Time to Re-evaluate my Treatment

There was a time, say seven or eight years ago, when I wasn’t doing very well, but I didn’t feel I had the right to take enough time to do much about it. True, I did go to therapy once every two weeks. And I tried to go to yoga about twice a week. But I was becoming increasingly depressed and overwhelmed, and these tiny windows of self-care were not enough to balance out the stressful schedule, the three teenagers, the impossible supervisor, and the general sense that there was always far too much to do.

But a couple of years later, I couldn’t ignore the not-feeling-well anymore. It was taking me over. I increased the therapy to weekly. But for a variety of reasons–from the amount of unprocessed childhood trauma to the overprescription of psych meds to an unrelenting workload–it wasn’t enough either.

Before I finally started feeling better, I had quit my demanding job, was going to therapy twice a week, seeing a cranio-sacral therapist every two weeks, had changed to a different psych nurse and a lot of supplements, and, in time, started working with a nutritionist. I also got fairly regular massages, when I could afford it, and practiced trauma-informed yoga, when I had enough energy to get out of bed. Oh, and don’t forget the sex therapist! Getting better eventually became the most time-consuming task in my life, because that is what I needed to survive and move forward.

I certainly felt guilty at times about putting that much time, money and effort into my mental health, but honestly, I couldn’t see any other way. Thankfully, my husband didn’t see this as excessive or self-indulgent. I don’t think I would have been able to invest so much in my well-being without his support.

So here I am in spring 2019, and except for a short, scary dip in April, I have been feeling a lot better for over two months. That is a far longer period of feeling well than I have experienced since at least 2013, or maybe before (hard to remember exactly). It’s amazing and I’m so grateful.

I’m coming to realize that it’s about time to reduce the intensity of my mental health treatment. Why? I suppose because 1) I still have things to talk about with E, but it doesn’t feel as urgent; 2) I feel better able to deal with my day-to-day challenges; 3) I increasingly feel that I have internalized a lot of what E has taught me, so I can conjure it up myself, even when I’m not with her; and 4) I want to have more time and money for other things.

I guess honestly, there is a #5 reason too. Some months ago, I stepped out on a limb and asked her directly if we could work on healing the attachment wound. She said she’s willing. But I don’t know that we are getting anywhere with that. On my own, I have been reading a lot more about developmental trauma and healing. It seems like most current research is pointing to body-based approaches. E respects that, but she’s not trained in it. It’s not her approach. She’s a talk-therapy therapist. She’s a sensitive talk-therapy therapist, and she’s creative and responsive. But still, I think we may have reached our limit.

What we seem to be doing, over and over, is talk about the importance of listening to and caring for whatever part is distressed. That is valuable, crucial probably. And most of the time, I would say I have stopped berating my parts for being so embarrassing or immature or needy or irrational. I am able to say to myself, “ouch, that hurts, doesn’t it?” I try to sense what is too intense and back off when I need to.

But if I’ve learned that lesson, now what? I don’t see us finding a way to do more together. Maybe I need to, and she can’t. Or maybe I don’t need to do more than this. The rest is just about continuing to apply what I know. I don’t know how much healing to expect. Should I even expect to stop getting so triggered? Or is it enough to have a range of distress tolerance and emotional self-management skills and be willing to apply them?

So maybe I’m done. At the same time, it feels scary to let go. What if this sense of stability doesn’t last? What happens when I start the next drop in that accursed Effexor? What happens if I let go and my youngest part starts screaming in terror because she’s lost her secure attachment figure? How can I reduce the intensity of my attachment to E?

In a therapy session ten days ago, I told E that I knew I was getting close to reducing the frequency of my sessions. I’m thinking I should first try going less often, before discontinuing entirely. E welcomed this, because she knew it meant I was feeling better. (Note: I didn’t take her agreement as “she’s sick of me and glad I won’t be coming as much,” which by itself shows I have made progress.) But I also said, “not quite yet,” and I didn’t set a start date for changing the frequency of sessions.

And then there are the other things I have going on. Cranio-sacral is fantastic for soothing and resetting my nervous system. It felt especially important while I was adjusting to the lower dose of Effexor over the winter. I’d love to keep going because if feels so good, but my insurance doesn’t cover any of it. It would be nice not to spend that extra money (especially because of upcoming work changes that I haven’t even written about yet). Maybe I can take a pause and restart the next time I drop my Effexor dose again?

I’m not done with the sex therapist, but I’m encouraged that we’ve made progress.

I’m not done with the nutritionist, though I’m not sure yet if it’s really helping or not. I guess I’m willing to give it a few more months, although to be honest, I’m getting bored of rich, fatty foods.

I want to be done with the psych nurse, because I want to be done with psych meds. But I’ve learned the hard way how bad withdrawal can be. It’s taught me that this long, slow process can’t be sped up. I have been working on getting off Effexor for more than 27 months, and it could be another two years before I’m off completely. I can’t say I’ve made peace with that idea, exactly. But I have decided that my stability and sense of well-being matter more than speeding up that timeline.

Damn, it takes a long time, enormous, heart-breaking effort, and a lot of money to become healthy. No wonder there’s so much suffering in the world.

As I think through the choices I’m making now and those that still lie ahead, maybe the upside is my own intentionality. I have enough knowledge now, and enough trust in my own instincts, that I am able to make thoughtful choices for myself. I remember going into E’s office, wishing she would help me with my panic and nightmares and chronic sense of overwhelm, but I couldn’t even articulate to her what it was I needed. I couldn’t tell her what was horrifying me, because it made me feel so disgusting. I just desperately wanted to be fixed. I was wandering, lost, in a forest, frightened and desperate, calling out to be saved. I still walk in that forest, but now I’m making patient, informed choices about what pathway to travel.

CREDIT:  Photo by eberhard grossgasteiger on Unsplash (modified)

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