26.4.19

"So, how exactly does therapy work?"

TW
mental health, self harm/suicide mention, abuse, sexual violence/child molestation




Photo by Steven Blechvogel


In the past couple of weeks, two friends who have no connection whatsoever have approached me to ask about my experience with therapy. Apparently, I am now an expert on this topic - in reality, I am just a person who is very open about having mental health issues and being in therapy. In fact, I don't even know much about those topics, I'd say my knowledge is the tip of the iceberg at best. However, I get why they're asking - the idea of therapy can be scary, admitting you are not okay mentally is scary, because we live in a society where mental health issues are often dismissed, played down and/or demonized. Because of this I figured it might help if I write about my own issues and my experience with therapy - here we go!
In 2012 I was emotionally abused by my ex boyfriend. It was a really rough break up that left a lot of damage in my brain that I still suffer from that today. Back then, I was basically broken, for the first time in my life I actively hated myself, I was suicidal, ended up self-harming after just cutting my hair had worked as a coping mechanism for years, it was... really bad. Back then, I was 18 and still going to school, which hadn't gone super well before that and now I became even worse because, as I like to put it, I was too busy just staying alive and thus had trouble doing actual school work. Of course, getting bad grades didn't exactly help against my self-hatred. Everything spiraled. That was also when I started smoking - I had a lot of panic attacks and smoking helped regulate my breathing. None of this was healthy, obviously. At some point, my amazing mum, who is a social worker and thus has an eye for people needing help, made me go see a therapist.
The therapist I saw back then was specialized on children and teenagers, so I was just young enough to go see her. I don't exactly remember why I actually saw her instead of a therapist for grown up people, but it worked pretty well.
One thing I remember specifically about the first couple of sessions was that I was asked to fill in a table about big life events, either positive or negative, for different sections of my life - and I had such trouble finding positive things. My mind was literally clouded by my negativity and my self-hatred - your girl was fucking depressed, and easily diagnosed as such, plus a nice little school phobia that I had developed. Back then, I explained it as the school being a magnet, and I had another magnet in my chest, and those were polarized the same way and thus repelled each other - it felt like I was actually physically incapable of going to school. The mechanism was clear: Couldn't make myself do homework or study, went to school, got bad grades, felt worse. If I wasn't going to school I was actively avoiding that, except it was never that easy - if I didn't go, I would obviously have a harder time learning things, and thus have an even harder time getting everything down and still get bad grades. Additionally, I would feel bad for not going, worrying about people thinking I was faking it because I was just lazy, and thus I spiraled a lot.
My first therapist was a very understanding woman - she was very warm and kind, literally handling me with kid gloves (remember: specialized for children and teens). It was what I needed back then because I was very fragile and stuck in blaming myself for everything bad that ever happened to me and thinking I deserved it. I needed her to realize in the first place that my ex had abused me and he had no right to treat me the way he did treat me. I needed her to realize that I didn't have to take the repsonsibility for having been sexually abused as a 7-years-old. I needed her to realize that I deserved none of this and other things I had suffered through, and instead deserved that people took care of me while I processed those things instead of me taking care of everyone else who had to process the second hand experience.
She also taught me how to break out of the spirals in regard to school, how to calm myself down when I had a panic attack, and how to defeat the magnet in my chest. Sadly, too much damage was done for my education and I ended up dropping out and starting an apprenticeship as a bookseller instead in 2014. However, that apprenticeship was cathartic for me in a way: I ended up learning how I personally study best and thus had an overall good and successfull experience learning a thing which finally got me out of my anxiety about education.
Then 2017 came and with it two very big life events that tipped over the mental stability I had going on for me in the past three years.
In April 2016, after 14 years, my case regarding the sexual abuse I had gone through as a child got picked up again, I went back to the police to be questioned once more (as if I was more likely to remember any specifics 14 years later), half a year later they found the guy and in March 2017, eventually, his trial took place and I was invited to testify against him in court.
Before all of that, I was lucky enough to cope pretty well with what had happened to me as a child, it didn't effect me too much, I was able to lead a normal life. The trial retraumatized me, seeing that person, having my memory refreshed by the judge reading my testimony I had given as a child where my brain had done such amazing work repressing the memories and additionally, the terrible way I was treated by the present reporters and the thoughtless way I was treated by the judges. I did feel very unsafe for a while after that, started crying randomly and had panic attacks again. I aslo started getting actually triggered by things for the first time in my life. Instead of the closure I had hoped for, I got new issues to deal with. That was my first reason to seek out therapy again.
Sadly enough, actually finding a therapist with free capacities, is the hardest thing in the world. Originally, I wanted to go back to work with my first therapist since she already knew all the important background info, but since I was definitely not a child anymore she couldn't help me. I was facing endless waiting lists and at some point stopped looking and did what I did most of my life: Dealt with it myself. It got better eventually.
The other big life event was more positive at first: In June 2017 I finished my apprenticeship on an absolute high, and after a long and frustrating jobhunt I found my first fully paid job and moved back to my home town. Unfortunately, the job turned out to be not right for me. It was technically a good job, well-paid, flexible hours, nice colleagues, own office. It was just not what I was trained for, I missed actual bookselling a lot, and it started to weigh on me really badly to the point where I had trouble sleeping and got horrible stomach and back aches as soon as I entered the office. So I started looking around and had to finally face the reality - there are just not enough jobs in bookselling, especially not if you have to make an actual living from it. Again, it was my mum who kicked my ass to actually look for a therapist.
The next nine month were hard. Nine month on the waiting list, calling in every month to tell them I was still interested. The hardest part about this for me was that probably, I would've had a better chance getting a slot if I would've been honest with myself about how bad off I actually was, on the other hand I was not suicidal, not selfharming and functioning pretty well in my day to day life, so I tricked myself into thinking it wasn't really that bad and thus feeling like a fraud for actually asking for therapy.
My coping mechanism, as usual, was joking about it a lot. Gallows humor is my best friend in situations like that, and thus the first thing I said on the phone was "Hello, this is my monthly call to tell you I am still nuts!" and I ended it with "Alright, speak to you next month!".
At my ninth call, I had the bad luck to talk to a person who was very insistent on keeping things seriously and thus robbing me of my coping mechanism. A few days later, I got a call from my therapist - a slot had opened up for me.
That was in the end of 2018. I have been in therapy again for 5 months now, and we have just finished the preparatory sessions by now. Those actually take up ages and are a bit frustrating because as the name indicates it is only preparation - telling your life story, talking about your current life, finding out what is going on and, if you're lucky, why it's going on. No solutions yet.
I am a very impatient person and that is probably the first thing my therapist found out about me - I stumbled in and basically diagnosed myself (was actually off to a good start but not in-depth enough) and demanded solutions straightaway. "Okay, sure, now I know the problem but what do I have to do to fix it?" Sadly, it's not that easy.
My new therapist is a lot more hand-on, a very direct, kicking your ass type of person - no kids gloves here. This man takes no bullshit. And that is probably exactly what I need because by now; I have become very good at bullshitting myself.
Instead of diagnoses, my current therapist likes to talk about what he calls "problem pots". I have three of those: Self-worth issues, a low tolerance for frustration, and the mentioned trauma. Unlike diagnoses, those problem pots help us to talk about the direct issues that are making my life more complicated - the self-worth issues make me set incredibly high standards for myself that I can't possibly fullfill and lead to very heavy reactions to minor difficulties, as does the low tolerance for frustration which also leads to me being likely to avoid things that frustrate me. Those are the two things we are tackling primarily right now.
Even though I don't know yet how we will actually work on those problems, I already learned a lot about myself during those preparatory sessions - not only about my problems but also about my way to live my life on a daily basis. That is very down to my therapist forcing me to question everything. Twice. Lately, we have been focussing on my time and energy levels. First, I was asked to list the things that I was doing in my week: Work, my hobbies, social interactions like seeing my family or friends, my relationship, taking care of my dog etc. Then we assumed I had 100 hours in a week to do those things (sleep and hygiene not taken into account) - how much time was I spending on those things, how much time was I willing to spend on those things, did I have enough time for the things I was doing? I was also asked to estimate how much energy those things were requiring. Needless to say that I definitely was spending more time/energy than I actually had. Then we had a closer look: A thing that was pleasant should take less energy from me than time, a thing that wasn't necessarily pleasant but okay could take as much time as energy (for example, I spent around 50 hours for work including breaks and commute, so it was allowed to take up to 50% of my energy), a thing that took way more energy than time would be a thing that should be questioned mercilessly and probably ditched from my schedule. That also meant seriously questioning why I felt like I should be doing those things, what the consequences were to not doing them anymore, and if I would rather face the consequences and thus not do the things anymore or keep doing them so I didn't have to deal with the consequences. That goes as deeply as "I technically don't have to work but that would mean I don't make any money and would be living off welfare and have less money and social repercussions." It also brought me more in touch with my own aspirations and thus with what I feel are the framework for my own happiness - and with the price those come with.
Based on that, I was asked to imagine my life in 45 years: Where do I want to be, what do I want to do, how did my life have to be in 45 years for me to be happy? How much time and energy was I willing to invest in those things in 45 years? Based on that, I had to lay out the way to that goal - what would I have to be doing in 30 years, 5 years, one year, now to achieve those dreams? And again, we were questioning all of it: Did I actually want that, was I willing to pay the price, how realistic was all of that? We quickly found out that I had completely bailed on stuff like cleaning my flat in my plans. "You don't want to clean your flat at all?" "I mean... technically I don't want to but I guess I have to if I want a clean flat, huh?"
Even though it gets frustrating at times, I like my therapists approach of, I don't even know how to phrase this... let me do all the work. I have to work hard in this therapy. He isn't giving me answers. He is guiding me through the process of finding answers myself. He doesn't give me answers but he asks the right questions.
So when my friends ask me how therapy works I can only say: That highly depends. On your problem, on your therapist, and on you as a person. Even two therapies for the same person can be extremely different. But one thing that I can promise is that it's always worth trying it, and it's always good to reach out for help!

No comments:

Post a Comment