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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by wittgensteinz on May 12, 2010, at 18:01:39
When I entered therapy I was in the depths of a crisis. At the time, it was a means of getting through the immediate future - there was no long-term future at that moment and I had no expectations regarding the course of the therapy.
Now, a few years later, the crisis is over and the therapy is in a different phase. I still have some difficult times but they seem to be more sporadic and I recover quicker. Life is really looking up (I'm a bit hesitant to type this - but I can't deny it) - I see a future ahead of me (a long term future, even).
Until a few months ago I'd been seeing my therapist twice weekly (sometimes 3x weekly, if the need was there). I've now transitioned to once a week. I found it difficult at first and it was more like 3 times in 2 weeks because I invariably asked for extra sessions. But the last month has been different - I didn't request extra sessions - I've become comfortable with the lower frequency.
I remarked about this today in the session, and he seemed pleased I felt that way but also said that as far as he was concerned I could continue to see him indefinitely - for as long as I wanted to - and then qualified that by saying that as long as he didn't die, which triggered me a little - I tend not to dwell on his mortality. Of course the "indefinitely" made me feel content/relieved/welcomed (although he has said something similar before).
Changing to once a week feels a little like stepping down onto the bottom rung of the ladder, one more step down and that's it, the end - that idea made me anxious to make the shift.
After today's session, I thought to myself, "but does that mean you want to go on indefinitely?" - but I don't seem able to answer that. At the moment, this works just fine and it's giving me the support I need to keep me in balance and functioning - so long as that is the case, it makes sense to continue. That to me seems justified. Another thought in my mind is "are you feeling too comfortable?" - maybe I am, but maybe that's ok. Ending therapy seems like an extraordinarily big thing (and I'm writing from the perspective of someone in an intensive long-term therapeutic relationship) - it's not just about stopping, it's about being ready to think about stopping - ready for the necessary grieving process and to stop clinging to the remnants of one's pathology.
I wondered what other people felt about this. I'm sure there are others who are in a situation where they might 'go on indefinitely' or at least 'long-term' - had you planned on this or did it just happen? Do you ever pause to think about it or does it feel comfortable this way? I'm sure on the "outside" some people might find it difficult to understand - that's why I almost never disclose about being in therapy. A lot of therapy nowadays seems to be focused on getting patients (clients) in and out in a minimum number of sessions, and highly goal orientated. When contemplating the inevitable pain of ending the long-term relationship with my therapist (however that works out - he is nearly 70 and I'm in my 20s - so there is almost certainly a finiteness to 'going on indefinitely'), I can see the attraction of a short-term therapy with less intimacy or attachment - not to say that I regret for a split second having opted for this type of therapy - I'm quite sure it's saved my life and the relationship itself was an essential element of that.
Witti
Posted by rnny on May 12, 2010, at 18:23:32
In reply to The course of therapy, posted by wittgensteinz on May 12, 2010, at 18:01:39
When I went into therapy, I was depressed and thought naively so, that there was some cure I would undergo and then therapy would be over. Maybe 3 months at most. The longer I stuck around more "fresh material" would surface and I liked having someone to talk to about the stuff. So I chose to have the therapy continue. And it did, for years. The therapist I had made it clear however that the goal of a therapist (or at least her goal) is/was to get the client to stand on their own two feet without the therapist to lean on. But as I found out, getting to that point can take different amounts of time depending on the client. You are blessed to have a T who hasn't tried to push you out the door. I see a new T now as the other one retired and the new one is also a 'long term' type T if that is what a person needs. I have to crack up when I read psych articles and it says something like "Normally 8 sessions should take care of this" and stuff like that. I shake my head and think, "OMG, not for me."
Posted by Verloren on May 12, 2010, at 21:32:39
In reply to The course of therapy, posted by wittgensteinz on May 12, 2010, at 18:01:39
"Changing to once a week feels a little like stepping down onto the bottom rung of the ladder, one more step down and that's it, the end - that idea made me anxious to make the shift. "
I'm currently at twice a week. I thought I could do once, but it just didn't feel like enough. If she'd allow it, I'd go 3 times a week but am afraid to ask for that.
In my opinion though, there are still plenty on rungs left on your ladder. I think once I start weening down (whenever that may be) I will go once a week, then once every 2 weeks, then once a month, then once a quarter, then twice a year, then once a year for follow-up and maintenance, and then quit.
Plenty of rungs there :-)
Each of those stages can last for as long as I need then. I might be on the once a month for 3 months or for 13.
My T has other patients that are on varying schedules like that. It only matters what you're comfortable with.
-Verloren
Posted by emmanuel98 on May 13, 2010, at 19:56:01
In reply to Re: The course of therapy » wittgensteinz, posted by Verloren on May 12, 2010, at 21:32:39
I saw a T once a week for five years. At around 4-1/2 years, we cut back to every other week because I was feeling better and not feeling so needful of him. At five years, we ended regular therapy. It was sad for a few days, but I was ready. The goal is to end and get you ready to end. I still contact him if I get depressed and I still see him less frequently for meds.
Posted by wittgensteinz on May 16, 2010, at 17:31:06
In reply to Re: The course of therapy, posted by rnny on May 12, 2010, at 18:23:32
Yes, I also don't get how 'in and out in 8 sessions' could possibly 'fix' someone - perhaps if someone has a highly specific phobia they want addressing, this could work?
I'm not sure I'm really wanting to be 'taken care of' per se - to be 'fixed' (and now I think of someone taking their dog to the vets) - more I'm hoping this experience will help me develop into a better, happier person - someone who can go about her life more comfortably/easily - my initial goal was just 'getting through' whatever it was I was going through, namely the crippling depression and anxiety.
I'm sorry your T retired - that must have been hard for you. Mine is post-retirement age - he seems to be of the philosophy that he will continue until his age gets the better of him, which it doesn't seem to have yet, luckily.
Witti
Posted by wittgensteinz on May 16, 2010, at 17:57:40
In reply to Re: The course of therapy » wittgensteinz, posted by Verloren on May 12, 2010, at 21:32:39
Verloren,
I can't help but comment on your babble name - German/Dutch for 'lost'. I live in the Netherlands so it's a familiar word :)
It was hard shifting to once a week. My T brought it up, and that was difficult in itself. He felt I was well enough and seeings my life has become more busy so fitting in 2 appointments is less easy it seemed a good thing to try. I wouldn't have suggested it myself and it was a while before I agreed to try it. It wasn't forced and we agreed that if it wasn't enough or didn't work, I could continue with two sessions per week. The first week we reduced to 1 session I became quite absent minded - ended up missing my station while on the train, and left an expensive gift behind on a bus (hmm... so much for saving money)! I felt quite upside-down for several months. In my case, it's easing though.
As for reducing sessions further, I guess this could be a possibility at some point although I recall my therapist mentioning that he prefers not to reduce frequency below once a week, and that's why I see it as the 'bottom rung' - maybe there is more flexibility there. Personally, I think it would be hard to connect on a lower frequency.
If you are feeling like you would rather see you T more frequently, then it doesn't sound like reducing to once a week would be at all easy at this stage. It is definitely quite different from twice a week - less intensity and less connection - that's something I miss, to some extent. Sometimes the week's appointment comes and goes in a flash and then a whole week before the next.
Witti
Posted by wittgensteinz on May 16, 2010, at 18:00:33
In reply to Re: The course of therapy, posted by emmanuel98 on May 13, 2010, at 19:56:01
Emmanuel,
This sounds like a good ending and a good arrangement as far as being able to go back when needed. I'm glad you are feeling better lately.
Witti
This is the end of the thread.
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