The Story

So in order to battle some melancholy, I've started walking. This weekend "The Story" by Brandi Carlile came up in my random playlist. I've always liked this song and her raw voice. I've been dealing with some issues in the therapist relationship and the song made me think of my T and where I am in our relationship (I substituted "I depend on you" for "I was made for you").

All of these lines across my face

Tell you the story of who I am

So many stories of where I've been

And how I got to where I am

But these stories don't mean anything

When you've got no one to tell them to

It's true.... I depend on you

I climbed across the mountaintops

Swam all across the ocean blue

I crossed all the lines and I broke all the rules

But I broke them all for you

Because even when I was flat broke

You made me feel like a million bucks

You do.....I depend on you

You see the smile that's on my mouth

It's hiding the words that don't come out

And all of my friends who think that I'm blessed

They don't know my head is a mess

No they don't know who I really am

And they don't know what I've been through

Like you do..... I depend on you

All of these lines across my face

Tell you the story of who I am

So many stories of where I've been

And how I got to where I am

But these stories don't mean anything

When you've got no one to tell them to

It's true.... I depend on you

Well maybe the second paragraph doesn't resonate so much in the T relationship, but the others certainly do. If I was more technologically competent, I could insert a youtube link to the song, but alas, I am not.

Thanksgiving

This one will be different - the first one without my mother. It seems odd already. Also, the date of her birth is this Sunday. And we are having a graveside service on Wednesday to inter her ashes. Lots of triggers in a short period of time.

I think I am still angry for everything that happened that she didn't stop at the time and swept under the rug after the fact. Angry that I can't confront her with it anymore. And sad - for the fact that I wasn't mothered in so many ways.

But - I am doing OK :) Tried to talk about some of this in therapy last night, but it's tough to express the emotions. I'm pretty sure my therapist doesn't realize how deeply I feel some things because my outward demeanor is so controlled.

Goals

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?

Memories

I was talking with T about memories last night. I have very few specific memories of my abuse. Not surprising - I was young when it started. I've read that visual memories might be few due to abuse taking place in the dark. I've also read enough about memory to know that what I do remember as specific incidences could likely be amalgamations of different times.

We've talked about these 4 or 5 incidents more than once, although perhaps we haven't talked through all of the feelings.

I think it would be helpful to remember more, but I really don't see that happening. And for me, it's become easy for me to talk about the memories without feeling anything. It's hard when the story is repeated back to me - I feel it then.

I thought EMDR might be a place to access more of my memories and/or feelings - but that has been postponed for now.

Although I know I've accomplished things in therapy the last two years, it's amazing how the same things circle around over and over again.

One more post about feet

Three posts in one day!

So one of my overwhelming thoughts during yesterday's session was -

How did she manage to paint her toenails with her dominant arm/hand in a cast?

An Egg

If I could draw - I would draw an egg with a splinter size crack that proceeds to a mesh of cracks with eventual shattering of the shell. That's what I thought about after therapy yesterday. The goal of my therapist (at least in my mind - she would say she has no goal - it's all about what I want) is to effect the first crack. But we all know what happens after you break an egg - you end up with a gooey mess.

And I've developed this thick shell for a reason - I'm trying to decide if there is a good reason to break it.

And whether I should call my T to let her know how I'm feeling - although I suspect she has a pretty good idea.

HOW DO YOU KNOW.....

WHEN YOU'RE DONE WITH THERAPY? WHEN YOU'RE HEALED?

I've read a lot of books and blogs about healing from the trauma of childhood sexual abuse. In some I am struck by how "up" everything is. There was a journey and a process and now there is

..........healing.

How do you know this?

Is there a light bulb that goes off that says "I've felt good for x number of months"?

Is it because your therapist thinks you are done and gives you a get out jail card?

Is it because you have well defined goals and those are now met?

Is it a conscious decision about not dwelling on the past but moving to the future?

Some of the above are tongue in cheek and I am sure that even those who have moved past my stage (whatever that is) will say they are still in the process. That there is no endpoint.

I still find it difficult to believe that 45 years of feelings (shame, guilt, inferiority.... pick your own) can be altered dramatically. I feel like I still have to find that one book or one person who can show me things can be different in my mind.

I sound down and maybe I am a little. That roller coaster ride of therapy. I think last night my T tried to change the session a bit in response to my comments last week. It came off seeming forced (lots of "tell me what you are thinking right now about what I just said") and was jarring. I went in thinking we had cleared the air last week and would get down to business, but it seemed "off" somehow. Historically, after a session where I've voiced concerns about the process and my progress, I've always thought she was distant the next session, like boundaries are being redrawn. Or is she like that because I think she is?? Or the proverbial circle.

Therapy update

After writing the last post about my anniversary date, I also spent time reading all my previous entries in my private journal. This was about 60 entries over a year and a half time span, many written in conjunction with reading "Courage To Heal". I was struck by what has been almost a roller coaster ride - the doubts I expressed in the last post about continuing with therapy were played out several times over the past two years.

So - I went in poised to express this thought about quitting and/or changing. One thing that has become clear to me is that I have changed in this time frame. Although it was awkward and embarrassing at times to express my unhappiness with lack of progress and her lack of feedback, I was able to talk about it and put it all on the table. I'm not sure I could have done that early in therapy. I admitted that I don't think I am done with therapy - I still realize that I am a "closed" and "cautious" person who holds feelings tight (if experienced at all). I admitted that I need to deal with being able to express my feelings, BUT that she needed to figure out the way to get me to talk about feelings. I'm not being resistant on purpose - it's just a difficult process.

So - I will stay on for at least awhile longer. I still have some doubts as to whether she can help me go any further with processing the abuse. I'm not sure I know what I need in that respect. But she does listen and I can talk to her. Perhaps she can help with the effects of the abuse.

Anniversary Date

So last week was my two year anniversary with my therapist. As is typical for me, I asked her where she thought we were (or perhaps where she thought I was relative to two years ago) and if she had any thoughts as to where we might go. As is typical for her, she punted the question back to me, because of course "It's all about me". I'm just not sure if I can do this anymore. It seems as if we have been stagnant for some time in the sessions. I asked her about her training for EMDR. She doesn't think she will. I'm considering termination. Or searching for a new T. The last option is anxiety provoking.

I had a dream that I quit therapy in quite a rude way - cancelling an appointment, telling her on the phone that I was quitting, telling her to count me as one of her failures. Like I was trying to hurt her. I'm sure that is saying something about where my mind is now. And I'm not that sort of person.

I will talk about this with her next week, but I am not hopeful. We've had similar discussions before.

Do others find that their therapists challenge them?

Confiding in others

I think one of the hardest things about my three week break from therapy was the realization that my T is the only one I talk with about my past. Besides those involved, only two others know my history. One is hubbie and we don't talk about it (one of my areas of anxiety). The other is a long term close friend who lives 3000 miles away and has a busy life with young kids. So we don't talk often.

Although I had a great vacation - it seemed like my "internal chatter" was greater and got fairly negative by the end of my break. I'm thinking that is because I had no outlet for my thoughts since I can't call or email T. Well I could call if there was something big, but this was the "usual chatter".

That led me to think about friends who I might tell so that I might be able to unload when needed. I see a few issues with this -

1) you never know how it will be perceived

2) is it selfish to tell someone so that I can talk to them when necessary? Would I be attempting to use a friend as a therapist?

Any thoughts on this?

The Language of Therapists

Everyone jokes about how there must be a course "Illegible Handwriting" in medical school. I'm beginning to think there must be a "Therapist Language" course.

Beginning of yesterday's session -

Me: So did you miss me while I was gone? (after 3 week break)

She (chuckling a bit): What do you think? (with emphasis on you)

Me: I don't know - only you can tell me what you were feeling. (Pretty clever, I thought)

She: I noticed your absence. Although there might have been someone else sitting in the chair, I was fully aware that the 5:30 Tuesday is your time.

So - what do you think? Did she miss me?

All joking aside - the session was neutral - not great, not terrible. She commented once that she thought I was quieter than usual. It did seem like she did more talking than usual - but nothing really new.

Now we have another two week break............

Just because I KNOW it is transference

Doesn't make it easier.

T and I have spent quite a bit of the last few sessions talking about "our" relationship. And how uncomfortable it is for me to tell her what she means to me. So I'm realizing that I am projecting feelings of wanting to be mothered or to have an intimate friend on her, and she, in her therapist way, is filling those roles. In a recent session, she mentioned that she "tells" me more about herself than other patients and she was wondering if I was interpreting that as "friendship" or as a sign that she likes me. And I had to admit Yes. I think that bothered her - she was using this disclosure (I think) as a way to build trust. Although I think I knew that on some level, I also thought we were just talking because we are (1) similar ages (2)both physicians (3) share similar humor. So it seems a bit forced now - where I analyze what she says to me and wonder how she processes what I say to her. We have a two week break and the week back will likely be a bit of "fluff" and then she is off for a week or two. So - it will take a while to get back into this discussion.

One book I've read on vacation is The Talking Cure. It is a quick read dealing with how psychotherapy alters the brain. I found it interesting to discover that this therapist seems to be constantly processing what the patient is saying with her own interpretations and then reprocessing in order to determine how much of her bias she is interjecting, before responding. Must be exhausting.

It all comes down to the mother again

So this past week in therapy, we were discussing my ability to express my anger/dissatisfaction at her the previous week. In the midst of this conversation, T threw in a comment about my mother. I've having difficulty bringing back what she said because it was so jarring in the moment. I did ask her about why she brought my mother up at that point and I don't remember what she said. She knows that I have many negative feelings about my mother. I've come to two conclusions -

1) She brought up a negative image (mother) in the midst of me talking about caring about her as a T and a person in an attempt to have me care less about her.

2) She's laying the ground to explore that when I obsess about her being gone, I'm dredging up abandonment issues related to my mother and when I get angry at perhaps misinterpret something - it's because I'm channeling anger to my mother.

Something to talk about this week. I sometimes despise therapists using these "techniques" to draw the lines between things present and things past.

EMDR anyone?

After a rough session last week - one that felt very disconnected - this week was good. I was able to vent all my anger/frustration/doubts/worries about last week, our relationship and therapy in general. One thing I was able to vocalize more clearly was my concern that she did not have enough experience to deal with helping me work through the abuse and wondering if I should see a "specialist". In the course of that discussion, she brought up EMDR as something she has been "holding in the back of my mind as a possibility for you". She does not do EMDR so I would have to go to someone else.

So my question - I know what EMDR is - I did a bit of reading about it early on. Has anyone been through this and willing to share the experience?

Therapy, thus far

So after a particularly bad session (you know the the type - nothing to say - staring at each other in awkward silence) this week, I've been evaluating what has been accomplished thus far in nearly two years.

The good -

1) I've disclosed everything I remember about my abuse.

2) I've told T, my husband and I've put it here.

3) I've broached the subject with my mother and learned a few more things.

4) I think I feel more secure in my parenting skills.

5) I don't think about the abuse nearly as much as I used to.

The bad -

1) My relationship with my husband is not what it was - it is more distant without much intimacy (physical and emotional).

2) My relationship with my mother is not what is was - I can barely stand to talk with her. She is now depressed again and somehow I feel guilty for this.

3) Instead of thinking about the abuse, I now think about therapy and my therapist more than I would like.

I'm at the point where I think I need a roadmap or some guidance to figure out where to go next. And I'm not sure I am getting that from T. So, once again, I am at the point of trying to decide whether to quit therapy completely, try a new T with more experience in CSA or stick with it with current T for a while longer. And yes I will talk about this with her - it seems like we have been over the issues before.

I particularly dislike how one week can be good and the next not so good. By good - I don't necessarily mean that I "feel" good after a session, but that we connected - even if the conversation was difficult.

Treatment plans

After a dissatisfying session this week, particularly because I am wondering where we are headed in therapy, I'm left wondering about treatment plans and goals. I've read a lot about how therapy is supposed to work - you go in and talk about what is bothering you and decide on a plan for working out the issues. Most that I've read indicate there should be goals with a treatment plan and a timeframe.

I don't have that at all and at times I feel like we are aimlessly wondering along. Despite what my T says about nothing being pointless and we'll go where things take us. So that leads me to ask - do any of you have well defined issues, goals and treatment plans?

Perhaps my lack of these is due to the "type" of therapist I have. I'm not even sure about that - I think psychodynamic.

An aha moment

Man I am an epic fail at this blogging thing - my last post was December 21. I haven't been writing in my private journal either. Perhaps my T is right - I am in avoidance mode now.

At any rate - I've been thinking a lot about issues related to trust and power lately. I've had some conflict lately with my teen daughter over studying, grades, etc. She is so much more self confident than I was at her age (perhaps even now in some areas) almost to the point of being defiant. Thinking about it this weekend, I thought that her defiance (which is really individualization) is triggering for me. And I wondered if that is because I am angry at my own "inner child" for not being more defiant and standing up to the abuse. Now, I am not big on "inner child" work - probably because it involves feelings. I've also never thought that I blamed myself in the past - but maybe I am on some level. Having a strong confident daughter has brought that out in me.

Food for therapy today.

Oh - and things are much better with the daughter now - she's one of those get it out in a dramatic way and then move on. I'm the ruminator who dwells on the same things over and over. It was good to hear what she was feeling and clear the air.

OLJ

How much time do you spend thinking about therapy?

Last night as I chopped ingredients for quesadillas, I was thinking about therapy - last week's session, what we might talk about this week, and of course thinking about therapist. It made me wonder if I obssess about it more than others. So I am putting the question out there. How much do you think about your process and is it -

• Processing a previous session
• Previewing/planning an upcoming session
• Just thinking about your therapist

Any therapists that might reply - how much time thinking (or should I say obssessing) about therapy is unhealthy. Makes me wonder how much therapists think about their patients and sessions between sessions. Replaying something said - wondering if your response was off base or not helpful in the situation.

As a follow up - I ended up not going to the holiday party that we were both invited to and spent most of last week talking about. At this point, it just didn't feel *right*.

Circuitous thinking and disclosuse

This post may not be coherent because my thinking is muddled about this. I've been thinking about disclosure a lot. I've been running down my list of friends - long term and shorter term - trying to decide which, if any, I might talk to about my past. The fact that I am spending time (aka ruminating about) with this tells me I will take the plunge soon. It's something I am working up to - like I worked up to -

• going to a therapist
• telling my therapist about my abuse
• telling my husband about my abuse
• asking my mother about my abuse
• telling one friend about my abuse (a safe one, that I don't see in person because she lives 3000 miles away, have known since college and who already suspected something)

I am stuck with feeling that if I tell a friend, I will feel like I've been a fraud all these years. I feel that my friends will view me differently. Which tells me that I still defining myself by what happened to me when I was a child. I am realizing that my thought process and reactions WERE formed during childhood - the circuits were laid down aberrantly. There are times when I've been sitting with a friend, chatting about this or that, when I've considered putting it out there. But I haven't. My T tells me that it will happen when I am ready. Seems like such a pat answer, but perhaps there is truth in it. I keep thinking about one friend who told me she couldn't deal with someone because there was "too much drama in her life" and she was "too high maintenance". The woman she is referring to went through a nasty divorce from someone with mental illness, has three children and is trying to make a go of it. My feeling is she deserves to be "high maintenance", but I don't want to become that person.

Perhaps part of my issue is the people I have shared with - at least hubby and mother - haven't persued it. My mother I can understand - she is self centered and it is a relief for her to have it out in the open and now she is done with it. My husband is more complicated - I have considered the following -

• he doesn't talk about it because he finds it awkward (the one time I brought it up he said he thought it was creepy)
• he doesn't talk about it because it hasn't changed how he thinks about me - I'm still the person he married and loves
• he doesn't talk about it because it has changed his thinking of me

I still am left with that fact that I withheld this information about myself from him for 25 years. It feels like I have cheated him.

So I am left with my muddled thinking. After a bizarre therapy session last night.

Follow up on Anger

So after a few back and forths with my therapist, I finally met with her last night. I printed out my private journals related to the phone call with my mother. I also journalled what I wanted to cover in this session including my anger at her for seeming dismissive about things. I printed that out and took it in.

It was a good session. We stayed on task. We got through a lot of material. Albeit, somewhat superficially due to time constraints. I felt like she listened and cared. She commented that she was worried that I would view her voicemail as "dismissive". We talked about the phone calls with my mother. She validated my belief that it is "all about my mother". She has continued to call me every day, but not once has she asked how I am doing. My T made a leap of faith - she said she didn't think my mother would injure herself (obviously she is basing this only on what I have told her), but even if she did, it would not be my fault. There is an ugly part of me that really doesn't care at this point.

The only downside to the session was that since I was so focused on what I had written and wanted to get through, I probably listened less than usual. My memory of what SHE said is not great. But I do know it felt right at the time.

One of the things I addressed with her was my concern that her experience with CSA survivors is not broad (by her own admission). We talked about the fact that she might consult with someone who works more frequently in the area. At one point, I would have thought that to be awful. Now, I welcome it.