ending therapy

I received a letter from my therapist explaining that he is no longer practicing at my psychiatrist’s office, and my scheduled appointments are canceled. If I want to continue seeing him, I would need to visit him at his new location.

After some thought, I’ve decided I’m not going to continue therapy with him, or anyone else. I was thinking about ending our sessions anyway, as I wasn’t getting a lot of benefit out of them. His emphasis on mindfulness didn’t seem to work for me, and sometimes he appeared to not really have any alternatives. There were a couple uncomfortable moments where he would struggle to find something to talk about. He might be effective for someone else, but apparently not for me.

I’m not really emotionally affected by this. I know some people have a true connection to their therapist and see them as a lifeline to their continued mental health, but I never had that feeling. In the past I have had the idea that I “failed” therapy three different times. I don’t feel this was a failure for either me or the therapist, I think we just weren’t compatible or complimentary.

When I started seeing him, I wanted some techniques to work on the constantly increasing anxiety that I struggled with a year ago. I now think it was a physical effect of a long manic episode, because my anxiety slowly decreased when we got the medication right. I still have plenty of anxiety, but it has returned to a manageable level at this time. I don’t think I need individual assistance in dealing with my problems. I need strategies to work on my social anxiety, but I think I can do it on my own at this time.

mindfulness update: end of the road

My most recent therapy appointment was online because his child had Covid. I suppose that gave me a small advantage as I prepared to tell him how I felt about the mindfulness exercises he had recommended.

Let me backtrack: at the previous appointment, we went through a mindfulness exercise where I was supposed to simply listen to all the sounds around me, not trying to process them but just listening. I listened, but my active brain was spinning in the background; I was processing the sounds, as well as thinking about how I was getting distracted, trying to refocus, and continually wondering if I needed to stop seeing the therapist. For the second exercise, he went to the office’s kitchen, and while I thought he was rummaging through everyone’s lunches, he returned with a protein bar. The exercise was to fully taste and smell the protein bar, feel it in your mouth, and be fully aware of the process of eating it. I did what he asked, but my active brain was thinking the entire time that this was stupid and unhelpful (although the protein bar was very tasty).

Back to this week: As he greeted me and asked if there was anything I wanted to talk about, I looked at the notes on my scratch paper and started into a somewhat-prepared monologue. I said I didn’t think mindfulness exercises were helpful for me because I was stressing so much over doing them “correctly” that I couldn’t do them at all. I can’t shut my brain off for more than a minute or two unless I’m in the right place and time. I let him know I didn’t want to fail therapy for the fourth time, but I felt that some other kind of therapeutic exercises might be more helpful.

I told him that under the right circumstances, I can naturally achieve some kind of mindfulness practice when I am writing creatively, listening to familiar music I enjoy, hiking or being out in nature, or when driving and exploring new places. Sometimes it may only last for a short time, but for a while I can let everything else go and concentrate in the present moment. I also said that writing has been more productive for me than any other kind of therapy, and that it has successfully allowed me to deal with a lot of anger, sadness, and negativity more effectively than with the efforts of any therapist.

I think he was a little surprised, but he took it in stride. He said that we don’t need to do the exercises if I felt like they weren’t doing me any good. He agreed that writing can be therapeutic, and he thought for me writing became a sort of self-directed trauma therapy. We discussed how writing allowed me to take the past fears and memories in the dark corners of my brain, examine them carefully and objectively, and help them lose their power over my current emotions.

Anyway, it was a good appointment, and next time we will be talking about my social anxiety and what triggers it.

the weekend update

Job update: I found out who was chosen for the job I interviewed for. She has no field experience and no design experience, but she was well known by the hiring manager. I was lied to, because I was told by that manager that they wanted someone with more field experience. I think I didn’t get the job because they didn’t know me personally and because I’m a middle-aged white male. I hate to be that way, but that’s the company culture. It’s not what you know, but who you know. I wasn’t bitter before, but I’m a little salty now.

Psych update: I saw the p-doc this week and told him I wasn’t having mood swings, but I’ve had a pretty good depression for weeks now. In addition, the Abilify makes me want to eat everything in sight. We are going to try a newer brand-name drug, Vraylar, because it treats both depression and mania, and weight gain is much less common. Hopefully I will have some good news to report.

Mindfulness update: I’m going to tell the therapist I want to concentrate on some other method of treatment. I’ve lost interest in the book, I can’t seem to get started on the exercises, and I don’t believe it will work for more than a few moments. What I need is to find a way to fight the social anxiety enough that I can actually exercise without thinking that everyone is looking at the fat guy trying to exercise.

Baseball update: I’m hoping the Giants can win today so they don’t have to play in the wild card game. I also hope the Cardinals beat the Dodgers in the wild card game. Fuck the Dodgers. If the Giants get to the World Series and lose, I’m afraid I will go into a deep depression like I did in 2002. It sounds silly, but I feel like I’m in a precarious place right now, and all I need is a trigger to push me into a spiral.

mindfulness update: pop quiz

My next therapy appointment is looming, and I haven’t done my homework. He will ask me if I tried any mindfulness exercises, and I will:
a) lie;
b) tell him I think mindfulness is bunk; or
c) ask for a hall pass to the bathroom, then ditch the therapy session.

When I was searching for a copy of the book on Amazon, the first promoted suggestion was a book about crystal therapy for anxiety. I have approximately the same attitude toward crystal therapy as I do mindfulness, right wing ideology, and the Los Angeles Dodgers. My wife said it would be funny if I went into the session and placed crystals in a pattern around me on the floor before beginning.

I contacted the therapist because my anxiety was off the charts and I needed coping mechanisms in a hurry. I didn’t really get what I wanted, although it was helpful to talk through a few things. Now my anxiety is down to my normal background level – it is there, but it doesn’t scare me. I survived bipolar and anxiety without therapy since 2007, so maybe I don’t need it now.

Then again, I shouldn’t break up with him just yet. If I get this new job, my anxiety will increase, but I haven’t heard back from HR yet. My anxiety will definitely increase in my current job, because we continue to get more work without adding people to spread the new work around.

mindfulness update: opening the book

I finally read the introduction and first two chapters of the book, but I have not actually done any exercises yet. My library wants the book back, so I might buy a used copy of the book. Surely some relaxed, anxiety-free person on Ebay or Bookfinder has an old dog-eared copy they would let go for a few bucks.

Here are a few disjointed thoughts:

Quote from the introduction:
… [there are] three common patterns of responding to anxiety … reacting to the painful emotions of anxiety with … self-criticism and judgement; then trying to escape the anxiety mentally; and finally, when that doesn’t ease the discomfort, trying to avoid whatever triggers the anxiety.

That sounds like my behavior in stressful situations. I have learned how to avoid many things that cause me stress, however I also miss out on things that might be beneficial, such as opportunities for professional advancement or just for fun.

The authors claim that mindfulness is a method of dealing with anxiety that will help me overcome fears and will provide me with a sense of fulfillment.

It turns out there are audio exercises to go along with the text in the book (well of course there are), but the link led to a defunct website. After some googling, I found the exercises at the publisher’s website. There are some short exercises, then there are longer ones lasting up to 37 minutes. I cut my mother off at 30 minutes on a good day, so there’s no way I’m listening to someone drone on about relaxing my muscles for that long.

Another interesting quote: “… we might recommend particular coping strategies that seem counterintuitive or that don’t immediately strike you as likely to be effective for you. We know from our own experience that sometimes all of us prematurely judge and dismiss information that doesn’t fit with how we typically view ourselves and the world.” This describes exactly what I am thinking about mindfulness right now.

mindfulness update: the book

As I told you in a previous post, my therapist recommended a book about mindfulness. I picked up the book from the library, and it has sat on my table for over a week now, unopened. I had a therapy appointment scheduled for today, which I knew wasn’t going to go well, so last week I moved that appointment to sometime in August. Just in case I go to that one, I made a second appointment for September.

In the meantime, the book on mindfulness still sits on my table, mocking me and my overactive brain. I picked it up once or twice in the past week, looked at the cover, thought “I’m feeling too anxious to concentrate right now,” then put it back down. I’ll probably renew the book so I have longer to worry about how futile it would be to try mindfulness.

mind over ice cream

I don’t know if I am on the same page as my therapist. Yesterday was an awkward appointment. I had very little to say and didn’t want to be there, and he seemed like he was stumped, trying to find something to talk about. Neither one of us seemed prepared. Granted, I’m the one asking for help, so I guess I should be the one with questions. I would have been fine if he had let me go home early.

After flailing for a few minutes, he started talking about mindfulness as a tool for reducing anxiety. He described what mindfulness is, and I was having trouble concentrating … as he’s telling me how to concentrate on acknowledging distractions then coming back to the moment. My brain was tired but bouncing all day yesterday, so it was a particularly poor time to have to listen to someone talk.

I have to admit I don’t get the mindfulness thing. I thought it was more about doing something to distract you from everything in your brain, allowing you to have a little reset. I know how to be totally present in the moment, like while listening to my favorite music for the 100th time, or when being by myself in the woods, or reclining with a purring cat. But either I get distracted by something or someone, the moment is gone, and I start thinking about all the things I took a break from.

I asked him if mindfulness was blocking everything out and just clearing your mind for a few minutes, and apparently that was incorrect, because he was trying to convince me that something like eating ice cream or the act of standing up can be the object of a mindfulness exercise. (Really? Does pooping count?) I asked him what did that solve, and I never really got an answer. He said he wrote a dissertation about the subject, so I decided not to tell him I didn’t get the point.

Then he started talking about Buddhists and India, and honestly he lost me at that point. Nothing against Buddhism, but I just need something I can understand. However he did refer me to a book on mindfulness for anxiety, so I’ll get that from the library and see what I think. He also told me about some guy’s videos, but I told him I can barely sit through an episode of a TV show on Netflix. My brain moves way too fast to listen to some dude drone on for an hour about how to enjoy ice cream.

I don’t know if mindfulness exercises are going to work for me, but I guess I will give it a good faith effort to see if I can get something useful out of this. If anyone has any tips or references for helping me understand this, I’m willing to listen. Comment or email me if you have something that might help.