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  • Writer's pictureErika Nichols-Frazer

You Don't Graduate Therapy

When I was in my early twenties, I finally sought out a therapist for the first time in a decade. I had seen a lot of therapists when I was thirteen and fourteen. I was anorexic and depressed with severe anxiety. There was the school psychologist, a series of therapists at a teen psych ward, then a mandated adolescent therapist whom I didn't get along with at all. All of these people felt condescending, judgmental, and took the tack of blaming me for my self-harming behavior, for what I was doing to myself, as if I didn't know in my bones. They made me feel terrible for what I didn't feel that I could control. Those early experiences of therapy turned me off from asking for help for a long time. Had I had the courage to see the campus psychologist in college, I might have spent less time alone and depressed in my room.

When I had gained back the weight but was still struggling emotionally with food and my body, was still depressed and anxious and refused to take medication anymore, my parents would refer to "that time you were sick," as if it was over, as if I was better now. It felt like a secret, that, though I could pretend, I could eat, I still hated myself and my overwhelming emotions. I felt that I had to fake it for my family, that they'd been through so much, with me in the hospital two-and-a-half hours away, every meal a battle. They didn't deserve my problems, I thought.

After college, I was depressed again. I was living with my boyfriend, Dylan, and two of our friends. There were always people around, even when I didn't feel up for socializing. I had no quiet space of my own. I was working a job I hated at a boutique immigration law firm and felt like I always had to put on a show. After one tearful fight, Dylan suggested I see a therapist. At first, I was furious. I thought he didn't want to talk to me, that he wanted to foist me off on someone else, like it felt like my parents had. I thought that no one wanted to put up with my problems. "You need help that I can't give you," Dylan said, and he was right.

After contacting a few therapists on who weren't taking new patients, I found Jennifer, who looked friendly and serene in her profile picture and always wore beautiful bohemian jewelry. I saw her every Tuesday for two years. She helped me make sense of my fear of failure, my omnipresent guilt complex, my crippling anxiety. Around the time I started seeing her, I also found a weekly writers group, joined a hockey team for the first time in a few years, and started mentoring a young refugee girl. I started filling my life with positive things, became busier and more purposeful, and rediscovered my passions. Following my first manic episode, Jennifer put me in touch with a psychiatrist, who prescribed me anti-depressants and anti-anxiety meds. Things felt pretty good for a while. Dylan and I moved into our own place. I was writing again. After two years, Jennifer was moving across the country and offered to give me a referral to someone else. But things were stable in my life, and it felt like our time together had come to an end. Maybe I was "cured," I thought. Maybe I didn't need this anymore. Three days later, my mom fell down the stairs and sustained a traumatic brain injury. Dylan asked me if I wanted to contact Jennifer for that referral. I decided that I didn't feel up for getting to know someone new, to laying myself bare in front of a stranger every week. I decided that I just wanted to get through this time with Dylan and the people I loved, to deal with it together.

For three years, I saw my psychiatrist for half an hour periodically for medication checks, but I didn't seek regular therapy. The month my mom was in the hospital was hard, but once she got out was even harder. I was convinced that she was going to get hurt again, and she and my dad didn't seem to take her injury seriously. I felt like I was handling this stress and worry all on my own. Things were stressful at work, too. And then, I had an ectopic pregnancy, which resulted in emergency surgery, and sank back into depression. After about a year, I thought I could handle things on my own and asked my psychiatrist if we could wean me off my medications. I knew almost instantly that things were very wrong. It became hard to get out of bed, hard to engage in anything. I cried a lot. Finally, I knew it was time to start seeing someone again. I asked my psychiatrist for a referral and found the best therapist I've ever had. She recommended we start psychoanalysis three times a week, which we did until I fell asleep at the wheel and totaled my car after an early-morning session (new medications were making me extremely drowsy). So we cancelled early sessions and did it twice a week for another two-and-a-half years, until I could no longer afford to pay out-of-pocket (my insurance didn't cover psychoanalysis). Now, we do regular cognitive behavioral therapy twice a week over Zoom. I've thought about going down to one session a week, but I know I still need the help.

Psychoanalysis taught me to think about my depression and anxiety differently, to explore my emotions and try to understand them, to recognize negative thoughts and feelings and move away from them. This experience has been invaluable to me. Even though my therapist and I explore the same themes and issues repeatedly, each time helps me make more sense of it, understand and be a little kinder to myself.

I'm editing an anthology of mental health recovery stories (submit your work here), to be published by Main Street Rag Publishing Company and yesterday came across a story and author bio that both referenced having "graduated therapy." This seemed suspicious to me. Though some people do use therapy to address a specific problem, you're never really done with this work. Self-exploration, making sense of trauma and deep emotions, and developing coping mechanisms isn't ever complete. Therapy is something you practice, not something you "graduate." For me, therapy has been a long and difficult process, but I'm so grateful to have this support. I know I'll never "graduate" therapy, though it may change shape a bit. I'll always need some form of help to deal with my Bipolar I Disorder. It's a part of me, not something that will ever be "fixed." So, don't focus on "graduating" therapy; focus on practicing it, an ongoing process that will help you address your emotions differently and with more patience.

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