been in therapy for about 5 1/2 years. My therapist, as far as I can tell,
is competent and wise. After the first year of therapy, I went through a
12 day manic episode. Since then, I have painstakingly worked to achieve
a greater awareness of my unconscious minddepression, rage, high anxiety,
feeling overwhelmed, terror, fear, crying so intense I feel I could shatter,
etc. I feel like I imagine a soldier would feel living day by day in the
combat field. Its so draining: I want a break; I want to sleep without
waking with terrifying dreams; I want not to feel absolutely isolated and
alone; I want not to cry so intensely; I want the suicidal thoughts to stop.
I feel that I am improving; yet, it is so hard to perceive when wading through
so many repressed emotions and conflicts. I ask him constantly how long it
takes for the process to end, but he only says that we will know when it
does. How long should therapy last? Is 5 1/2 years too long? How come every
time I feel like Ive taken a step forward, the emotions coming flooding
back in? I wish the effects would lessen, but they only get stronger. When
will it abate?
You ask a question that started the whole
managed care business
in the first place. The business executives in the health insurance industry,
concerned about their profits, started asking, How long should
psychotherapy last? When does it all end? Well, they may as well have
been asking, How long is a piece of string?
look at how you end your message: When will it abate?
To interpret your
question, lets look at how you began your message: you have been in
psychotherapy for 5½ years, and after the first year you had a 12-day manic
missing between the beginning and the end? Well, actually, whats
missing is what came before the beginning. Now, this statement might
sound obscure, but you cannot navigate to where youre going if you
dont know where you are, and you wont know where you are if you
dont know where you have been.
In other words,
you say that after a year of treatment you had a manic episode. But you
dont say if you ever had any manic episodes before you began treatment.
You dont say what sort of life you had before treatment. You dont
even say why you decided to begin treatment.
So there you
are, a soldier in the combat field who doesnt know what he is fighting
for or with whom hes fighting. Hes just there, fighting, in
So when your
so-called therapist says that you will know it when it
does, what does that mean? Does he even know what he means? The truth
is, its necessary for you to find out how it all began; that
is, to discover the
roots of your current symptoms. Trying to eradicate symptoms, like a soldier
in combat getting rid of enemies, is the equivalent
of pushing away a crying child. When you can attend to that child with compassion,
understanding, and comfort, the real healing begins. So, when you can attend to
your symptoms as if they were frightened children, your psychotherapy will have
started. When you can attend to the childs tears with compassion, the flood
of pain and tears will abate because the joy of understanding will have
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