Preparing for Therapy and Emotional Honesty

July 5, 2017 4:15 PM

I am seeking a therapist, for the first time since high school, and I want to do well at it. How can I prepare myself to maximize the return I get from each session? How do I make sure that this expensive listening session is something I actually listen to and act on? More details are below.

I am recently married, and I have a long history with anxiety and mild to moderate depression. It hasn't been much of an issue for a few years, but anxiety is coming back for me recently. I expect that this is an expected reaction to life changes, but I want to face it head on while I can. In the past, anxiety and depression have cost me jobs and relationships, and I have my first good job and my marriage to defend. I want to kick it in the teeth before it tears down anything I've built.

My anxiety is not entirely baseless, unfortunately. I have problems with money, specifically spending, usually dining out. I don't do a good job tracking my budget, and I run low, and I panic. I find it really hard to be truthful about this behavior with my partner. Her income is much higher than mine, and I often spend on dinner and outings as though it wasn't. Financial responsibility is very important to her, and I have a substantial fear that my failure to fix my behavior will cause her to isolate or leave me. Intellectually, I know I need to be honest and seek help. I have in the past year borrowed against savings, and even taken out a payday loan, to fulfill financial promises. I wouldn't have to do that if I spent better. But the idea of confessing this fills me with terror.

Today, I was confronted again with borrowing savings money against my paycheck Friday. This has to stop. I am trying to work up the courage to confess to her tonight, but I am struggling to do so. I am very shame driven, and I cannot face her disappointment. I am, in no small part, hoping she sees this post.

I reached out to four counselors in my insurance plan today to try and confront these issues. I know I can't ignore them anymore. I haven't seen a therapist since high school, and there are many times I should have. But how do I do well in therapy? 45 minutes every other week, or once a month, doesn't sound like enough to fix me, but it'll have to do. Are there things I can do to make sure my time is effective? I don't want to waste time struggling against improvement, or searching for words to describe how I'm feeling or what I need. How have you had good sessions?

If you are still with me, thank you. I know this is a ramble, but it is hard to sum this up for myself. My only other question, and it's clearly a huge one, is: How do I set aside my fear and open up to my wife about this critical issue? I love her so much and I want to be a better, stronger person than I am being here. I cannot allow this to destroy my life again! How do I prioritize my marriage, my work,
and my life over this animal fear and shame?

Thank you so much, MetaFilter.

posted by skookumsaurus rex to Human Relations (13 answers total)

This post is a great starting point. You have articulated your feelings well. You could print this out and take it to your therapist.

For preparation, you could explore Brene Brown's work on shame.
posted by Thella at 4:34 PM on July 5, 2017 [4 favorites]

It is so fantastic that you are taking this first step - way to go!! This is not easy.

I am very shame driven, and I cannot face [her] disappointment.

It will be important to acknowledge that you might feel compelled to say the "right" thing to your counsellor in an effort to gain their favour and/or get their stamp of approval. You can even be candid and tell them so! My counsellor always encourages me to use my words :) and say things like "This is really hard for me to admit." Nobody said it was easy, and you don't have to pretend that it is.

I would encourage you to resist the urge to say what you think they want to hear. This is your time to open up and be honest. You'll do yourself a great disservice if you approach this with the same approval-seeking, shame driven behaviour you've relied on in the past. That behaviour is driven by anxiety and depression, by the way. It's not your true nature.

I would encourage you to explore the second part of your question "How do I set aside my fear and open up to my wife about this critical issue?" with your therapist once you feel comfortable and safe opening up to them.

You can do it!!
posted by Juniper Toast at 4:36 PM on July 5, 2017 [3 favorites]

Sweetheart, I have been your wife and this is what I needed to hear:

1. The truth
2. Acknowledgement of the impact on me
3. Concrete steps towards both accountability and a path to truly changing.

You are doing this, or about to be! Please be open with her asap.

45 minutes of therapy every other week should actually work out okay, because you will be thinking about therapy on other days. I am not sure I would worry too much about being "good" in therapy to make the most of every minute. Just take your concerns, including good use of time, to your therapist. They are there to help you with it, that anxiety, the shame, the changing behaviours. It's all okay.
posted by warriorqueen at 4:36 PM on July 5, 2017 [9 favorites]

Have you ever heard the saying "bring me solutions, not problems"? That saying was meant for this situation.

Do not go to her with "I did the thing again and I am the lowest worst person in the world here beating myself up before you get a chance" (this so often comes with a side order of "now you have to make me feel better because I'm so so sad", don't do that either).

Go to her and say
1. I did the thing again
2. I'm very upset and anxious about doing the thing again and very afraid you won't like me anymore
3. I don't want things to be like this or to feel like this
4. I'm going to go to therapy to tackle the issues behind the thing, and also the issues behind the anxiety
5. I'm going to see a physician, get a proper physical to make sure I don't have health issues that need addressing, and will discuss the anxiety that is triggering the behavior and subsequent spiraling to see if medication would be a help to me right now as I get a handle on things
6. I'm going to make it harder to do the thing again in the future by implementing X and Y controls on my access to money, but I probably still need to figure out what I'd do in an emergency et cetera
7. And because I am so panicked it would probably help me if you had any input on how we, as a team, should handle this so it doesn't create additional problems for you or us (like having to leave work to bring me money when I run out of the cash-only allowance I'm going to give myself), but I am not putting this on you to either solve or fix for me.

I've been in your shoes. I know the horrible searing pain that you are feeling right now, and how strong the urge is to ease the pain rather than fix the problem, so your focus is on winning therapy (all anxious people want to win at therapy, it's how we do) rather than the 50 steps ahead of that point.

Part of the mechanism of anxiety is a wildly overblown panic response to the slightest discomfort. You didn't kill anybody, you just mismanaged your money (and money, for a lot of people of all kinds of backgrounds, is the godzilla of anxiety triggers). Embrace that owning up to that is going to hurt, but you will not die of discomfort, and that learning to be in the presence of your own discomfort is a good skill to obtain. It's as good a skill as decent money management is.

You will be okay. Your therapist will give you homework. It will be hard and you will fail sometimes by design. Struggling with your therapy is part of the therapeutic process, it is necessary. Really the most important two things you can do in therapy are 1) don't tell lies to your therapist 2) when you commit lies of omission, which you will because it's part of the process*, circle back and say so when you realize you've done it.

*A lot of what therapy is is digging up the narratives you've created for yourself and examining them under a bright light so you can make repairs where necessary. You will be astonished at the things you have built giant elaborate Rube Goldbergian blind spots about. You will be shocked at the lies you have been telling yourself, and how many of them are multi-generational, handed down from someone else.

And one day, you will realize that you are making a good choice about a thing because it is so much easier to make the good choice than make the bad one and deal with the hassle of being miserable. There's your win. It'll come.
posted by Lyn Never at 5:05 PM on July 5, 2017 [35 favorites]

I managed my money very badly in the past and eventually started trying to make things better. I'm still not a personal finance genius but I'm a lot better than I was.

I also had trouble talking to my therapist about the situation. I finally wrote a list of all of the ways my struggles with my money were impacting my life - calls and letters from collection agencies, fear of answering the phone because it might be collections, overdraft fees, etc, overspending on clothes while behind on rent - and presented the list to my therapist at the beginning of my session.

Most of therapy happens between sessions. You'll talk through things and then have time to think about, do homework, and take action. It can be very motivating to try to reach a milestone between sessions so you can report back to your therapist and move on to the next thing.

I find it helpful to take notes and set reminders for things my therapist suggests that I try. In the moment it all seems quite clear, but then I go back to work and I forget about it until the next session - unless I set a reminder. Journaling about the sessions is helpful, as is journaling about whatever comes up for me thinking about the sessions and any new realizations or questions about the issues I'm dealing with.

Otherwise - be honest, try the things your therapist suggests, tell them when something doesn't make sense to you or doesn't ring true for your situation, and leave if it's not a good fit. It sounds like you are seriously committed to making a change, and that's such a well-known indicator of therapeutic success that it's a lightbulb joke.
posted by bunderful at 5:38 PM on July 5, 2017 [4 favorites]

You put together your issues and feels well here!
When you talk to your wife, it is better to have plans here. If you think you have problem handling your budget, have a plan. List all your possible spending for the week or month. Find areas to cut budget. Stick to it (just use cash instead of using credit card to stick with the budget).
I am sure you will do well as you think really seriously about your marriage. Good lucky!
posted by mysunshine at 5:44 PM on July 5, 2017 [1 favorite]

I find it helpful to write about the session the same day it happens. Often it's just a bulleted list of topics with some more explanation sandwiched in between.

I also find it helpful to make a list of things I want to talk about, and I bring my journal with me, in case I forget. I find often the things that I really, really don't want to discuss are the one that I need to discuss. Sometimes for those topics, I'll write about them first, then just read what I wrote to my therapist. I think a lot of people do this because I've never had a therapist question it.
posted by tuesdayschild at 5:50 PM on July 5, 2017 [1 favorite]

P.S. I've heard good things about YNAB (You Need A Budget) for budgeting and tracking spending.
posted by bunderful at 5:58 PM on July 5, 2017 [2 favorites]

Here's one thing I really wish I could have done long ago before starting therapy: Look up my personality type and try out methods that are typically effective for that type. It turned out that my type was very rational and intuitive, and I was letting emotion and sensory stimulation overcome me with "their" solutions to problems (get sad, reflect on sadness, buy stuff) before I could step back and be rational about things.

Also some types benefit from counseling mainly because they need to kind of externalize the problem--get it out of their heads where it has been vaguely defined and thus turned into a sort of shape-shifting demon. In this case you could get huge benefits from keeping a journal between visits, because you'd end up defining the problem better and could perhaps use your time with your therapist to get help with specific approaches toward a solution.

Other types desperately need to process the deeper emotions, identify them, and then once that's done, they know how to do the rest. Still other types just need to learn how to make a checklist instead of listening to their less-rational pouty side. It really depends. But I found that personality type theory was a gift that kept on giving, for me. The more I researched it, the less I needed therapy.

I also kept a life-improvement journal in which I asked myself every day if I was getting better at life, and if not, why not. There are only so many times you can write "this sucks I hate it" before you find yourself improving your situation.
posted by circular at 6:16 PM on July 5, 2017 [4 favorites]

Response by poster: Thank you, everyone. I spent a long time today making sure that I was going to talk to my wife tonight, and I did. I printed out my question for her to read, and explained my plans for therapy, a visit to my doctor, and financial transparency. We're just fine. She is open to me improving, and forgiving of my mistakes. Our marriage is strong, and I feel much better.

I am going to keep the thread open for another week in case anyone else has something to share. Thank you to everyone who did; you helped me compose myself towards fixing the problem. I am happy to be moving forward, rather than just burying things and moving on.
posted by skookumsaurus rex at 9:53 PM on July 5, 2017 [13 favorites]

Good for you! Keep practicing that kind of courageous risk-taking with your therapist, and you'll do great.

While you're waiting for your first appointment, let me second the recommendation to read Brené Brown on shame and vulnerability, specifically Daring Greatly, or The Power of Vulnerability if you like audiobooks. I tend to think a lot of self help books are crap, but her stuff is the real deal.
posted by ottereroticist at 11:03 PM on July 5, 2017 [1 favorite]

Awesome job! Speaking as someone who's gone to therapy with a brilliant therapist for 3 years, what I've received feedback on from my therapist is that I tackle myself head-on with the techniques that I learned in our sessions and apply and work it into daily practice. It's gone to the point where now I basically introduce the same methods to my friends now to help them guide their understanding, if it aligns with how I do things. Don't be afraid to disclose your discomfort or hesitation during the therapy process either if there is anything you are unsure about, you are the client so you need to be able to communicate what your needs are as well.

Be curious about therapy, yourself, and your inner ways and mechanizations. I've found it to be an incredibly relieving, although exhausting, way of being and I treat myself very much like a story or a game that has a lot to uncover and unlock. Try to have fun even during the really intense parts, because you know you are doing something good for yourself, your wife, and your life :)
posted by yueliang at 11:19 PM on July 5, 2017

Glad it went well!

You might think about some of the more anxiety-inducing things you need to do and talk to your therapist about doing them in their office. If you need to make a phone call, open a bill, whatever -it can be helpful to do that in a supportive context.

Learnvest offers financial planning to people who are outside the traditional financial planning market. You can pay a one-time fee for someone to look at your numbers and your goals and help you come up with a plan.
posted by bunderful at 5:08 AM on July 6, 2017