The End of Therapy
Thinking of the end:
I have learnt, faced and remembered so much since I started therapy. I have spent hours talking, processing and writing about all of this crap, sharing some of it publicly. I have found a little bit of purpose, and sourced some courage and I have identified and pinpointed some of my triggers. I have found my medium of expression and I have became acquainted with my inner child (both of them). My therapist and I have dealt with so much together, but I now have to face and prepare for the very real situation, that therapy will soon end, and a very large part of me is completely freaking out, because I don’t feel like I am done. Even though I knew I had 26 weeks of therapy, (which has been extended a little), I do not feel prepared for this to end.
I am hoping to get to a point, where I no longer need my therapist. I want to get to a place where I can process, unpick and feel the trauma, without the overwhelming, spiralling effect, that sees me question my ability to cope. This feeling sparks self harming behaviours and self doubt and makes feel like I am not ‘there’ yet. I feel a little lost at the idea of facing this stuff alone, but therapy is not a way of life. Soon I will have to cope without therapy. I wrote a post on the HAVOCA forum, to ask other people like me, how they coped with therapy ending. The comments have been helpful but more than anything, they have really made me think about how I am feeling.
Somebody wrote that they had left heavy, dark things behind them in their therapy room and that they felt good about leaving them behind when they left therapy. Someone else said that the healing journey does not end when therapy does and that they now use the forum as a kind of therapist, to bounce thoughts, ideas and feelings around. This person also explained that they had spent half the weeks processing a therapy session, while spending the other half of the weeks preparing for the next; this disappeared when therapy ended for them. This makes a lot of sense to me and accurately depicts my experience too. This same person also mentioned dependency.
I don’t think I am dependent on my therapist, but maybe I have become dependent on the safety I feel with her (maybe ?). These sessions have become a comfort blanket of warm acceptance, where I am heard and never judged. I have been made to feel like it is OK to show, express and embrace my vulnerability. I have felt comfortable enough to cry. It has become a place where I realise, nothing I say shocks. I have 3 children at home and I value this safe space so much and this is one of the reasons, that I am so scared about therapy ending. Sessions have been a chance to stop and take a really focused look at myself, to explore memories and feelings in a safe place, where I am nobody to no-one: I am nobody’s friend, no-one’s mummy: I can just be me. I do not have to hold it together; I do not have to pretend to be OK. I do not have to worry about the impact of this ugly reality, on anyone else (especially my children). My therapist provides a safety net to catch me and bring me back to the here and now, after looking at this painful history, before putting me back together and packing me off, in to the reality that exists outside of my therapy room.
I have been voicing my concerns to my therapist. She told me that I could create a safe place at home, ring fence the time to focus and that this could be at the same time as our usual weekly sessions. I think I have been doing this a little with my writing, but an actual safe place to go, stop, and just be, every week? Maybe I could do that. I will miss the interaction and the challenging responses I receive though, because they also make me focus at a deeper level. I think I am doubting my ability to keep going on my own, because I know I have only just scratched the surface on this road to recovery and healing, in the 26 weeks of therapy I was originally offered. I have a fear of not having the safety net to catch me after allowing myself to drift with watching, hearing and feeling the tough stuff. I think I only go to that level of depth, because my therapist is there, to talk these things through with me, as they come up organically.
Maybe I am more ready that I feel? Maybe I am preparing myself with posting questions and concerns on the forum? Will I even know if I am ready for therapy to end? And what is ready? What if I struggle afterwards? Can I go back to therapy? I was able to ask these questions of my therapist a few days ago. She told me we could have a follow up session, to see how I cope after the last session, to which I agreed. She also told me that if anything specific comes up, I can phone my service provider’s head-office and she and I can speak on the phone. She also told me that I can re-refer myself back to the waiting list, for another batch of sessions, but the likelihood of having the same therapist will be small. At first this bothered me, because I do not want to have to start from the beginning with some body else; but since I have had a chance to think about it, the work that has been done, has been done. And if I do decide that I need more therapy, it will be about continuing to move forward.
As a result of feeling fear and unsafe about therapy ending, I recently tested the strength and validity of my relationship. I started to look for evidence to support the irrational thought that my partner does not love me, and I started to convince myself that this was true. (It was a result of feeling insecure and unsafe, although I could not see this straight away). I looked for things to back up this brutal, critical voice and the things that are in the back of my head. I doubted my partner’s commitment to me and I felt no sense of warmth or intimacy, at a time I felt I needed it most. The truth is, I shut down a little emotionally, after a night out about 2 months ago; a night I hit my self destruct button. I stumbled across a message that I should not have read and I planted and watered this seed, to grow in my head, myself.
My therapist suggested writing my partner a letter, to take to hospital (he had a 48 hour sleep study to partake in), so that I could re-open our lines of communication; he could read it again and again and respond to my fears in a comprehensive and proper manner. Even though sending him to hospital, with a letter hidden in his bag made me feel very vulnerable, I did it, and the response and conversation which followed as a result, saw us reconnect. He gained some understanding of the place I am at. I was wrong about a lot of the evidence I had created and I can see that now. The thoughts that I convinced myself were true, were in-fact very far from the truth, but I needed to test my level of safety and security within this relationship, with therapy ending very soon.
One of the reasons I feel like I am not ready for therapy to end is, that even after 23/24/25 sessions, great big discoveries and connections are still being made. New memories are being unlocked and new triggers are being uncovered and they really have an effect on my mood, sense of control and functionality. I have felt the lowest I have felt since starting this process, thinking about therapy ending and I tried, unsuccessfully, to phone the Samaritans. My body has crashed a little with the stress I feel and I have become sick.
My body is really making me remember the abuse, in all it’s horrible graphic detail, for the first time. I’ll give you some examples to explain what I mean:
• The large white spots at the back of my throat are not particularly painful, but the sensations which go with them, are all too familiar for me. It has triggered memories of my abuser hitting the back of my throat with himself and my body has been reacting, the same way as it did when I was 8, with gagging, retching and sickness.
• I have issues going to the toilet, due to internal damage, caused by prescription medication for relief of fibromyalgia symptoms (I don’t take this medication any more but the damage has been done). On the day I packed the other half off to hospital, I needed the toilet, but it did not happen and I really hurt myself trying. The throbbing sensation, (although from a difference place), was also very familiar to me.
Just how am I going to cope with all of this all on my own?
The week before the end:
It took me ages to get used to going to therapy, but now that I am, I’m really freaking out, as this end date draws closer. My mood and tolerance have dropped and I feel really low. I’m doubting my ability to cope with all of this shit on my own. I am currently dreading waking up, because something else happens every single day and I am not sure I can cope with any more. I started all of this to heal and it all hurts more than ever, I don’t feel strong at all and I am questioning what is the point. I have done all of this for what? I feel worse now than I did at the start, but there has been progress. I have really delved in, but I am not done. The self doubt is loud and strong and is screaming at me, telling me I can’t do it on my own. I’m fighting the need to hurt myself because I know it won’t help. My little inner child keeps saying, she does not trust me to keep her safe. My irrational brain and my critical voice have kicked in and I feel like I am going to be abandoned when I need the support the most. I need to slow down this irrational and over emotional brain!
OK! In session 16, my therapist used an analogy of ’emptying the box’ out on to the floor. The idea of picking things up and putting them back in the box when I have looked at them, created a framework of work, which I understood. My therapist suggested creating something, that depicted the items on the floor, and the idea really interested me. I felt like it could help, to show me the bigger picture, so I created 2 mind-maps: 1 which depicts the things that are all over the floor; and one that depicts the things that are still in the box. In the last few weeks of therapy, my head has been a little muddled; I think I have felt a little under pressure, to get as much out as possible and this has impacted on my level of clarity and focus. I looked at those mind-maps today and I was surprised to see that a lot of the things on them, have now been spoken about or written about and this has been done without reference.
The focus of the last few sessions has definitely changed: it is no longer about dealing with the abuse, the memories, the triggers and the emotions. The focus is now about working on me and making sure I am strong enough, to continue the work on my own, and trusting that I will be OK to keep going. I have been working really hard to help with this and I have been writing a lot. I wrote about “What therapy has been about for me” in order to remind myself of the things I have learnt in therapy and how far I have come. I wrote about “My self destruct button and I” in an attempt to take better care of me and to keep myself safe. I have been writing about “Positive self regard” for about 3 weeks, to try and focus on the positive qualities and attributes I have, to try and see what others can see, that I can’t. I have been trying to identify who I am, but doing so when you feel so affected and disconnected from reality, is not an easy task. Trying to find and focus on positives, when you feel so negative and low, is very hard. (My self esteem is low at the minute). I have written all of these pieces as a kind of toolbox, designed to help me through the dark days to come, to catch me when I fall. I have control over what I write and what I write about. How will I know what I need to write about without therapy?
Looking forward, my aim is to keep writing, to keep being honest and open, to keep journalling, to keep using the forum, to really lean on the people around me who care about me, to read the documents I have written when I feel crap and to remember everything I have learnt. I do want to be OK and I do want to cope while continuing to process all of this stuff, I am just finding this ending very difficult. I want to finish this “Positive self regard” piece so that I can take it to my last therapy session.
I need to stay positive this week and cling to the good, as I want to try and end therapy positively. I can’t let fear take over: fear of crashing; fear of falling apart; fear of having another breakdown; fear of self harming behaviours getting out of control. It’s all fear! I worry about stuff that has not happened yet. Hopefully my girlie trip to Birmingham with my dear friend, will keep me calm and worry free this week.
The last session
There was a small part of me that did not want to wake up today, because I felt like I couldn’t cope with today. “If I don’t wake up then I won’t have to deal with it” was running through my head and I remember thinking that as a kid too. I was trying to tell myself that I was being irrational and that my thoughts about the lack of safety net, were also irrational. I will not be on my own. I have some good people around me and I now have the forum and the people I have met there; I did not have that at the start. On top of this, I felt really ill when I woke up so I went to visit my doctor, who told me I had a lymph gland infection, a throat infection and an ear infection and was probably a bit run down.
I started this session as I have started all sessions, by reading out my journal from the week since the last session. My therapist read her notes out from each session and I was shocked at the distance of the journey travelled so far. When I started therapy 28 sessions ago, my focus was only about disclosure to my mum. I wasted time worrying about what her reaction would be and how this reaction would never be good enough, but now, none of this seems so important. (I’ll just send her a copy of my book, when I have finished it).
In my therapists notes for week 2, I checked on her, to make sure she was OK at the end of the session. That is me right there. It got me thinking about how much I have changed in the last 6 years. I have changed. My focus has changed and my approach has changed. My tools and skills have changed. Everything has changed. And right now, I can see the progress and I am feeling very proud of it. Before I met my dear friend (the mum I would choose), if anybody asked about my family, I would say that, “I had not seen them in so many years because they were not very nice people,” and I would desperately try to end the conversation. My therapist asked me what I would say if anybody asked me the same question today. I told her I would now say, “I have not seen my family for 20 years and I am now working towards recovery from child sexual abuse”. This is massive progress and my therapist clapped with her approval.
My therapist said that, what we had in that therapy room was unique and my experience with a different therapist would not be the same. She also told me that I had worked very hard and I kind of knew she was going to say that. She was right, I had done the hard work, but only because she made me feel safe enough to do it. So I told her that. And I cried. I was hit by a massive wave of appreciation and it made me very emotional. I am so grateful to my therapist. I won’t ever forget what she has done for me.
There was some laughs today. About me going the wrong way on the M6, on the way back from my girlie Birmingham trip and about the girl in my mindfulness course falling asleep in last week’s session. Ending needed to be on a positive note for me, so the giggles were nice. I finished my piece about positive self regard yesterday and I took it to my last session today and read it out-loud; I just need to start believing the things I wrote in it.
I couldn’t drive straight after the session and I sobbed in my car, for about 30mins before I could drive and tears spiked all the way home. I think the tears were a reflection of how much this whole journey has meant to me. 8 months worth of work. I was not ‘together’ enough for my afternoon aerobics class. I guess I need to give myself some time, to grieve this separation, but also to use this time until my follow up session, as a chance to re-group.
I will follow this up with another piece, entitled “Life after therapy”, which is currently work in progress.