I am frustrated over not understanding what is supposed to be happening and not knowing if something is happening or not. I do not know how to determine if this is worthwhile or a stupendous waste of money for me. I have asked T to explain, in non-nebulous touchy feely terms, but she is either incapable or unwilling to do so. She says she does not have any answers but things are going along in a usual fashion. I do not want to depend upon her characterization, I need to be able to understand this myself. I have read books but have not found them useful either - they often seem (to me) to be anecdotal recollections by condescending paternalistic men
(and sometimes women) rather than science based explanations for how this works and why. Actually there seems to be little explanation at all as to how therapy works and why even when not science based.

Hi Stoppers. Do you have goals for yourself in your therapy? I measure my progress by where i'm at in relation to my goals.

Jones

There is a goal, but I cannot tell where anything is at in relation to the goal. I am beginning to think therapy is not for me because I cannot seem to get the part of me that needs to understand this rationally to stand down.

So what's the goal? Is it concrete? Is there a way to make it concrete? I have a strong need for rationality too - I find it's ok if I work with that need, rather than against it.

It may be i just hate the process. An expensive lesson to learn. I think the cure may be worse than the disease for me.

Hi, stoppers...

Idk...goals. I have a tough time with that one. I was in a family where nobody had any goals. I still am. So goals in therapy feels foreign and uncomfortable to me. I've realized that I am really there just to get some sense of caring about me from someone. And I feel pathetic admitting that...especially since my T is all about goals and meeting them..? It's confusing. I wonder about the idea of attachment in therapy all the time. It seems to play into the "goals" thing somehow.

just mulling all of this over...don't have much valuable to add I realise.

sorry about that...

BB

BB - In that case, I think the goal becomes to change your interactions with the world that are under the power of your injured attachment pattern. For instance, my codependent behaviors seem to have a root in my attachment issues. So, I can have concrete goals like:
-Being able to make decisions for myself without feeling guilty.
-Taking responsibility for my own feelings/reactions/boundaries and not those of others.

Or less concrete like:
-Having my own sense of identity that is not based on the expectations of others.

But even those less concrete ones can have concrete sub-goals...

Thanks for the input. Goals are not the problem or the solution. I really think the subjectivity is a huge provlem for me. Having nothing i can consider to be real about the so called process is making me feel crazier than why i decided to try it.

It seems like some strange religious type leap of faith rather than a logical process. I was never good wirh the religious leaps of faith either.

Thanks DF. I wonder if I could afford an mri twice a year - that seems reasonable doesn't it?

Why would an MRI tell you more about what you feel than your feelings?

I think subjectivity becomes a big problem when we try to discount or push away or we simply don't trust our own feelings and experience. I mean, we live in subjectivity. We live utterly and completely bound in our own thoughts and feelings. We can take in outside input, but we can't actually escape being a thinking, feeling, embodied person. Everything comes through that filter. So one way or another, we gotta live with the reality of our subjectivity. Our feelings are never going to become objective and get scientifically verified, MRI or no MRI.

This is connected to the goals issue. Seems to me that therapy goals don't make any sense when we don't recognize or value our own wants and needs.

Mostly the mri thing was playing, i think (it was for me although i would love to do it to get the evidence). But if it could be done, and the brain science people are right, it would give an objective measure of change -which is what I am looking for. How does one know if therapy has worked or if one is just in a better mood for whatever reason without some ability to measure it?
I fully admit the whole attached to T thing as the thing that works makes no sense to me, nor really does the feeling part as opposed to doing things to change thought patterns. Please note I am not saying anyone is wrong or trying to invalidate others, just that I have no idea what it means or why it matters. And i have been trying to figure it out.

Sure - sorry if I sounded aggressive/defensive, I didn't mean that. Can you explain more about this part -

quote:

nor really does the feeling part as opposed to doing things to change thought patterns.

?

I'm not sure what you mean there.

My point is that the kind of thing that we want to get out of therapy - feeling better, being able to operate more effectively in the world and in relationships - that stuff *is* enormously subjective - but that doesn't make it any less valid. You could do all kinds of tests and it wouldn't give you the accurate and detailed information about your experience that your thoughts and feelings do. As in - I have a conversation with my therapist, something makes sense to me in a new way, I find I don't get upset about something that I used to. There's no real way to measure that through a test. Attending to your thoughts and feelings and the patterns in them is what gives you a picture of what's happening. And then if you need more concrete measures, there's your behaviour as well.

Not sure I'm helping here though. I know it can be really disorienting to engage in this, and I have times myself where I can't see the wood for the trees.

I liked your question, though.

It *would* be nice. Sorry, I know I sound totally crotchety today. I confess - it's because I *am* crotchety. But it's nothing to do with you guys. Just neglected to take off my getting-things-handled work hat.

xxJones

Aw, it's ok - just kinda grumpy and under-slept! (((DF))) Thanks! xx

PET and fMRI scans show changes w/ emotions and the brain with treatment - I learned about it in my physiologic psych class in school. I'll see if I can find some of it and post it. They actually have been able to measure that therapy does actually change your brain over time.

At the same time, it's hard to hold on to the science and the theories in the middle of it. The science behind it all helped me get in the door, but my own subject experiences of progress keep me staying - and when those are gone - I stay because of a mix between the science, other's stories, and my simple desperation. It's not an easy clear cut process, especially when I'm inside of it.

jd

It is psychodynamic mostly I think or eclectic. She was not very good at a label on the type. I do ask her and she lies and says she has no ability to explain or and does not know why or how this works, just to trust and I will know it when I see it. I have consulted with others and although they have explanations, the whole thing doesn't seem rational at all except from the brain change thing and without an mri or something, it is not measurable. Thanks for the responses, I think I simply have to accept I am no good at this and move on.

For me when I'm in one of my flashbacks I am unable to see the change therapy has had on me, then when the flash back is over, which can take days, its like something new within me has been born, each time It feels I have taken yet another step back, when through it, I realise Ive leaped forward.

In the early days of therapy, it was very hard to trust the process, always wanting some concrete proof things were going to change for me, I'd read lots and lots of therapy books, all of this was a defence against feeling, and trusting, now books do not hold anyting for me, I've managed to take the leap from the safety and securtiy of the written word, to the reality of the theraputic relationship and even when I am in one of my flashbacks there this inner knowing that I've been here before and survived it and that new knowledge comes from it and an inner strenght is felt, its like still being me, still having all my memorys and experiences, but not being swept up by them.

I dunno if this is helpful at all stoppers - I might be totally missing the mark, but here are some links to some info about brain scans studies they have done to evaluate psychotherapy's effectiveness in general,

http://www.healthieryou.com/ex...erspectives0496.html
About a study from 1996 and the article says: “Researchers at UCLA have reported that psychotherapy for obsessive-compulsive disorder, or OCD, results in changes in nervous system functioning so marked that they are visible on PET scan, a form of radiograph that measures energy usage in different regions of the brain.”

http://pn.psychiatryonline.org/content/39/9/34.1.full
"Brain Data Reveal Why Psychotherapy Works"
Part of this article talks about psychodynamic therapy

http://news.unchealthcare.org/...cts-of-psychotherapy
About depression and brain changes

http://jppr.psychiatryonline.o...g&pmid=10079458#SEC4
A very technical article, but really interesting, about how psychotherapy changes neurobiology

It talks about a lot of different problems including bipolar, enxiety, depression, and PTSD and how therapy changes the brain.

"Viinamaki et al.59 used SPECT imaging before and after 1 year of dynamic psychotherapy in a patient with bipolar personality disorder and depression. Her imaging studies were compared at the same timepoints to those of a control bipolar patient who received no therapy and to those of 10 healthy control subjects. Both patients initially had decreased serotonin uptake in prefrontal cortex and thalamus compared with the healthy control subjects. After 1 year, the psychotherapy patient had normal serotonin uptake. These findings suggest that dynamic psychotherapy can affect serotonin metabolism. "

---------------

But regardless of any studies - what matters the most is how it is working or not working for you. I don't think you are beyond help, but it almost sounds like you feel you do. Maybe your T is not the right fit. She should be able to explain more to you what she thinks will help and why - not say just trust. I'm sorry she didn't help more. Not all Ts are the right fit for everyone. I ran into a couple of Ts that totally didn't help in any way - kind of made me feel worse actually.

- jd

Freuds fly-thank you for the interesting perspective on how it changed for you.

JD- I really appreciate the time and effort to list all those links. I shall start reading right away.
I have gone to talk to a neuroscience person which was interesting. I just wish the t I have been seeing would tell me some of the neuroscience parts instead of lying and saying there is no explanation.

stoppers ~ just wanted to say hi and that you came to mind. hope things with you are turning around and you have found a helpful path that will work for you through all of this...
take care,
~ jd

Stoppers,

Just wanted to add my two cents really late. Personally, I really think there is a "map" of progress and my T has reluctantly admitted to one. BUT, I think me needing a "map" has more to do with my anxiety about being in the relationship with T, feeling out of control, wanting to please but not knowing how, etc., I could go on and on. It has been said that the healing is in the relationship that you build with your T. If you had a map, you might tend to try to build a relationship by following the map instead of following your feelings and learning that way. Just my two cents.

JD- Thanks for checking in. I am very depressed right now. I barely get out of bed or the house fornthe last couple of weeks.

Liese- I would like a map or a structure of some sort. I do not care for the relationship idea at all.

((((stoppers)))) I'm sorry things are so hard right now. I can relate to barely getting out of the house. I need an obligation to other people to do it most days.

In the beginning, I often asked T for a map or more structure, specifically so I wouldn't HAVE to do the relationship thing. The relationship thing, in my case, is where my stuff surfaces, though. Your situation could be different, though. My stuff is, I think, mostly attachment issues coming into play.

It's good to hear from you. I'm so sorry you are feeling so down. I hope things get better for you soon. Depression is a tough monster to deal with.

Yeah, the relationship part is tough and messy. In most therapies, there are different levels of structure and some are more... I guess you could say formulaic, and others are much looser. They have done studies about what works the best, and again and again, they say the theraputic relationship is the best predictor of therapy working to change how the client is doing. This doesn't mean you NEED a therapy relationship to get better - there are other ways. For me, I've found that part to be the hardest, and the most healing - in ways I can't describe how it works in my own therapy relationship. I can see it in others but in my own, it feels so foggy and messy and unclear - almost like trying to bite my own teeth - I can't get outside of it enough, and this is really hard and scary for me. It makes it hard to hang in when it't tough and I wonder why I keep trying, and then I see how it works for others or remind myself of the science behind it in a general way... and mostly, I keep notes on where I'm at, then I can compare it with how I am in the future. There are a ton of ups and downs and tough dark times and szet backs, and also steps forward that I never expected. I'm not saying this is how it works for everyone, just saying this is how it has been for me.

It's really confusing in the middle of it. I hope you find something that fits and works for you soon.

Hang in there,

~jd