Schema Therapy Blog

[Natara]

We made it up to the first hospitalization in 12th grade. I don't have therapy next week, and I really appreciated it when he spent 10 minutes after the session making sure that I would be okay.

[Natara]

Well, it turns out that I really wasn't okay two weeks ago. I had an awful week, but the next week -last week- was blissfully full of treating a very nasty head cold (a break from myself!).

The two week break from therapy gave me an easy chance to start talking about some very serious, very sudden psychological problems rather than continuing a review of the past.

Thes session was largely my talking and him asking questions. We spent a significant amount of time on my recent problems with paranoid delusions and anxiety, which transitioned to talking about how my close friend's death months ago might have triggered a desire to completely isolate. We talked about different types of people and why I rejected them and how I rationalized it.

I think we were more solution-oriented than cause-oriented this time, maybe because I was largely directing it, and I'm much more familiar with problem-solving than connecting the [fairly murky] dots. S asked me to keep a record of when my paranoia pops up. I've shared with him my most recent plans to improve my quality of life (sleep schedule changes, activity/routine changes). I've also decided to have some good thinks on how I currently view specific types of people; especially first impressions. I much prefer to do my introverted explorations on my own than in his office.

Therapy is decidedly the opposite of relaxing. Today, I walked into the waiting room, and I thought of the hospital, of what S and I had talked about two weeks ago. Immediately, my pulse started racing and I felt blood rush to my face. I wanted to run. I think there is something beneath the surface going on, and I want to be able to associate therapy with safety rather than discomfort. That's why I think doing the "trudging" will be more beneficial at home. (My mind is a swamp, apparently.)

[Natara]

It figures that as soon as things really start intensifying and real change starts taking place that I stop updating. I'm not going to try to recap the past two/three months, but I will try to regularly update from now on.

My sessions tend to fall either into exploring things through a "schema therapy lense" or into small lessons. The first half of today's session was venting about my awful, awful week and the second half was learning about another type of therapy I can do at home to help improve my relationships. Just learning and trying to apply new perspectives can be very useful and have long-term benefits.

[Natara]

The session started by my relating to him how I found out that I really am a "worrier," or rather, someone whose thoughts are primarily driven by anxiety. (Just like Dad, haha; as I've gotten older, I've become more and more like him.) Although I briefly went over some of the big things there were to worry about, S concentrated on teaching me the different ways anxiety can "feel."

He said that most people* feel anxiety, it's usually felt as a strong sense of anticipation or nervousness. That person is about to do something or is planning to do something, and they're not sure it will go correctly. Anxiety can also be caused by cognitive distortions, and generally result in physiological responses. The two he focused on were "catastrophizing" and "overgeneralization."

Unfortunately, I tend to be a rambling patient, and we go on a lot of tangents. I related some of my most recent thoughts and my concerns about my thoughts to him, and he explained where or how the two cognitive errors might manifest. He didn't quite offer a solution to fixing these errors, but he did offer an exercise:

He told me for 10-15 minutes a day (early in the day), to worry intensely about everything and write it down. Drain the worry out of me for the rest of the day, so to speak. It's called "exposure."

He said that self-destructive and "odd" thoughts spontaneous occur to everyone, even happy and healthy people. The way many psychologists determine whether or not these thoughts are a problem is by how disturbing they are and how frequently they occur.

I think with this exercise, although the disturbing-ness would be quite high, it would be voluntarily induced, and it would theoretically make me worry less frequently.

The next two Tuesdays are therapy-free as S is on a break of some sort. Let's hope concentrated worrying doesn't backfire! *fingers crossed*

* When he says most people, he's talking about a general population, not just the mentally ill population.

Edited to fix link 21/05/10

[Natara]

It's the first time in several months that I've been to see S. It hasn't been as long as September, but around September marked when I started seeing him infrequently because of other medical bills. The break wasn't intentional, rather, I hadn't had a regular starting time for several months and couldn't reliably schedule a session. Things have finally started to settle, and booking an appointment without taking time off work became a possibility.

I saw S two days ago, Thursday, and he seemed genuinely happy that I had restarted therapy. It was a stark contrast to the, "I'm your therapist, not your friend, so when we're not in session, I won't be worrying about you in my own time," introduction he'd given me our very first meeting (establishing healthy therapist-patient boundaries, I know now, but boy it freaked me out back then, having previously been with a therapist who was more like a friend). I'm sure he wasn't happy to see me because he thought I needed therapy; I think I'm more of an interesting file or read, and you kind of wonder what happens next even after the story is over.

Anyhow, I restarted because I hadn't wanted to stop, and I also felt more urgency to restart because I've been having problems managing my anxiety lately. Or rather, for the past month and a half, I've been experiencing much more anxiety than I'm used to, and it's been a hassle managing it.

Here's what happened during our break: (not much)
Worry exposure didn't reduce the frequency I worry about things, but it reduced the intensity or volume, if that makes sense. It, if nothing else, gave me points to work to focus in and work on. If, in the morning, I spotted alpacas in the pasture near the street and thought of it as an omen predicting that I would die that day, I could try to work out why I would jump to that conclusion. It was jumping to conclusions/fortune-telling (drawing a conclusion from little if any evidence), and while we're not sure of the origin, when I was a child, I used to have the paranoid habit of thinking that any moment could be my last. It seems that, for whatever reason, I was reliving that state/falling into old habits. The solution was to look at imaging myself as a mother/nurturing figure that could comfort this child part bringing up this feeling.

"What would you say to an 8 year old who believed that a murderer was lurking behind that closed door, when you know for certain, there isn't?" And, at first, I couldn't come up with a response, because I couldn't convince myself a killer definitely wouldn't be behind that closed door. It seemed ridiculous to try.

It took the summer and more to develop a "voice" that could comfort a child. I didn't want to act like a mother. I couldn't be an older sister. I didn't want to be a male, as a child, I had an irrational fear of men. What was there to be? I ended up on Future Self; the person I wanted to grow up to be. So when I acknowledge that I'm distressed or feeling vulnerable, I pretend a part of me from 10 years in the future is giving me advice and showing me her compassion and understanding. In this way, I can be gentle and kind and tolerant towards myself without feeling distracted or overwhelmed with guilt or resentment.


I updated S on what had been going on with my health and my immigration status and my relationship with my partner and my family's well-being. He asked what I wanted to work on, now that I was back, and I had two things in mind to share:

(1) I was on a medication for abdominal pain that didn't relieve the pain, but instead gave me panic attacks. Even though I'm no longer on the medication, I feel my body over-react to stressful situations in unpleasant ways. He rephrased is as, "an overly sensitive button," that seemed to be being pushed, which was more accurate a description. I would be at work and feeling slightly stressed out about the time or somewhat overwhelmed by the amount of work I'd have to do because someone wasn't doing their job right or had called in sick, and then I'd feel my body reacting as if I were in life-threatening danger. Talking myself down was not providing much relief, but I've yet to do anything drastic or believe anything irrational. I think we moved on to the next topic before we could look at ways to fix this problem.

(2) I was feeling trapped. There was a way of explaining schema modes S once shared with me a while ago. He said, "Imagine a land with many hills on it. Each hill is a different mode, but the land is you. So no matter where you are, you're still yourself, but when you're on a hill, the view is different and you may not even be able to see the rest of yourself depending how high up you are." It really resonated with me.

I drew on the white board a crude landscape with four hills. The first hill and third were quite small, the second was moderately high, and the fourth was almost a mountain. I put names to these four hills: healthy adult, Eye, Apple, and Ver. I put a small, but still unclimbable wall around Eye, and drew a stick figure me on top. I explained that I could see the other hills, and I knew I that I was on my land, but no matter how hard I tried, I could not travel to these other, healthier and more balanced hills on either side of me because I couldn't seem to climb over this wall. I don't know why the wall is there, but I am sick of running into it. The more I try to climb over, the more exhausted I become, and I never end up any closer to getting past the barrier.

It was about here that the session time was over, and I had to rush to the bus. S said that there was still a lot more yet to talk about and work on, and so we scheduled an appointment for three weeks from now. I intend to see him on a fortnightly basis from now on, whenever possible. I'm really curious to see what he'll have to suggest.

In the meantime, I'm slowly acquiring music and sounds that I can hopefully use to enter an altered state of consciousness. Being in an ASC means for that period of time, I wouldn't be trapped on top of Eye. I'd be in a different mode, on a different hill. I also intend on writing in my private journal about personal boundaries and priorities, and trying to find out why I've become stuck in a conservative, automatic, people-pleasing type of mode as I've grown older.