Last psych appt

Yesterday afternoon I was seen by the doctors, and my community nurse/case manager also sat in on the meeting. I was asked whether I wanted to be discharged that day or the next, I chose to be discharged that afternoon. Though I still wasn’t great, I at least felt a little better than when I came in and I guess there wasn’t much point in staying any longer. We also discussed my medication, I still remain on 200mg of Pristiq and 50mg of Seroquel XR but have also commenced on 450mg of lithium as a mood stabiliser. It was either lithium or sodium valproate, but according to the doctor the latter has a greater chance of hair loss, weight gain and sedation occurring as side effects.

Spent this morning in tears as I emailed a uni lecturer about something totally unrelated, and in her reply she again brought up an incident last year which resulted in a general miscounduct and me getting into a whole load of trouble. It feels awful that I continue to have that held against me by a lecturer I will again have this semester despite me completing the disciplinary action that was dealt to me and having damn well learnt my lesson. I then attended the last session with my psychologist at the eating disorders program in which I cried some more both talking about this situation with my uni lecturer, and then saying I felt “A bit sad,” when she asked me how I was feeling about it being the last session. It’s the first time I’ve ever admitted to feeling anything other than indifference towards any psychologist I’ve seen as I’ve always been ashamed of feeling attached to or having any emotional connection to others, especially when it’s not reciprocated. Though it wasn’t easy attending knowing it’s my last appointment, I’m glad I did and handled it much better than I did the last time I had to change psychologists. It’s quite embarrassing when I remember how I spent the second last session crying, refused to come back for another session or to see the psychologist I was being transferred to, overdosed and ended up in hospital thus never having a proper concluding session, then wrote him an angry email about how useless therapy is.

I’m starting DBT next week with the group component running on Tuesdays and my first individual therapy session is on Thursday. I’m really nervous about DBT and how full on and strict it seems. At the end of my assessment sessions for DBT I was given a contract and asked to sign it, with rules such as not being allowed to miss a certain number of group or individual sessions, having to complete the homework, rules around interactions with other clients and your therapist not having contact with you for 24 hours if you’ve self harmed. I also have a lot of ambivalence about whether I really do want to change and to stop self harming or not, and so much fear when I think about doing so. Plus I’m hesitant about starting all over again with yet another psychologist knowing that if I do develop a connection it will feel like another loss when we have to cease therapy, especially after weekly appointments for a year. 

8 thoughts on “Last psych appt

  1. Wishing you the best for the DBT. I know it’s scary for a lot of people but helps A LOT of people too so I hope it will be for you too. I am on the waiting list for DBT group skills. Unfortunately they don’t do one-to-one therapy alongside it too which seems a bit useless as I have read that’s a very important part of it too. But nothing I can do about that.

    Good luck and keep us updated.

  2. I do not know if DBT is the same as CBT (Cognitive Behavioral Therapy) in the US, but will plow on risking ignorance in a good cause.
    Dr. David Burns wrote “The Feeling Good Book” around 1980. It is a really a “people talk” translation of the theories of Dr. Aaron Beck, who talks doctorese strictly.
    There are ten basic types of distorted thinking which lead to depression, “All or nothing thinking being the chief one.”
    I am sure it will be to your great relief that I will not recount it all.
    However, there is one thing many people do not know.
    There is a work book, cleverly named “The Feeling Good Workbook.”
    The workbook is replete with questions, none of which is what kind of jam do you prefer, unfortunately. Nope.
    These questions are not of the cozy comfy type.
    Which is good….and not quite as good.
    The good part is that when you finish them a demon or two is banished, your boat floats a little higher.
    That’s good!
    Then there is the not quite as good part…the demons don’t leave easy – they like it there!
    In order to evict those cheeky devils (sorry), you have to make them like it less by asking pointed questions.
    This does make the devils very anxious, but it is no picnic for you, either. Not even one with ants.
    It is, in short, hellish, and not for the faint of heart – you have to picture the goal of actual serenity and little by little liking yourself, from which good things stem. I did it for Alcoholics Anonymous – a self inventory – and then in AA you must review it with someone – all the worst stuff – the crap you push to the back of your mind – way back.
    My advice is not to try to do too much at once. Have a goal, but don’t pressure yourself.
    I’m almost ready to stop nattering, now. I hope this was of some value.
    Writing out thoughts always helps organize them, I have found.
    Toodles, and I hope life gets more pleasant for you!

    Lance

  3. Wishing you all the best for DBT. I found it absolutely life changing. I totally get your reservations – but it’s impossible to know how you’ll feel about therapy & leaving in a years time and how you’ll cope with it. I guess id suggest focusing on every day as they come and sticking to the contract you signed. If you self harm or slip it’s ok, the rules are just there to benefit your progress in the program not to punish you. It’s really great you have access to the program, DBT has really good evidence behind it. Also, well done on going to your last psych appointment – I admit to bailing on one before. I have my last therapy session with a therapist I’ve had for 6 years coming up. I’m nervous but also feel like it’s time & I’ve learnt all I can. I’ll certainly miss her but I don’t feel the same panic I used to feel at the thought of being without her or my psych. Things change =) take care

    • Unfortunately I don’t think changing therapists is really an option from what I know, and it’s the same with all public services. Do you have ED, SH, AF, SB or someone else? And because they are the only ED specific program, I don’t have any other suggestions sorry :/. I’ve come up against the same problem too though at my public mental health service in not liking my psychologist.

  4. Someone else. I was finally upfront about my concerns though and surprisingly they took it onboard and were good about it. Hoping things might get a bit better now :). I’m having a less rough time then my friend did with AF anyway. Who did you have?

    It’s almost pointless if you dislike your psych… (Obviously your never going to like them all the time..) but when you really don’t like them…just get nothing out of it.

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