My therapist Lori, who’s been treating my anxiety and depression with talk therapy for over four years now, has been challenging me more frequently in-session during the past few months. Early in therapy, soothing, verbal pats on the back, purposefully meant to help validate my emotions, were often sprinkled into our talks. But, with progress, they’ve mostly been replaced by nudges to dig deeper into the causes of my emotional state, to work harder at problem solving.
Just last week, after starting a session off with an eight-minute rant about my landlord not addressing the faulty heating in my apartment (something that angered me exceedingly), Lori, her game face intact, asked straightly, “What’s really going on here?”
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After some time, I concluded that my fear of not being able to cut it as a writer was to blame for my overreaction. It sometimes bugs me that I still can’t afford the lifestyle I wish to have—a decent apartment of my own, money in savings and for some travel—while putting in the hours of work that I do. The chilly temperature in my bedroom was palpable proof that my choice to become a freelancer, after 11 years as a teacher, was a poor one—at least in my head, where I was momentarily ignoring any professional achievements over the past half-decade, of which there’ve been plenty.
Distilling such heavy shit in the moment isn’t easy, though; those mental gymnastics take practice, which is what Lori is guiding me through at this stage of my therapy. But at some point I’m going to have to handle such emotionally challenging moments on my own, so they don’t exhaust, or overwhelm me. After all, that’s the whole point of therapy: to learn coping skills and employ them to better yourself. But Lori had sensed some reluctance on my part to push toward doing so, and she called me out on it—in about the kindest way possible.
“I just want to remind you, I’ll always be here for you,” she said. “Whenever the time comes that you don’t have to attend regular therapy sessions, you can certainly talk with me if you ever feel the need to.”
It was a beautiful way for her to suggest that I might be self-sabotaging, that perhaps on some level I was operating against my own best interests and denying myself the right to get better. If I keep myself buried in the muck of my mind, I could continue to absorb the euphoria that comes with the compassion, empathy, acceptance, and support she gives me twice a week.
But did this mean I was becoming addicted to therapy?
“I don’t know that I would say we become addicted to it,” says Anthony P. DeMaria, a New York-based psychotherapist and associate director of adult ambulatory psychiatry at Mt. Sinai, speaking on behalf of patients. But, he confirms, a patient can develop a dependency on their therapist’s emotional embrace.
“Like most pleasurable experiences, we try to seek it and we would be reluctant to let it go,” DeMaria says. Usually in talk therapy there’s “a quality of emotional warmth” that people enjoy and “can be curative in certain respects,” he says, too.
“When a client comes in, and they have a lot of emotional pain, and they’re trying to deal with everything that’s going on in their lives…this may be the first time they’ve been listened to and really understood,” says Nancy Sherman, an Illinois-based therapist and clinical coordinator for the counseling program at Bradley University. Because of a counselor’s training to be empathic, facilitating a patient’s dependency can be something that they—especially new ones—“fall into pretty easily.”
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Enjoying therapy and the growth it awards you is one thing, but when a client wants to cling to this crutch of sorts, she or he might begin patterns of self-sabotage, and operate against their own best mental health interests.
Sherman, who specializes in counseling patients who’ve survived trauma, says if a therapist mentions the idea of wrapping up therapy or scaling back the number of sessions to a client who’s become overly dependent upon it, sometimes “old behaviors start emerging” in the patient, often in their relationships with romantic partners or coworkers.
They might begin “doing the same things in their relationship that caused it to fall apart the last time,” Sherman says, “even though they’ve learned new and healthy ways of relating” to others. “I don’t think self-sabotaging is a conscious process,” Sherman continues. “It’s the fear that ‘what I have here is going to be taken away.’”
In my case, it’s possible that I’m self-sabotaging with inaction, by not taking better care of myself outside Lori’s office.
At this point, I know I can develop better behavioral habits to combat my anxiety and depression when they torpedo into my life. I can breathe deeper, slow my brain down and flood my mental threshold with more positive thinking to disrupt the negative, spiraling thought cycles that have been my norm. (See: turning a bad radiator into “I’m a bad writer.”) I could exercise more, eat a little healthier, and drink a little less. But doing all that might, Gasp!, make me feel better, which is not part of my comfort zone, and would mean the dissolution of my relationship with Lori as I’ve come to know it.
But, alas, that must happen at some point. Otherwise, what’s been the purpose of all this therapy?
Still, DeMaria notes that saying goodbye to someone, ending a relationship that’s provided so many positives to one’s life, is often a really tough thing. He adds that the best way to work through this is to talk about it. “In most of our life, an ending happens and then we make sense of it,” DeMaria says. “Therapy reverses the order, where we talk about it beforehand, we process our reactions before the ending has actually happened to really make sense of it.”
Therapists can make this more palatable, according to Sherman, by setting measurable therapeutic goals with their clients. To generate those, therapists can ask patients “What do you want to work on? What would you like to see changed?” If a client broadly says that they “want to be happy,” a therapist should coax the client into drumming up some specifics by asking a follow up, such as, “What would you be doing if you were happy, that’s different from what you’re doing now?”
Some patients meet their therapeutic goals in a small handful of sessions; for others it can take years. Neither is “right” nor “wrong,” and the time for “termination,” as the end to regular therapy is called by counselors, is determined on a case-by-case basis.
DeMaria says one of a few possible indicators that a patient might be nearing termination “is, as simple as it might sound, my patients telling me that they are feeling better.” The patient may, “during termination, reflect on the initial catalysts for seeking treatment. With change being a gradual process, people often look back on where they were then relative to where there are now, and remark, ‘Hmm…yeah, that actually isn’t part of my life anymore, that no longer presents an issue.’”
To get to that point, it’d behoove me to employ tactics and strategies on my own time—no matter my professional standing—that will lead to a healthier mind. Though I don’t foresee an imminent end to my therapy right now, I know that having conversations about termination with Lori is itself a step toward that.
And if that’s not enough proof, I can look at what happened just the other night for more: After dinner I suddenly began feeling depressed, and decided to go for a walk and get a few groceries, just to occupy myself. I don’t quite know exactly how much time I spent in front of the ice cream racks at the supermarket, debating what Ben & Jerry’s mix was going to cure my craving, but I know eventually I moved on, without pulling a pint out of the freezer.
I’d thought to myself: “What’s really going on here?” I was probably feeling a little lonely, as I’d been working all weekend, by myself at home, and with the temperatures dropping, my seasonal affective disorder was starting to kick in. Would a mound of frozen sugar and milk make me feel better? Of course. But only for a little while. At some point down the road I’d be upset again—perhaps over unsightly cholesterol levels after my next blood test.
My therapist can’t elbow me into these thought patterns moment to moment, day-to-day, though.
It’s up to me. I’m in control. Challenge accepted.
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