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Therapy sessions coming to an end


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Hi everybody, just needed some advice. So I had a therapy session this morning, she said I’m not ready for my big exposures with knives? That I should come back when I’ve settled in my job for around 6 months to then start tackling that. 
 

I’m not sure what I should do now, If i  should stop the therapy sessions? Is it normal for a therapist to say your not ready? I’m just worried, I don’t want to feel as though she’s fobbing me off. I haven’t done any exposures on my list yet with her because she said say’s I’m just not ready, then I believe her. I’m now on my way to work just feeling extremely anxious about it all. :( 

Edited by Summer9173
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Every time I tried therapy in the last 7 years I've been told I'm not ready and to come back when I am...

Perhaps they're right in my case, as just getting to the room for assessment made me incredibly unwell.  However, I haven't been given any ideas on how or when I'm likely to 'be' ready!  Or even anything I can do in the meantime.

Maybe it's a cynical view but I think it's just too much for them to deal with.  They'd rather focus on people with issues that they think are more manageable (easier for them!) with a higher chance of success to look better on their record.  

If your therapist hasn't suggested that you stop sessions yet, but doesn't think you're ready for big exposures, have they made other suggestions about what you'll be working on with them in the meantime?

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1 hour ago, Keyboard Worrier said:

Every time I tried therapy in the last 7 years I've been told I'm not ready and to come back when I am...

Perhaps they're right in my case, as just getting to the room for assessment made me incredibly unwell.  However, I haven't been given any ideas on how or when I'm likely to 'be' ready!  Or even anything I can do in the meantime.

Maybe it's a cynical view but I think it's just too much for them to deal with.  They'd rather focus on people with issues that they think are more manageable (easier for them!) with a higher chance of success to look better on their record.  

If your therapist hasn't suggested that you stop sessions yet, but doesn't think you're ready for big exposures, have they made other suggestions about what you'll be working on with them in the meantime?

That’s exactly it isn’t it :( even with my therapist, she’s fairly newly qualified and I guess your right in that sense, she just wants to look good on the records. I wish I didn’t have my therapy session this morning if I’m completely honest. I feel absolutely awful at work now I’ve felt awful for most of the day, I just want to go home and feel incredibly sick. It sort of made me feel like I ‘can’t be helped’ and that i should come back in 6 months, but what if she’s right? I don’t think I am ready for the big ‘knives’ exposures yet, even speaking about it with her this morning, I’ve gone into work feeling incredibly sick and poorly.
 

She has suggested doing smaller exposures, but every time she mentions how she feels that I should end the Therapy sessions now as I’m not ready (she’ll say it in a more professional way.) 

 

I’m in work and my OCD is horrendous today, I just want to go home and I feel so sick :( 

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1 hour ago, Keyboard Worrier said:

Every time I tried therapy in the last 7 years I've been told I'm not ready and to come back when I am...

Perhaps they're right in my case, as just getting to the room for assessment made me incredibly unwell.  However, I haven't been given any ideas on how or when I'm likely to 'be' ready!  Or even anything I can do in the meantime.

Maybe it's a cynical view but I think it's just too much for them to deal with.  They'd rather focus on people with issues that they think are more manageable (easier for them!) with a higher chance of success to look better on their record.  

If your therapist hasn't suggested that you stop sessions yet, but doesn't think you're ready for big exposures, have they made other suggestions about what you'll be working on with them in the meantime?

That’s exactly it isn’t it :( even with my therapist, she’s fairly newly qualified and I guess your right in that sense, she just wants to look good on the records. I wish I didn’t have my therapy session this morning if I’m completely honest. I feel absolutely awful at work now I’ve felt awful for most of the day, I just want to go home and feel incredibly sick. It sort of made me feel like I ‘can’t be helped’ and that i should come back in 6 months, but what if she’s right? I don’t think I am ready for the big ‘knives’ exposures yet, even speaking about it with her this morning, I’ve gone into work feeling incredibly sick and poorly.
 

She has suggested doing smaller exposures, but every time she mentions how she feels that I should end the Therapy sessions now as I’m not ready (she’ll say it in a more professional way.) 

 

I’m in work and my OCD is horrendous today, I just want to go home and I feel so sick :( 

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I’m in work at the moment and I feel so poorly and awful. I did have a coffee so I don’t know if that’s why I feel worse? I just feel like I need to go home I’m trying to work but my heads all over the place with the OCD

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11 minutes ago, Summer9173 said:

I’m in work at the moment and I feel so poorly and awful. I did have a coffee so I don’t know if that’s why I feel worse? I just feel like I need to go home I’m trying to work but my heads all over the place with the OCD

The coffee probably doesn't help. I'm the same. I absolutely love coffee but I can't have it anymore as it sends my anxiety through the roof. I go really jittery and panicky and start sweating. I have decaf now but it's not the same 😭

Regarding your therapist I'm wondering if she meant that you need to start with smaller exposures relating to your harm theme, and once these have been successful you can then move on to more triggering exposures such as ones with big knives. It's completely futile to do exposures around something that you have a high amount of anxiety about first, as they won't work and will only make you feel more anxious. I'm not sure why she wants to end your therapy sessions though. Is your therapy through IAPT and you've come to the end of your allocated amount of sessions? If so you should be entitled to more sessions.

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Also have you got any techniques for calming yourself down when you're feeling panicky? The breathing exercises on the CALM app really work well for me, as does listening to brown noise.

Here's a good brown noise clip on YouTube. I find brown noise a lot more effective than white noise for calming down my anxious brain!

https://youtu.be/pfbdrBFKSf0

Edited by Lynz
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Hey! 

Baby steps! You went to work so that’s a massive thing, you should turn that process of thinking into something good that despite her giving you the news you didn’t want to hear, you’ve left the house and endured work! Us OCD’ers love looking at the negatives. 
 

I can’t tell you wherever you should stay or go home, but remember this: Your irrational brain wants you to go home to hide and avoid the situation, avoidance is a massive thing in OCD. Do NOT give in to the avoidance, just think “this feeling will pass” it is JUST a thought 

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8 minutes ago, Lynz said:

The coffee probably doesn't help. I'm the same. I absolutely love coffee but I can't have it anymore as it sends my anxiety through the roof. I go really jittery and panicky and start sweating. I have decaf now but it's not the same 😭

Regarding your therapist I'm wondering if she meant that you need to start with smaller exposures relating to your harm theme, and once these have been successful you can then move on to more triggering exposures such as ones with big knives. It's completely futile to do exposures around something that you have a high amount of anxiety about first, as they won't work and will only make you feel more anxious. I'm not sure why she wants to end your therapy sessions though. Is your therapy through IAPT and you've come to the end of your allocated amount of sessions? If so you should be entitled to more sessions.


That’s exactly how I feel!! I had one cup of coffee as I felt exhausted this morning, thinking ah yeah this will definitely wake me up and make me feel more alive - 5 hours later I feel so hyper alert to everything including the intrusive thoughts, like I’m on illicit drugs I feel like 😭

Thank you @Lynz that’s so kind of you 💕I love brown noise, it really helps me relax also. At first when I listened to the white noise version it made me feel like my brain was itchy, so when I found the brown noise I was very happy as it also helps me sleep lovely 😂😂

I did have a chat with the mental health first aider, she said we can have a walk around the outside of the office at 3 for a chat. I do feel like I need it as today is quite of a struggle OCD wise, but it’s lovely knowing there’s people to help xx

As for my IAPT therapist, I think having theorist at 9:15am on a Monday morning in general is extremely triggering for my OCD. It consists of speaking a lot about my triggers and then I have to go into work straight after, I’m really considering on going private. I just hope my OCD don’t overcome me this week, I feel so **** in the office right now :( that coffee really does have a lot to answer for!! 

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9 minutes ago, Smithy29 said:

Hey! 

Baby steps! You went to work so that’s a massive thing, you should turn that process of thinking into something good that despite her giving you the news you didn’t want to hear, you’ve left the house and endured work! Us OCD’ers love looking at the negatives. 
 

I can’t tell you wherever you should stay or go home, but remember this: Your irrational brain wants you to go home to hide and avoid the situation, avoidance is a massive thing in OCD. Do NOT give in to the avoidance, just think “this feeling will pass” it is JUST a thought 

Hiya @Smithy29 Thank you for replying to my post :) 

 

I agree, i definitely freaked out with what she told me - I was ‘high on coffee’ as I could say it too, so my anxiety and hyper awareness is completely all over the place. I’m usually good at letting the OCD thoughts go in work as a healthy distraction, but today I really am so all over the place. 
 

I know for me going home is totally out of the question, I think that’s why I’m happy I’ve got the mental health first aider here. I’m having a chat with her at 3 today so hopefully that should be helpful :) it’s just horrible as my office is only a room of 3, when I’m not having a general chit chat they think something is up when sometimes, I really just need to be left alone to calm myself down you know.

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Therapy sessions coming to an end

Summer9173, just a note on your thread title.  I saw the end of therapy not as an end.  I saw it as the start of my road to recovery.  Where that road takes me - we shall see!  I often refer back to my therapy notes as I walk (or at times stumble) along the road.  The good thing is - I am still on the road!  🚗

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When you talk about "big exposures with knives" it's worth trying to put things into perspective & think what's going on here.  Knives aren't really a problem, it's the danger/fear thinking that's gone on in the background.  My first major OCD issues was about knives & harm (supposedly).  I could now walk round with a sharpened meat cleaver without a hint of worry....or even thinking about it.  I didn't have therapy for it as none was around then.  I didn't read books or articles on the internet because they didn't exist either.......but I did do self-applied exposure....so it can be done.  I had to look at the thinking that created and sustained this fear.  It happened when I was suffering from an acute episode of anxiety, some would call it a nervous breakdown.  I felt so bewildered and out of control  that I feared it would build & build and I would go mad and lose control.  The chain of thoughts then tumbles like a stack of dominos ......What does losing control mean? I might become insane -----> What does that mean?  I might lose control -------> What does that mean? I might harm someone, I'm a danger --------> How, what could happen? I might lose control & attack someone with a knife 😪 (Why a knife? Because it's generally the only dangerous item in a domestic household)

Can you see how the chain of events quickly tumbles from one thing to another and before you know it, here you are, a monster who is a danger to others.  You are now so afraid and convinced of your insanity you avoid knives, people, pets, situations where this might happen.  Once this has happened you spend every waking moment thinking, ruminating and become ever more afraid, you avoid more and more.

The only thing to fear is fear itself and the thoughts that you have that keep it uppermost in your mind

 

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17 minutes ago, Caramoole said:

The chain of thoughts then tumbles like a stack of dominos ......What does losing control mean? I might become insane -----> What does that mean?  I might lose control -------> What does that mean? I might harm someone, I'm a danger --------> How, what could happen? I might lose control & attack someone with a knife 😪 (Why a knife? Because it's generally the only dangerous item in a domestic household)

Can you see how the chain of events quickly tumbles from one thing to another and before you know it, here you are, a monster who is a danger to others...

I think this is EXACTLY how it goes for everyone with OCD - thanks for this extremely helpful explanation! It's not like we are immediately having some kind of fear out of nothing, but as you said, because of our faulty thought process, we apply false logical conclusions to truthy statements and thus, we from one to the other moment convince ourselves of the worst possible outcomes. Over and over again. I'm not sure why we do that, but I guess it has something to do with our issues regarding uncertainty: We can't say, for sure, that something isn't the case and that we are in fact this or that, so that's why we take the worst interpretation into consideration. And then we chain another thought on top of that, making the next worst possible conclusion, which then just makes it even worse for us. It's like "always going the safest" aka "always take the worst outcome", because in that case, we don't have to deal with uncertainty → It's the worst outcome anyway, so it doesn't matter if we know it for sure or not. And that's something we need to stop.

I think I might never ever see a better example regarding OCD, than this, because, and I swear by god, this is exactly how it went for me. It wasn't like an immediate process, but it went like that the more I ruminated about certain stuff, I convinced myself more and more of horrendous stuff about myself and as a person. And here and then I was like: "I wished that I stopped ruminating here, because back then, before I convinced myself of that, this was so much easier to handle. How was I so stupid to still feel the need to ruminate? Why did I not stop it there?". And I think that with each "conclusion" I made - which obviously was always the worst - I also made my intrusive thoughts worse. It went from super simple to dealt with, to super hard to deal with.

And I also remember this sudden spike of anxiety, when I got aware of an "even worse possibility", because this just dragged me deeper into the rumination hell, where I lost even more self-confidence. I think I re-traumatised myself over and over again, by not stopping this stupid behavior and by chaining worrisome thoughts on thoughts. It's like as if I set lower standards about myself each time:

From the fear of accidentally being inappropriate to others → To the fear of actually liking it → To the fear of actually wanting it → To the fear of actually doing it on purpose → To the fear of being a psychopath/sociopath. 

It's as if our brain wants us to feel like trash. Our brains make our lives like hell. I don't wish this experience to anyone. And the best way to stop all of this is just to stop thinking about these intrusive thoughts, by not giving them any meaning. Let them rot where they came from. Slowly, but surely their grip on us will fade away, and we'll see things, for how they actually are. 

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3 hours ago, northpaul said:

I saw it as the start of my road to recovery.  W

I’m sort of feeling the same with mine. I think i do need to stop seeing it as a race, sometimes I just wish I could get better as soon as possible, but I know it isn’t like that :( your reply really helped me though, thank you :) 

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2 hours ago, Caramoole said:

My first major OCD issues was about knives & harm (supposedly).  I could now walk round with a sharpened meat cleaver without a hint of worry....or even thinking about it.

This is so inspiring, thank you @Caramoole. I hope I can get to this stage in my recovery, no, I know I’ll get there :) 

2 hours ago, Caramoole said:

The chain of thoughts then tumbles like a stack of dominos ......What does losing control mean? I might become insane -----> What does that mean?  I might lose control -------> What does that mean? I might harm someone, I'm a danger --------> How, what could happen? I might lose control & attack someone with a knife 😪 (Why a knife? Because it's generally the only dangerous item in a domestic household)

This is exactly it. Ugh, I hate OCD so much :dry: the thing is too which is even more frustrating, I’m getting a lot better at handling exposures etc but when it’s my time of the month I’m an absolute mess!! It’s something I’m actually going to speak about with my doctor, as it’s physically and mentally awful. I feel like I’ve been hit by a car today.  There’s just so much physical and mental tension, overall just feeling awful this evening but I’m not going to see it as a set back - just a bad day :) 

Your reply really helped me though as always @Caramooleso thank you for that. I probably shouldn’t have had that coffee in the morning either….. not as an avoidance but genuinely because I feel like I’ve been high & drunk and crashed down back onto earth! 

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2 hours ago, discuccsant said:

And the best way to stop all of this is just to stop thinking about these intrusive thoughts, by not giving them any meaning. Let them rot where they came from. Slowly, but surely their grip on us will fade away, and we'll see things, for how they actually are. 

It is a hard process isn’t it :( it’s one that takes time I understand, but when you’re in the midst of it, you just want it to go away. It’s quite frustrating that you have to do the total opposite of what your ‘fight or flight’ mode is telling you to get better, I stayed in work today instead of running back home and I feel like I’ve been hit by a truck. I know it’ll be worth it but I need to get out of the cycle of associating things with negative stuff. E.g i had a bad day today, now my OCD will try to conceive me I’ll have a bad Monday every Monday. 

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1 hour ago, Summer9173 said:

It is a hard process isn’t it :( it’s one that takes time I understand, but when you’re in the midst of it, you just want it to go away. It’s quite frustrating that you have to do the total opposite of what your ‘fight or flight’ mode is telling you to get better, I stayed in work today instead of running back home and I feel like I’ve been hit by a truck. I know it’ll be worth it but I need to get out of the cycle of associating things with negative stuff. E.g i had a bad day today, now my OCD will try to conceive me I’ll have a bad Monday every Monday. 

It's extremely hard, I know. I just want to share a big huge to everyone struggles here right now, as I know how tough all of this is and how proud I'm that each one of you keep going! Yeah, to resist these compulsions is the biggest problem, especially ruminating about it, but I think being on this forum and sharing the experience with others, who have the very same fears and problems as you, is always encouraging to keep it going with not doing any compulsions - especially when there are people who got so much better in the end. I think there isn't any better motivation than to see, how all of this could end, if we just keep going and going :)

 

 

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1 hour ago, discuccsant said:

It's extremely hard, I know. I just want to share a big huge to everyone struggles here right now, as I know how tough all of this is and how proud I'm that each one of you keep going! Yeah, to resist these compulsions is the biggest problem, especially ruminating about it, but I think being on this forum and sharing the experience with others, who have the very same fears and problems as you, is always encouraging to keep it going with not doing any compulsions - especially when there are people who got so much better in the end. I think there isn't any better motivation than to see, how all of this could end, if we just keep going and going :)

 

 

That is such a kind message, all the same to you too :) 

 

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3 hours ago, Summer9173 said:

This is exactly it. Ugh, I hate OCD so much :dry:

The thing is that those initial chain of thoughts aren't OCD, they are/were anxiety.  The obsessions that are part of OCD come next,we become obsessed by the fearful thoughts we had and start to ruminate and take avoiding behaviours.  The initial thoughts were part of the fight/flight mechanism, they are part of our own safety mechanism for keeping yourself and others safe.  We barely notice this but our brains are assessing situations most of the time....."Will that burn, am I too close to the edge, watch that car...........and of course "what if I crack up and lose control?"  So the thought wasn't OCD or some nasty opponent with a malicious agenda.....they were a normal chain of thoughts caused by heightened anxiety (generally)  OCD happens when we become obsessed by a particular thought or fear.

Try and look at your own chain of thoughts and how they led to particular obsessions, understanding that can help

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I wonder if you could ask for a different time or day to have the therapy sessions?  Perhaps on a day that you don't work, or in the afternoon if that's better for you?  Sounds like the combination of timing and coffee really didn't help the situation yesterday! 

I don't think there's any sure-fire way to determine whether you should stay in a situation or not.  We only know whether it was beneficial or detrimental after the event, and of course it's too late by then!  I don't believe that staying in every situation is beneficial personally.  There are certainly some I wish I'd left sooner in hindsight.

Also just want to pick up on the thought that you 'can't be helped'.  That is sort of true and something I think a lot of us will relate to.  Over time I've realised the help ultimately has to come from yourself, there isn't any help that can be done to you...if that makes sense!  The best analogy I can think of for that is a broken leg...  You'd go to the hospital, and someone else would do the main bulk of the 'help' there (setting and plastering your leg), then you're left with a clear idea of what to do...keep the weight off it for few weeks, then slowly start to introduce weight etc.  But that's not what happens with mental issues.  With OCD and anxiety, the other person just offers ideas, some useful, some not useful, but the bulk of the help has to come from you trying different things to see what works and what doesn't.  Those ideas are certainly helpful, especially when stuck in a negative OCD spiral where you can't see the wood for the trees, but they aren't actually a necessity.  You probably do know which compulsions you can work on at the moment, and which ones would make the most impact to your daily life...so those are the ones to try and work out a plan for. :smile:

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