How is therapy supposed to help when it can't change why you are sad?
December 3, 2014 9:18 PM Subscribe
How is therapy supposed to help when it can't change why you are sad?
I am in therapy for grief and it's not helping. I understand that therapy can't bring back the person I miss, but since that's the only thing I want, I can't figure out what therapy is meant to do. It would be helpful to me if I could understand at least what's SUPPOSED to happen even though it obviously isn't.
I've been with my current therapist ten months. I was with someone before her for seven months, and I tried several other therapists years ago (for the same problem), and it's never been helpful. Please don't just tell me I need to try another therapist...I have done that and done that, we start all over from the beginning (it takes months to get through all the background stuff) and then nothing happens.
I have tried medications and they did nothing for me.
There is nothing I want to change (and nothing that is wrong) about any other aspect of my life or my personality. I just miss someone who is not there.
I keep reading things that suggest that the "therapeutic relationship" is what's supposed to be helpful: i.e., the relationship between the client and the therapist is itself beneficial, more than anything else that happens in therapy, but....it really isn't helpful for me. I get nothing out of the therapist empathizing with me, and in fact it makes me feel worse because then I feel bad about them being sad too. Moreover, I don't understand WHY this is supposed to be helpful.
I've asked my therapist (and the therapist I worked with before her), what's supposed to be happening and neither of them was able to explain it to me in a way I understand. She also loaned me a book on different methods of talk therapy....which is not what I'm asking, AT ALL. Please for the love of god do not answer this question with stuff about treatment methods. Assume that I have the ideal method for me and that I have the perfect relationship with my therapist....THEN what's supposed to happen?
If the therapeutic relationship is truly the only beneficial thing about therapy, should I give up on therapy since that isn't helpful for me? What am I supposed to do?
I've been with my current therapist ten months. I was with someone before her for seven months, and I tried several other therapists years ago (for the same problem), and it's never been helpful. Please don't just tell me I need to try another therapist...I have done that and done that, we start all over from the beginning (it takes months to get through all the background stuff) and then nothing happens.
I have tried medications and they did nothing for me.
There is nothing I want to change (and nothing that is wrong) about any other aspect of my life or my personality. I just miss someone who is not there.
I keep reading things that suggest that the "therapeutic relationship" is what's supposed to be helpful: i.e., the relationship between the client and the therapist is itself beneficial, more than anything else that happens in therapy, but....it really isn't helpful for me. I get nothing out of the therapist empathizing with me, and in fact it makes me feel worse because then I feel bad about them being sad too. Moreover, I don't understand WHY this is supposed to be helpful.
I've asked my therapist (and the therapist I worked with before her), what's supposed to be happening and neither of them was able to explain it to me in a way I understand. She also loaned me a book on different methods of talk therapy....which is not what I'm asking, AT ALL. Please for the love of god do not answer this question with stuff about treatment methods. Assume that I have the ideal method for me and that I have the perfect relationship with my therapist....THEN what's supposed to happen?
If the therapeutic relationship is truly the only beneficial thing about therapy, should I give up on therapy since that isn't helpful for me? What am I supposed to do?
What's supposed to happen depends on the school of thought your therapist comes from, and these vary radically. They're all lumped under one word, "therapy," but that's misleading.
In some schools you're learning how to manage and fight against unrealistic thoughts and unproductive behaviors. In others, you might be seeing how your current grief is a way of avoiding something else, or reflects some kind of deep-seated and unresolved issue in your personality or childhood. In others still, you might be trying to come to terms with the fact that the pain of grief is an unavoidable fact of life. And some therapists don't aim at "fixing" your pain at all, but at helping you understand yourself, if you want that.
So it's not as simple as assuming you have the ideal method and therapist for you. It is not certainly not necessarily the case that the therapeutic relationship is the only thing that's helpful in the process.
posted by shivohum at 9:36 PM on December 3, 2014 [12 favorites]
In some schools you're learning how to manage and fight against unrealistic thoughts and unproductive behaviors. In others, you might be seeing how your current grief is a way of avoiding something else, or reflects some kind of deep-seated and unresolved issue in your personality or childhood. In others still, you might be trying to come to terms with the fact that the pain of grief is an unavoidable fact of life. And some therapists don't aim at "fixing" your pain at all, but at helping you understand yourself, if you want that.
So it's not as simple as assuming you have the ideal method and therapist for you. It is not certainly not necessarily the case that the therapeutic relationship is the only thing that's helpful in the process.
posted by shivohum at 9:36 PM on December 3, 2014 [12 favorites]
The "therapeutic relationship" is most definitely not the only beneficial thing about therapy -- or at least it isn't in some kinds of talk therapy. However, for some people, the therapeutic relationship IS helpful. For some people, having a nonjudgmental person whose job it is to simply listen to your problems can be helpful.
Some people have trouble expressing grief, anger, or sadness, and the therapeutic relationship can allow them to express those things without fear or guilt.
Have you told your therapist that you feel guilty expressing your sadness to her? Working through that may help you find more benefit to the therapy. In some kinds of therapy, the therapist can also help guide you to appropriate coping mechanisms to better manage your feelings of grief and loss.
The outcome of therapy is not to take away your feelings, it's to help you better express and manage them.
posted by erst at 9:38 PM on December 3, 2014
Some people have trouble expressing grief, anger, or sadness, and the therapeutic relationship can allow them to express those things without fear or guilt.
Have you told your therapist that you feel guilty expressing your sadness to her? Working through that may help you find more benefit to the therapy. In some kinds of therapy, the therapist can also help guide you to appropriate coping mechanisms to better manage your feelings of grief and loss.
The outcome of therapy is not to take away your feelings, it's to help you better express and manage them.
posted by erst at 9:38 PM on December 3, 2014
I know grief. I know about losing the person you love most. I know this pain intimately.
You're not supposed to stop feeling your feelings.
Your goal is to learn to live alongside such profound grief. And continue on.
Hopefully, with time, you find new profound joys in Life. This will be tempered by the knowledge NOTHING stays the same or lasts forever - so new important connections will never feel quite as "real" as the connection you lost. I know.
I know.
Life will always feel a bit muted or tempered from here on in. But it IS possible to still feel connected and content. I swear this a thousand times.
You should watch the film Cloud Atlas.
Do NOT read anything about it! Just watch it with an open mind and heart.
After many many many years, nothing spoke to my grief more and consoled me as this film experience did.
You are supposed to gain tools in therapy that help you come to a place where you can be OK again. You'll never ever be the same, but you CAN be GOOD. Maybe even GREAT.
Join me. You are not the only one.
Please don't give up.
Memail me if you want to share or know more. I've walked this path. Keep going. It is worth it.
posted by jbenben at 9:50 PM on December 3, 2014 [14 favorites]
You're not supposed to stop feeling your feelings.
Your goal is to learn to live alongside such profound grief. And continue on.
Hopefully, with time, you find new profound joys in Life. This will be tempered by the knowledge NOTHING stays the same or lasts forever - so new important connections will never feel quite as "real" as the connection you lost. I know.
I know.
Life will always feel a bit muted or tempered from here on in. But it IS possible to still feel connected and content. I swear this a thousand times.
You should watch the film Cloud Atlas.
Do NOT read anything about it! Just watch it with an open mind and heart.
After many many many years, nothing spoke to my grief more and consoled me as this film experience did.
You are supposed to gain tools in therapy that help you come to a place where you can be OK again. You'll never ever be the same, but you CAN be GOOD. Maybe even GREAT.
Join me. You are not the only one.
Please don't give up.
Memail me if you want to share or know more. I've walked this path. Keep going. It is worth it.
posted by jbenben at 9:50 PM on December 3, 2014 [14 favorites]
Therapeutic relationship is important when you're coming from a background of abuse, for example. You should feel a general sense of trust in your therapist - you don't want a BAD relationship with them, but that is not otherwise a significant mechanism of the process in situational depression, grief, life-event-type therapy.
In theory, you are going there because you are sad, and a) to have a safe place (no social expectations, not having it used against you etc) to talk about those feelings, b) learn techniques for dealing with the feelings when they are (in your opinion) interfering with your life, functionality, etc.
So, as a random example, if you're in one of the several kinds of common talk therapies, you might say, "I am staying late at work just to avoid going home to an empty house" and then with guidance from your therapist examine the individual anxieties/pain involved in the empty house feelings and walking through mindfulness or acceptance or anxiety-reducing exercises so that it is easier for you to go home on time.
In bereavement therapy there's quite a bit of room for you to just vent and talk aimlessly, but I think the reason they are handing you these books is to give you an idea of what it is you should be trying to do on your end. Most therapists are versed in more than one style, they may be expecting you to have a preference about how to proceed.
posted by Lyn Never at 9:57 PM on December 3, 2014
In theory, you are going there because you are sad, and a) to have a safe place (no social expectations, not having it used against you etc) to talk about those feelings, b) learn techniques for dealing with the feelings when they are (in your opinion) interfering with your life, functionality, etc.
So, as a random example, if you're in one of the several kinds of common talk therapies, you might say, "I am staying late at work just to avoid going home to an empty house" and then with guidance from your therapist examine the individual anxieties/pain involved in the empty house feelings and walking through mindfulness or acceptance or anxiety-reducing exercises so that it is easier for you to go home on time.
In bereavement therapy there's quite a bit of room for you to just vent and talk aimlessly, but I think the reason they are handing you these books is to give you an idea of what it is you should be trying to do on your end. Most therapists are versed in more than one style, they may be expecting you to have a preference about how to proceed.
posted by Lyn Never at 9:57 PM on December 3, 2014
I have never found therapy helpful for embedded grief. I have found it useful for exploring feelings and coping tools for a myriad of other personal troubles, but not the grief and loss itself.
I have had a small number of personal epiphanies about my grief that have help me move through it, but none of them have happened with a therapist. Moving through grief, for me, means the waves of grief don't get smaller, just less frequent. Journaling, talking with friends who have also experienced grief, reading books that touch on some of the feelings I think I might feel if I let myself... Those things have helped the waves hit less frequently, not 'a therapeutic relationship' with someone who has no real appreciation for what I have lost.
Grief is not something that gets fixed. It just gets less. Cognitive tools can help the lessening but they can't fill the hole.
I find talking about grief with people who also experience it to be very useful now and again. Memail me if you'd like.
posted by Kerasia at 10:03 PM on December 3, 2014 [2 favorites]
I have had a small number of personal epiphanies about my grief that have help me move through it, but none of them have happened with a therapist. Moving through grief, for me, means the waves of grief don't get smaller, just less frequent. Journaling, talking with friends who have also experienced grief, reading books that touch on some of the feelings I think I might feel if I let myself... Those things have helped the waves hit less frequently, not 'a therapeutic relationship' with someone who has no real appreciation for what I have lost.
Grief is not something that gets fixed. It just gets less. Cognitive tools can help the lessening but they can't fill the hole.
I find talking about grief with people who also experience it to be very useful now and again. Memail me if you'd like.
posted by Kerasia at 10:03 PM on December 3, 2014 [2 favorites]
The first day I went to therapy, my therapist wanted to know what was up since I was suicidal and profoundly depressed after being callously treated by my first boyfriend in college. I told her that my brain felt like one of those attics that's been jam packed with stacks and stacks of stuff, all in boxes, and I wanted very desperately to clear them all out so I could, essentially, move away. She met me in the middle and appointed herself my cleaning lady and decided that all her efforts then were to help me sort through the biggest stacks and get to the base of each using our agreed upon method of treatment (which for me was EMDR + CBT). She told me that whenever we have a traumatic experience, our brains start lumping together similar experiences into piles and packets, even if later experiences are only tangentially related to the original trauma. It's our brain's way of being helpful, because we really do appreciate it when stuff gets sorted into piles, but what happens is that then those traumas just get more and more buried and shoved into spaces we can't access or don't know what to do with.
So, with the help of EMDR, my therapist started picking away at the big stuff, much in the same way you might try to untangle a giant ball of Xmas lights. We started with the negative cognition, "I am gross and therefore unlovable and unworthy" because it was and still is the source of most of my worries. She then asked me to essentially go through my mental attic and identify the first time I felt that statement was true and pull that box out from under all the others that stood on top of it. Shit came down around me while I did it, but man, unpacking that one foundational box (which took about a year, mind you) suddenly made going through all the other boxes (aka stuff I couldn't sort out) really easy. Sometimes the original event I'd chosen wasn't actually the original event, but I only discovered that there were other things buried deep by starting with my first real memory of the traumatic feeling. Then we'd adjust and accommodate that new info until all the stuff in this particular trauma category was out in the open. The EMDR I was doing then helped me move it to a different part of my brain, one that was neutral and unassociated with trauma triggers (which for me is/was strong and overpowering feelings of shame and worthlessness). And we kept doing that, over and over with different negative cognitions, and each time we ended each session with the positive thing I wanted to think instead (which for me is, "I am okay" or "I have always been worthy, just the way I am".) Suddenly I wasn't looking for evidence to prove to her that my negative cognition was true; instead I was finding an abundance of reasons to show myself that everything was just the opposite.
Why was I sad? Because to me, my boyfriend being an abusive dick was just another box to add to an already teetering pile of what I thought was evidence of my worthlessness. I wanted him back desperately, or I wanted to die. Chipping away at the root issue, the long-standing feeling of worthlessness, was the key to unlocking my ability to reevaluate my dying relationship and categorize it as just one of many good lessons I was going to need to learn before I find my proper partner. Therapy did exactly what it was supposed to do for me: help me figure out the REAL reason I was sad, and then equip me with the tools and the methodology and the thought practices and the support system I needed to make that real reason crumble into nothingness. My therapist was perfect for me because she likes this mental framework I'd envisioned regarding my emotions and stressors and she used it to help give my work some context. It wasn't an abstract space I was working in anymore. I made progress every day. I still do. I have the tools I need now.
Maybe the reason you've not made progress with your grief is because you're only treating the superficial stuff and not the roots. Being honest with your therapist is the first step. Don't worry about what she thinks or how she feels. Those things are her responsibility to manage, not yours. If she empathizes with you, and you feel gross when she does, tell her immediately. Those negative feelings are likely significantly closer to the real issue at hand that's making your grief seemingly insurmountable. Keep going.
posted by Hermione Granger at 10:14 PM on December 3, 2014 [36 favorites]
So, with the help of EMDR, my therapist started picking away at the big stuff, much in the same way you might try to untangle a giant ball of Xmas lights. We started with the negative cognition, "I am gross and therefore unlovable and unworthy" because it was and still is the source of most of my worries. She then asked me to essentially go through my mental attic and identify the first time I felt that statement was true and pull that box out from under all the others that stood on top of it. Shit came down around me while I did it, but man, unpacking that one foundational box (which took about a year, mind you) suddenly made going through all the other boxes (aka stuff I couldn't sort out) really easy. Sometimes the original event I'd chosen wasn't actually the original event, but I only discovered that there were other things buried deep by starting with my first real memory of the traumatic feeling. Then we'd adjust and accommodate that new info until all the stuff in this particular trauma category was out in the open. The EMDR I was doing then helped me move it to a different part of my brain, one that was neutral and unassociated with trauma triggers (which for me is/was strong and overpowering feelings of shame and worthlessness). And we kept doing that, over and over with different negative cognitions, and each time we ended each session with the positive thing I wanted to think instead (which for me is, "I am okay" or "I have always been worthy, just the way I am".) Suddenly I wasn't looking for evidence to prove to her that my negative cognition was true; instead I was finding an abundance of reasons to show myself that everything was just the opposite.
Why was I sad? Because to me, my boyfriend being an abusive dick was just another box to add to an already teetering pile of what I thought was evidence of my worthlessness. I wanted him back desperately, or I wanted to die. Chipping away at the root issue, the long-standing feeling of worthlessness, was the key to unlocking my ability to reevaluate my dying relationship and categorize it as just one of many good lessons I was going to need to learn before I find my proper partner. Therapy did exactly what it was supposed to do for me: help me figure out the REAL reason I was sad, and then equip me with the tools and the methodology and the thought practices and the support system I needed to make that real reason crumble into nothingness. My therapist was perfect for me because she likes this mental framework I'd envisioned regarding my emotions and stressors and she used it to help give my work some context. It wasn't an abstract space I was working in anymore. I made progress every day. I still do. I have the tools I need now.
Maybe the reason you've not made progress with your grief is because you're only treating the superficial stuff and not the roots. Being honest with your therapist is the first step. Don't worry about what she thinks or how she feels. Those things are her responsibility to manage, not yours. If she empathizes with you, and you feel gross when she does, tell her immediately. Those negative feelings are likely significantly closer to the real issue at hand that's making your grief seemingly insurmountable. Keep going.
posted by Hermione Granger at 10:14 PM on December 3, 2014 [36 favorites]
In the year-ish after my parents died, I used therapy in a couple different ways. I used it to process the not always positive feelings that I had about my parents (my mom in particular, because we were closest), and that were now never going to get resolved, and that felt weird to talk with other people about. I used it to get used to using the past tense. I used it as a place to just plain talk about them, because sometimes it felt like people were weird about me talking about my dead parents. Like that. I also used it, and the time, to grow scar tissue and get used to that.
I didn't go in expecting it would be fixed, or go away. It got easier, or at least it got less acute.
posted by rtha at 10:15 PM on December 3, 2014 [5 favorites]
I didn't go in expecting it would be fixed, or go away. It got easier, or at least it got less acute.
posted by rtha at 10:15 PM on December 3, 2014 [5 favorites]
Grief therapy should help you construct a new life without the person you lost physically in it. It's not about replacing the person who died, or reconstructing your life as it was before. Your life has radically changed, and you need to change to cope with it. Therapy is about giving you the tools you need in order to change yourself, because whether you want it to or not, your life has changed.
posted by jaguar at 10:18 PM on December 3, 2014 [4 favorites]
posted by jaguar at 10:18 PM on December 3, 2014 [4 favorites]
I understand that therapy can't bring back the person I miss, but since that's the only thing I want, I can't figure out what therapy is meant to do.
A couple of thoughts.
Therapy is supposed to help you want and appreciate other things. Help you get in touch with feelings, needs, interests, and aspects of identity that are independent of that person, so you can have a life that satisfies who you are, which is much greater than your loss.
If you hadn't suffered that loss, if your life had gone off in some other direction, would you think that alternate self should want only one thing in the world? That can be a really unbalanced way to live.
posted by clockzero at 10:21 PM on December 3, 2014 [5 favorites]
A couple of thoughts.
Therapy is supposed to help you want and appreciate other things. Help you get in touch with feelings, needs, interests, and aspects of identity that are independent of that person, so you can have a life that satisfies who you are, which is much greater than your loss.
If you hadn't suffered that loss, if your life had gone off in some other direction, would you think that alternate self should want only one thing in the world? That can be a really unbalanced way to live.
posted by clockzero at 10:21 PM on December 3, 2014 [5 favorites]
Just echoing (as a client; I am not a therapist) that therapy doesn't erase feelings. It helps you build tools to adapt to having those feelings in your life.
On a more personal note, I know exactly and intimately what that hole in your life feels like. I don't want to sound trite, but with time it does slowly start to get better (3 years and counting, here). You still miss them, but it becomes bearable. Slowly. The toolbox that therapy helps you build will accelerate that process a bit. And sometimes it gets worse for a bit. You're not alone, is what I'm saying. Perhaps a question to ask your therapist is "How can we build tools so I can tolerate living like this?" Because maybe once you get there and get comfortable with that, you can start building the tools to live happier than this. Small steps.
posted by feckless fecal fear mongering at 10:26 PM on December 3, 2014
On a more personal note, I know exactly and intimately what that hole in your life feels like. I don't want to sound trite, but with time it does slowly start to get better (3 years and counting, here). You still miss them, but it becomes bearable. Slowly. The toolbox that therapy helps you build will accelerate that process a bit. And sometimes it gets worse for a bit. You're not alone, is what I'm saying. Perhaps a question to ask your therapist is "How can we build tools so I can tolerate living like this?" Because maybe once you get there and get comfortable with that, you can start building the tools to live happier than this. Small steps.
posted by feckless fecal fear mongering at 10:26 PM on December 3, 2014
Response by poster: Guys, I know I'm not supposed to threadsit, but I'm really after what is supposed to happen neurologically or chemically that is supposed to make therapy helpful. I don't want or need to know what "goes on" in therapy; I'm wanting to know WHY what goes on is supposed to be helpful.
f you hadn't suffered that loss, if your life had gone off in some other direction, would you think that alternate self should want only one thing in the world? That can be a really unbalanced way to live.
I really, really, truly think (after spending tons and tons of time on this in therapy and in general) that if I hadn't suffered this loss, my life would be exactly the same as it is now, only without the horrible pain of missing someone 24/7.
posted by Violet Hour at 10:29 PM on December 3, 2014
f you hadn't suffered that loss, if your life had gone off in some other direction, would you think that alternate self should want only one thing in the world? That can be a really unbalanced way to live.
I really, really, truly think (after spending tons and tons of time on this in therapy and in general) that if I hadn't suffered this loss, my life would be exactly the same as it is now, only without the horrible pain of missing someone 24/7.
posted by Violet Hour at 10:29 PM on December 3, 2014
Your life has changed. Whether you wanted it to or not, it has changed. Grief therapy is about learning to cope with the new reality, about recognizing the loss, setting it aside, and getting on with life. It sounds brutal typed out, but that is what healthy mourning looks like, and what grief therapy helps facilitate. Not a filling in of the hole so that you feel the same as before and can live your life as before, but a recognition that "Oh, shit, this is a whole new existence" and a shifting of focus.
posted by jaguar at 10:38 PM on December 3, 2014 [6 favorites]
posted by jaguar at 10:38 PM on December 3, 2014 [6 favorites]
Alright. As I understand it, therapy helps your brain strengthen and create neurological pathways to help transfer information from one part of the brain to the other, much like when we learn and assimilate new information as children. Therapy therefore is supposed to act as an external model of neurological connections, enhancing and revealing connections between clusters of concepts and allow you to sort them, regroup them, make sense of them, and, eventually, move past them. If you've undergone severe physical or emotional trauma, your brain can put up blocks between pathways and it takes more time and effort to carve through them. As such, therapy is a means of teaching your brain to re-learn how to think, and that's why it's helpful.
posted by Hermione Granger at 10:43 PM on December 3, 2014 [6 favorites]
posted by Hermione Granger at 10:43 PM on December 3, 2014 [6 favorites]
I'm not sure I can explain it more clearly--perhaps other people here, like jaguar, can. (and on preview has, and Hermione, but here's my 2c anyway)
What makes therapy helpful is learning the skills to cope with the feelings you are having. You say you are feeling horrible pain 24/7. Therapy is aimed at helping you live with that feeling in a way that doesn't hold you back. More or less, it is (or can be, modulo different therapeutic approaches) going from "I feel awful about X" to "X is an awful thing that happened and has changed me, and now I am moving on."
It sounds like what you want is for therapy to be like surgery--go in, cut out the offending bit, and move on. Unfortunately it's not that clear-cut. It may help reorient your worldview to consider it to be more like physiotherapy after a debilitating incident; you learn to move your body in what is your new normal, and how to use assistive devices--in this case, coping strategies--to maximize what you can do with your altered body/new life.
As for chemical changes, perhaps it is time to coordinate your primary care physician and your therapist to look at medication that does make chemical changes in the brain to help soften the pain. (You didn't make any reference to medication in your question so I'm assuming you're not on any).
posted by feckless fecal fear mongering at 10:45 PM on December 3, 2014 [5 favorites]
What makes therapy helpful is learning the skills to cope with the feelings you are having. You say you are feeling horrible pain 24/7. Therapy is aimed at helping you live with that feeling in a way that doesn't hold you back. More or less, it is (or can be, modulo different therapeutic approaches) going from "I feel awful about X" to "X is an awful thing that happened and has changed me, and now I am moving on."
It sounds like what you want is for therapy to be like surgery--go in, cut out the offending bit, and move on. Unfortunately it's not that clear-cut. It may help reorient your worldview to consider it to be more like physiotherapy after a debilitating incident; you learn to move your body in what is your new normal, and how to use assistive devices--in this case, coping strategies--to maximize what you can do with your altered body/new life.
As for chemical changes, perhaps it is time to coordinate your primary care physician and your therapist to look at medication that does make chemical changes in the brain to help soften the pain. (You didn't make any reference to medication in your question so I'm assuming you're not on any).
posted by feckless fecal fear mongering at 10:45 PM on December 3, 2014 [5 favorites]
One other thing: something my therapist and a few of my doctors have told me is that when we are in the throes of extreme grief or depression for long periods of time, our mind is literally poisoning itself and the body it lives in and eating it from the inside out. Sometimes we need medicines to help put that process in pause, and jump start our body's ability to clear the mind to make way for more effective and productive thought patterns. Sometimes just therapy (or medicines + therapy), is the exercise that builds the muscle back and helps our brain find other ways to sort information so it does not give up and start killing its host (aka us). Therapy subsequently helps our mind and body become resilient so that toxic thoughts don't become literal toxic waste. That's a neurological/chemical process for sure.
posted by Hermione Granger at 10:57 PM on December 3, 2014 [5 favorites]
posted by Hermione Granger at 10:57 PM on December 3, 2014 [5 favorites]
I don't know what level of chemical or neurological changes you're looking at, but we really don't have a perfect neurological model for... anything, least of all the effects of something as high-level as a conversation or a decision or a realization. Everything you do changes your brain. The simplest example is that every time you repeat the same thought pattern, that pattern gets reinforced (this we do see at a very basic cellular level - neurons that fire together, wire together). So it can become difficult to break a pattern that is harmful to you without some external stimulus or without learning to recognize the pattern and start building contrasting ones.
Living a life that is dominated by wanting someone back who cannot be brought back is harmful to you. But the longer you do it, the more deeply it becomes reinforced in your brain. Therapy can teach you ways to put other patterns in place in your life. But of course it takes time.
posted by Lady Li at 11:03 PM on December 3, 2014 [34 favorites]
Living a life that is dominated by wanting someone back who cannot be brought back is harmful to you. But the longer you do it, the more deeply it becomes reinforced in your brain. Therapy can teach you ways to put other patterns in place in your life. But of course it takes time.
posted by Lady Li at 11:03 PM on December 3, 2014 [34 favorites]
Oh, and - it takes time and it takes active reinforcement by you outside of the therapy sessions. Often a therapist can help with this by giving you techniques that you can use to counteract your own harmful habits or thought processes.
But it's also possible that therapy is not helping you because it is serving as a place for you to keep digging deeper and deeper into your grief, or as a place where you are reinforcing in your own mind the idea that your loss is unsurmountable. If therapy is reinforcing rather than disrupting the harmful patterns you would want to change what you are trying to do in therapy, for example ask the therapist directly: "I want to work on reducing my feeling that my life is dominated by an empty space where this person used to be. How can I start doing that?" or "It feels like my grief isn't getting any less with time. What can I do about that?"
Or perhaps, "I feel like I don't want to stop grieving for this person, because..." might be the right path to go down.
The goal is to disrupt the pattern of self-reinforcing grief and allow you to lay down some new neurological pathways. And if there's something in you that's keeping you from doing that, you want to find that and overcome it, so that you can - again - disrupt the pattern and develop some new habits of thought.
posted by Lady Li at 11:15 PM on December 3, 2014 [15 favorites]
But it's also possible that therapy is not helping you because it is serving as a place for you to keep digging deeper and deeper into your grief, or as a place where you are reinforcing in your own mind the idea that your loss is unsurmountable. If therapy is reinforcing rather than disrupting the harmful patterns you would want to change what you are trying to do in therapy, for example ask the therapist directly: "I want to work on reducing my feeling that my life is dominated by an empty space where this person used to be. How can I start doing that?" or "It feels like my grief isn't getting any less with time. What can I do about that?"
Or perhaps, "I feel like I don't want to stop grieving for this person, because..." might be the right path to go down.
The goal is to disrupt the pattern of self-reinforcing grief and allow you to lay down some new neurological pathways. And if there's something in you that's keeping you from doing that, you want to find that and overcome it, so that you can - again - disrupt the pattern and develop some new habits of thought.
posted by Lady Li at 11:15 PM on December 3, 2014 [15 favorites]
Personally the thing I got out of therapy (years ago) was developing coping skills. None of my problems ever went 100% away, but my thinking patterns surrounding them changed as a direct result of therapy.
posted by deathpanels at 11:56 PM on December 3, 2014 [2 favorites]
posted by deathpanels at 11:56 PM on December 3, 2014 [2 favorites]
I'm really after what is supposed to happen neurologically or chemically that is supposed to make therapy helpful.
The Neuroscience of Psychotherapy by Louis Cozolino is an attempt to answer precisely this question. It doesn't require preexisting expertise in either field and is pretty fascinating.
And on a side note, yeah EMDR. I went in sceptical as hell (my therapist was prettty upfront about there not yet being a clear scientific understanding of why and how it works) and was blown over by how much it helped in treating my trauma/PTSD. And I'd had a ton of talk therapy & meds before to compare it with. Sounds to me like you're grappling with emotional trauma so it might be right up your alley.
posted by sively at 12:30 AM on December 4, 2014 [7 favorites]
The Neuroscience of Psychotherapy by Louis Cozolino is an attempt to answer precisely this question. It doesn't require preexisting expertise in either field and is pretty fascinating.
And on a side note, yeah EMDR. I went in sceptical as hell (my therapist was prettty upfront about there not yet being a clear scientific understanding of why and how it works) and was blown over by how much it helped in treating my trauma/PTSD. And I'd had a ton of talk therapy & meds before to compare it with. Sounds to me like you're grappling with emotional trauma so it might be right up your alley.
posted by sively at 12:30 AM on December 4, 2014 [7 favorites]
I'm with you; therapy won't bring back the person that's missing, so why do it? People kept telling me that I should go to a therapist to deal with the pain of my singlehood; I kept saying, how is that going to make me not single? If therapy isn't helpful and you have your own ways of coping with the grief that seem to be as effective as anything else, then don't go.
Metafilter is my therapy.
posted by Melismata at 1:24 AM on December 4, 2014
Metafilter is my therapy.
posted by Melismata at 1:24 AM on December 4, 2014
When you say that nothing is wrong about "any other aspect of my life or my personality," that strikes me as kind of worrisome. Can you really say that there is nothing that bothers you about yourself or your life, other than your grief? It makes me wonder if the reason therapy isn't helping you is maybe because you have some big walls built up. Your grief probably isn't just a hole in an otherwise flawless life. Maybe the loss has affected other aspects of your life, in ways you don't want to think about. Maybe you have issues about the person you lost, and you don't want to face them. There is that old cliche that therapy only works if the patient wants to change, and it sounds like you don't want to change much.
If you are not truly prepared to work with a therapist, if you go in there with a defensive attitude, it will almost certainly be a waste of your time. You may need to be more vulnerable than you want to be, to really open this up and work on it.
posted by Ursula Hitler at 3:08 AM on December 4, 2014 [12 favorites]
If you are not truly prepared to work with a therapist, if you go in there with a defensive attitude, it will almost certainly be a waste of your time. You may need to be more vulnerable than you want to be, to really open this up and work on it.
posted by Ursula Hitler at 3:08 AM on December 4, 2014 [12 favorites]
I understand that therapy can't bring back the person I miss, but since that's the only thing I want, I can't figure out what therapy is meant to do
It is not within your power to alter the fact that the person you miss so badly is no longer here.
What is within your power is to change the thoughts that habitually occupy your mind when that fact occurs to you. And changing what you think will change the way you end up feeling.
Therapy is supposed to help you learn to change the way you think in ways that result in you feeling less miserable.
It's hard work, because the very idea that you ought to change the way you feel about missing somebody important to you would initially strike most people as revoltingly disrespectful. It takes a lot of time, and a lot of talk, and a lot of listening, and a lot of practice, to unpick that.
If you go in with the attitude that therapy is supposed to do something to you, then you will most likely end up very disappointed with it. Because that's not what it's for. Therapy is scaffolding for the work you need to do on yourself, if lessening your present suffering is your aim.
And it might not be. You might actually prefer to spend the rest of your life miserable than to make the interior changes required to alter that. Which is fine: nobody else has the right to tell you what you ought to do with the inside of your own head.
But I think you'll find that most people who have used therapy to change the way their brains work do end up feeling better for it, and this suggests that feeling better is something that's probably available to you as well.
posted by flabdablet at 4:53 AM on December 4, 2014 [9 favorites]
It is not within your power to alter the fact that the person you miss so badly is no longer here.
What is within your power is to change the thoughts that habitually occupy your mind when that fact occurs to you. And changing what you think will change the way you end up feeling.
Therapy is supposed to help you learn to change the way you think in ways that result in you feeling less miserable.
It's hard work, because the very idea that you ought to change the way you feel about missing somebody important to you would initially strike most people as revoltingly disrespectful. It takes a lot of time, and a lot of talk, and a lot of listening, and a lot of practice, to unpick that.
If you go in with the attitude that therapy is supposed to do something to you, then you will most likely end up very disappointed with it. Because that's not what it's for. Therapy is scaffolding for the work you need to do on yourself, if lessening your present suffering is your aim.
And it might not be. You might actually prefer to spend the rest of your life miserable than to make the interior changes required to alter that. Which is fine: nobody else has the right to tell you what you ought to do with the inside of your own head.
But I think you'll find that most people who have used therapy to change the way their brains work do end up feeling better for it, and this suggests that feeling better is something that's probably available to you as well.
posted by flabdablet at 4:53 AM on December 4, 2014 [9 favorites]
Also: if you're not already thoroughly familiar with the work of Albert Ellis, have a crack at this book.
If my guess about your present interior state is right, it will make you fucking furious. Take that fury to your next therapy session and see what happens.
posted by flabdablet at 5:07 AM on December 4, 2014 [1 favorite]
If my guess about your present interior state is right, it will make you fucking furious. Take that fury to your next therapy session and see what happens.
posted by flabdablet at 5:07 AM on December 4, 2014 [1 favorite]
There's no special thing that's supposed to happen in therapy that changes your brain. A good therapist will help you grieve and help you move on so that you're not physically aching from your loss.
Grief is a mental and a physical pain. Time can help you get used to not having your person in your life, you will always feel sad at the loss, but after some time has passed you will accustom yourself to the loss, and you will go on.
What therapy is supposed to do is to help you see that while you can't ever get back what you lost, that there is still joy and love to be had in your life.
I will ask you this. Would the person that you lost WANT you to grieve forever? Would that person want you to live your life sad and unhappy?
Open yourself up to the possibility that you can feel happy, express joy, appreciate beauty and love and be loved, even though you've suffered a terrible loss. Once you do that I think you'll see how your therapist can help you process your feelings and help you see the possibilities of the rest of your life.
posted by Ruthless Bunny at 5:39 AM on December 4, 2014
Grief is a mental and a physical pain. Time can help you get used to not having your person in your life, you will always feel sad at the loss, but after some time has passed you will accustom yourself to the loss, and you will go on.
What therapy is supposed to do is to help you see that while you can't ever get back what you lost, that there is still joy and love to be had in your life.
I will ask you this. Would the person that you lost WANT you to grieve forever? Would that person want you to live your life sad and unhappy?
Open yourself up to the possibility that you can feel happy, express joy, appreciate beauty and love and be loved, even though you've suffered a terrible loss. Once you do that I think you'll see how your therapist can help you process your feelings and help you see the possibilities of the rest of your life.
posted by Ruthless Bunny at 5:39 AM on December 4, 2014
The other thing therapy is good for is you can dump stuff on your therapist that would quickly wear your friends and family out and make them start avoiding you.
posted by Jacqueline at 6:07 AM on December 4, 2014
posted by Jacqueline at 6:07 AM on December 4, 2014
I had a friend with your exact same problem. She lost someone and never got over it. It's sad when we lose people.
The reason this destroyed her was because there were other things wrong with her that she could not see. She had other issues.
I don't mean to discount your reality, but the insistence that there's absolutely nothing at all wrong with you except this one circumstance... that doesn't sit right. It doesn't sound honest. I'm sorry - I have no doubt that it feels correct. My friend firmly believes that the only issue is circumstantial too. But I can tell you that it became impossible to be her friend because (a) she treated me like a therapist and wanted to talk about the person she lost a lot and how painful the loss was, and (b) she had some serious issues that likely contributed to her losing that person (they certainly contributed to her losing me) that she refused to examine or acknowledge.
If the only issue is that you lost someone... well. People live with loss. If you cannot live with this loss, something is going on. Something was causing my friend to churn this loss around in her mind constantly. It's not circumstantial at that point. It's just not.
I suggested EMDR to her until my face was blue and I'd do the same for you. Ultimately, she liked her pain. She liked the loss. I mean, it was horrific and so painful for her, and I don't think she knew she liked it - but she kept it going. She got some kind of benefit from staying stuck in the loss.
A therapist can help you work through what that benefit is and why you are holding on to this belief that it's the loss that is causing issues. It's not. Sorry. I know you don't believe me, but it is not the loss that is making you feel this way. You are making yourself feel this way. A therapist can help you figure out why that's happening.
Best of luck.
posted by sockermom at 6:08 AM on December 4, 2014 [22 favorites]
The reason this destroyed her was because there were other things wrong with her that she could not see. She had other issues.
I don't mean to discount your reality, but the insistence that there's absolutely nothing at all wrong with you except this one circumstance... that doesn't sit right. It doesn't sound honest. I'm sorry - I have no doubt that it feels correct. My friend firmly believes that the only issue is circumstantial too. But I can tell you that it became impossible to be her friend because (a) she treated me like a therapist and wanted to talk about the person she lost a lot and how painful the loss was, and (b) she had some serious issues that likely contributed to her losing that person (they certainly contributed to her losing me) that she refused to examine or acknowledge.
If the only issue is that you lost someone... well. People live with loss. If you cannot live with this loss, something is going on. Something was causing my friend to churn this loss around in her mind constantly. It's not circumstantial at that point. It's just not.
I suggested EMDR to her until my face was blue and I'd do the same for you. Ultimately, she liked her pain. She liked the loss. I mean, it was horrific and so painful for her, and I don't think she knew she liked it - but she kept it going. She got some kind of benefit from staying stuck in the loss.
A therapist can help you work through what that benefit is and why you are holding on to this belief that it's the loss that is causing issues. It's not. Sorry. I know you don't believe me, but it is not the loss that is making you feel this way. You are making yourself feel this way. A therapist can help you figure out why that's happening.
Best of luck.
posted by sockermom at 6:08 AM on December 4, 2014 [22 favorites]
Your question reminds me of my friend who is sad because she was born into a conservative religious family and she is lesbian. At first, she tried a bunch of different therapists briefly, who each described their methods that basically amounted to providing her with supportive listening and helping her build her own coping skills. She quit each of them saying, "how is therapy supposed to help when it can't make me straight?"
OP, if you were her friend, would you tell her yeah, just give up on therapy. It can't make you straight, which is the one thing you need, so screw therapy. Nothing can ever make you straight, so to hell with the world. Or if you were her friend, would you tell her that being lesbian is not a problem that needs solving. It is a situation that needs accepting. Would you tell her you love her and want every good thing for her, and that you believe she can have a truly meaningful life as she is, if she chooses to make it as good as she can.
posted by Bentobox Humperdinck at 8:09 AM on December 4, 2014 [5 favorites]
OP, if you were her friend, would you tell her yeah, just give up on therapy. It can't make you straight, which is the one thing you need, so screw therapy. Nothing can ever make you straight, so to hell with the world. Or if you were her friend, would you tell her that being lesbian is not a problem that needs solving. It is a situation that needs accepting. Would you tell her you love her and want every good thing for her, and that you believe she can have a truly meaningful life as she is, if she chooses to make it as good as she can.
posted by Bentobox Humperdinck at 8:09 AM on December 4, 2014 [5 favorites]
What am I supposed to do?
You know what? I have had good, helpful therapists in the past, but I found therapy to be only minimally helpful when I was dealing with grief. Whatever it does on a neurological level, or a chemical one...maybe that just doesn't work for all people and all griefs.
In the end I just had to hurt and rail and cry and rend my garments and, yes, say to hell with the world. At one point I had to be placed on 24-hour suicide watch. And it didn't even get better in that gradual, one-step-at-a-time way. At that point I'd been out of therapy for probably at least 2 years, and definitely wasn't working any of the therapeutic tools or methods. I just got tired, and finally my brain stopped fighting the absence and just accepted it for what it is. It was almost an epiphany; walking down the street near my house I thought, for the eight billionth time, "he is gone; you will never be with him again in this life," and for the first time I heard it, believed it, and did not fight it. I just thought "yes, and isn't that such a shame?"
Sometimes I think of it, to use a simile, like the loss blew a hole through my heart, and those years of raging were just the cells knitting themselves back together. When they were done, they were done. I still feel sadness, and probably will until I die, but that no longer feels like an unbearable burden that I must fix or destroy.
The only reason I regret leaving therapy is the reason Jacqueline mentioned: having someone to absorb my nihilistic, self-destructive raging. Instead, during that time I lost most of my friends, (though a couple of them have since come back in an arms-length kind of way) and even some of my very closest family. I ruined some relationships forever. But, some of them needed ruining anyway.
So maybe stick with the therapy and let the therapist absorb your rage and grief and the unfairness of our stupid, cruel, unfair world that we didn't ask to be in. When you're done, you'll know it.
Best to you, OP.
posted by We put our faith in Blast Hardcheese at 8:32 AM on December 4, 2014 [4 favorites]
You know what? I have had good, helpful therapists in the past, but I found therapy to be only minimally helpful when I was dealing with grief. Whatever it does on a neurological level, or a chemical one...maybe that just doesn't work for all people and all griefs.
In the end I just had to hurt and rail and cry and rend my garments and, yes, say to hell with the world. At one point I had to be placed on 24-hour suicide watch. And it didn't even get better in that gradual, one-step-at-a-time way. At that point I'd been out of therapy for probably at least 2 years, and definitely wasn't working any of the therapeutic tools or methods. I just got tired, and finally my brain stopped fighting the absence and just accepted it for what it is. It was almost an epiphany; walking down the street near my house I thought, for the eight billionth time, "he is gone; you will never be with him again in this life," and for the first time I heard it, believed it, and did not fight it. I just thought "yes, and isn't that such a shame?"
Sometimes I think of it, to use a simile, like the loss blew a hole through my heart, and those years of raging were just the cells knitting themselves back together. When they were done, they were done. I still feel sadness, and probably will until I die, but that no longer feels like an unbearable burden that I must fix or destroy.
The only reason I regret leaving therapy is the reason Jacqueline mentioned: having someone to absorb my nihilistic, self-destructive raging. Instead, during that time I lost most of my friends, (though a couple of them have since come back in an arms-length kind of way) and even some of my very closest family. I ruined some relationships forever. But, some of them needed ruining anyway.
So maybe stick with the therapy and let the therapist absorb your rage and grief and the unfairness of our stupid, cruel, unfair world that we didn't ask to be in. When you're done, you'll know it.
Best to you, OP.
posted by We put our faith in Blast Hardcheese at 8:32 AM on December 4, 2014 [4 favorites]
Hi there,
I'm sorry that you are hurting. I too am finding therapy to be of little help with grief.
In case you don't know about it, some psychologists now distinguish grief from what they call "complicated grief". Unlike other forms of grief, complicated grief is not responsive to anti-depressants or traditional talk therapy. But there is treatment available. Perhaps this is something to explore.
posted by girl flaneur at 8:46 AM on December 4, 2014 [3 favorites]
I'm sorry that you are hurting. I too am finding therapy to be of little help with grief.
In case you don't know about it, some psychologists now distinguish grief from what they call "complicated grief". Unlike other forms of grief, complicated grief is not responsive to anti-depressants or traditional talk therapy. But there is treatment available. Perhaps this is something to explore.
posted by girl flaneur at 8:46 AM on December 4, 2014 [3 favorites]
In case you don't know about it, some psychologists now distinguish grief from what they call "complicated grief".
This was a breakthrough concept for my father, who unwillingly went to therapy after my mother's death because he was barely functional and getting worse.
This framework allowed him to understand that he wasn't simply grieving for my mother. I was grieving for my mother, and I was sad and it made my life more difficult, but I wasn't destroyed. I didn't feel like a shell of my former self (different with children than with spouses, I know, but still).
What my father finally realized was that in addition to grieving my mother, he was grieving for himself, because he had based his own identity on her for so long that he no longer felt like he had a self to be once she was gone. His family had taught him he was unlovable, and my mother loved him, but when she died, his instincts told him that his status as a creature worthy of love had disappeared. Her illness gave him a series of tasks to do every day, and so he was grieving the sense of purpose. He was grieving his identity as a married man. He was grieving for his future with her. He was grieving for all of his relationships that had been made with other people by both him and my mother, because deep down he felt that none of those people would still love him or care about him or want to see him once my mother was gone.
Once he began to study his grief as complicated grief, he was able to actually make progress. He realized that he was not just grieving for the real life person who was my mother, but for all the things she represented, all the ways he had unconsciously built her up into something no human can actually be (i.e., another person's entire motivation for living).
If you feel life is pointless without one specific person, then you are grieving for a lot more than that one person. Therapy can help you figure out what you are grieving, and how many of those things are lies (I'll always be alone now, that was the only person who could ever know me, the only good thing that ever happened in my life was when we met, etc), and therapy can help you untangle and undo the effects of those lies on your mind and your emotions.
posted by a fiendish thingy at 9:25 AM on December 4, 2014 [13 favorites]
This was a breakthrough concept for my father, who unwillingly went to therapy after my mother's death because he was barely functional and getting worse.
This framework allowed him to understand that he wasn't simply grieving for my mother. I was grieving for my mother, and I was sad and it made my life more difficult, but I wasn't destroyed. I didn't feel like a shell of my former self (different with children than with spouses, I know, but still).
What my father finally realized was that in addition to grieving my mother, he was grieving for himself, because he had based his own identity on her for so long that he no longer felt like he had a self to be once she was gone. His family had taught him he was unlovable, and my mother loved him, but when she died, his instincts told him that his status as a creature worthy of love had disappeared. Her illness gave him a series of tasks to do every day, and so he was grieving the sense of purpose. He was grieving his identity as a married man. He was grieving for his future with her. He was grieving for all of his relationships that had been made with other people by both him and my mother, because deep down he felt that none of those people would still love him or care about him or want to see him once my mother was gone.
Once he began to study his grief as complicated grief, he was able to actually make progress. He realized that he was not just grieving for the real life person who was my mother, but for all the things she represented, all the ways he had unconsciously built her up into something no human can actually be (i.e., another person's entire motivation for living).
If you feel life is pointless without one specific person, then you are grieving for a lot more than that one person. Therapy can help you figure out what you are grieving, and how many of those things are lies (I'll always be alone now, that was the only person who could ever know me, the only good thing that ever happened in my life was when we met, etc), and therapy can help you untangle and undo the effects of those lies on your mind and your emotions.
posted by a fiendish thingy at 9:25 AM on December 4, 2014 [13 favorites]
Also, I just want to stress that there are deep differences between how people respond to loss. Some of the comments above seem a little...parochial, for lack of a better word. While some people are resilient in the face of loss, and bounce back relatively quickly, about 15% of people don't. And while some of these unresilient people have other, undiagnosed and unrecognized mental health problems, others do not. Their pain is circumstantial. That is precisely why psychiatrists like Katherine Shear think that complicated grief exists and has its own treatment modality.
posted by girl flaneur at 9:31 AM on December 4, 2014 [2 favorites]
posted by girl flaneur at 9:31 AM on December 4, 2014 [2 favorites]
I'm really after what is supposed to happen neurologically or chemically that is supposed to make therapy helpful. I don't want or need to know what "goes on" in therapy; I'm wanting to know WHY what goes on is supposed to be helpful.
So here's my story, of how grief therapy was helpful for me. I don't understand the neurology and chemistry behind it, but I can explain how it affected me on a cognitive level.
When my mom passed away, the first therapist I saw did her best to help with the grief, but it was a mixed bag. First Therapist used talk therapy, with a touch of CBT. What kept it from being effective was that I was very resistant to changing my outlook -- the framing that I used to think about my mom, our relationship, and the loss. First Therapist would bring up a new perspective for me to consider, and I'd shoot her down. And so there was little change in my everyday life outside of my sessions, because I wasn't allowing my perspective to change within the sessions.
When I told First Therapist that our sessions weren't working for me, she was very professional about it and gave me a referral to a few other therapists. First Therapist also offered to brief Second Therapist about me, so I wouldn't have to start from scratch with Second Therapist. (These are both standard practices for therapists.)
Second Therapist used more visualizations and meditative techniques. So instead of talking with me directly about my sadness, she'd do a guided meditation with me. Like, she'd often have me visualize my heart as if it were a person standing next to me, and ask questions like: what does your heart look like, what is it doing, what does it want. It was pretty woo, and it pushed me outside my comfort zone. But it also did an end run around the inflexible parts of my brain.
It's like the rational/linguistic part of my brain was a gatekeeper for the emotional part. First Therapist was trying to affect change by working with the rational part of my brain, in hopes that it would affect the emotional part. Second Therapist snuck by the gatekeeper to deal with my emotions directly.
So why was this helpful? Not only was it a safe space to express my emotions, but it helped me express my emotions in new ways. The visualizations got me to understand the other perspectives that I was so resistant to explore with First Therapist. So in session, I might have a brief flash of insight; and when those feelings would come up again in everyday life, I was more open to understanding them in new ways. Eventually, the rational part of my brain changed its perspective. The visualizations also made me feel safer talking about my feelings to my boyfriend, and my other friends.
posted by Banknote of the year at 9:39 AM on December 4, 2014 [3 favorites]
So here's my story, of how grief therapy was helpful for me. I don't understand the neurology and chemistry behind it, but I can explain how it affected me on a cognitive level.
When my mom passed away, the first therapist I saw did her best to help with the grief, but it was a mixed bag. First Therapist used talk therapy, with a touch of CBT. What kept it from being effective was that I was very resistant to changing my outlook -- the framing that I used to think about my mom, our relationship, and the loss. First Therapist would bring up a new perspective for me to consider, and I'd shoot her down. And so there was little change in my everyday life outside of my sessions, because I wasn't allowing my perspective to change within the sessions.
When I told First Therapist that our sessions weren't working for me, she was very professional about it and gave me a referral to a few other therapists. First Therapist also offered to brief Second Therapist about me, so I wouldn't have to start from scratch with Second Therapist. (These are both standard practices for therapists.)
Second Therapist used more visualizations and meditative techniques. So instead of talking with me directly about my sadness, she'd do a guided meditation with me. Like, she'd often have me visualize my heart as if it were a person standing next to me, and ask questions like: what does your heart look like, what is it doing, what does it want. It was pretty woo, and it pushed me outside my comfort zone. But it also did an end run around the inflexible parts of my brain.
It's like the rational/linguistic part of my brain was a gatekeeper for the emotional part. First Therapist was trying to affect change by working with the rational part of my brain, in hopes that it would affect the emotional part. Second Therapist snuck by the gatekeeper to deal with my emotions directly.
So why was this helpful? Not only was it a safe space to express my emotions, but it helped me express my emotions in new ways. The visualizations got me to understand the other perspectives that I was so resistant to explore with First Therapist. So in session, I might have a brief flash of insight; and when those feelings would come up again in everyday life, I was more open to understanding them in new ways. Eventually, the rational part of my brain changed its perspective. The visualizations also made me feel safer talking about my feelings to my boyfriend, and my other friends.
posted by Banknote of the year at 9:39 AM on December 4, 2014 [3 favorites]
I don't think it's possible to know why, or really what happens during therapy with our current knowledge - I tend to think of it as other branches of medicine:
- we don't know how people catch a cold (we have hypothesis in general, but why one particular person catches it is hard to diagnose)
- we have practices to solve the issue (stay home, take drugs, blow your nose, etc) and have a general idea of how things will turn out if not managed
- we don't really know why or how the drugs work (our knowledge has holes at best - the chemical part may be understood, but again, why a particular brand of drug will work on one individual hard to figure out)
I find it helps to look at therapy (and medicine really) as a tool/a technology and not as a science - we know it's generally the right tool to fix the thing, the why and the what are beyond our understanding
ianad, ianyd, and I'm not even sure that's what you're asking about, but I found in my experience that focusing on how therapy works, etc was not that helpful to actually cope, but of course ymmv
All the best
posted by motdiem2 at 9:45 AM on December 4, 2014
- we don't know how people catch a cold (we have hypothesis in general, but why one particular person catches it is hard to diagnose)
- we have practices to solve the issue (stay home, take drugs, blow your nose, etc) and have a general idea of how things will turn out if not managed
- we don't really know why or how the drugs work (our knowledge has holes at best - the chemical part may be understood, but again, why a particular brand of drug will work on one individual hard to figure out)
I find it helps to look at therapy (and medicine really) as a tool/a technology and not as a science - we know it's generally the right tool to fix the thing, the why and the what are beyond our understanding
ianad, ianyd, and I'm not even sure that's what you're asking about, but I found in my experience that focusing on how therapy works, etc was not that helpful to actually cope, but of course ymmv
All the best
posted by motdiem2 at 9:45 AM on December 4, 2014
Unlike other forms of grief, complicated grief is not responsive to anti-depressants or traditional talk therapy. But there is treatment available. Perhaps this is something to explore.
Just a clarification on that: Complicated grief can be responsive to talk therapy, and in fact the protocol for treating it involves talk therapy/psychotherapy. That wikipedia article is rather incomplete on the treatment part of it.
And regular grief is generally not treated with antidepressants. A pre-existing or developing depressive disorder could be treated with antidepressants (and many people get diagnosed with Major Depressive Disorder while in treatment for grief or loss), but the transient sadness and depression associated with bereavement is generally considered normal and not treated with medication. If those symptoms last longer than usual, then a separate diagnosis of depression, and appropriate treatment for that depression, might be considered.
posted by jaguar at 9:49 AM on December 4, 2014 [1 favorite]
Just a clarification on that: Complicated grief can be responsive to talk therapy, and in fact the protocol for treating it involves talk therapy/psychotherapy. That wikipedia article is rather incomplete on the treatment part of it.
And regular grief is generally not treated with antidepressants. A pre-existing or developing depressive disorder could be treated with antidepressants (and many people get diagnosed with Major Depressive Disorder while in treatment for grief or loss), but the transient sadness and depression associated with bereavement is generally considered normal and not treated with medication. If those symptoms last longer than usual, then a separate diagnosis of depression, and appropriate treatment for that depression, might be considered.
posted by jaguar at 9:49 AM on December 4, 2014 [1 favorite]
Just a clarification on that: Complicated grief can be responsive to talk therapy, and in fact the protocol for treating it involves talk therapy/psychotherapy. That wikipedia article is rather incomplete on the treatment part of it.
Yes, this is why I contrasted the treatment of complicated grief with "traditional" talk therapy; the treatment protocol for complicated grief is really different than most forms of talk therapy.
Here is another resource for learning more about complicated grief and its treatment:
The Center for Complicated Grief
posted by girl flaneur at 9:56 AM on December 4, 2014
Yes, this is why I contrasted the treatment of complicated grief with "traditional" talk therapy; the treatment protocol for complicated grief is really different than most forms of talk therapy.
Here is another resource for learning more about complicated grief and its treatment:
The Center for Complicated Grief
posted by girl flaneur at 9:56 AM on December 4, 2014
I understand that therapy can't bring back the person I miss, but since that's the only thing I want, I can't figure out what therapy is meant to do
In all the years of dealing with losses of this magnitude, I have never faced therapy with this attitude. Perhaps it's because I realistically accepted the losses, and I used the therapy at hand as a means of coping, of changing the pattern of my life to fit the new existence I was faced with. That doesn't mean I didn't rage at the world, at the therapist, and raise my fist to the sky on occasion. But in my soul I know what can be changed and what cannot be changed. And that you go on, and hopefully find peace and perhaps joy.
Forgive this internet stranger, but I think perhaps you need to ... let go. And allow yourself to live.
All the therapy in the world cannot do as much as you giving yourself that gift.
posted by alwayson_slightlyoff at 9:59 AM on December 4, 2014 [1 favorite]
In all the years of dealing with losses of this magnitude, I have never faced therapy with this attitude. Perhaps it's because I realistically accepted the losses, and I used the therapy at hand as a means of coping, of changing the pattern of my life to fit the new existence I was faced with. That doesn't mean I didn't rage at the world, at the therapist, and raise my fist to the sky on occasion. But in my soul I know what can be changed and what cannot be changed. And that you go on, and hopefully find peace and perhaps joy.
Forgive this internet stranger, but I think perhaps you need to ... let go. And allow yourself to live.
All the therapy in the world cannot do as much as you giving yourself that gift.
posted by alwayson_slightlyoff at 9:59 AM on December 4, 2014 [1 favorite]
If therapy isn't working for you, try a course of regular therapeutic massage, and/or acupuncture.
I'm very serious. These two things will help you.
You can and should also try meditation with headphones and binaural beats.
All of these modalities will create new neural pathways and help change your brain.
posted by jbenben at 11:40 AM on December 4, 2014 [1 favorite]
I'm very serious. These two things will help you.
You can and should also try meditation with headphones and binaural beats.
All of these modalities will create new neural pathways and help change your brain.
posted by jbenben at 11:40 AM on December 4, 2014 [1 favorite]
This thread is closed to new comments.
posted by cecic at 9:25 PM on December 3, 2014 [24 favorites]