Why I Hit the Pause Button on All Those Therapy Appointments

Or, Just how much therapy can a person do?

January was a hard month. Okay, it wasn’t as hard as January 2019, or 2018, or 2017, or for that matter 2016–my depression often worsens in the winter–but I went into it with a stable mood and some hope for the new year, so I was expecting better. But Effexor withdrawal, unexplained stomach ache, a severe neck pain that literally forced me to lie flat on my back for most of a week, and unexpected complications from a simple medical procedure all combined forces, and I just felt lousy most of the month.

And you know, it’s not like I’m not one of those high-energy, super motivated, busy-busy people in the best of times. I’m more like–plodding. Methodical. I like to pace myself. I was one of those people back in college who started her term papers two months before they were due because I didn’t want to have to stress about it at the last minute. I like to plan. I block out time on my calendar for work (part-time, freelance), for physical therapy exercises, for errands each week. Time for breaks in between. Slow and steady.

But the thing is, in January I rarely had any sense of well-being and hardly little energy. I just couldn’t get things done, no matter what the calendar said and no matter how many breaks I scheduled in there for myself. I watched the weeks go by with zero sense of accomplishment. (Never mind those New Year’s resolutions: “I will write for at least 15 minutes every day. I will take at least a short walk every day…”)

It started to bother me, a lot, that what little energy I did have was often taken up with appointments: twice a week with E, every other week a cranio-sacral appointment, weekly with Elaine for EMDR, monthly with the nutritionist, monthly with the psychiatric nurse, weekly now also with the physical therapist, and a slot held for me with the sex therapist, even though we weren’t having regular sessions lately.

Image of a calendar for the month of January, with therapy appointments written in for 17 of 21 days, and two appointments some days.

There was a time, well, honestly, most of the time the last two years, when I clung to all that support. Those appointments were my life raft on the stormy seas of severe depression and out-of-control Effexor withdrawal. But with an increased sense of emotional stability, more skills to deal with challenges, and persistent low energy, what was once a life raft started to feel more like heavy boots that was making it harder for me to swim.

To give you an idea, here’s a typical day in January: I sleep badly, tossing and turning or lying awake a lot of the night. Around 5:30 am, while my husband is getting ready for work, I drink a half a cup of tea and talk to him a little until he leaves around six. I read the New York Times online for 45 minutes, and then I sink into a deep, dream-intensive sleep until the dogs wake me up around 9:00, complaining that their breakfast is overdue. I feed the dogs and make myself a spinach and egg white omelette, look at my list for the day, maybe tackle a little work, and then fall asleep again until maybe noon. I decide this is ridiculous; I really need to get going! So I get dressed, maybe start a load of laundry or wash dishes, do 30 minutes of work, not really feeling well, not focused and concentrated. Then it’s time to drive to an appointment. I have my hour-long appointment, and then head home, maybe picking up some groceries on the way. Perhaps I read for half an hour at home, or talk to my son, or maybe work on a proposal. Then my husband comes home and we make dinner. I should try to work after dinner, but I’m exhausted, so instead I watch something on Netflix.

The only thing I really accomplished many days was whatever appointment I had. And then half the time, I couldn’t implement the physical therapy or nutritional changes or self-care routine, or I couldn’t journal about what we talked about in therapy, all because I was too drained.

I even missed some of my volunteer work, which I love and which I’ll write about in a separate post, another day.

Three times when I had appointments with E, I felt it was too hard to make it into her office, so we did them by video chat instead.

Clearly something needed to change. And while I wished that something was an angel coming down from the heavens to bless me with good health and with a high dose of energy, I didn’t see any angels headed my way. So instead I decided to slow that steady stream of appointments and reclaim some of my time and limited energy for work, writing, blogging, or just taking a walk. If I am only going to have four good hours a day, dammit, I’m not going to spend two-thirds of that time in appointments and transportation.

Like I said, I tend toward caution, a steady pace, and a don’t-rock-the-boat approach to change. I tend to make only small changes at a time. But in late January I was feeling smothered by the schedule I’d created for myself. This has got to change, and it’s got to change right now! some part of me was screaming. I needed a big change.

So I changed my nutritionist appointments to every two months, pushed the psych nurse out to seven-week intervals, stopped my physical therapy appointments (I can use the exercises I have, for now), agreed to completely give up my slot with the sex therapist, moved EMDR to every other week, and most dramatic change of all, cut my appointments with E to once every two weeks. I will still see her alternate weeks at group as well, but individual appointments will only be every other week. (That last change made me the most nervous, and we agreed it could be an experiment for the month of February. I didn’t have to commit to permanently giving up more frequent appointments.)

I didn’t know how all the providers would react, but in fact, the have all been immensely kind about it. Tabitha, my psych nurse, said, “Oh, I totally understand what appointment fatigue is like!” Also, honestly, I think they all saw my move toward less frequent appointments as a sign of increased stability and health. Maybe it is a sign of that, even though I’m telling myself it’s a response to exhaustion.

So I’m going from literally four to six appointments per week down to one per week in February. And my response to that, predictably, is a combination of Phew! Some time to do other things! and Oh my god, what have I done??


  1. OH, Q, I so get this. I have increased my therapy to 4X a week….. and have ZERO energy AFTER a session….. and NONE BEFORE a session. So, what? We tough it out until we are, LO and BEHOLD, cleansed …????
    I AM sending you invisible Hugs for Valentine’s Day. TS

    Liked by 1 person

    • Maybe there is a time in our lives when we essentially have to live our lives primarily to go to therapy.

      I am not cleansed (in fact I need a shower!) but I am certainly not in the same place I was a year ago, or two years ago. All that therapy has moved me to the point where I can say–not without trepidation–that I want some time for other things, too. I am quite sure you will get there as well, all in your own good time.

      Sending invisible hugs back to you as well. xxoo

      Liked by 2 people

  2. Yes! According to the books, I am making progress ….. so: “Somewhere, Over the Rainbow” …. [wish it would rain on my witches, already!] Darn!! TS

    Liked by 1 person

  3. so how’s it going with E? that’s a really big shift, from 2x to 1 in alternate weeks. do you thin you’ll stay with it?


    • With her, it’s going fine. With my anxiously attached younger selves, it’s challenging. I don’t know yet what I’ll do after this month. If I had to decide today, I would see her weekly instead. And maybe that is what I’ll decide, but if possible, I’d like to stick it out this month and see how it feels when it becomes more “normal.”

      Liked by 1 person

      • Oh, “anxiously attached younger selves” – that IS what it’s all about … I have a double session tomorrow – how can I sleep tonight??? TS


      • Tell them, “Oh I know, little ones, you are so worked up about tomorrow’s session! It’s hard, isn’t it?” Just give them empathy and show you care. That’s the best way to start, E always says, and over time, I have come to believe her.

        I hope you sleep well, dear TS.


  4. Hey Q! Good on you for taking some time and space back for yourself. Nothing is set in stone so you can adjust and rejig as necessary but it’s great you listened to yourself and gave yourself a breather when you needed it. Big hugs xxx


    • Yes, the “nothing is set in stone” part has been important for me to remember, because having fewer sessions with E is harder than I expected. Even though it is my decision, it has still set off the attachment sirens: WARNING WARNING LESS CONTACT DANGER SHE DOESN’T CARE WARNING WARNING

      Liked by 1 person

      • Oh man! I understand this! The positive is that you can experiment with therapies and how regularly you attend. E is still there and if you want to up your sessions then do it. I suspect reducing the frequency of some of the others might give you enough breathing space. Just keep tweaking til you find the right mix! Xx

        Liked by 1 person

  5. Makes a lot of sense to me to hit the pause button, and you can always un-pause! I find all therapy exhausting, to the point where I’m careful to leave the rest of the day and the next free for a bad mood. I believe it’s worth it, but moderation is key for me. I bet you’ll find what works best for you with some experimenting. take care

    Liked by 1 person

  6. […] “The schedule?” I am not even sure what she means. “You mean our schedule, of sessions?” It’s only March 9, so we have barely returned to our regular schedule after my experiment of far fewer sessions in February. […]


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