Monday, September 1, 2008

To therapy or not

I've been thinking about going back into therapy for awhile. Whenever I decided to do this, it becomes an ordeal of analysis, and you'll see why below. However, I find writing it out gives me better success for follow through.

It's been almost nine months since I've been in any form of therapy, though that's not the longest I've been without therapy. Honestly, I feel a little pathetic that I feel this kind of need. It's not even really that but moreso in that it's the same issues--fears, anxiety, my future, my parents, and other issues as well. I guess I'd call them unresolved, though I've come a long way in learning the whats and whys.

So here I am trying to think of who I should see, and this is where my dilemma comes in. Do I want to see one who specializes in eating disorders or do I want a more general therapist? Do I want to see one I'm familiar with or start brand new with someone different? Do I want a passive approach or a more aggressive approach? Do I want one who is CBT-focused, psychodynamic, interpersonal, eclectic, or something completely different? So the run down of therapists are:

Therapist K. specializes in eating disorders and uses CBT and psychodynamic. I have seen her off and on for the last five years, so she knows me well. She takes an in-between approach of passive and aggressive but mostly gives you full rein of decision making which is sometimes not my forte. She is very knowledgeable about eating disorders and keeps up to date on the latest research which is something I really do like. She's probably the only therapist that has let me have my dogs there which I found helpful. Okay, that reason isn't a great criteria, I just thought it was cool, despite the fact she was allergic to dogs! Plus, I think she enjoyed seeing them a lot too!

A few drawbacks to Therapist K. are that she doesn't take my insurance and she has limited time.

My last therapy stint with therapist K. went okay, but we both became frustrated (she at me for not making progress and really wanting to recover and me just frustrated with myself). So we ended our time together with her leaving the door open for me. I took that break up hard and felt a sense of loss. I needed time to get past that. Though what she said was true and hard to hear, I still felt crushed and dejected.

Therapist R. also specializes in eating disorders and body image issues. She's currently the ED therapist at the main university here and has a small private practice as well. I've only spoken to her once on the phone which was awhile ago. She has told me she uses more of an interpersonal style of psychology and looks at a lot of relationship issues. Her approach is more aggressive than passive. I'm pretty sure she accepts my insurance and is willing to be negotiable with her schedule.

Therapist V. specializes in eating disorder and body image issues. She currently shares an office with Therapist R. I don't know too much about her style of therapy, but is more on the aggressive side. I haven't officially spoken with her. I chickened out at the last minute when I had originally thought about seeing her.

Therapist A. is a general therapist but also deals with body image issues. She was the ED therapist at the main university here (maybe five years ago) until she decided to open up her private practice full time. I saw her for about six months. It didn't go that well. We had different styles and didn't mesh well. She takes more of a passive approach towards eating disorders and therapy in general. We had many moments of silence! I terminated that one due to our differences. She understood and left the door open for me to come back if I so chose to.

Therapist C. was my therapist in college for about three years. I abruptly ended my sessions with her, because I took a medical leave of absence my last semester. It was an emergency session, and by the end of the week, I was gone. Her style is CBT and psychodynamic. She is more of a general therapist but specializes in working with fear as well as a few other things. Overall, my time with her went well, and she did help me through some very rough patches.

The one drawback for her is that she shares an office with Therapist A. Now, I know that that really shouldn't be an issue. I'm sure both are professional, it's just me and my paranoia. Therapist C. also knows several clients from my work. I did deal with a similar situation in that Therapist K. shared an office with a client whose dog I have taken care of many times. I dealt with it okay, but again, it's just that paranoia and six degrees of separation feeling.

Then there is Therapist D. I don't know much about her other than reading her website. She doesn't give specifications as to her style and seems to be a general therapist who works with eating disorders and sports performance as well as other issues.

There is also one other group in town with a variety of therapists. I don't know much about them but have heard good things.

Ultimately, I know I need to call these therapists and get information. I've been in therapy long enough to know what works for me and what doesn't. I know with a therapist who is more the passive type, well honestly, I'd probably just bullshit my way. And I don't mean that in a smart ass type of way, just that I'd have more trouble opening up, sharing my true feelings, and just not getting anywhere. I know I'm the type that needs challenges (I wouldn't necessarily call it "homework"), lots of food for thought, that type of thing. This doesn't mean just go read this book, it will make you feel better.

With Therapists K. and C. who know me well, what holds me back from seeing them is feeling like a failure. Logically, I know therapists are there to help you cope, deal with life, give new perspectives, etc. But sometimes I wonder if it is better for me to try someone completely different, kind of like having a "blank slate," though I despise the thought of going through my entire history again. A friend of mine would tell me make a pro/con list and decide what my factors were for therapists, but that just seems too logical. This is why I say therapist shopping for me becomes an analysis procedure.

The other thing for me to think about is WHY I would want to be in therapy now? It's really more about my life, getting over certain phobias, learning to move on, letting go, and gaining self-esteem than it is about the ED, although everything is essentially intertwined. Sure, I've talked about a lot of this in therapy in the past, but I know I can't keep putting these major life decisions on hold anymore. I'm 28 and not getting any younger. There are several other issues involved with my parents, expectations, social approval, etc.

I guess right now I'm feeling a bit "blue." I'm not sure whether it is the fact that three-quarters of the year has gone by, and I feel like I've accomplished nothing. Or that fall is coming soon and there is a hint of nostalgia. Or that I get tired of my father continually harassing me about graduate schools and moving closer to them. Or the sense of disappointment and inferiority I feel. Or the anxiety about my upcoming marathon which I feel very ill-prepared for. It's probably all of the above.

Sometimes I hate the fact of knowing these things but yet feeling so stuck that everything feels insurmountable.


kb said...


I think, for so many people that suffered (in the past) from a pretty big mental health issue, it seems indulgent to return to therapy when we aren't in "crisis mode". I'm not saying that is where you are; but to just work on ourselves and improve our quality of life and work out all of those issues with our parents and coming to terms with 'who am i" - well, this doesn't seem urgent or necessary enough to truly warrant therapy.
BUT, I think it's actually far more effective to be in therapy and to do the hard work when we are stable and not dealing with day-to-day drama. That's my take.
So, good for you for wanting to return. Or for considering therapy again.
Can you see the new people, try things out with them, AND with previous or "known" therapists? And see how things feel? See which person feels like a good fit for you?
Good luck,

Tiptoe said...

Kristina, thank you so much for responding. I really needed to hear that. You are right that it is often difficult to go into therapy when you're not in a crisis mode. It goes back to the whole validity thing, at least for me anyway. You're right that therapy can be more effective when you are stable and things are not so chaotic.

I'm going to make some phone calls this week--ask some standard questions and go from there. I normally have a 3- appt. rule to see whether a T. and I click. I'm going to see how it works with my insurance too since that is a factor right now. I'll keep you posted.

KC Elaine said...

this sounds like a very tough decision for you! But I am glad you are so aware of yourself and what you need. I think in your heart you'll know what's best, even if its' a tough decision. - Kyla

grey said...

Sounds like you have made the decision TO go back to therapy... I go back and forth on the same issue as well. I was in treatment for 6 straight years, and have been out of therapy for 15 months now. I probably should go back, and I think about it... but don't think I'm in a place right now where I really think that therapy can help me (I've been stuck for years).

Anyway, you have a lot of therapists to choose from. I know your reason for not seeing a professional that you've seen before is the fear of failure... and everyone will tell you that you have NOT failed... but I would like to weigh in and say that I think it would be beneficial to see someone you've seen before. Starting over is just that -- starting over. At the beginning. You've started over how many times now? It's just going to take a lot of time... and put off the stuff that you really need to deal with. Picking up with a professional who knows some of your history is a big advantage. If there is one who's treatment style meshes with yours... I would definitely go for that.

When I've been able to return to doctors, therapists, and nutritionists that I saw in that past, I was so much more open and comfortable with them the second time around. It was almost a relief to be able to see them... to see someone who I knew already understood; who I DIDN'T have to start all over with. The relationship was pretty valuable.

Just my two cents! Good for you for going back -- good luck!

Tiptoe said...

Kyla, thanks for the support. Yeah, it's a tough decision for me, but I really do know it would probably be beneficial to me.

Grey, thanks for your input. You give good validity in going back to someone I've had experience with. I do admit to dreading the whole start over process.

I haven't made any calls yet. I think that is one of the hardest things for me to do initially. I'm going to start with Therapist C. even though she is in the same office as Therapist A. whom I didn't mesh well with. Plus, her office was very drab. Hopefully, it's better now.

My mantra for this week, "just make the phone call."