Thursday, September 16, 2010


Frequently the concept of goals comes up with my therapist. What am I hoping to accomplish with therapy? Is there something I want to change? Same questions with EMDR - what would I hope to accomplish? Remembering? Forgetting? I've always had a hard time with verbalizing what I want out of therapy - what would give me a sense of accomplishment? I've only come up with broad things - such as being able to trust more, have a greater sense of intimacy, an ability to feel "feelings" and to verbalize how I feel. These goals seem so nebulous and not quantifiable. So, I've been doing A LOT of thinking and trying to pay attention to what causes my heart to race or my stomach to clench. I've come up with a couple of specific things I would like to change -

1) I would like to be able to experience a disagreement or confrontation without spacing out and feeling ill. To realize that it is OK to get angry and to express anger and for others to do the same.

I've always kept everything inside. My daughter is the opposite - she's quick to react and quick to forget. I'm sure much healthier in the long run. But when she "loses" it - I can't deal with it. I feel physically ill. I realized last night at dinner (during such an event), that in my eventful childhood, I learned to check out to avoid the drama. And that's what I do now. I also internalize the drama of others. I "carry" my daughter's outbursts long after she has forgotten about them. My daughter finds it difficult to say she is sorry. Last night late into the evening, she kept coming to me with a question about this or that and I know it was her way of trying to make amends for her outburst at dinner. But I wasn't able to accept it - I was still cold and monosyllabic and pushing her away.

2) I would like to be able to experience physical touch, particularly intimate touch, without my abuse coming immediately to the forefront. Or if it does, to be able to recognize it and move out of it.

I'm actually proud that I've come up with something concrete. I'm not sure if the goals are reachable or what to do to reach them, but at least they are more specific.

Have others set specific goals for healing and/or therapy?


  1. I think those are really great goals. Does your therapy include any touch (not sure what this is really called) ?

    The specific goals I am working on for therapy are:

    1. To stop using cutting as a coping mechanism.
    2. To stop thinking, considering, and planning for suicide.
    3. To be free of all mental health intervention (therapy, meds, p-doc)
    4. Establish and maintain healthy boundaries with other people.
    5. Feel and want to spend time with people outside my family.

  2. We've never articulated any goals, but there must be some. I think I would be afraid to actually verbalize them, for fear that I would never accomplish them. Left unsaid, there is less to fail at.

  3. These sound like great goals. It would be interesting to see how your T responds to the touch one, as I think you've said before she doesn't work with therapeutic touch. Having said that, I'm not sure that the kind of touch you want to work on is the kind you work with in therapy, so perhaps it is more of a talking thing.

    My goals are flexible and change according to what is going on, but there are a few over-arching goals. The one I came to therapy with was to work with emotions, as I knew that I had some deep stuff in there but couldn't access the feelings. I guess I came to work on my 'stuff' - the whole shebang. At the moment the specific goal is to deal with the assault (which means really looking at it without avoiding so I can accept what happened, dealing with the shame it evokes, and expressing my anger at what happened). Other shorter goals are working on anger, looking at really early stuff (attachment/abandonment) and I think probably to look at my school years is on the cards too. Oh and dealing with endings! But these things are all for later.

    In each session, we tend to work with what is there and present at the time. Sometimes we pick things up and put them down, come back to them another time. At the moment we are pretty focused though.

  4. Sanity -
    Thanks :) No - my therapy does not involve touch (not even a handshake or pat on the back. I'm struck that at three of your goals are measurable (1-3) which is a good thing, I think. The boundary issue seems more ambiguous (at least for me - I'm not sure I completely understand the concept of boundaries). I'm not sure I want to be completely "free" of therapy. Once I "finish", I think it would be nice to have periodic check ins. That probably just reveals my attachment to her right now though.

    Harriet -It's hard to articulate goals and fear of failure is strong, I think. I'm struck from skimming some of your recent posts that you have developed a relationship with J and that you talk about things. Do you think that?

    Samesky - I think my T will like the "touch" goal, but how to achieve it will be an issue. I was thinking this might be one for EMDR? Your last paragraph gives me pause "we tend to work with what is there and present at the time". My T frequently brings up (particularly when I report I have nothing to talk about) that we should talk about what is in the here and now - what's on the surface. And that important things will surface again. And your goals sound very similar to mine. As always, thanks for your insight.


  5. OLJ - ack! Please don't mention the "R" word. Yes, we talk about things. I don't want to have an "R" with him. Thinking of it as a "business arrangement" is much more comfortable.

    Do you think you have an "R" with your t? Is that comfortable for you?

  6. Now Harriet - you've been going to J for over a year - what you have qualifies as a relationship of some sort ;)

    And yes - I do have a relationship with my T - at times it is too intense for me and I shut down. I think going to her and talking through things has certainly helped me communicate better in my everyday relationships.

  7. I had a hard time articulating the goals I wanted to work toward in my therapy. My t had to walk me through it in order to come up with some. Even with the EMDR it took a couple of sessions to try to come up with goals with the help of my t. The more specific she wanted them to be the harder it was.

    I have a hard time with goals. Somewhere in my mind the word goals means there will be an end. This my be twisted thinking but I will think what if I reach my goal quickly - will this be the end of therapy. (mote point apparently). And I always associate the word goals with performance - what if I don't perform properly or up to my therapist's standard.

    I guess that I'm trying to say is that the word goals often brings up a pile of blocks in me.

    I really like the goals that you have stated here. I think they are realistic goals to work toward however that will be done.

  8. Goals and expectations are good things to work on. Not so easy though when it comes time to follow and live by them. They have to be realistic as you say.

  9. I've never been able to work with therapy that just wandered around. I didn't know what the process was and felt I was paying for that expertise.

    While I've always understood the need to deal with goals loosely and let what needs to happen happen, I'd get too frustrated going in and rambling on week after week.

    I have wasted good time with a therapist that was a poor match because I felt too 'invested' emotionally. I regretted it after, time lost, not good. Not every therapist is great at all things. I need one that has delt with childhood abuse specifically.

    Don't know if that helps... Gia

  10. inamaze - when you said even with emdr you had a hard time coming up with goals - do you mean things you wanted to accomplish with emdr or goals that came through the experience. I hear what you say though - if you accomplish concrete goals - then you are done. Doesn't have to be that way though - there's always something to work on.

    Thanks Dr. Deb for stopping by - we'll see how my "goal' work goes. My T always brings them up but we don't evaluate them very often.

    Gia - we sound alike in some ways - usually my frustration with therapy comes from feeling we cover the same ground all the time with no purposeful end. I have wondered about switching therapists and have brought it up with my T - she certainly is not a trauma T. It would be hard for me to switch though after 2.5 years. The fact that I continue to look for a trauma T in my area (and that I have a list of two names with phone numbers not yet called) tells me there is something my uncertainty.


  11. OLJ - the most important thing I learned in therapy is I am responsible for finding 'effective' help. I had the same problem recently.

    Read it here:

    My biggest fear was 'having to go through and relive all the bad stuff that comes up' when initially laying the foundation of who I am in terms of my childhood. It's really hard to do that.

    But, OMG, it was so worth it. My new T specializes in childhood trauma. Our time is way more effective.

    I told my husband about the difficulties of switching T's. (i have nightmares and get over stressed for days because of it) I let him know what I would need from him - that extra love & support - just til I got back to being in the effective part of therapy with the new T. He was a tremendous help. I am in a much better place now.

    Your goals sound excellent. Remember that you deserve the best care. The effectiveness of any therapy is measured in our willingness to do the work AND the therapists knowledge of our issues. Keep in mind, they usually didn't live through what we lived through. So they need to gain specific knowledge about childhood trauma to effectively help us. They also need experience dealing with trauma victims.

    The T that fired me, she had no trauma experience, so my 'excessive anxiety' presented itself, in her mind, as mania - bipolar disorder. If I have liver disease, it doesn't matter how great the heart medication you put me on is, it won't help me. And I will die from lack of treatment of my liver disease in the process.

    We have to be responsible patients - that is our responsibility.

    Again, I hope this helped - Gia

  12. Thanks Gia for the comment - I have a couple of names of trauma therapists that I've toyed with calling. I'm thinking current T might view that as resistance to the process with her. Not sure - I have started to trust her and most sessions we spend more time talking about issues than with chit chat. She's really big on accessing the "feelings" of the little girl - something I have a hard time with.