Dear A (therapy break edition)

A,

I have decided I need a break from therapy. I am feeling a strong desire for significant amounts of space from the work we are doing together. 

I would like to cancel my next two sessions (April x and x), and schedule something for the first week of May. 

– PD

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Wrong and Dirty

I had session with A today. I feel wrong, and dirty, for talking about what we talked about. I’m also tired, and sick.

I’ve made so many new mental connections, and I am simply tired of talking. I see her next Tuesday, it feels too soon. 

I need to go to sleep. I need to gather my resources.

Trigger warning: sex and eating disorders

I feel like I should be punished for bringing up sex and my sexuality and talking about those things we aren’t allowed to talk about. I want to purge, something I haven’t done (if you don’t include my wedding night…) in 8 years. 

You see talking about being healthy sexually and having a sex life and how I feel about all that goes hand in hand with my relationship with my Dad which goes hand in hand with my eating disorder(s).

I was fine when I left A’s office, even though I felt like we missed each other (both of us were sick today). But in the last half hour things have slowly gotten worse. She also hasn’t hugged me either of these last two sessions. She says it’s because she is sick, but I know it’s because she thinks I’m wrong and dirty. 

I never should have talked about any of this with anybody. 

Session

Before I even got there, to my additional session, there was added stress. I received an email from A at 8:30 in the morning saying she wasn’t feeling well and was likely going to have to cancel her afternoon sessions. Thankfully I didn’t get this email until 12:30 so I didn’t panic for too long. But it also suggested I come earlier. 

My initial reaction to this was not motherfucking impressed. Have you never heard of a phone, A? I was now at 12:30, facing having to leave in 15 minutes because of the time change and not knowing what was going on. So I emailed her back with “I am leaving now, call me otherwise” basically feeling really shitty. Why offer me a session if you’re not feeling well? 

So when I got there, I asked how she was feeling (she actually looked legitimately sick, super flu-esque and for a hot minute I wondered if I should just tell her to go home). I asked her if in the future she could call me the day of, if she has an emergency. I addressed it right away because the idea of showing up and her not being there on that day, the day I had that letter to read, that would have really hurt me and our relationship. She said she understood, and apologised for her lack of forethought. 

I gave her the letter and freaked out. I told her it was a shitty day for her to not be well, because naturally she wouldn’t be as attuned (she looked really sick guys). I told her I felt like I needed to take care of her and NOT share what was in that letter and she told me that I absolutely should bring up what I came to talk about. So I told her I needed her to read the note and absolutely WOULD NOT read it, and didn’t have time to debate her on it (it was 50 minutes today).

She read it, and was like “so you’re asking me if I would be willing to come with you.” And I wasn’t looking at her, and I nodded and was like “but honestly I’m not attached to the idea at all, really.” And she said “so tell me what that would do for you, having someone there.” And I just looked down and away and whispered “I am so ashamed. Just forget I asked.” And I couldn’t talk and she said “PD, remember you’re safe here. Can you look at me? Do I look angry or upset or disgusted in any way?” And I said no. And she said “good, because I’m not. I have never been asked this before and there is a lot to consider. And I’m glad you realize that you can’t assume the results of this conversation unilaterally. I am glad you brought this up. And impressed you brought this up. We are getting practice having a compromised discussion around something that would affect us both. So I am going to ask you again what having someone there would be like for you, what it would help with, so I can figure out that need and find a way to meet it.” 

I told her it was about comfort and stability, someone to help me through it, make sure I could safely leave. And she really carefully considered it, and then said to me “my biggest concern here is operating with another practitioner, in another practitioners space. That would be very new to me and I’m not sure that it is best for me to do that for the first time at such an important moment for you. The circumstances wouldn’t allow for the kind of work we do here – the very attached, very attuned, it’s just me and you in the universe type work. And this is what concerns me. We really need you to be properly supported. That being said, I think we can come up with some really creative ways to meet your need together without me physically being there at that moment. And I would like to work together to find something that works. I can meet you there or we can come back here, I can see you before and after or just one of those. We can figure out something that makes you feel supported and safe. How does that make you feel? What do you think about that?”

When she asked that I couldn’t find much. I was so activated and overwhelmed as is. I did know I wasn’t upset, so I told her that. I told her that what she was saying made sense and that I wasn’t particularly attached to having her there and that I wasn’t sure about logistics. I mean, I can’t even talk to her in the elevator. The office is the only place I’ve ever felt comfortable speaking with her. So I do think it’s the right call, and I’m glad she’s willing to find a plan with me. 

The plan right now is to have Lu with me before and during, and she will walk me to A right after, so there is no point where I am alone. A said she would make sure she is available immediately and for a longer appointment, so I can get her assistance if I’m dysregulated or out of it. And she said “Dr R, Lu, and me – three women you trust. This sounds like the beginning of a plan, and we will figure out, together, step by step, what you need and what safe looks and feels like.”

We discussed the relative urgency of the situation, and that she is worried I am going to end up completely avoidant or develop a phobia of pap smears, which neither of us want. Which means that it is so important for us to keep dialled in to what’s going on, and as she said yesterday, “PD, I know that you are not going to like this or want this but I am going to be pushing a little here. I am going to do my best to keep this dialogue going and open, and I’m going to ask you to try to work with me on it. I know that this is hard and I know you don’t want to have these conversations, but part of my job is keeping you safe and right now I think the best way to do that is to be asking about this and planning and following up.” And I nodded. I know she’s right. I want to take care of my body I just find it really hard right now.

I am glad I told her.

And I did tell her everything about the dream and my parents and sex and sexuality and how hard sex has always been for me (shame shame shame). 

I also emailed my parents threatening to never speak to them again if they couldn’t parent up and tell me what I deserve to know. That they spout all of this stuff about loving me, but they’re doing the opposite right now and making it worse. They have emailed me back, but I’m not ready to talk about it yet. There’s grief that I had to threaten to leave them and stop communicating if they didn’t. 

So, I am overall okay with how she reacted. Considering how sick she was I’m really okay with it. I also don’t think she was fully even against coming, she tailored her response to my needs. She might have played it differently if I had answered differently, and I like that she asked for clarification before making a choice.

I did tell her that I hate discussing this stuff. That I feel so wrong and bad and dirty. And she said “I know. I can see it. It radiates through you. But it clearly has such a grip that we need to address it. I know it hurts. But I think we really have to dig in to this one.” Which I know means we aren’t done talking about it, by a long shot. I’m trying to take comfort in the fact that my body feels calmer and I’m more able to focus at work. I slept better last night. All of these, despite my intense desire to avoid her and talking about this, are good signs I’m on the right path. 

I was her last session. She cancelled everyone after me. And considering how legitimately sick she was that made me feel special, like she cared, despite the rough handling of it. And I told her that and she said that I have never abused her extra session policy, that my visits have always been legitimate, and she didn’t want me to miss seeing her. There was no way I would have hung on to all that until Thursday.

So I am still unsettled, still anxious, still don’t want to address any of this, but better. I need her to be pushy about this, and I asked her to be, but I also know I am not going to enjoy this series of work on sex and assault and trauma and my dream and sexuality. These are things I don’t talk about, that were not brought up at home. She even asked why I had kept the dream and conversations with my Mom about it from her, and I told her it was because it was never okay. 

My homework is to come up with a list of things I need to get through the pap smear. Lu has been super helpful, calling it The ‘great pap adventure!’ We have been joking about wearing tiaras and feather boas and toasting with champagne after and somehow that makes it really easy to think about.

I’m glad I told her, but my next few sessions are going to be really rough. 

What the actual fuck.

Yesterday I emailed A and asked for an extra session. I need to give her the letter and get it over with and feel some sort of control over this situation that has been exacerbated now.

I thought about it all afternoon, knowing if I didn’t see her earlier than Thursday, I would obsess about giving her the letter the whole time. It’s 4am and I’m up again middle of the night second day in a row. I’m motherfucking tired. Exhaustion represents my least stable moments. All my breakdowns have been after three or four nights of little to no sleep. I’m hoping to crush another hour here, after I get these thoughts down, but I’m not hopeful. 

I can’t stop thinking about giving her the letter. I can’t stop thinking about her saying no to coming to my exam. I don’t even know if I want her there but I need some semblance of control over this back because I feel incredibly unbalanced. 

I don’t know if this is going to trigger anybody, so consider yourself warned.

Here’s the thing, a thing, that I haven’t talked to anyone about really until yesterday. For the longest time I have had this random dream. Since I was little. A doctor’s office, a man in a lab coat telling me gently to relax, and I get this freaky feeling every time, and wake up all cold and shaky. I didn’t know what it meant. I had it a lot as a kid, then again around the time I lost my virginity, and more recently almost every day since September, after the assault. I can read the doctor’s name in the door in my dream. After about a week of this non stop in September I called my Mom and asked if I had ever had a doctor with the name “Dr. T”. She was like “what an odd question, no, you’ve only had Dr. C”. So I moved on with things.

Sidebar: the word “relax”, or being told to “relax, sweetheart” has always, always, always been a trigger for me. 

Then, when we were back home before the wedding, I was looking through my baby book with my now husband, and SAW DR T’S name on my baby bracelet. THE GUY BIRTHED ME. So my mom was lying. I googled him, and his picture looks like the man in my dream. So then I’m furious, and I confront my Mom about lying. Turns out, he was my doctor for almost four years including a time I had a nasty infection as a child, “down there”. So I haven’t been able to stop thinking about this. 

Last weekend I called her and asked again. I told her I had a really weird feeling about it, that I couldn’t stop dreaming about it, and basically begged her to tell me the missing pieces of the puzzle. And she said “my God, nothing happened. You’re overreacting. I was there the whole time and it’s just not my proudest parenting moment so can we drop it please?” 

Umm… Excuse me!? This makes YOU uncomfortable so we can’t talk about it? I pushed it, she hung up on me, and yesterday my Dad called to tell me “this is one of those things we don’t talk about to protect your mother. You know how she is. That’s why we don’t talk about this.”    

So now I’m really confused. I had myself convinced that dream meant nothing. Now I feel crazy and insane, and it adds a whole layer to this fear around my exam and around talking about this and what in the actual fuck.

I’m not crazy, right? To be obsessing over this?

My unskillful 4am letter to A

​A,

This is going to be the least skillful series of moments I’ve had with you in a while. And yes, I realize that I am already assuming that and have no proof. I also know I am allowed to show up messy and unskilled, and isn’t that the whole point? But bear with me.

My whole body literally recoils and trembles when I think about you reading this letter about this topic, with shame and ‘how dare you even ask about it’ and ‘its not okay to need or want something’, which is why I’m bringing it up. Because I’ve now obsessed over how wrong it is to the point where I need to address it with you simply to challenge that. Even if you say no, I know that you will also reaffirm it is okay to ask and okay to bring it up. 

I need a pap exam. I need one badly, at this point. With a family history of early uterine cancer I should be getting one every 6-8 months. It’s been three years. And <naturopath> has been really helpful. She suggested a lot of things that would be really helpful, including having people there. She said she has had clients bring their friends, their partners, or their counselors. And as soon as she said that last one I was done – because I had not even considered having you there as an option. I’ve been thinking about that non-stop and having this running commentary through my head about how dumb that is, and counselors don’t do that, and how stupid it is to even want you to be there. 

This opens so many cans of worms. The sexual assault, the fact that sexuality and sex were never talked about, shame around the fact that I need assistance in any way, shame around even wanting assistance and wanting to grab on to that. A really painful and stupid memory I never want to talk about. The fact that as a grown woman I can’t suck it up and get a pap done. That I’m overreacting and making a big deal out of nothing. 

Let’s be clear that I’m not even sure I would want you there. Its more curiosity at this point. I don’t know what I want to do. I know that I need it done and soon, and I also know that the idea of you there is super comforting but brings up a whole lot of shit around a lot of things. But I am obsessing over this, and whether or not you’d do it, and it’s bringing up so much crap that I need to talk about it, but to talk about it I need to ask you. So I guess my question is – is that even a thing? Off site counselling? I searched the internet and polled my friends who go to therapy and it seems like yes, it’s a thing counselors do. But is it a thing you do? Or would do? I just need to know what my options are so I can figure this out. Because if I know that you accompanying me to super scary shit outside this room is not a thing you do, then I know and we can deal with that because regardless I need help with this whole situation. And I’m not talking about the situation right now in order to avoid asking you. 

I have also assumed your answer is no. I have gone so far to assume that you don’t and imagine you telling me “not to be ridiculous” and that “I’m a big girl and can go do it myself”- and those are childhood narratives. Which is why I know I need to ask, because those aren’t things you would say. But I’ve also let a part of myself believe in the idea that maybe you do. Maybe you would come. And I am trying not to control the situation from inside my own head, or follow the path of “of course she wouldn’t you’re wrong for asking you should be ashamed of even thinking about needing help” and not asking supports that narrative. So yes.

It’s like you said the other day – asking and having the question heard and respected is often more important than what the answer would be. And like I said, I honestly do not know what I want to do about this pap and assault situation. And to talk about it I need to ask you this question.

So I am asking today in an effort to show myself two things. One, that I shouldn’t assume your reaction (or anyone’s reaction) to things is going to fall in line with the past. And two, that it’s safe to ask you questions like this. (And a third reason, I definitely need to talk about this sexual assault and sexuality and my issues with doctors even though all of it makes my skin crawl).

See what I mean? Not eloquent or skillful at all. I just need to know if that’s a thing you do or would do, that’s it. But I’m so ashamed to ask. 

The Therapy ‘Aha’

I always discover that a therapy lesson or skill has stuck during a seemingly random and spontaneous moment. The transitions in therapy are slow, painfully slow, and there is often no big ‘aha’ moment when things switch or a habit sticks or a thought pattern forms. But there is often an ‘aha’ moment when I realize something has switched, and I am different.

My first memory of a therapy ‘aha’ was with Em as my counselor. I was riding the bus to school and realized that for the first time, the endless self-deprecating chatter that had been going on in my head had ceased. For months we had been talking about making room for and encouraging the critical voice and I had rolled my eyes every time but participated and it finally worked. I remember being so happy and thinking on that bus ride about it and realizing I couldn’t remember the last time I had had that endless chatter. I remember exactly where I was standing, riding down that hill on a crowded bus, smiling like an idiot because I had finally stopped hating on myself constantly. 

That was an internal aha. I still have those although not as often, because I generally either have the inside situation under control with a really good understanding of my motivations and what makes me tick, or because I avoid certain topics.

But I still have external ‘aha’ moments. I imagine there may be a day where I realize I’ve become more patient, for example (as if!). And these moments almost exclusively happen first with my husband. I mean, he is my better half, now that we are married I’m no longer paranoid that he is leaving me at every turn (which is somewhat hilarious because every time we’ve separated in the last decade has been me pushing him away and leaving even though I had done things like throw laptops and lie incessantly, but I digress), and he will tell me like it is. Plus I spend the majority of my time with him. So it’s only natural I’m trying out all these therapy lessons on my closest relationships before moving outwards and (eventually, hopefully) applying them to my family. 

So, today, he woke up grumpy. And he was grumpy and cranky all day. And at some point in the grocery store when he was being super surly I told him “you’re grumpy, I understand why. You haven’t been feeling well. It’s okay that you’re grumpy.” And we kept shopping. And I’m pushing the cart (cause the crowd frustrates him) and I realize to myself that I haven’t internalized his grumpy all day. Not once. 

And I realize this there in the parking lot in the rain and I just stop moving, mouth agape, and he’s like “you okay?” Probably thinking ‘WTF is she doing it’s wet and I’m grumpy’, and I respond “yea, I’m good, let’s go”. In that moment I was marvelling at the fact that my husband has been grumpy all day and not once did I think it was my fault. 

One of the things I’ve been trying to learn is I’m not responsible for the feelings of others and how they feel is not something I need to fix. And I may not execute it perfectly, always, but something in me today (maybe those affirmations I’m repeating every morning and night no matter how reluctant I feel are part of this) felt strong enough to be like “this isn’t us. This isn’t about us.” And to not apologize and give him space and not ask constantly for reassurance.

And man, what a really refreshing sign that things are still going well and I’m still growing. I didn’t automatically assume something was my fault, and that’s huge for me. 

When was your last therapy ‘aha’? Congratulate yourself on your growth and remind yourself that just because you can’t always see it doesn’t mean it’s not there. It may surprise you on a bus or in a rainy parking lot sometime soon. 

Affirmations 

I am deserving of a peaceful and loving life.

I am worthy. I am worthy of love, of kindness, of care, and of compassion.

I am whole.

I am strong.

I am allowed to have needs, to express them, and to have them met.

I am allowed to take up space.

I am allowed to say no.

My experience is valid.

I am allowed to own my story.

I am allowed to have a voice.

I am enough.

I am allowed to have feelings.

I am at peace with the past.

I am resilient.

I am allowed to ask for help.

I am allowed to relax.

I am safe.

I deserve to heal.

I do not have to be perfect.

I owe nothing to anyone.

Connection and trust do not always equal pain.