![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Entry tags:
Saw the doctor today
Dr. Sagov is very difficult to make appointments with, so I saw Dr. Altman, who's the other physician in the practice. I'm starting to really like him. Not as much as I like Dr. Sagov, because, well, Dr. Sagov has been my doctor since I was a wee tot, but Dr. Altman has many of the same traits that make Dr. Sagov a good doctor.
Anyway, the upshot is he upped my dosage of Lexapro, with the comment that it looked like the medication started failing about when the days started getting shorter, so we'll revisit the dosage in six weeks, and, if things are getting better, possibly cut back to the original dosage, with a note to go back up to the higher dosage in November.
And we also talked briefly about therapy as a possibility. I said that, while I wasn't resistant to the idea in principle, I wasn't enthusiastic about it, because I've seen maybe a dozen therapists of one stripe or another in my life, working with six of them fairly extensively, and had really nothing to show for it.
But Lis and I were talking about it further, and I'm trying to figure out if it's time to re-open the question and maybe start again.
And, well, as my friends list is chock full of 1) therapists 2) medical personel of various sorts 3) generally wise people 4) people who've benefited from therapy (with lots of overlap between categories), I figured I'd ask here.
The problem is that, well, therapy has mainly been a great waste of time and money for me. I don't know how to judge if I'm making progress, and I CERTAINLY don't want to hurt a therapist's feelings by saying that I feel like I'm NOT making progress, and, anyway, if I'm depressed, I'm feeling enough inertia that I don't want to make changes like changing therapists. . .
Also, this livejournal is the only forum I've ever found in which I'm comfortable talking about myself. I mean, the ONLY forum. Writing a private journal seems pointless, because who am I writing it for? Talking about myself in person feels egotistical. And while writing a livejournal IS egotistical, definitionally, it doesn't bother me, because I feel certain that y'all can just not read it if you're bored. Which means that I feel free to be boring, because I know that, no matter how boring I am, I'm not going to bore anyone who doesn't freely choose to be bored. Since there's no way you'll offend me by NOT reading this, I know that, if you ARE reading it, it's because, for whatever reason, you're interested.
So, in person, in therapy, I feel awkward. I understand that I'm paying the therapist for his or her time, so I should feel free to talk about myself. But I'm also pretty skilled at drawing other people out, so I've also managed to get them to talk about themselves. Which I am more comfortable with, but which kind of defeats the purpose of therapy.
And, in general, I can't figure out what I'd be trying to DO with therapy, anyway. I mean, I get depressed. The ability to feel happiness sometimes gets sucked out of me, so quickly and violently that I get a physical sensation of it draining out of my feet. There's not much I can DO about it. Talking about it doesn't help.
I can certainly see that, if I was to get some of the depression under control, I'd need to learn how non-depressed people do things, and that might be useful -- I remember that, when Lis and I were seeing a coach, that had some value for me. But I don't see how therapy would help for me.
I wish to stress that this is not intended as any sort of general dismissal of therapy -- I think therapy is a wonderful thing, and I'm actually a little proud I can list so many therapists among my friends. I just don't see how it would help me.
But I'm also aware that I could well be wrong. So I guess my question is -- how do I know if I'm wrong about this, and that I actually SHOULD give therapy of some sort another shot? It's not like we've got unlimited money, and I'm a bit resentful about the money and time I've wasted in it so far. . .
Anyway, the upshot is he upped my dosage of Lexapro, with the comment that it looked like the medication started failing about when the days started getting shorter, so we'll revisit the dosage in six weeks, and, if things are getting better, possibly cut back to the original dosage, with a note to go back up to the higher dosage in November.
And we also talked briefly about therapy as a possibility. I said that, while I wasn't resistant to the idea in principle, I wasn't enthusiastic about it, because I've seen maybe a dozen therapists of one stripe or another in my life, working with six of them fairly extensively, and had really nothing to show for it.
But Lis and I were talking about it further, and I'm trying to figure out if it's time to re-open the question and maybe start again.
And, well, as my friends list is chock full of 1) therapists 2) medical personel of various sorts 3) generally wise people 4) people who've benefited from therapy (with lots of overlap between categories), I figured I'd ask here.
The problem is that, well, therapy has mainly been a great waste of time and money for me. I don't know how to judge if I'm making progress, and I CERTAINLY don't want to hurt a therapist's feelings by saying that I feel like I'm NOT making progress, and, anyway, if I'm depressed, I'm feeling enough inertia that I don't want to make changes like changing therapists. . .
Also, this livejournal is the only forum I've ever found in which I'm comfortable talking about myself. I mean, the ONLY forum. Writing a private journal seems pointless, because who am I writing it for? Talking about myself in person feels egotistical. And while writing a livejournal IS egotistical, definitionally, it doesn't bother me, because I feel certain that y'all can just not read it if you're bored. Which means that I feel free to be boring, because I know that, no matter how boring I am, I'm not going to bore anyone who doesn't freely choose to be bored. Since there's no way you'll offend me by NOT reading this, I know that, if you ARE reading it, it's because, for whatever reason, you're interested.
So, in person, in therapy, I feel awkward. I understand that I'm paying the therapist for his or her time, so I should feel free to talk about myself. But I'm also pretty skilled at drawing other people out, so I've also managed to get them to talk about themselves. Which I am more comfortable with, but which kind of defeats the purpose of therapy.
And, in general, I can't figure out what I'd be trying to DO with therapy, anyway. I mean, I get depressed. The ability to feel happiness sometimes gets sucked out of me, so quickly and violently that I get a physical sensation of it draining out of my feet. There's not much I can DO about it. Talking about it doesn't help.
I can certainly see that, if I was to get some of the depression under control, I'd need to learn how non-depressed people do things, and that might be useful -- I remember that, when Lis and I were seeing a coach, that had some value for me. But I don't see how therapy would help for me.
I wish to stress that this is not intended as any sort of general dismissal of therapy -- I think therapy is a wonderful thing, and I'm actually a little proud I can list so many therapists among my friends. I just don't see how it would help me.
But I'm also aware that I could well be wrong. So I guess my question is -- how do I know if I'm wrong about this, and that I actually SHOULD give therapy of some sort another shot? It's not like we've got unlimited money, and I'm a bit resentful about the money and time I've wasted in it so far. . .
no subject
As a number of people have noted, long-term neurochemical depression leaves fingerprints all over our lives that medication can't address. One of the things I got out of talk therapy was learning to sort out causes of what was going on with me. Living with decades of under-treated depression left me with destructive habits of both action and thought, and I needed a lot of help identifying and addressing those habits that had been dysfunctional coping mechanisms when I was unmedicated and that now are actively problematic. That was really difficult -- those habits *had* served me well, for a long time.
I still have neurochemical ups and downs. But now I can much more reliably recognize when a downslide I'm feeling is chemical and when it's situational, and I can react to it appropriately. It's nice to be able to recognize that it's time to up (or in some cases, down) my meds *before* I hit crisis.
It also helped me a lot to have a more-objective viewpoint on what was going on with me. Most of us are terrible at objectively identifying our emotional state -- a friend of mine reported that he could tell when his medication was working, because when it wasn't, more bad things happened to him. He recognized that for the most part, the same kind of things happened to him whether or not his medication was working, but when his depression was active he couldn't shake the deep-down emotional conviction that the problem was external, no matter how much time he spent recognizing on a logical level that that wasn't the case. That's not exactly the way it works for me, but it did take a couple of years of talk therapy to develop the skill to sort out "this sucks because I'm depressed" vs. "this sucks because it sucks." I really needed that objective voice who could say, "no, actually, that *does* suck; that's not your depression talking" or "you seem to be reacting to things from a very depressive state; let's consider upping your meds for a little while and see if it goes away."
Right now, I'm taking a hiatus from talk therapy. First I dropped to every-other-week, and then when I had five successive sessions in which I had nothing to talk about, I told her I'd call her if anything changed. I've made a deal with myself that I'll go back if *anything* gets difficult for more than twenty-four hours -- even if I'm *sure* that it's something I can handle on my own. Because once it's clear I can't handle it on my own I'll be too depressed to actually go make the appointment. And if that means a couple of sessions I pay for that I really didn't need, well, that's much better than getting to the "too depressed to get out of bed" stage.
My partner also goes to talk therapy. He's not neurochemically depressed; he's dealing with other things, some neurochemical, some situational. From what he's said, his sessions sound a lot more like life-coaching. They talk about his goals and passions and how to bring his life more in line with what he loves. And that's a perfectly valid brand of talk therapy, too, and you might find that's what works better for you.
[continued...]
no subject
A lot of highly intelligent non-mainstream people seem to share a similar set of resistances to conventional therapy: we've been pretty introspective much of our lives and it's hard to bring a therapist up to speed on what we've been thinking about for years. We're smart and we may have known that about ourselves for awhile, and especially if we've found a peer-group who can keep up with us, we're impatient with people who don't understand our angle. If we've felt different from our peers for a long time we've probably developed a sense of self resistant to outside pressure, so we resist suggestions that therapists make just like we've resisted pressure to change ourselves to fit societal norms. Particularly if we had a period of social-outcast-ness when we were young, we may not have developed the same kind of interpersonal tools around expressing our emotions to people (and sometimes, since we've not done emotional processing with other people, we've not really had to develop the skills to identify our own feelings in the first place). We've protected the softer bits of our personality thoroughly over the years and honed the ability of our logical sides to interface with people, so the language of emotional intelligence sounds like new-age hoo-hoo to us, and we're suspicious of ideas that don't translate neatly into pure logic.
I think that's why we so often hear "take up a new art form" as an adjunct or alternative to talk therapy. It gets us out of our comfort-zone and away from the intellectual confidence that normally serves us very well. It gets us away from the realm of pure logic via a path that most of don't *expect* to adhere firmly to logic. (For the extra-geeky subset of us who've developed our introspection and social marginalization into an exceptionally stubborn sense of self, it can shake us up into realizing there are in fact things we can learn about ourselves from or with the help of other people.)
Figuring out some of the underlying causes of *my* particular resistances to therapy was, well, very theraputic. :)