Ask MetaFilter questions tagged with anxiety and therapy

Too good to leave, too bad to stay - therapist edition

guessthis — Thu, 16 May 2013 02:41:59 -0800

Should I find a new therapist when I'm only in town for 6 more months? I have been in therapy for about 2.5 years, twice a week for most of that time but in the last couple of months, only once a week. I originally sought treatment for anxiety related to my parents, who disapprove of my partner because he is of a different ethnicity. My therapist describes what she does as psychoanalysis. She never speaks before I do at the start of a session. She gently asks me questions about my feelings and experiences. She suggests ways of looking at things, but she never tells me what she thinks is the solution. If I ask her direct questions, like "What do you think I should do?" or "Was this out of line?" she won't give me her opinion, she will try to help me understand how I feel about the situation by asking more questions.

I do feel I have gotten a lot out of therapy. I do understand myself better, and I can see very clearly how my childhood has shaped who I am. I have better boundaries with my parents, though our relationship is still more distant and strained than I would like, and I still find it very tough to enforce my boundaries or create new ones.

The trouble is, though I understand myself much better, I don't feel I have the tools or skills or whatever I need to actually enforce changes in my life. I feel like I need more direct, straightforward advice or some kind of action plan to follow, and therapy is not giving me that. I still feel anxious most of the time, my gut is usually cramped up with it. I'm not sure of the next step with my parents, my relationship of almost 7 years is going really badly - we're about to break up, partly because my boyfriend thinks I'm not direct enough with my feelings. I'm such a mess.

In addition, though I don't wish to self-diagnose, I think I may have Obsessive Compulsive Disorder, and this has never really been addressed by my therapist. For as long as I can remember, I have suffered anxiety over silly things like whether or not my teddies are touching the edges of the bed (as a child) or how the door mat lies in our hallway (as an adult). I also check things a lot - the lights, the oven, the sink - multiple times every time I leave a room. This got better for a bit, but right now it's worse than it has ever been and I'm worried people in the office are going to notice. My therapist knows all of this, but she has never said much about it other than to tell me it's a manifestation of my anxiety.

Typically, a full course of analysis takes four years to complete, says my therapist. I only plan to remain in this country (not my home country) for another 6 months, so I will not reach the end of the course. Is there any point to switching therapists now? It might take me several weeks to find a new therapist anyway - there are not that many native-English speakers here, and they are often fully booked. But on the other hand, after I move it will be a while before I can afford therapy again. Should I try a different approach to therapy while I still have the chance? Will I still get something out of it even if it's just a few months? Or am I unjustly dissatisfied with my current treatment - do I just need patience?

Bonus question: is there anything self-directed I can do to supplement my therapy which might bring about the changes I'm looking for?

Datapoint: I have never been in therapy before. At university (UK) I was prescribed antidepressants (Prozac) following an incident of self-harm after a bad break-up. I filled out a form, had a 15 minute chat with the doctor and left the office with a prescription - I can't really remember if the Prozac did much except make me nauseous, and I am angry at the experience of being fobbed off with drugs without being given other options. So I am hesitant and a bit mistrustful of the antidepressant option, but at this point so miserable that I would be open to it.

Thanks so much in advance for any thoughts you may have.

How do I gain the courage to see a therapist?

Anonymous — Mon, 22 Apr 2013 20:13:19 -0800

I have pretty severe social anxiety. How do I gain the courage to see a therapist? I am mostly afraid of my parent's reaction. I wrote this post a dozen different times, unsure about which problem to focus on. But the truth is that all of my problems boil down to social anxiety.

I just turned 22 and I live with my parents. I was always very shy, but it got really bad in high school. I am fine small talking with people my age for the most part, but I will still avoid it at all costs. I have been in college for 4 years and I have absolutely zero friends. I hate to be seen out in public (I don't like the way I look) and dread the warm weather because I can no longer hide under a big coat. I will take the longest paths possible to get around campus so I won't be seen. I come right home after my classes instead of staying in the library (where I am thousands of times more productive than at home).

I have never spoken to a professor in FOUR YEARS of college, with over a hundred credits earned. That's about 30 different professors I've had and I've never spoken a word to any of them. I have no internships and no job experience except one job when I was 16. I've been putting all of this off for years, but now that I only have one year of college left I really need to take action.

I want to be normal and have friends. I want to be in a relationship. I want to get a job. There is no reason why I should live like this. A new club that is extremely relevant to my interests just formed on campus, but I'm too afraid to go to a meeting. I also desperately need to officially my major but I am terrified of speaking to the department head that needs to review my transcript and sign the form. I REALLY!!! need to do this, within the next 2 weeks, but I really don't think I can.

I was previously in therapy as a young teenager and diagnosed with major depressive disorder. I could not get out of bed, constantly felt like I was going to die and had panic attacks for months. I was put on medication and stayed in therapy for a few months until I was functional. My parents are fairly toxic and they have very skewed ways of thinking. I've been told several times that it was completely unnecessary, that I insisted on seeing a therapist for no reason, that all teenagers are depressed.

I still live with them and I'm on their insurance. There is no way to hide this from them. I just really don't want to deal with the eye rolls, my mother telling everyone in the extended family, "this is unnecessary" and "why would you need to go to therapy?". They can be mean, but I still value their opinion (seeing as they are pretty much the only people I interact with). My college offers 3 free therapy sessions and then has a list of low-cost therapists in the area, but I'd rather just go to one on my insurance plan instead of switching around after 3 sessions.

How can I go about telling them I need to go to therapy? How do I deal with the aftermath?

And of course I am afraid of actually going to therapy, but not that much. I feel like it will take a few hours just to outline my problems and history. Any tips on how to deal with that?

I would appreciate any advice on any aspect of my situation at all. Thanks for reading all that. You can contact me here: anonymous4222013@gmail.com.

Help fix my crazy

woolly — Wed, 10 Apr 2013 07:38:26 -0800

What techniques can I employ to help deal with crippling anxiety and bug-phobic behaviors until I can afford regular therapy appointments? Ugly details inside - apologies for the length. I recently started seeing a psychiatrist who diagnosed me with Major Depression and Generalized Anxiety Disorder, along with symptoms of PTSD and OCD (though not necessarily a full-on diagnosis of the latter two disorders).

As a psychiatrist, his only role in helping me cope has been to prescribe a cocktail of meds, and about three weeks in I don’t feel much different than I ever did. The doctor prescribed me a daily dose of 10mg Lexapro in the evening, 150mg Wellbutrin in the morning, and emergency Ativan for panic attacks.

Even though I am one of the few people lucky enough to have great insurance, I have a fairly low-paying job and can’t afford a ton of regular co-pays every month. For that reason, it may be a few months until I can begin regularly seeing a psychologist (when I can afford it, I would like to focus on Cognitive Behavioral Therapy as treatment).

One of the biggest ways the anxiety affects my current day-to-day life is my phobic behavior surrounding insects. I had a really terrible experience this past summer with an awful apartment that had a centipede infestation, and that combined with all the other issues the apartment had, it turned into an anxiety shitstorm the likes of which I had never experienced before. I had many, many panic attacks, my depression flared up, and after a few months of this I attempted suicide before heading to a walk-in clinic and then an ER.

After moving and getting things together, I still am struggling to deal with the anxiety-laden behaviors I engage in to quell my fears about bugs. My current place has a large window basically at ground level and so I get little critters wandering in that way – especially with the recent onset of spring. I see the odd silverfish, spiders, and this morning some kind of worm I found belly up on the kitchen floor.

I know logically this is simply no big deal, but my logic doesn’t have much say over my anxious brain. I get really upset every time I find a bug, because it sends me into a self-hate spiral and I start the inner monologue of being a failure because I live in an apartment that “has bugs”. It can really depress me for days and I get stuck in cyclic behaviors – checking the walls all night, being unable to sleep, waking up in the middle of the night, generally being paranoid about cracks around the window, the a/c unit, etc. I feel physically sick when I find an insect and worry obsessively that I will be forced back into the situation I was in at my previous apartment.

Additionally, I have never had bed bugs, nor has my building, but I feel compelled to check my sheets on a daily basis and occasionally have to pull the sheets up to check the mattress at some odd hour of the night because if I don’t I won’t be able to go back to sleep. Every time I find an insect in my place my throat closes up a bit and I get really paranoid that it’s a roach, or bed bug, or representative of some terrible infestation hiding in my walls.

When I catch myself in these behaviors, it depresses me further because I start realizing that this is what my life has become and I don’t know how to get better and let these things slide like normal people seem to be able to.

I understand that part of the reason the psychiatrist diagnosed me with OCD symptoms is my deep-rooted belief (that I'm trying to change) that everything in my life must be perfect, and anything less means I am a total failure. I get looped into this thought process daily and really end up hating myself an inordinate amount of the time because I did not do everything 100% perfectly and to the highest ideal. So when I find an insect in my place, I immediately think that I should have done something to prevent it, or that if I had done a better job of bug-proofing, I wouldn't be so anxious. This is dumb, I know, but it happens nonetheless.

So until I can afford a therapist – can you offer me any suggestions on developing healthier coping strategies/ways to deal? Any help would be much appreciated.

Trans-friendly therapist in Melbourne AU?

Anonymous — Wed, 13 Mar 2013 20:32:53 -0800

(Australian) Melbournian mefites - can any of you recommend a trans-friendly therapist? Hello - I'm asking this question for my lovely partner. He's asked me to help him find some sort of therapy to help with his anxiety. He identifies as genderqueer and has had some unfortunate experiences in the past when seeking therapy, so we would really appreciate any recommendations - basically someone who is trans-aware and good with anxiety.

He's open to psychiatry as well as psychology/counseling, and is located in the inner northern suburbs. I've found some names on Ausgender.com and the Zoe Belle Gender Centre website, but any personal recommendations would be very much appreciated.

Many thanks in advance :-)

Throwaway email: askmeanonemail@yahoo.com

Therapist for anxiety/depression in Inwood/Riverdale/lower Westchester?

The Elusive Architeuthis — Tue, 05 Mar 2013 06:53:45 -0800

Asking for a friend-- Can anyone recommend a therapist for anxiety/depression in Riverdale, Inwood, or nearby Westchester? No particular approach preferred, although approaches like CBT that have some literature supporting their efficacy would be better.

Therapy while traveling or in transit.

Anonymous — Wed, 12 Dec 2012 06:59:39 -0800

What are my options for therapy while I am traveling and in the midst of a move to a different part of the world, with a lot more travel on the horizon? I think it's time for me to go to therapy. After struggling with anxiety for most of my adult life and recently realizing that my anxiety is having a pretty big negative impact on my relationship with my SO it's pretty clear to me that I need some help dealing with things.

The issue is that I am bouncing around between locations at the moment. As I type this I am in a major city in North America and I will be here for the next week or so. I have access to my GP, constant access to the internet and some time to do research and figure things out. In a week or so when I move on I will be in a foreign country where I don't have a family doctor and my time/resources will be limited relative to where I am now. How do I get the help that I need?

I have tried working through a few different workbooks (Feeling Good among them) and I've also tried MoodGym and e-couch. None of these things worked well for me. I find talk therapy to be the most helpful. Talking with others really helps me work through my problems and having someone to ask questions and provide an opinion makes a big difference for me. I don't really know what the therapy situation is in my new home country but even if there are therapists available/accepting patients, I will be traveling a lot as part of my new position. I am afraid I am overlooking an option (like a more interactive version of MoodGym or something) and I don't really know where to find the help that I need.

Where can I go to find the help I need and what do you recommend given the circumstances?

Too scared to work

one of these days — Wed, 05 Dec 2012 05:28:23 -0800

How can I cope with extreme professional/work anxiety? My life is better than it ever has been in almost every aspect lately, at least on paper. I graduated last May with a degree in Computer Science from a good university and got a job instantly via one of my professors. I work in a research and development position funded by one of the world's most recognizable companies, dealing with challenging and interesting technology.

I am not very good at it.

For the first six months my project lead, residing halfway across the country, was on leave. Now that he is back, my various performance issues either have been or will be brought to attention.

I work in a lab with several other researchers and postgrad students and I am most likely the least experienced and educated among them. I am expected to interact with them in order to pick up on their research. For example, I need to learn to use a program I am unfamiliar with to grab recent versions of something I should be testing, but every afternoon I think "today I will ask" and never actually do it. Or I hear about tools other researchers are using and, because I am unable to inject myself into these conversations, I never learn the address of such-and-such server. Since I have been here so long, I feel as though asking elementary questions would be embarrassing.

I also have issues checking my e-mail, for some reason preferring not to know if I am being criticized or doing poorly (I had the same issue with checking transcripts while attending school). Obviously, this makes no sense, but I don't check these important things as often as I should because I procrastinate when I am worried there will be something unpleasant.

Plus, general phone anxiety. I hate hate hate talking on the phone, always have. Given that one of my bosses lives a thousand miles away, this is a problem.

My concern that I am useless and incompetent among these more experienced people has made it very difficult for me to actually get up and *go* to work. Every morning is a drag and I have to psych myself up just to get out of bed. More than once I've called in sick because I couldn't bring myself to move.

I have a long history of mental illness (surprise, surprise), having gone through depression and suffered through panic attacks extensively as a teenager, stuff triggered by some pretty extensive and complicated family issues. I got therapy for those, so I'm not unfamiliar with the whole deal, and obviously since I'm verging on non-functional I need it again. But I'm not sure how long it will be until I can find a therapist, and how long it will be until I am able to function without this heavy anxiety.

What do I do at work until then? I never saw myself working in this field forever, so I might just need to take a lower-demand job, given my history. But for the time being I would really like to keep this one.

This is my first time being independent and although many aspects of my life are going well for a change, this one has me very worried about my future.

The idea that people don't change: what does it mean for me?

Anonymous — Tue, 04 Dec 2012 18:14:49 -0800

People don't change. If accepting that reality is the way to peace, how do I reconcile it with being married to someone with whom I'm incompatible in fundamental ways? (I am committed to this marriage because we have a young child who means the world to me and needs me.) Do I need to stop believing there could be core change in another person's outlook on life? My marriage often feels unsustainable to me. Yet it's also unthinkable to be away from my son for much of his life (we agreed to share custody should we ever split), not to mention the toll on him that being away from Mommy even part-time would mean.

Because of this conflict, I feel a strong hope that my wife is capable of fundamental change. I really need some help with thinking about whether that hope is unrealistic and therefore unhealthy for me.

She has lifelong mental health issues that are beyond my ability to understand or help with. We're currently a few months into (very long overdue) individual work with a psychiatrist for her and relationship therapy for us. I waver constantly between thinking "give the therapy time" and thinking "the core issues are not going to change and I do not want to spend my life like this."

If it's false hope to think people can change at core, then is it unhealthy to base hope for a relationship's future on that hope? (Some core differences here: I think the world is essentially safe and good and exciting; she thinks the world is essentially unsafe and people are essentially predatory, nothing is exciting except our son, and concepts such as forgiveness and "gratitude" [I am not allowed to speak the G word around her because of how negative she feels it is] are tools of the people who would take advantage of her if she bought into those concepts -- and she thinks I'm very naive for believing in good the way I do. She's extremely focused on anger and vengeance, on 'getting back at' people who do wrong and need to be exposed for what they are, and the idea of "letting go" of anger makes her, well, really angry, because anger is power.) She is very clear she's not interested in any chemical treatment, and I don't know how much core effect talking with her psychiatrist is going to have.

I've tried a lot to write a question about the validity of the "staying together for the child's sake" idea, but I've realized that question seems moot because I feel like I would stay with the child despite almost anything. So I'm hoping a broader question will help -- this question about expectations/realism, my philosophical approach. I need to know whether I really need to adjust to the idea of living with a person who's going to be fundamentally 'about' depression, anxiety, and simmering anger for the rest of her life, rather than hoping that can change. (If can change my own perspective/hopes, could that be a way toward peace for myself?)

Need non-therapy therapies.

TheManChild2000 — Fri, 30 Nov 2012 13:25:06 -0800

I need therapy for really bad and unwarranted relationship jealousy and insecurity but I wouldn't be able to get started until sometime late January. What would be some alternatives I could pursue in the meantime? Short Version:
I have a great gf that I should have no issues with, but yet my head causes me all kinds of crazy issues anyway and I am suffering quite a bit. Talking to her, journaling, and exercise isn't enough. Need other ideas until I can get into therapy.

Sorry This Got Long version:
I'm out of a marriage that featured significant neglect: a decade of celibacy, zero intimacy of any sort, and awful loneliness and isolation. I'm a 41yo male if it matters. I have a great gf now but I'm all nutty and I kinda feel like it's my first relationship ever; I've completely lost any sort of instinctive comfort level for how things work normally and so anything less than us lying alone and wrapped around each other in bed with her whispering her love to me seems to just pump me full of neediness and insecurities. I've got jealousy issues too. It's so bad that I have crazy physical symptoms; my head tingles, my chest hurts, sometimes I stay awake all night, weight loss, etc. Of course I can't keep my head straight during these bad times either.

Some of things that add to the difficulty I'm having:
* Our lives are very busy, and so often we can't get quality alone time for weeks at a time.
* She's recently divorced too and so we're hiding our relationship for a while.
* Originally needy and insecure with me too, she's become secure enough that I now take up a healthy place in her life, meaning the crazy intense attention she paid me at the beginning has tapered off.
* She's ultra-social and also generally prefers being friends with men. So she goes out a fair bit, talks to everyone, texts her guy friends all day, parties with them, will let them crash with her if they're too drunk, etc.
* She's unusually attractive and has a wild, open, and magnetic personality, so she is hit on constantly.
* I have crushing self confidence and self loathing problems. Oh, and sporadic ED to boot.

On an intellectual level I truly trust her, have no problem with all of the above (although I recognize that they're challenges for someone in my state), feel she loves me and likes me, feel secure that she wants our relationship to continue and grow, recognize that she makes considerable effort to find ways for us to be in contact or together, appreciate that she is okay with me and my problems, and believe I'm the only one she wants to be with. I really have it so damn good. Intellectually I accept that I'm the best bf I can be, work hard to get better, give her the benefit of the doubt always, and accept that if shit goes south then it was always going to happen no matter what I did.

But I can't seem to get my emotional understanding to conform to the same things, and can't control the amplitude. I get wigged out often, in awful mentally and physically uncomfortable ways, and I really need to get control of it. I'm doing a pretty good job not inflicting this stuff on my gf, that's not the problem, it's just the getting control of myself that's my problem.

She understands and listens, but I can't dump everything on her always everytime. I journal. I repeat the serenity prayer as a mantra. I exercise. I get down the road. I take things day by day.

This stuff all helps in tiny ways, and I'm getting better, but I need to step it up because I am suffering quite a bit and for really no good reason and would like to be healthier sooner rather than later. What other things could I try?

Seeing a psychiatrist for anxiety. How does that work?

Anonymous — Fri, 16 Nov 2012 09:02:34 -0800

Seeing a psychiatrist for anxiety and depression - How does that work? I went to a doctor about my anxiety issues and she gave me a referral to a psychiatrist to get some anti-anxiety meds as she did not feel comfortable prescribing them. (She didn't give me a name, I have to call my insurance to get a list or something I guess. Also, she gave me a no refill xanax prescription after I begged.) I am somewhat bewildered by this as I didn't expect to have to go to a psychiatrist so I have some questions. I posted this a couple of weeks ago. This question started out as an comment in that thread, but I realized that I had some questions.

I understand that some psychiatrists treat patients with therapy but most just prescribe medicine.

How do you find out what type of psychiatrist (counseling vs medicine) they are? What if I end with one who actual counsels patients? Should I not go to them because I only need one who prescribes meds? Should I just go to one who prescribes and get a psychologist for actual counseling for anxiety? Is that the best way?

Do you just go to an appointment, talk to them, and they prescribe you something?

Should I tell the psychiatrist I am only looking for meds when I call? I don't want to look like a drug seeker. Medical shows have taught me that is a "thing".

Thanks. Anon email: allbymyself001@gmail.com. If it matters I'm in Chicago.

Girl needs therapy

indognito — Fri, 02 Nov 2012 09:51:13 -0800

Therapy hasn't helped in the past. But I need to do something, FFS. What else should I try? I've struggled my whole life with various issues--shyness, anxiety, inattentive ADD, depression, blah blah blah. It occurred to me the other day that I'm depressed, worried and/or down on myself nearly all the damn time, and it just isn't going to get better on its own. I function, but I'm pretty miserable. And sometimes I do dip into being nonfunctional for a day or two. So I called and made yet another appointment for therapy.

But at the same time I'm wondering if there's any point in doing therapy any more. I've seen over a dozen therapists in my life, starting in college. Therapy methods I've tried include CBT, ACT, psychoanalysis, transactional analysis. Honestly, other than the first therapist I saw at age 18, none of them helped, other than providing a kindly presence for me to complain at. (I saw several of these therapists for 6 months to a year, so it's not as though I was merely therapist-hopping.)

I've also been on a colorful array of drugs, including Paxil, Zoloft, Wellbutrin, Klonopin, Vyvanse (second worst drug ever), Strattera (worst drug ever), and others that I can't recall at the moment. Paxil and Zoloft did considerably chill me out, at the same time that they zombified me. They were also hell to get off of. So I don't know that I want to head back down the psychopharmaceutical trail again so fast.

Or is all of this just the depression talking? Maybe it is better to be zombified and not freaked out all the time.

Is there anything else I could do? I try to eat well, lots of vegetables. I'm vegetarian, but have also been omnivorous with no change in my symptoms, so don't think it's that. I supplement with vitamin D and omega 3s. I drink one cup of coffee a day because I am lost without it. I exercise every day (jogging and weight-lifting). I try to meditate daily but it's hard to find the time. 36 yo female, no other known health problems.

Thanks, all.

What to do when to depressed and anxious to get therapy for depression and anxiety?

Anonymous — Mon, 22 Oct 2012 07:01:50 -0800

What to do when too anxious and depressed to get therapy for one's anxiety and depression? So the question above the fold pretty much covers it, but for more details:

About me – black, female, mid-30’s, currently employed w/ health insurance but expect to be laid off early next year, live in Chicago.

I have had severe social anxiety all of my life from very early childhood until today. I didn’t realize what was wrong with me until I was an adult and saw a Paxil commercial several years ago. Since then I have bought around a dozen self-help books about social anxiety, including Feeling Good (which made me realize I am also depressed), but I always get too anxious to do the exercises.

I want to get therapy but am too anxious or apathetic (it varies) to actually start the process of getting therapy.

I’ve seen There is Help. I know about Psychology Today. I have an EAP at work. And I found the Panic/Anxiety/Recovery Center in Chicago (via goggling but it seems legit). So, I know how to find a therapist, I just don’t want to go to one. Scratch that, I need to go to one, but every thing about the whole process makes me anxious and/or resistant and/or apathetic so that I end up not wanting to go to one.

Psychology Today will just give me list, just like my insurance website and I suspect my EAP will also just give me a list of people to call. And really, I just can’t call some random person I don’t know about something that's as emotionally fraught for me as this. Novel situations and social situations with people I have no pre-existing connection with trigger the hell out my anxiety. Plus there’s that whole thing about how you will have to keep going to different ones until you find one that clicks. The whole idea of that puts me on the express train to Anxietyviille captial of Anxietystan.

The thing is I have no coping skills. If I actually got my shit together enough to 1) call, 2) make an appointment, and 3) actually go, I know if I didn’t work out, I’d be all depressed and "eff all this". I was incorrect before, I do have one coping skill. It’s avoidance, which doesn't help at all.

Lastly, because of my anxiety I don’t have any friends and I haven’t been to a doctor in a very long time so I have no one to ask for help. I do have family but they are completely useless and we don’t talk anyway.

Anyway, I figure I can’t be the only person in this situation so if anyone has any advice on what I can do, I would be grateful.

Anon responses can go to allbymyself001@gmail.com

Is CBT just not for me? Or am I not giving it a fair shake?

Anonymous — Tue, 16 Oct 2012 06:21:12 -0800

Is CBT just not for me? Or am I not giving it a fair shake? For about 16 weeks now I've been seeing a therapist who specializes in cognitive-behavorial therapy and mindfulness. The issues I'm seeing him for are dysthymia, social anxiety, fear of intimacy, and general uncertainty about myself and life in general.

I have been giving therapy my 100% and doing all of the homework and trying things even though I may have felt skeptical about them. I've tried to be as honest and open in therapy, which has been really hard for me. For different situations and feelings I've brought up, he has assigned daily mood logs as well as cost/benefit analyses and other things pulled from the Burns "Feeling Good" books.

I found the mood logs to be a little helpful in identifying twisted up thinking and replacing the negative thoughts with positive thoughts, but they just haven't been working. I feel like it's one thing to know something intellectually but I still feel like I'm where I started 16 weeks ago. Still completely afraid of relationships and intimacy, no social circle or close friends, unsure of my future and just not feeling great in general.

As we progress it seems my therapist just wants me to do more and more of these fucking mood logs. I'm getting resistant to them because they feel pointless; circling what emotion I feel then identifying the twisted thinking and putting a number on it just doesn't do anything for me.

Please help me to be more open to this process or maybe point out what I'm doing wrong; I really want to get better and live a somewhat normal life. It took me years just to get the courage to go into therapy and I'm left with a feeling of, "this is it? filling out forms?"

Does anyone have experience of Core Process psychotherapy?

terretu — Tue, 02 Oct 2012 02:36:01 -0800

Does anyone have experience of Core Process psychotherapy? I've been looking for a therapist in my area (Cambridge, UK), and it's confusing, expensive & scary. I've found someone who uses Core Process, and he's significantly cheaper than most of the other therapists, mainly (it seems) because he's in the last year of further studies (though he's qualified to practice). His office is also close to my work, which is a definite plus.

Some cursory research on Core Process has thrown up the fact that it's mindfulness/Buddhist-based. Which, mostly, sits fine with me. I know that mindfulness works for a lot of people, and I studied Buddhism briefly (in an academic sense) and am interested in its central ideas. There's a little cynical part of me that thinks this might be closer to hippie alternative medicine bullshit than I'm comfortable with, but this cynicism isn't strong enough to be a dealbreaker.

The main problem is that my Googling hasn't thrown up any medical or scientific studies on the efficacy of Core Process. The only resources I've found are either from the main place in the UK that trains people to become Core Process therapists, or from individual practitioners advertising their services.

Also, I'm seeking therapy in the hope of getting a better handle on some long-standing issues (history of pretty bad depression & anxiety, whole bunch of family problems, some eating/food stuff). I know that no one seeks therapy lightly, but I want to do some serious work on things which I've been struggling with for a long time, and I want to know before I commit that this is going to be rigorous (and likely to help).

I don't know if I should go with this guy because he's cheap, or suck it up, pay more money and get a different/better-know/more well-tested type of therapy. I know that I really don't want CBT or any kind of traditional analysis, but outside of those limits I don't know what I want or what would be best for me. I also have a history of flaking out on therapy because it's hard and I'm scared and the whole situation makes me really anxious, but I'm hoping that this time (with the added incentive of paying for it myself, rather than taking whatever I can get from my former University/socialised medicine) I'll be able to stick with it and make some real progress.

Tl;dr - I like the look of this one therapist & he's relatively cheap, but I can't find any science or resources on the type of therapy he offers; does anyone have experience of or anecdata around Core Process?

How to make therapy work?

Anonymous — Wed, 26 Sep 2012 15:04:38 -0800

"You can't get over this unless you really want to." Do I not want to? I need to want to, and I'm a self-sabotaging ball of nonsense. Have therapist and group therapy, intake appointment for medication on two days, feeling like I'm maybe just making it all up. Or I'm using my intelligence to pull one over on either my therapist, or myself. Long, sorry.

Anxious, or maybe depressed? Or just a bad coper? And a crier. And a magnifier of my problems, like maybe if I can get a better diagnosis and meds it will mean that I am a real fuckup instead of a fake fuckup and then people will really believe that I'm huirting and not making it up. And I'm not hurting as bad as so many people. and I go to my job and I have friends and I'm FINE five or six days in a week, and then that last day, something sets me off and I lose the whole day to crying, or anxious thoughts, or most probably zoning out on the internet all day because I just can't face whatever it is I need to do. And most days I'm on the internet at least half of the hours I'm there, because I can't get my head into or around the endless work I have to do, and even especially the work of figuring out what work I need to be actually doing. (Think dissertation in a science department with absolutely free reign to do whatever science I want, and relatively hands off mentorship, AND an expectation that students from this department will change the field and populate the best research university faculties around the country.) I have a lot of smarts in the toolbox (I guess I can say that since this is anonymous), which means I don't know if the 'fine' that my therapist sees is me being pretty good for your average bear but not performing at my potential, or if I'm overanalyzing myself into unneded therapy and medications.

The diagnosis my therapist has for me (she told me for an insurance document a few sessions ago) is something lame and very minor, which it literally says on the wikipedia page for the diagnosis is a nice thing to have so you can have *something* to put down for clients who don't have another diagnosis. But I worry that maybe I'm fooling her, because I'm smart enough that my anxious self is still going to graduate school and doing experiments and *functioning* and I haven't yet destroyed my relationship with my partner. And then again I think maybe I'm magnifying my problem for some twisted reason, everyone says there's nothing really wrong with me and I'm a good person, but I just feel like I'm creating this deeper and deeper pit for myself that I don't know how to get out of.

I've been in therapy (group therapist for 2 years, therapy for a bit more than 1) and I just don't know. I've seen a few different therapists and like the one I see now, but I think I'm not doing it right. She keeps saying, when I talk about how I interpreted a situation, that we will work on helping me see things differently. And I can rattle off the story about how the parents I grew up with and their issues have shaped me, and why being anxious and sad and self blaming was safer than anger, why that was adaptive for the kid I was. I feel sick of that kind of discussion, honestly. And intellectually I know the CBT reframings, I know how to turn all those messages around and what I should think instead...and I just don't. Or can't. Or don't want to. Or crying and being the fucked up one is to much fun (ha) or something. I read in Metafilter threads to imagine that I was saying these things to a child, to help me be kinder to myself. Or to think about how I don't care how awesome my friends are at every aspect of their lives, just that they are good people. I feel like I hear/read those things, and just feel....tired. Like they just won't work - or I can look at those thoughts from a distance, but they just don't penetrate or change anything.

Today I cried in my advisors office, over a series of failed experiments and a continuing conversation about the fact that my work is "good...but not worthy of you. Not as exciting as it should be." She says I'm one of the smartest students to come through my program, and it just feels like smart is not enough, smart is maybe actively bad because I don't have the intuitive talent to just know how to pick the right problems and find the new theory and dazzle everyone. I really really don't say that to brag, in fact I find it terrifying and it makes me guilty that I haven't done better than I have. And now I feel like I've gone down irreparably in her eyes by crying in front of her. I have two years until I am supposed to graduate and I feel like I'm staring down this road of three uninspired postdoc appointments and then nothing, and then my boyfriend supporting me while I struggle with dead end jobs.

Last week my therapist said something along the lines of how it only works if I want it to. Which makes me feel like I'm choosing to be a mess. Except I'm not really a mess, AskMe is just catching me on my 'bad day', but there have been slightly more bad days these past two months, but that only puts me up to maybe 2 days a week bad, 5 fine, instead of maybe 3 days a month where I feel like this. Do normal people feel like this at this rate and I just suck at managing it? And good days are often days where only 4 out of 9 hours are on the internet avoiding work. And usually more internet at home, instead of hobbies I wish I pursued or keeping up the house.

When I cry, I'm stuck in a weepy place for the rest of the day. I don't know if its physiological, or if I have some weird either phobia of crying which keeps me terrified and upset, or attraction to crying and being upset because it's better than...some alternative. I have a terrible time calming down when I get upset, and I RESIST any and all advice on how to calm down. Everything in threads like these (http://ask.metafilter.com/72267/Big-girls-dont-cry) feels like too much work, and doomed to not work, and anyway I could stop if I wanted to and if those things are all it takes to feel better then I'm clearly just being a drama queen. And I feel very guilty about not...wanting to, not being able to do my CBT (? I think it's CBT? This week I have to wait a few seconds rummaging to get out my wallet at cashiers, to practice getting in people's way just a little bit), and not being able to put things in perspective and feel calmer. It's clear that being upset is filling some kind of psychological need (like it's just easier than doing science, or thinking about my actual problems, or feeling angry of something), and that makes me feel like an unfixable sicko. Except saying that makes me feel (again!) like I'm just overstating my problems a huge amount. I don't know if I"m pulling one over on my therapist or on myself or what.

And the bad day two weeks ago was bad enough to finally request medication, and I have an intake appointment, at which I predict I will both cry like a ridiculous unprofessional mess, and also be a waste of their time, and I'm still worrying whether I'm running away from my problems.

tl:dr I don't know if I'm trying to talk myself into or out of medication for my possibly very minor anxiety issues, and I feel alternately bored with, resistant to, and totally hopeless about whatever steps I'm supposed to take to feel better, and that fact makes me feel like some kind of drama-seeking vulture.

throwaway: tooanxiousornotanxiousenough@gmail.com

OK, fine, the sky IS falling.

Bardolph — Wed, 26 Sep 2012 07:54:29 -0800

What are some good, supportive conversational strategies for dealing with someone who's catastrophizing? I've got a relative (let's call her Amy) whose character over the past few years has taken a turn for the pessimistic. Despite herself being a successful person with a pretty fortunate life, she's got a couple of key concerns about friends and relations that frequently stress her out-- not really stuff amenable to solution, but more general impending worries like the overall health of people she loves, and what she fears will be the ultimate consequences of various of their poor life decisions.

When we hang out, she seems to want to talk to me about these fears, but these conversations usually entail her running through vastly darkened scenarios of the situations she's worried about-- talking about how Bea is worn away to a thread these days, she never gets enough sleep and she's probably going to be flunking out of school, Carl will never get a job now that he's been unemployed for nearly two months, what on earth is Darla going to do now that she's married to that loser, he'll certainly be leaving her five years from now and where will she be then, etc. Mind you, some of these concerns are valid-- Carl's not particularly employable, maybe Darla doesn't have a wonderful marriage and Bea's grades haven't been great or whatever. But many of the worst-case scenarios she discusses aren't remotely plausible given the actual severity of the problems. And because these are third parties we're talking about, we're dealing with very imperfect information and a complete lack of agency over any of the issues on the table.

When things head in this direction, I've been having difficulty figuring out how to respond to her concerns. It seems callous and unhelpful to agree with the disaster-scenarios ("Totally, Bea will be dead or expelled before the year is out"), but when I try to point out, however gently, the logical reasons for taking a more optimistic view, Amy just accuses me of being selfishly indifferent to our family members' plights. Once I just out and said that I don't know why she insists on imagining the worst all the time, and she got really angry and called me a "terrible listener."

Since these thoughts, logical or not, are clearly coming from a real emotional place (and yes, it is legitimately painful to have loved ones who're not 100% happy and healthy), I'm wondering if anyone has suggestions for better ways for me to support Amy emotionally when she starts this kind of catastrophizing. Just to clarify: I am NOT looking primarily to protect my own well-being by setting firm boundaries, cutting her off, or whatever. I love Amy, she's not an intrusive conversationalist, and I'm happy to be her sounding-board if she needs one, but I really need some sort of script that'll help me give her whatever it is that she's trying to get from these talks. I could take the Rogerian route and guide the conversation therapeutically to how she feels about all this, I guess, but she's a pretty practical, results-oriented person and I doubt she'd follow me there.

tl;dr: in conversations, my relative tends to get stuck in pessimistic disaster-scenarios about family members. When someone's venting to you about how worried they are about [X semi-realistic but still fairly unlikely thing], is there a supportive and helpful way to respond, that doesn't involve either dismissing their concerns or confirming their fears?

Specialist for a very special illness

lunalaguna — Fri, 14 Sep 2012 21:04:39 -0800

Gastroenterologist for brain cooties? After 12 years, nearly 20 psych drugs, three therapists, three psychiatrists, and a few endocrinologists, I'm faced with the fact that I have a highly treatment resistant mix of agitated depression, GAD, panic and Bipolar II-ish symptoms with comorbid hypothyroidism. (Official diagnosis is Bipolar II and GAD. Hypothyroidism is under control for now.)

I am running out of feasible med options, and I have a very frustrated psychiatrist who's stumped, even after consulting with a specialized pharmacologist. Complicating matters is his general unwillingness to treat me aggressively because I seem "high functioning," and because -- in my mixed states -- I tend to become obsessed with my health. It sounds like a positive thing, but believe me, it's not.

During our last session, he admitted he was reaching but brought up the possibility of either: 1) an autoimmune disorder being partially responsible for my symptoms, or 2) a metabolic or GI reason behind my insane sensitivity and intolerance to nearly all medications, psych or otherwise.

Now, my question is not what drugs to take next or what therapy to explore. I'm heading into a long medical leave to try to get some of this under control, and my therapist, partner, and I are working on a plan for me to get by without meds if necessary.

My question is whether -- as my pdoc suggests -- a gastroenterologist might be able to help me.

If so, what should I mention, and what would he/she be looking for? I have a lot aches and pains and strong physical symptoms of anxiety and agitation, like a high heart rate and tremor. There's dry skin and hair, but that can be explained by the thyroid issues. I also currently have mild bloating, water retention, and acid reflux, plus strong sugar cravings, but I'd bet most of that is from my recent increase in Lithium. Blood panels have been normal.

So, any diagnostic guesses? GI, autoimmune, or metabolic issues that mimic or exacerbate mood disorders?

Can I/should I get a "prescription cat?"

Anonymous — Tue, 28 Aug 2012 07:23:25 -0800

Getting a prescription cat... How to, should I, and can I? Please don't flagellate me, I'm truly not trying to abuse any systems here--I just learned of this possibility and am trying to figure out if it's something for me. I have a history of depression and anxiety, am currently in treatment for a compulsive eating disorder which is definitely related to anxiety. I moved to San Francisco less than a year ago and am currently living in an apartment that allows no pets at all. Reading AskMe for other cat-related things, I saw mention of doctors "prescribing" cats. When I've cohabited with cats in the past, my anxiety has been noticeably better/more manageable, as has my depression (which now seems to be dysthymia, and I'm coping... okay). I'm an excellent pet owner/foster cat owner, and their presence benefits me significantly. From what little I know, it seems like a therapy cat might be an option?

So: is this something I should look into? I really don't want to misuse a system that's set up for folks who are much worse off than me, but I do struggle with some mental health issues and I do know that cats have a history of helping. Are my issues too trivial? I imagine cats make everybody feel better, so perhaps this is a silly idea.

If this is a) a real thing which b) I can use without moral qualms or taking advantage of a system that's intended for other purposes (therapy dogs, etc.), how does it work? Do I just talk to my regular eating disorder psychiatrist? Are my landlords obligated to accept a therapy cat? Does the cat need to be in some way exceptional/trained to qualify as such? Would future stigma about therapy animals make it less likely for me to find a place in SF's insane housing market, or would having taken this action negatively affect me in other ways I haven't thought of (some nightmarish insurance company issue, etc.)? This is far, far down the line, but I'm a good pet owner and the difference I noticed when I've had a cat was palpable.

Again, I'm not trying to be a jerk or take advantage of the system, but I don't feel like I have a sense of perspective about when therapy animals are appropriate.

How do I get better at managing multiple social cues?

Anonymous — Sun, 19 Aug 2012 11:11:01 -0800

How do I get better at managing multiple social cues? Being a part of multiple cultures and subcultures means I have to learn multiple social conventions and social cues. Lately I'm finding it difficult to keep up, and have found myself tripping over unspoken rules and hurting people in the process.

Some examples:
* Getting overexcited in conversations and blurting out something too intimate or saying something unclearly, misjudging people's receptiveness to what I'm saying
* I'm touchy-feely and realise others aren't always so, but even after trying my hardest not to touch people without explicit consent I still get told that I'm doing so, to the point that I'm now paranoid about some unconscious tic I'm harbouring
* Getting too loud and being unable to get my voice to an acceptable level
* Coming off as either too earnest or too aloof

Often I don't get specific enough feedback (e.g. "you poked me in the elbow the other night" or "that thing you said about X made me uncomfortable" - it's just "you did something wrong") so I'm not sure what people are picking up on and am racking my brain trying to figure it out. Just *asking* is considered offensive ("how dense can you be to not know already?!"). Sometimes after some time I learn what it is that I did wrong, the remorse hits me, and I work hard at putting what I learnt to good use...but then I end up messing up again. It's like the more I learn the more confused I get.

It's gotten to the point where I'm no longer able to trust myself or my judgement or situations, like my calibration is all off. Sometimes I am the receipient of someone else's misjudgement but I feel like I don't deserve to feel bad about it because I fuck up so much. Some people (loved ones and casual acquaintances alike) tell me that I'm being too hard on myself and that my standards are too high, but it's hard for me to internalise that without feeling conflicted about it.

I'm in therapy. I'm about the opposite of the Aspergers stereotype. Is there anything else I can do?

Resources on Adult Attachment Therapy?

Anonymous — Sat, 18 Aug 2012 21:59:16 -0800

I may be starting adult attachment therapy in the next week, on the advice of a crisis counselor and after a few years of on-and-off treatment for anxiety and depression that's not getting me very far. Point me to some quality, hopefully easy to find resources that can spell out what the experience might be like. The types of questions I'd like to know more about: what's the theoretical base behind adult attachment theory, how long might I expect to commit to therapy like this before seeing results, what's the primary objective of the therapy (put another way: under what conditions should I consider the therapy to have been successful), what questions should I ask as I speak with therapists, what (if any) are the viable alternative therapeutic approaches for understanding and coping with issues related to intimacy and expectations in relationships.

Throwaway e-mail: mefiadultattachment@gmail.com.

Demographics, if relevant: 24 year old straight male, American.

How do I fix my issues with women and problems with people in general?

johnx — Thu, 09 Aug 2012 21:42:05 -0800

How do I fix my issues with women and problems with people in general? I was raised by both parents even though they are divorced, but some would say my father more. My mother cheated on my father (accuses my father, I believe his story more since he has proof and I don't know just an inner feeling I have). I'm not exactly sure how this plays a role in my life, though I believe it has to do with my hate of a lot of women I meet (not that i dislike all women, I just make quick judgments without meeting them), paranoia generally surrounding them, and inability to commit to a serious relationship. I have no plans to get married, have children, or ever stay with a woman for long. My few experiences with women didn't end very well. I just started hating women even more (although in all cases I broke up with the girl), and it made me only want to use them for sexual pleasure, just one night stands all the time.

My problems with people in general stem a little further. I had a terrible highschool experience and just general social experience (which continues today). Not that I was anti-social, I just didn't get along with certain people and never quite acclimated to particular social groups. I never used to be like this but certain things happened changed me slowly but surely over time. I spend most days indoors besides work, shielding myself from the world. I had a few friends, but I wasn't especially close with any of them. I'm never myself around anyone, in fact I'm become so wrapped up in the chasm of various "mes" that I'm not sure who I even am anymore, its been so damn long. I don't know who I am, I've been someone else or what i think people want forever now.

Due to unfortunate situations with some people I have become very anxious in certain social situations. I find it nerve wrecking to go out in public for fear of being judged. I'm massively paranoid about the people around me, I constantly think they are mocking me either in their heads or to their friends. I've let people's small comments rule my life and they've impacted me forever. I constantly fear my house being robbed after it was robbed by teenagers in my teens.

I have been deeply depressed for as long as 8th or 7th grade. Deeply depressed. Its burrowed down so far I can't even express my deep unhappiness.

I have never been to therapy and I think they are useless to me since I wouldn't be myself around them anyway. I want a fix, I've thought about searching for medication for my anxiety and depression but I'm not sure how I even obtain them. What should I do?

Are all therapists the same?

Anonymous — Thu, 19 Jul 2012 15:15:27 -0800

I need therapy. I have no idea how to start. How does one pick a therapist if all seem the same? I have searched online for information about therapists in my area and found a network of local psychologists and psychotherapists. They are all listed with their special fields, but those sound very broad and generic to me. There are at least 7 in my immediate area, about the same distance, so just starting with the most (logistically) conventient isn't working either. And all look like nice people on the photos. The only ones I could exclude so far are couple therapists. I know I'm not a couple, but other than that, the special fields aren't very helpful. All of them list "depression, anxiety, stress relief" and one also has "OCD" listed. I'm not an expert, but OCD is likely one of the few things I don't qualify for. Since I don't know what I actually might have, beyond a broad category, I don't know how to decide which of them I want to make an appointment with.

Do I just call all of them and ask "Hello there, do you have experience with (list of approximate self diagnosis)?" I could be wrong about my "diagnosis", they are the experts, after all. So this approach seems like I could easily find the "right" therapist for something I don't really have.

I have a bad history with doctors in general. I was pumped up with sleeping pills in my youth to "cure" my insomnia and really none of them worked. In my late teens, I tried to find a therapist and just went to the first I found in the Yellow Pages. He proceeded to diagnose me with several different personality disorders, most contradicting the previous one (basically jumping from Cluster A to C to B and back on a weekly basis). The next told me in the first session that I had "too many symptoms" and none were his field of expertise, so he wouldn't treat me. Asked for a recommendation who to see about it, I got a shrug. I pretty much lost my faith in doctors due to that.
What I want to treat is the massive problem to focus on anything (I'm hestitant to self-diagnose, but inattentive ADD fits the bill; super-easily distracted, can't focus, can't organize easy tasks, can't ever shut up the inner monologue, occassions of hyperfocus, trouble sleeping; lifelong issues with most of that) and the growing anxiety. Getting full blown panic attacks because of the door bell ringing (and being pretty sure it's just mail) was what made me realize I need therapy, really really bad.
Due to my unemployment being cut to barely anything (not enough for basic needs such as food and electricity) because I missed appointments - because some days I'm too afraid to leave the house - makes things just worse. So the problem is not just "possible ADD and bad case of social anxiety", it's also financial pressure, fear of debt (something I magically managed to avoid so far), making it all rather urgent. I don't want to rush the therapist search (I've seen where that got me in the past), so any advise how to select and approach a potential therapist from my list is welcome.

How do I know a therapist is a good match, if they all look like nice people, are close to my house and list the same fields? They are also all accepted by my health insurance.
What do I ask when I call and what answers would be red flags/don't bother to make an appointment territory?

Who can help me?

Anonymous — Sat, 16 Jun 2012 12:54:11 -0800

How do you know what type of mental health professional you need? I've been feeling immense anxiety because of issues at my work. My whole life I've had problems concentrating (I can only work for a few hours a day), and now with this added anxiety, I'm wholly unproductive. I thought I would seek the help of a professional. I looked through the listing of mental health specialists who participate in my insurance (I'm in the US). But there are many different kinds of specialists: psychiatrists, psychologists, licensed clinical social workers, psychiatric nurses, psychiatric social workers, etc. I've gotten some recommendations from people I know -- but these specialists also have different backgrounds (psychologist, counselor, nurse).

Which type should I choose? Thanks.

poke, scratch, sniff, tap, shuffle

guessthis — Fri, 15 Jun 2012 02:40:11 -0800

I need to stop fidgeting. How? Help! For as long as I can remember I have been a fidgeter. I don't have one particular 'brand' of fidget, rather I cycle through many throughout the course of the day: twirling my hair, picking my cuticles, cracking my jaw, etc. repeat ad infinitum. It feels like this fidgeting is constant, to the point where it's really starting to bother me.

I have also had OCD for as long as I can remember, and struggle with anxiety. OCD plus fidgeting makes it really difficult for me to stop. For example, I have hair which is mostly smooth but with some coarse hairs (I used to pull my hair out as a child). I spend huge portions of each day, while I am working, sort of combing my scalp looking for the coarse hairs. When I find one I feel a sort of temporary soothing peace, and something like a moment of bliss when I pull it out. I don't want to pull my hair out and I am much better at not doing so these days, but I don't get the satisfaction of pulling the hair out, and so I feel like I have to keep searching for more and more of them.

I have read suggestions in other threads about finding something else to do with your hands, e.g. coin tricks or knitting. But this is not really feasible for me because I fidget constantly. I do it with one hand while I'm using the mouse or stirring the soup or whatever with my other hand. If both hands are occupied my feet start moving.

I am also someone who gets distracted really easily, and somehow this feels related to the fidgeting. Often when I fidget I find I've lost concentration on the task at hand and I'm thinking about something else - usually worrying. I consciously try to take in my surroundings as I walk down the street, but I inevitably turn inwards soon enough, and sure enough, I realise I'm fidgeting. When I walk I often listen to music, and I find that it's difficult for me to listen to a whole song, or any song other than a handful of really catchy songs with big beats, even though I feel like I want to enjoy the many other tracks in my library - I skip through them really quickly and just pushing the buttons to skip feels like a form of fidget too. During conversations I can quite easily stop paying attention, even though I look like I am - my fingers start moving and my brain does too, even though I WANT to listen! It's tiring. I feel like I can't focus and I miss a whole lot because of this problem. It's hard to follow verbal instructions, and my spacial awareness is crap because I'm so often in my head and worrying my hands instead of looking and noticing.

I am in therapy, classic psychoanalytic style. I feel like therapy has helped me a lot, though it has been sloooow going. My therapist knows about my OCD - we have discussed my problems with constantly checking faucets and ovens and avoiding cracks and all that - but it hasn't really been the focus of our sessions, and hasn't been treated in any practical way. The OCD compulsions have definitely reduced since therapy started two years ago, but haven't gone away. The fidgeting is the same as ever.

I'm not on any medication other than birth control. My caffeine intake is pretty low, usually one cup of coffee a day.

Anything you can suggest that might help? Thanks heaps.

Too much anxiety, therapy isn't working, help?

Anonymous — Tue, 15 May 2012 13:11:20 -0800

My anxiety is running my life. I've been to therapy, it made it worse. What next? Basic problem: I have really high anxiety mostly related to my work performance, I live in fear of public failure, I have high expectations for myself, and I can't be proud of much about my work since objectively I have achieved less than some of my superstar friends/peers and I feel I'm underperforming even relative to my own capability.

I have a tendency to quit things that make me feel bad rather than stick them out, so I can have down time to feel calm again, even if I know I shouldn't quit for some good reason. I think a work project is going poorly because I'm getting stuck and making mistakes, so I ignore it until my boss demands to see progress, even if I liked the project for its own sake at the start. I am terrified that my career is going to stall or even worse that I will get fired, that I'm not good enough to stay in my field and I'll need to find a whole new less ambitious line of work, but that will be "settling" and will also make me miserable. I am a decent cook but constantly feeling guilty about how much I eat out because I'm stressed and busy and just want someone else to worry about the food preparation. Same with exercise; I bike and jog short distances inconsistently but its not enough and I feel bad occasionally that I'm still unfit, and I know exercise would help. I should probably be more proactive about socializing even though I have a bigger social network now than I ever have. But the main goal is to improve enough so I don't risk my job at this point.

So I need therapy, obviously. I went for several sessions. I said that the main problem was that my work was suffering because I couldn't manage my time, I was constantly stressed, not having many good days where I felt calm and mentally sharp, which I really need to do my kind of work, which is intellectually taxing. She said I was just secretly telling myself I sucked and that deep down I think I'm a terrible person all the time, and that I had to stop that (I don't think that was true, but okay, she's the therapist). Then we talked about my social life, and she thinks I am too cold or introverted. I guess this is true, that I am slow to establish intimacy with people, but I think I'm well liked in general but I never want to push closeness on someone who doesn't indicate they want it, so I have quite a few friends I have fun with, none of whom are best friends or people I regularly tap for support. She focused on this problem, and the work stuff was getting ignored in sessions. This made me feel like even more of a failure than when I started therapy, so I quit (see problem with quitting previously mentioned). Apparently I misled her or something, or I was doing therapy "wrong." I feel like most of my worries are totally rational and normal but I just can't set them aside long enough to be super productive, and that's what I want to be able to do.

Questions-
1) I am putting my career at risk if I don't fix the work performance anxiety eventually. I am smart, I don't suck at my work, on a good day I find it interesting, but I'm not a superstar. My boss just says I need to work harder and be more passionate/committed. That's not helping. We have a plan for some concrete things to fix but if I can't turn around the anxiety, the plan won't work. That means I have a few months to get this under control and find some calm source of inner motivation or I will probably end up fired, broke, and in an even deeper hole. Are there any stopgap measures I can implement RIGHT NOW that will help me avoid this outcome?

2) I probably need to go back to therapy but I don't know how to do therapy right, apparently. I'm not even sure it will help because I'm just realizing how bad the anxiety is and how much it feels like just part of who I've always been, and it's not always at some crazy dysfunctional level, I'm just bad at managing/ignoring it even when it's mild. How do I do better with the next therapist? I won't have much choice for the next therapist, I will get one pretty much at random, and there are only a few available to me that are covered by my insurance.

3) Is there ANYTHING else I can do to get some traction other than trying my best to make therapy work on the second round? First therapist said drugs won't help me, but do I need to demand to try benzos for the short term until this is under control?