Scheduling Changes

It’s probably fairly clear from all the time I spend blogging about scheduling issues that my therapist and I often struggle to keep our three weekly sessions. We’ve somehow always managed to figure it out thus far, but it’s tough. We both end up doing a lot of rearranging and making small sacrifices here and there to make it work. Overall, I think it’s worth it, but that doesn’t necessarily make it less challenging.

I’ve been seeing her on Mondays for a very long time. That has probably been the most consistent day in which we’ve had sessions together. Due to my latest clinic schedule, however, she’s had to do a lot of shifting her schedule in order to offer me three “primetime” (i.e. after standard work hours) slots.

Which means no more Mondays. For the next month I will see her on Tuesday, Wednesday, and Friday. Except for a couple of weeks where I either have class or she has a conflict and we have to switch Friday to Thursday. As I mentioned recently, we changed my session to Thursday last week. And then I didn’t have session today because my Mondays were switched to Tuesdays.

I really don’t like that. I’ve gotten into a nice little routine of starting my week with a session after school/clinic. It was bizarre and unsettling to realize that wouldn’t be happening today. One positive is that it opens up my schedule to attend my favorite yoga class again, but I still felt sad and upset about the missing my normal session time.

Sickness as Abandonment

All week long my therapist has been sick. Not severely sick, just a head cold. But when I got to my first session of the week, I immediately realized she sounded congested and I asked her about it. She said she has a bit of a cold, but it was nothing major.

Sure.

Except, it totally freaked me out. In the past year and a half, she’s never been noticeably ill before. She’s never cancelled or rescheduled a session for personal reasons at all. So I don’t know if I was worried she would get more sick and then take time off from work or what, but it really upset me.

Then for our second session of the week, she called me an hour before my session and left a voicemail. I was nervous that she’d called to cancel, but she actually just had a client cancel their session, so she wanted to know if I happened to be available to come in earlier.

I was a little irritated with her for unidentified reasons (probably her head cold, to be honest) so I’d considered just not showing up for session at all. I almost stayed on the train when it stopped by her office. But then I told myself that I didn’t have to go to session just because I was in the area, so I got off the train.

Breaking Down the Mother Emails

My therapist and I didn’t have a lot of time to process the emails I shared with her on Wednesday. We did touch on the most obvious points on Wednesday and we revisited some of that on Friday as well, but I imagine this content will need lots of time and room to breathe over the next several weeks months years (?).

So I wanted to take the time and space here to break down the major points, primarily for my own sanity. I’m just going to quote her words and free associate my reactions to them. I’ll start at the beginning and work my way down (so if you’ve read the original, this should hopefully make a decent amount of sense). I’m also going to try and group things together somewhat thematically so I’m not repeating myself.

Here goes…

Not My Favorite

The first thing my therapist and I discussed during Friday’s session was the upcoming schedule changes. As I wrote previously, my school and clinic schedule will be shifting (yet again), causing me to change all three of my weekly sessions.

My therapist had originally discussed the option of having sessions on Mondays and Wednesdays, with the choice to do a double session on Wednesdays or two 90 minute sessions. I respected her efforts to maintain our three hours of session per week, but knew that the length of time from Wednesday to Monday would be very challenging for me.

My plan was to bring this up with her and explain my feelings. I didn’t have solution, but I wanted her to understand how this could potentially impact me.

But in a rare act of initiating the conversation, she asked if she could start out session by talking about scheduling. She said she’d gotten a little mixed up when giving me possible times and wanted to clarify. She said the Monday time would work, but that she couldn’t see me until 7pm on Wednesday (no big deal since that actually would work a little better on the days I have my seminar class). She also said there’s a chance she could see me for a third session. She said, “I could see you on Fridays, maybe, but that’s not my favorite.”

Um, what?

Mother, Money, Medication

As I mentioned in my last post, I really wanted to talk to my therapist about both scheduling and money in our last session. We got through the scheduling conversation fairly quickly, which left nearly 45 minutes to tackle the money part.

Oh boy.

My therapist and I have tried to have conversations about money, primarily within the context of how the financial cost of therapy impacts me. It’s a lot of money. A LOT. It is the biggest expense for my wife and I (and that includes rent in NYC). It wasn’t so bad when I started with this therapist because it was just one session per week. But then one became two and a few months later, we settled into three sessions each week.

It’s pretty clear that this frequency works well for me. I don’t mind seeing her so often, but I won’t pretend the cost isn’t a burden for me. My wife insists that my health, including my mental health, is worth the expense. I believe her. But there is still so much intense guilt that comes up for me, especially since I’m still in school and thus not generating income for myself.

I do get a small stipend and all of my education is paid for in grants and scholarships, so at this point all of my therapy expenses have come from my own bank account. I am happy about that, but it also means that I’m literally contributing NOTHING to our other bills – rent, utilities, groceries, cell phones, transportation, etc. And that is very hard for me to swallow.

Birthday Grief

Last week was my birthday.

I told my therapist in the session leading up to it that I’d need her support. I wasn’t able to articulate exactly how or what she could do to help, but I knew it would be a difficult week. My birthday is always hard for me, for us, as a system. There are difficult memories and emotions that come up in a seemingly unavoidable way each year.

But things have also been very difficult for River lately. She’s been showing up in session more, talking in a really open and honest way that makes me, my wife, and my therapist very happy. It has made it kinda worse in terms of having an eating disorder, but my therapist is convinced this is all part of the recovery process.

So on Wednesday, River went to session. I’m not entirely sure what was discussed, but I know she ended the session by asking my therapist if we could call her the next day to check in. Apparently my therapist hesitated just long enough for River to feel something that was upsetting. My therapist told me she said, “Ugh, never mind” before more or less storming out of the office.

And then she didn’t call our therapist. No one did. Which sucks because I know I could have certainly used the added support.

Anyway.

Rejected

Late last month I saw my shrink. It was one of those days where I woke up drowning in self-loathing. As I wrote about in this post, I showed up to my appointment about ten minutes late and was a sloppy incoherent mess of emotions. I mostly just cried and rambled before leaving in an admittedly abrupt and tantrum-y way. My frustration was not with my shrink, it was with myself and how dysregulated I felt at that time.

She called the next business day and left a voicemail saying she wanted to check in. She also offered a couple of times for our next appointment and said we should talk about “how you want things to proceed from here.” She mentioned that my medication seems to be more or less “squared away” and she’s wondering how this would “work best for me.”

It was a nice enough voicemail but I had a bad feeling about it. I mentioned this whole scenario to my therapist who suggested I schedule a follow-up sooner rather than later and suggested that my shrink was simply trying to open a dialogue about our work together.

Perhaps.

February

I hate February.

I was born in February. Late February.

I have many trauma anniversaries. Probably at least one for as many days as there are in a calendar year. It’s hard to imagine that nearly three decades of abuse wouldn’t have covered all 366 potential days.

But something about February is always harder than the other months.

Maybe it’s my birthday. The beginning of it all.

I know there are traumas around my birthday, as there are around all holidays and celebrations. I know I was always hurt on or around my birthday. Not only by my parents.

I was date raped on my birthday in senior year of college. And there was an earlier incident…

Yesterday in session, I was flipping through an old journal. I opened the page to February 5th, 2002.

The entry is one sentence long:

New Levels of Self-Hatred

My levels of self-hatred are at an impressive and nearly debilitating high right now. I recently wrote about my decision to not weigh myself every damn morning.

That lasted one week. Or six days, really.

Then Saturday came and I’d gained nearly 4lbs. Logically I knew this was likely water weight from having my period, but seeing that number threw me into a tailspin. I was devastated. I weighed myself on Sunday and was already back down 2lbs, but the emotional damage had been done.

I’ve weighed myself every morning since, seeing anything within a 5lb range of Saturday’s number. I either stay the same or gain.

That is unacceptable.

I could tell myself it’s hormones or water weight or even muscle weight since I’ve been doing more strength training and eating more calories to fuel those workouts. I can look at my intake and know, rationally, that it is impossible for me to have gained actual fat. I don’t even eat enough to fuel my body through its basic functions like breathing and pumping blood, so there’s no possibility that I could be eating an excess that would add fat to my body.

Yet still, I see that number go up and I immediately feel fatter. I look in the mirror and just KNOW I am fatter.

Making Space for Anger

One of the key things my therapist and I spoke about during our phone conversation Wednesday night was emotions. I told her I felt like I had trapped a bunch of difficult emotion within myself, specifically in my chest, because there didn’t seem to be a safe place to discharge them.

I was admittedly upset with her for leaving me in the waiting room for fifteen minutes. I wasn’t able to identify exactly what I was experiencing emotionally, but I knew there was a lot of energy built up. It felt hard to even breathe.

I didn’t want to go to Friday’s session. I considered bailing, but I’d had a difficult day at clinic (unrelated to the actual internship, more about food stuff) and I needed a place to process it. I decided while walking over to my therapist’s office that I would use my hour in session to talk about all of that nonsense.

Which I did. I opened the session by telling her I’d had a difficult day and then started to explain what had been happening. I was telling a story about my colleague who’d lost some weight and was passing around her before/after success story photos that were featured on a prominent website recently.

While everyone was reacting with the obligatory, “Wow you look so great!” comments, my classmate encouraged me to share about my own weight loss. She met me last year, about two months after my relapse so she’s watched my lose a pretty good amount of weight. She doesn’t know it’s due to restricting and disordered behavior, so I know she was just trying to be kind.

I told my therapist that I shared my weight loss with my colleagues. She asked me what number I gave them. I said I didn’t want to tell her that. She asked if I told the truth and I said yes. Then she asked me why I wouldn’t tell her what I’d told them.

“Because I don’t want to.”