Therapy - how to decide what to talk about/address

[storyworld]

Hello, all,

How do you decide what to talk about each session?

[NarcKiddo]

A lot of the first year was spent telling my story with lots of stops along the way as my T asked how I felt about certain aspects.

Now she always asks me what I want to talk about. I often have a list of topics that are bothering me right now, or reports of what I see as progress. I do have a list of stuff that would be nice to discuss if we ever have time, including some more theoretical stuff, but we never seem to get that far!

[Armee]

My therapist used to say something a lot that would piss me off a lot. But it also turned out to be true. "All roads lead to Rome." He also said something that pissed me off slightly less but did confuse me for awhile, and also turned out to be quite true: "trust in the unfolding"

It's not fast. None of this is fast with cptsd. Things will come out as they need to. It took me years to be able to talk with him about the harder stuff. For awhile we just worked on me becoming overwhelmed trying to do chores on the weekend. It felt so silly because there were all these huge issues under it all. But it was a very very good place to start. It almost doesn't matter. Just work on building trust and tolerance for feeling things. Slower is faster with trauma therapy unfortunately.

[storyworld]

Thanks, NarcKiddo,
I feel like I understand many of my triggers, or at least, where they stem. I don't know if that means I should, or don't need to talk about them. Also, I feel like my anxiety has become much more manageable--except at night, when I try to sleep. I don't know if that's something I need to explore. I have no idea why I get anxious when I begin to fall asleep, but I have been able to sleep, which is progress. There are things in my past I feel anxious about whenever I consider talking about them. I wonder if I need to talk about those, but then I wonder if those particular things are actually impacting me in the day-to-day. And sometimes I wonder if I should talk about sort of background stuff, which I know logically probably impacted me but that I don't remember feeling anything about as a kid. (Then again, I feel I was pretty emotionally numb for much of my childhood, which makes "digging" up stuff ... confusing? 

[storyworld]

Thanks, Armee,
I do feel I've gotten better at not getting so dysregulated. Your two phrases are helpful, as is your experience.

[storyworld]

As I was starting to list out things I wanted to mention, including explanations of why I wasn't ready to talk about certain things (and am not sure I'll ever be), I realized I need to talk about slightly unpleasant things to grow my courage. Thank you for helping me process this out! I feel I have a game plan that will be helpful but also feels manageable.

[woodsgnome]

Having been through lots of therapists before my present one (nearly a decade now), the first steps in, looking back my our first forays involved my looking for hints of how the 'fit' meshed. My old trust issue dominated that attitude.

It soon became apparent that there was a good fit -- she expressed the notion that she didn't 'do' therapy for anyone; that the therapy part is more of a partnership, exploring mostly along lines suggested by the client.

At first I found this a little disappointing. She didn't have answers? Like many, I wanted the easy-on approach. But it soon became obvious she wasn't buying that one -- she might have her own opinions but everything reverted to how I felt, with the allowance that her expertise in trauma therapy was always present.

Another intriguing thing I learned early is that she was a keen listener, and totally open to me as part of the process. It wasn't about her doling out fantastic advice and my going off to live happily ever after. She accepted my input, even delving into some of the books I'd come across that she hadn't.

All along, she trusted my own yen for self-discovery beyond the therapy appointments only. I have a huge inclination for what's called Bibliotherapy, and what I discover in reading often gets into our meetings (mostly telephone now, following the pandemic (one of her offices is in a medical centre). I wouldn't have favoured this at the start, but once we knew each other better the telephone approach saved me some hefty travel.

I do set out some notes ahead of time ... BUT I tend to want to rely on them so much, it can feel like I'm reading a story to her. She's actually okay with that, but I never do catch all of what I want to say either.

But I'm prob getting a little too self-critical here. Plus comparing therapists for unique individuals is tricky anyway. We're all different, prefer different ways to experience therapy.

That said, I'd just encourage patience, especially at the start. Some notes probably help, but they can get a little carried away, too (mine is also partly due to ye olde 'perfectionism many with Cptsd develop; following years of explaining for others and not feeling understood, it feels natural to make clear what one is trying to say.

I wish you well in establishing a pace and style that seems comfortable. I used to have doubts about in-person therapy's usefulness, but my experience with this T has changed all of that.

[storyworld]

Thanks, Woodsgnome,
Your response was helpful and encouraging. I realized, as I was processing through my feelings regarding therapy, what to share and not share, that I have a whole jumble of emotions and concerns all interwoven. Which sort of frustrates me. But at least I'm more aware of my roadblocks and inner "freak-outs."