I’ve been struggling in therapy the last few weeks. Topics come up that I don’t want to talk about, things that I know will make me dissociate. I don’t want to go there, so I shut down. Then my therapist gets frustrated, and brings up intensive outpatient, because that is what is in the contract I agreed to in July in order to avoid hospitalization. Then I get frustrated because it seems like she just wants to send me off to IOP. It makes me feel like she just wants to give up on me. It makes me feel like I’m not good at therapy.
It happened again during Thursday’s session. Her mentioning IOP just made me shut down more. I was hurt. I was angry. But I couldn’t voice any of that.
I ended up writing my therapist an e-mail early Sunday morning.
Sometimes I get frustrated whenever you bring up IOP. I know that’s what we agreed on, but I didn’t know that any time anything goes wrong, IOP was going to be brought up. It just further solidifies my belief that I’m not good at therapy. And I know you said not to judge myself, but that is how it translates for me. That I’m not doing this right. That this is just another of many failed attempts at therapy. And then the others think the same, and then it becomes a battle just to go to therapy. It doesn’t help me. It just makes me shut down more.
I know I can be frustrating. I know you have to repeat things a bunch of times because they don’t get through to me. There are times I really don’t understand what’s going on. There are times I don’t feel like my brain is working. There are times when I am sitting there, but I am not there. I’m sorry for that. I am trying, but I’m not perfect.
Sometimes I don’t want to talk about certain things because someone is telling me not to, or because I know I won’t be able to stay present, or because I am afraid to feel. It’s not that I don’t want to. It’s that I can’t.
I’ve made progress. Maybe you don’t think it’s enough, and maybe it’s not enough on paper, but I think it is. Because I live it. I could be so much worse than I am right now. I struggle, but we figure out how to work through it. I don’t know what else I’m supposed to do.
I’m sorry if this didn’t make sense. I just had a lot on my mind that I’d never be able to say out loud.
She didn’t reply back. I actually told her not to. We were having a session the next day, anyway, and I just wanted to get it out there because I knew I wouldn’t be able to say it out loud.
When I walked in her office this morning, she told me was that she got my e-mail. I immediately apologized. I regretted sending it, because I was afraid it was mean, and that she was going to be mad at me. She assured me that she wasn’t angry, that it wasn’t mean, and that I didn’t need to apologize.
My therapist asked why I couldn’t say the things I wrote in the e-mail to her in person. I told her it wasn’t because of her. I am just so afraid of people sometimes, so scared to communicate. I still feel that talking is wrong. I still feel unable to speak the thoughts in my head. Sometimes I can, and sometimes I can’t. I can’t explain it.
She told me IOP isn’t a punishment. She’s not sending me off to Shady Pines. She doesn’t want to pass me off, she wants to help me. She thinks the program will help with some of the basic things I still struggle with, like eating, daily triggers, and handling my emotions. I know how hard it is for you to get through each day. I know how hard it is for you just to get up in the morning. I see it in you every time you’re here.
Then she started with one of her metaphors.
“Let’s say you broke your leg. Luckily, your insurance covers everything and you have to choose between a wheelchair and crutches. Which do you choose?”
“I choose crutches.”
“But why? Choosing the wheelchair will help you recover faster and easier. With crutches, you’ll still be struggling, and you’ll risk falling and making your leg worse.”
I understood her analogy, but I still insisted on the crutches. I can’t do as much in a wheelchair. Sure, I may recover faster, but at what cost? I won’t be able to do my job in a wheelchair. I won’t be able to get around everywhere I could if I were walking. Half of my ability will be gone.
But with crutches, I can still walk. I can still get around. Sure, I will struggle to keep myself upright. And yes, knowing me, I’ll probably fall over quite a few times. But I’ll still be functioning. I can still hobble around and do what I need to do. Even if it takes me longer to heal, I’d pick the crutches.
In a deeper way, crutches are a less obvious sign that something is wrong. When someone sees someone in a wheelchair, they know it’s serious. No one uses a wheelchair for minor things. When someone sees someone using crutches, they assume well, at least they’re still walking. They’ll be fine. Maybe it’s just a sprain. Maybe you just need a crutch for a little stability. Nothing too serious.
Let me stumble through life on my crutches.
I don’t want to admit that I’m too broken to need a wheelchair.
Life Without Hurt 
Wow. This is so good and poignant. I admire how you fight for yourself. I am also one who has A LOT in my head that I want to say but often can’t get it out. But as soon as I start writing it all becomes clear and I can formulate my feelings into words pretty clearly. I fear people too. It’s very hard for me to trust anyone. Very hard. There’s some things I’m being encouraged to do to “move along” my healing that I am not sure I want to do. I don’t know if I want “faster” (the wheelchair). I just want to know I’ll be ok. I would choose the crutches too….for your exact reasons. I think it’s ok to choose the crutches. Thank you for sharing this. It has given me a lot to think about.
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Thank you.
I almost wish I could just write everything down in therapy. That would probably be time-consuming, though. Writing is so much easier for some reason. Maybe because I’m scared of looking at people, I don’t know. I’m relieved to know I’m not alone.
We’ll be okay with our crutches.
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We will.
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It is ok to choose the crutches. It is more than okay.
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Thank you.
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You have to pace yourself. IOP is not the answer for everyone. What skills do you need to learn from therapy? Things around the lines of mindfulness (this can help you stay present and also helps with stress).Or coping skills? It might help if you had a target to work on. And it will help you be ready to process trauma.
You can’t fail therapy. It’s not a graded experience.
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My therapist doesn’t work in DBT or CBT and she thinks I would benefit from some of those skills. I’ve tried the coping skills and grounding but it’s not enough. I’m okay for a little and then I get worse.
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It’s a journey. We all have times we move “back.” Hopefully, we improve from there.
I found this book helpful:
“The Dialectical Behavior Therapy Skills a Workbook.” (McKay, Wood, and Brantley)
It teaches the basics of DBT, including mindfulness.
The Mindful Way Through Depression is another useful book.
I’m curious- what does your therapist specialize in?
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Psychodynamic therapy and trauma focus.
I actually think I have that book somewhere in my collection. I haven’t read or used it yet. I’ll look.
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I’m glad I found your writing- I’m finding it very helpful. I’m also finding DBT skills and mindful exercises very helpful when I need to stay grounded or come back from disappearing. Focusing on and describing an item nearby keeps me from spinning off into overloading feelings or cyclical thinking.
My mother was abusive also- I’m just noticing my identity confusion linked with her as you noted in your writing- up to this point, I’ve been focusing on my own inner identity confusion without realizing how much I’m mixed up re: me ? Mother ? Us ? I noticed a similar theme in your writing- I, too, am often told I look like my Mother- makes it tough when I’m trying to separate myself enough from her to know it’s okay to cry even though crying brought severe punishment and isolation.
I’ve been working for a couple of years now on my therapy and am amazed at how far I think I’ve progressed yet am really at the point of figuratively knocking at the front door😃
Thanks for your writing
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Thank you for reaching out!
I’ve heard a lot of good things about DBT. I’m just going to have to find time to educate myself about it more in-depth.
I’m sorry that your mother was also abusive. In one way, it feels different to know that you are not alone, but sad to know that others have experienced this and share so many feelings and difficulties.
Keep working in therapy! I’m just over a year now and barely reached the welcome doormat.
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