Posted by CareBear04 on January 18, 2008, at 22:50:52
I don't know why, but I just can't bring myself to talk in therapy. Part of it, I know, is mood-dependent-- when I'm manic, I can't shut up, whereas when I'm depressed, I don't feel like talking at all. In the past, I've frequently had trouble initiating conversation, breaking those long silences, so my pdocs have taken on the task of asking questions. With one pdoc, I was also worried about shocking him and disrupting his conception of me as innocent and wholesome, so I was really embarrassed about personal details, particularly relating to my sex life. Right now, though, I can't even really answer general questions about how i'm feeling, and I dread the point of the appointment when we move from meds to the talking. for a lot of reasons, I seem to leave appointments feeling worse than before.
Even though I'm more reserved when I'm depressed, the way I'm acting in therapy is a new low. THe neuropsych tests I once had said that I was very neurotic but also very extroverted, which the psychologist said was an unusual combination. No matter how bad I'm feeling, I can usually muster up more enthusiasm or at least a semblance of responsiveness when I talk to someone. A couple of weeks ago, my pdoc wanted to point out a discrepency he noticed. He dialed my cell #, waited while it went to VM, then put it on speaker for us to listen to the message. I had no idea where he was going with this, until he disconnected, looked at me and asked me who that person was-- that she sounded bubbly and happy, completely different than how i was in therapy. it's true-- i'm so far removed from the person I was, and it makes me sad and hopeless about getting back to that state. i wish i could be more talkative with him; i'm upset at myself because i can't seem to make myself.
Until the past couple of days, I thought the problem was entirely me; that the therapeutic relationship was fine, and it was just my fault that I couldn't talk more. My appointment yesterday, though, frustrated me so much that I wanted to scream at him and run out. I'm starting to wonder whether part of the reason I don't talk is because I don't see the point. he seems to think my situational problems stem from my expectations and standards for myself, which, to him, are fundamentally faulty. I don't doubt that I'm unhappy because I feel stuck on a path that I hate, but platitudes like "you don't have to do anything you don't want to do" and "follow your heart" do nothing to convince me to abandon what i'm doing and just make me feel upset and misunderstood. It also seems hypocritical for an MD to keep telling me that I shouldn't pursue a professional degree, when such a degree is very likely necessary to do the work I want to do or that I have tons of time and there's no time to rush. I guess he could be realizing these things in retrospect, but he certainly didn't apply these ideas to his own life. We seem to have a clash of perspectives, where he wants to impose the viewpoint from having finished his education and training while I just want him to set all that aside and remember how it felt to be starting that process. Sure it may be true that the difference between an A and an A- is insignificant when you're established in your career, it is not much comfort to be told that when you're still a student. I know my perspective is way too narrow, but lectures about what matters or what my priorities should be aren't helping. I feel like I have a lot of factors complicating his simplified analysis, but some of them feel private and, in general, I just can't bring myself to speak up. and if i ever do start to talk, there's just so much going on in my head-- so much anxiety, insecurity, isolation-- that i think i'll embarrass myself and never go back.
Since I was diagnosed, I've had therapy between once a month and three times a week. Before, I was seeing this pdoc about every two weeks, but last week, he suggested increasing to every week. I agreed, mostly because it would make it easier to adjust the meds, but now I'm wondering whether it's a mistake. Therapy has been making me feel worse. I can't keep up my end of the conversation. I don't know whether our views can be reconciled, and I don't even think I could bring the issue up. There seems to be competing considerations as to frequency-- i'm not in a very good place right now and should probably be followed more closely, but the appointments aren't helping. Should I ask to go back to the 1/2wk arrangement or maybe just do med check appointments every week? Or are there other options or suggestions?
Thanks!
CB
poster:CareBear04
thread:807534
URL: http://www.dr-bob.org/babble/psycho/20080114/msgs/807534.html