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I have been in and out of counseling for a few years and it's been a struggle to maintain for one reason or another but I go tomorrow for my second (first was 'intake/life story so I don't really count it anyway..) session with a "clinical professional". I've only seen counselors prior to this and when I got the option, recently, to see a social work/psychologist type person, I decided to try that route this time. Partly because I know that I have depression/anxiety issues but I think there might be some undiagnosed mental illness issues as well and am hoping this gal will be able to help me figure some of that out. Not that having a 'diagnosis' will magically make me a better/safer person but it might give a more focused direction to deal with some things.

Anyway, that's a long winded way of giving background for my request for suggestions on how to best use the time I get with this gal. (Not sure how much my insurance will cover, yet). I don't want to get off on tangents or fall into the 'how was your week' and then the whole session is gone and we didn't make progress on core issues. Someone mentioned cognitive behavior therapy, I tried EMDR (didn't go well but willing to try again) and so far just talking through the past and trying to 'let go' of it and the shame, depression, etc, hasn't really improved the day to day. Maybe it's just a 'do it' type thing...idk. but am curious of some ideas of things to best use the time and things not to say/try that might derail the process of becoming a decent/safe human.

And yes, I struggle with consistence but am 'trying' to improve in that area, as well..

Maybe write down some personal goals you hope to attain thru this and present them to the Phd. At least it's a start.

Good on you for wanting to best use your time with the IC as opposed to just filling it up.

My 2 cents - old fashioned note taking [electronic or pen/paper]. Jot things down as they arise. Many of them will sort themselves out after a few hours or days and then can be crossed off. The ones that remain can be great starting points. A good IC would be able to take it from there.

If you focus on CBT, you should have workbooks with practical exercises. And you can do your homework and review them with your therapist so it becomes a very productive session.

For example, mind reading. Your IC presents you with a scenario (could be based on your real life or a made up one). Now, you have to write down your thoughts about what you think the other person is thinking. Then you can use that as a basis for your session to reframe and introduce new ways to think about it. Or if you’re trying to reframe negative thinking. Same idea. You write down your initial thoughts but then there are questions like what would a friend think about this situation? Or do I have all the facts? Or does this really matter, so why am I so focused on it?

Part of it is discussion based because you have to identify the things you should focus on, but your IC should be able to guide you and then give you the materials to do the work.

A good thing with writing things out is also to put down on paper three things. You do this daily.

At the start of the day, write down how you feel, what you look forward to most and what you are most afraid will happen. Quick 1 sentence stuff.

Then at the end of the day, you write down the scariest/worst time and why, then right down the best time and why.

This gives you an idea of your swing from the start of a day to when you go to relax. Then your doctor can see a potential pattern. Trends in your fears versus what actually occurs. If you have anxiety you most likely over anticipate. It means you have deep seated trust issues. Mostly, you don't trust in yourself. You will see where that goes.

Good question, and good suggestions so far.

I would suggest to make sure that you have a goal or focus nailed down before anything else, and then work on those things that will give you the most "bang for your buck". For most WS's, I think they would want to explore why they allowed the lies, deceit and betrayal to occur. For me, it was all about a lack of self-love, and the inability yo trust anyone else, especially those that loved me, since they were the ones who hurt me in the past. Once I could understand the how's and why's of that, then a lot of other pieces simply fell into place. (e.g My mother said she loved me but then hurt me, so if my wife says she loves me, isn't it simply a matter of time before she hurts me too?)

The other thing I need to say however is this. Repairing this damage takes time. It just does. One therapist likened it to having a broken knee. A broken knee takes time to heal. It doesn't matter how hard you work on it or how many doctors are there, it will take as long as it takes to heal, period. Our personalities are no different. You have poor coping skills, learned poor coping skills, that color the way you see and interpret things. Those poor coping skills exist for a good reason, and likely served you well in the past, but now you need to unlearn them, and to even see them as they happen. That takes time, patience, and humility. So give yourself a break, and just do your best.

For me, my therapist is starting from my begining. We are focusing on you guessed it, mother issues. Those started my crappy coping mechanisms. This week she sent me home with a homework sheet about values.

I didn't have any luck with "regular" therapy. I honestly felt like I was paying $150hr to bitch about my problems to someone with a sympathetic ear.

CBT and EMDR made a world of difference for me. I also had workbooks and exercises assigned outside of therapy. CBT taught me the relationship between feelings, thoughts, and behavior. It made a difference not just in my marriage, but in other parts of my life as well. I highly recommend it.

I have thought about looking into CBT and EMDR -- seem more grounded in brain science.

Also, I've been seeing an IC lately who specializes in betrayal trauma, which has also been more helpful.

(EDIT: And I think a betrayal trauma specialist would be an important IC step forward for WS's as well bc they understand much more about what the betrayed spouse is going through).

[This message edited by Thumos at 4:27 PM, December 13th (Friday)]