When Therapy Makes It Worse
After the manic episode a few years ago that I thought of as a break down ("Think of it more like a breaking open," my therapist said), my therapist, Betsy, recommended we switch from one cognitive behavioral session a week to three sessions of psychoanalysis per week. Psychoanalysis, she explained, would allow us to go deeper and explore the root causes behind my manic episodes, panic attacks, and long bouts of depression. We would delve into what had caused me to be convinced my marriage was doomed and leave for two-and-a-half weeks. We would explore where my feelings of guilt and inadequacy came from and tackle the darkest parts of me, the parts I wanted to avoid.
Psychoanalysis is intense, Betsy warned, and may make things harder for a while, may bring up stuff that I wanted to stay buried. She was right; it was emotionally exhausting. It was more rigorous than a regular, once-a-week chat. Whereas previously I'd sat on a couch across the room from Betsy's arm chair and have a face-to-face conversation about my week, barely skimming the surface, now I laid on a couch that looked much more like the stereotypical image of therapy that you see on TV while she asked me more about the thing that was making me cry. The couch faced the window and an abstract blue and purple painting with something that looked like a ladder in it. Betsy sat behind me, so that we could not see each other's faces. I usually pulled the beige fleece blanket she kept folded on a chair up to my chin, closed my eyes, and let the tears come.
For nine months, we met like this every Monday, Tuesday, and Wednesday, three days in a row of intensive self-exploration that usually ended up in ugly tears (Do you know how hard it is to sob lying down??). We dug deep into all my regrets, all my negative, self-deprecating feelings, all the trauma I'd been through and pain I'd inflicted. I left exhausted, racked with emotions. Monday mornings were OK because I didn't work Mondays and usually spent the rest of the afternoon watching TV or reading, trying to recover before soccer. Wednesday afternoons were OK because it was the end of the day and I could go home and focus on making dinner, which calms me. But Tuesday mornings at 7:00 were different. For one thing, Betsy was an hour away, so I had to leave the house by 6:00, and I am not a morning person. More than once on the drive I'd struggled to keep my eyes open, and I'd mentioned it to Betsy several times. After a series of manic episodes that resulted in my biploar diagnosis, I'd been put on new anti-anxiety meds and a mood stabilizer, along with increased anti-depressants. All three bottles warned of drowsiness and to take caution when using heavy machinery. They'd left me feeling like I was sleep-walking. I couldn't concentrate, like on an hour-long drive, without my eyelids getting heavy. For another thing, it was hard to go to work after that, rub a cold paper towel on my puffy crying-eyes, and be a normal, professional human being.
I complained to Betsy one Tuesday morning that I was having trouble keeping my eyes open on the way there. Even with my eyes closed for most of the session while I talked, once I got back in the car, I again struggled to stay awake. I even pulled over at a rest stop for a few minutes, but, eventually, I had to go to work. I was almost at my office, on a back road that curves slightly to the left, when I snapped awake as the car hit the guard rail on a bridge head-on, then bounced over to slam into the guard rail on the other side. Thankfully, no one was coming. Thankfully, I didn't flip off the bridge. Thankfully, I was going the speed limit (30 miles/hour) and had my seat belt on. My car, however, was totaled, its front end scraping on the ground as I'd pulled to the side of the bridge and waited for my husband in the rain. "But it's 8:30 in the morning," the cop who responded to my call said, as if that made a difference. I didn't know what he wanted me to say.
After two and a half years, I had to stop psychoanalysis because I couldn't afford it twice a week out-of-pocket (our insurance doesn't cover psychoanalysis). It was just as coronavirus was hitting hard that Betsy and I agreed to go back to "regular" therapy, where we sat across from each other. We only had a few sessions before everything shut down due to the pandemic and we started meeting on Zoom. Online meetings, which I took from my bed, mimicked the feel of psychoanalysis. Even though I could see Betsy on the screen, without her in the room I could imagine she was just a voice, as if it came from behind me while I stared into a swirl of blue and purple and wondered why I always felt inadequate.
I happened to start a second job just as the severity of the virus was setting in. I had hoped to be able to work remotely more with this new second job editing/coaching first-time writers in writing their books. And suddenly, we were remote and I could balance my schedule better. Six months later, I'm still pretty much remote, though I occasionally go into my office at the Children's Literacy Foundation to mail or put stickers in books. Working from home for my in-person job allowed me to juggle it with my already-remote editing job. I thought not having to drive an hour each way to therapy twice a week or drive 35 minutes to work three days a week would give me a lot more time. I'm also not doing team sports, while I would normally be playing soccer and hockey, an hour away. Though rules are adjusting, I still don't feel comfortable doing these things. I'm not sure what happened to that time - perhaps it was the three books I'm writing, the mental health anthology I'm editing, my various side gigs (freelance editing, judging writing contests, reading for a literary journal, etc.), or trying to spend time with my husband. We take the dogs on long walks together most mornings. We eat lunch together and check in throughout the day. That 'extra' time seems to fill up pretty quickly.
This is my second 'cohort' working as a Developmental Editor at New Degree Press. This time around, I have students from Singapore and Nepal and Turkey and have a lot of different time zones to coordinate. My Singapore student - twelve hours' time difference - and I meet Wednesday evenings at 7:00 my time, after a full day of meetings. This summer, I had six or seven meetings every Wednesday, from 9:00 a.m. - 7:00 p.m., with a therapy session right in the middle. It felt like too much, like just another thing I had to get done. Finally, a few weeks ago, I told Betsy I had to take something off my plate and Wednesday therapy sessions had to be it. Just the thought of a session Wednesday afternoons was stressing me out even more. I didn't have time to stop and reflect all day and suddenly having to do that in between meetings was reminiscent of going to work right after psychoanalysis.
When therapy becomes a stressor, it might be time to take a break or re-envision your therapy practice. You want therapy to be able to help alleviate some of the stress, prioritize, and bring more understanding to yourself. But, sometimes, it feels harder to open up and pour yourself out twice a week than to not and you need to be able to recognize that.
Years earlier, I stopped seeing my former therapist two days before my mom fell down the stairs, sustaining a traumatic brain injury, and my life was upended. My husband asked if I wanted to find another therapist, but the idea of opening myself up to a stranger and digging through the mess that was currently my life sounded too hard. I wanted to deal with it on our own, I said. I would later recognize that this wasn't a great move and that having somewhere to let out my fears and frustrations, someone besides my understanding husband (then-fiance) to listen, might have been helpful through that difficult time.
Therapy can be a lifeline, but it can also be hard, emotionally-draining, painful, and sometimes you need to draw a line to make it work with, and not against, your life.