It's time to do the thing, therapy edition

May 23, 2023 4:36 PM

I started to go to therapy for the first time back in February to specifically deal with cumulative grief, years after I probably should have. Right when I started though I had pressing, overlapping crises and have used the sessions to talk about that. But now it's time to do the therapy (EMDR) on the original issues and... I'm not ready anymore, I'm sure I'll never be ready, but it needs to be done, and it starts Friday. So how do I do this?

When I started to see my amazing therapist, with whom I have a great relationship and a lot of trust, it was to deal with all this cumulative (multiple losses) grief, as well as decades of complex trauma. It's a mess. But there were other very immediate crises going on and I spent all of my sessions working through them.

And then... those resolved (therapist was invaluable!) but since then I've spent one full session talking about anything but the thing I was there to talk about (delay tactic), and another full session asking her how switching to the originally-planned EMDR therapy will work (another delay tactic, which I know she sees through), and discussing whether it'll be weird switching from just kind of casually talking to another, structured form.

She walked me through all of it and on paper it makes sense and I know the process will unfold and I'm super comfortable with her. I just don't feel like I can face everything I need to, and which I'm spending money to do, and which will benefit me in the long run, and which is many years overdue. It's all too big, and too much, but it's time.

Have you ever dealt with this? Going to therapy but doing your absolute best to not actually do the therapy part, but then finally doing it? Or have you switched from one mode to another with the same therapist? Any guidance would be helpful and many thanks in advance.

posted by reader to Health & Fitness (11 answers total)

Response by poster: I should add - a couple of sessions back she was like "hey, so... we should probably start getting to the therapy part of these sessions".

So... that's how I know I need to, and how I know that she knows.
posted by reader at 4:44 PM on May 23 [2 favorites]

Hi, I have a therapist who has done EMDR with me for some past trauma.

I have worked through 3 different modalities of therapy with this therapist (CBT, EMDR, and more casual talking). Because of a bad experience with a former therapist who introduced the idea of EMDR badly, I was very, very resistant to it at first even though I badly wanted to work on those issues.

My current very good therapist introduced it very gently and only after I was ok with and responsive the gentle part did we fully get into EMDR. We still have have sessions that work through the other two modalities when appropriate (e.g. immediate grief thing that I just want to talk about; cognitive dissonance that I recognize but need help working through).

TL;DR version: since you trust this therapist, I recommend mentioning that you feel resistance but want to work through trying it anyway. Part of the EMDR process (at least as my therapist does it) involves working through that resistance. If you hate it or it turns out you aren’t ready to dive hard into that part, you can always switch back.

If you want to talk further, please feel free to reach out.
posted by eleanna at 5:19 PM on May 23 [4 favorites]

Aaaaaaahhhh I know this so well! I let my therapist know how immense my resistance was to opening any tiny portion of that box, even knowing that I needed to.

The first time I did somatic trauma therapy, my therapist suggested we just do 30 seconds. No more. Just 30 seconds. I countered with “I’ll do 5 seconds and if I want to quit, I’ll quit.” She agreed, we did 5 seconds, and I spent the rest of the session talking about what gets kicked up.

But — the next session, I did 4 minutes.

I think — I think for me, there was a part that was terrified of what was in that box, and as much as I wanted therapy, it was afraid that it would die - again - if I went there. I think when I advocated for 5 seconds, only did 5 seconds, and no pressure to do more, “that” part of me learned that Therapy-me would advocate for terrorfilled-me and hard-stop, if things got too intense too fast.

Kudos to all the parts of you who have been showing up for the sessions, in any capacity.
posted by Silvery Fish at 5:29 PM on May 23 [11 favorites]

Huge fan of EMDR. HUGE. And I literally sweat through my shirt the first session before we even started. I was terrified. BUT - you can just edge towards things. You don't need to face anything full on or all at once. Also, you'll be doing (or *should* be doing, which you can ask about) standard EMDR exercises to contain and manage any anxiety or panic. Also also, the practice really is, as they say, a lot like watching old events from a moving train. Nothing will feel as intense as if it's happening all over again. It already happened and you already survived it.

You've got this.
posted by Ink-stained wretch at 5:57 PM on May 23 [5 favorites]

I found EMDR very helpful. One of the things I liked about it was that I didn't have to rehash my trauma. No trauma narrative is necessary.
posted by intrepid_simpleton at 6:10 PM on May 23 [3 favorites]

Nth-ing everyone who has said you can try short durations of EMDR and move towards longer ones. There's no reason your next therapy session must be entirely trauma processing/EMDR and it's completely okay to ask your therapist to work with you on transitioning to using more of this new modality. When I've previously done EMDR with a therapist, it was as shorter sessions that happened during my appointment, but did not last the entire 50 minutes.
posted by augustimagination at 6:25 PM on May 23 [2 favorites]

It sounds like you and your therapist have a good dynamic: you know you're willing to try even if you're scared and she knows you're ready even though you're scared. I get the fear because I had it too!! But I'm so glad that my courage was slightly greater than my fear and I followed through. The EMDR sessions were super helpful as was my therapist in general. I continued with talk therapy after for a few more months before moving away; now I do occasional check ins with her as well as have a telehealth appointment with my psychiatrist who's also excellent.

My whole therapy experience -- once I found a good match and which included multiple sessions of EMDR to address traumas that started in childhood -- was truly life-changing. I can't say what exactly was the a-ha moment or thing that helped most but I can say that my life now is better (more stable, relaxed, happy, etc.) than I had ever imagined possible. EMDR was part of it!

Anticipating the first session was scary although being there felt fine; you'll probably be tired or feel a little awkward after. A good therapist will help you readjust to present after the exercise (I'm using totally unprofessional language here but you get it!) Take the evening off if you can, treat yourself to something yummy and watch Netflix or read or sleep or whatever is best for you. I found solitude helped but I can imagine some people like company. I remember not thinking about the trauma or anything in specific after but rather feeling a mixture of fuzzy and clear? I don't know if any of this will help but you have my encouragement!! You can always wait another session or two but I believe you'll feel much trust in the process -- or at least safer -- once you try.
posted by smorgasbord at 6:38 PM on May 23

Here's the thing. Exposure-based trauma therapies *will* make you feel worse before you feel better. You're not being resistant, you're scared of a side effect of treatment that is painful and difficult. It's ok to plan to do this at time that works for you. It doesn't have to be this second. If you know it's time now, it might be good to talk over with your therapist a self care plan to get you through the tough part. It is totally worth it! But it's also ok to pick the best time, and doesn't make you avoidant or a bad patient.
posted by shadygrove at 7:21 PM on May 23 [3 favorites]

It sounds as if you are in safe hands with your therapist.

You are in control of this process. If you want to, you can stop it.

EMDR is very much in your control.

Your therapist will ask you, at every step, whether you want to take the next step, or stay where you are, and both of those are valid choices.

You're not going to be swept off your feet, you're going to be strapped into a safety harness with a professional, kind, knowledgeable person right there with you ready to bail you out if things get too much for you. You'll be able to tap out at any time, if you need to.

You get to set the pace. And it might be very slow, with just a tiny step at a time, but that's OK, if that's what you need.
posted by Zumbador at 9:54 PM on May 23 [2 favorites]

I found EMDR helpful and was apprehensive about it at first. Things that helped me (with a lot repeated from the answers above):
- talk with therapist beforehand about how to cut a session short if I needed it and get back to a grounded state before going home.
- practice grounding techniques
- make a plan with therapist as to what to do if I feel overwhelmed in between sessions.
- trust myself to stop an emdr session when no new images/feelings arise/my mind goes blank. For me it was a sign that I was at capacity for the day and to continue in another session. I hardly ever filled my entire time slot with EMDR and usually ended 15 min early.
- plan for extra rest after a session and the day after
posted by schamper at 7:37 AM on May 24

Response by poster: All - thank you very much for the kind words and encouragement, I knew I could count on thoughts and guidance but I was really moved by the empathy and didn't know how much I needed it.

I feel a lot better about going into this on Friday and I really appreciate hearing about your experiences. It also truly hadn't occurred to me that I didn't have to go into it head-on and take up the full session on the intense work. I know she'll be on board for that not just because she's a great therapist, but when I think back to her explanation now she maybe even said something to that effect but I had a hard time comprehending as my entire body was telling me "well sure, SHE'S great, but you should definitely run".

Thanks again all. :)
posted by reader at 3:40 PM on May 24 [1 favorite]