer really helped put me at ease. If the why's for the additional appointment is bothering you then ask. I'm sure whatever the answer is, it's less scary than your imagination.

 

[ButterflyBean]

Cwolf,

Do you mind if I ask what CPT stands for is? Specifically, the "P"? I don't want like C*B*T anymore, and I'm doing EMDR and thinking about adding mindfulness. Not sure yet, but I'm definitely curious about your experience with therapy!

 

[Cwolf220]

I believe for me sort of airing out my demons was essential- I'm sure it differs for others. Discussing the hard stuff was awful and I still dread going there; however, there's something about finally establishing trust w my doctors that has been tremendously helpful. Before I found insane relationships plus alcohol as my therapy- was a mess. I suppose you have to trust your instincts to find what works.

 

[Cwolf220]

Holly- Cognitive Processing Therapy. In a terribly understated nutshell, you have chapters to cover each week. Can't remember the order but yr therapist will assign homework- you do a sort of essay about primary trauma, mine had me read it to her and I read as much as I was capable. Then you fill out worksheets focusing on perceived beliefs/thoughts, what could be wrong with those, fact v fiction, how can/could you change things etc. topics include intimacy, relationships, trust, respect. I honestly thought it was a bunch of nonsense until we got into some tough topics and she really helped me see how my thinking had become skewed as a result of abuse, and how to look at facts and make intellectual instead of emotional decisions. My therapist is great, I cry and laugh and get through the craziness with her by my side. Hope this helps.

 

[Deleted member 1860]

It may have nothing to do with you. She may need the business. My last therapist was always trying to fill her week, scheduling so every second was filled.

Edited to add...

Just ASK your therapist! Here you will get 1001 ideas as to what it could be, none of which may be true. Instead of playing a guessing game, pick up the phone and call her.

 

[Hashi]

I think she knows that some parts of the therapy isn't really helping so she said I don't have to do it anymore. She said I could just go in and talk to her about what's been going on... I don't even know if she really thinks my symptoms are getting worse or if she just wants me to open up about my trauma.

Do you feel able to ask her about this? It's important that you and your therapist agree on what you're working towards, and are both clear about it. If you try to guess, it will only ever be a guess. Better to ask.

It's a joint decision what approach to take and how often you see her. She has to act in your best interests, so if she feels a change would be a good idea then she's being responsible to suggest it. She should be able to explain why, and if it's still not clear or you have concerns then it's fine to keep talking to her about it. It's still your choice in the end.

I personally believe that some talking about trauma is necessary - after building a relationship with the therapist and working on stability, grounding and coping skills. I also think that once a week is a good frequency, and anything less than once a fortnight would have little impact. Other people may feel differently, but whatever the approach I think you need to feel it's an effective approach for you.

Therapy needs a plan of some kind. That can change at different times. For example, it might be to do some trauma work, to address more general life issues, or to focus on support and stability for a few months. As long as there's a reason for the approach, and you're both clear and agree about it, then you can monitor whether it's helping you. If it feels like drifting or is simply unclear, then I think you really need to talk it through.

I'm wondering, have you been seeing her long, and how much do you think she can help you overall? Is she a trauma specialist?

 

[Lucycat]

Frequency of therapy IMHO is irrelevant. What works for one does not for another.

I have a very flexible arrangement and over the past 3+ years I have at times seen T from several times a week down to leaving it a few months when all is going well. At all times I am in control- I just have to send a text if I think I need help sooner than the next scheduled appointment.

At the moment it is every 2 weeks.

Speculation as to why T has suggested more frequent contact is not helpful. The only one who has the answer is T and you will simply tie yourself in knots if you choose to worry about it.

 

[BloomInWinter]

It may have nothing to do with you. She may need the business.

There are many, many perfectly valid reasons why a patient would be offered more frequent therapy sessions.

There are so many people needing help and so few therapists that it is highly unlikely they would ever need to drum up business. All our service agencies are full with lengthy wait lists. Most therapists want to help as many as they are able because they are empathic professional healers, not corporate businesses trying to push out products for sale.

Reasons why a therapist would offer more frequent sessions are because it:

• is more effective
• helps patients receive regular support
• strengthens trust
• deepens the therapeutic relationship
• helps patient and therapist work together to stabilize the patient's life emotionally, vocationally, physically, cognitively, etc.
• helps the patient learn how to regularly express their feelings so they stop bottling them up
• lays down a habit of receiving help so if a crisis hits, the patient is more likely to seek help promptly before it becomes a crisis
• helps the therapist get to know the patient better
• provides for deeper cognitive restructuring of non-helpful thinking styles
• provides a secure attachment emotionally to the therapist so attachment issue from childhood can be identified and healed

So many are waiting for help that it's a lucky patient who receives the option to have more frequent sessions. But it's only an option. You can always say no. That time can then be given to someone who wants it.

 

[Abstract]

I agree with a lot of what has been said by others. I hope you don't mind me saying but I think they way you have been having therapy (with little frequency and no regularity) is far from ideal. The only time I have seen that be preferable and work well for someone is when they are near the end of their journey and very skilled in self management and coping skills and doing trauma work. In other words they want the two weeks inbetween to settle. But even then it was two weekly.

I think you T is doing the ethical and correct thing by getting you to book ahead. Just for interests sake all the charities in the UK (which are very well run) have policies in place where you have an appointment each week at the same time and day come what may.

There are a lot of reasons for having more than one appointment a week. I know I would benefit from it. For me it is because of my trust issues. By the time a week has passed it is as if I am starting from scratch and opening up feels impossible. I can't hold that place with my T from the week before. I also find it near impossible to experience the t session while I am there and it all comes out afterwards. Being able to discuss what comes up and actually build a relationship is hard when the time lapse is too long. I think frequent appointments are particularly helpful for those of us who have trouble opening up.

If you are not stable at present then she is doing the correct thing by prioritising that first. The rest does need to be dealt with after but that is the first stage.

PS. Afterwards wan't sure why I thought she wanted to see you twice a week. :confused:Once weekly sessions are entirely standard and are done in most therapy and that isn't even when dealing with PTSD