Therapy Not Working - WWYD?

[LLJETO]

As the title says. I’ve had lots of therapy with 5 different therapists over the last few years - since about 2020. I’m lucky to have been able to pay for it.

For context: the therapy has been centred around my self esteem/feelings of worthlessness. These feelings have been a lifetime in the making but have been made worse by me becoming ill with Fibro and ME. I had to give up work so can’t contribute to finances anymore which contributes to these feelings. I do get a small amount of ill health benefits but it’s obviously not an income.

My husband has also recently become obsessed with running and fitness, which is good on one hand, but it’s pretty much all he talks about. Obviously it’s not really something I can relate to, though I try to be supportive. The amount of activities and fitness he does can have negative effects on our marriage at times. I constantly compare myself to his (female) friends who can enjoy the fitness with him (they often do things in groups). And of course I’m always lacking and that feeds into my insecurities because I can’t do a great deal of things.

Anyway, my therapy has mostly been about coming to terms with all this but I genuinely don’t feel like I’m any further forward even after all this time. I feel good temporarily, particularly after my sessions, but it never lasts, even when I’ve done my homework.

In case it’s relevant (and I think it is), this all peaked when I started with what I now know to be peri symptoms.

Does anyone have any ideas of what I can do to move forward? Or what they would do if they were me please?

Thank you.

Hmmm… therapy doesn't always “work”. Have you been through what a good outcome looks like for you? And how long you’ll allow to get there?

it’s always an option to cancel, save the money and have some time off. Maybe start to explore other ways of managing emotions- reading, podcasts… trying to find another way to heal?

What sort of therapy have you had? Talking therapy is very different to say, hypnotherapy.

I would actually raise the issue with your therapist. Say that you temporarily feel better but it doesn't last

I agree that there are various different types of therapy and not everything suits everyone

In my experience, making lasting changes by "rewiring" the neural pathways in the brain does take quite a while.

I’d say therapy isn’t going to work,
if it hasn’t worked in 5 years worth of therapy !

invest time / money in something pleasurable -
join a group, learn a new skill, do something that is pleasurable -

sometimes therapy perpetuates unhealthy rumination and introspection and connecting with the world around u in the here and now is more effective e

Just to add -
if you find you feel better immediately after the session, but there is no lasting impact, that sometimes means the benefit of the therapy is the attachment with the therapist rather than the actual therapy itself -
and that means u may benefit from developing stronger attachments with people outside of the therapy room

Sometimes therapy isn’t the thing you need. Particularly when you have a chronic health condition - as your body is dealing with a lot of inflammation that will want to keep you in a low mood however hard to try to work on it cognitively.

Sometimes it’s a good support group of people who really get what your daily reality is like, and the grief and envy that are a normal and natural part of coming to terms with chronic illness.

Sometimes it’s an osteopath or massage therapist or yoga teacher - someone who is working more directly with your body and nervous system to help you internalise a sense of safety and soothing even when you are tired and in pain.

Sometimes it’s meds (and SSRIs don’t work for everyone - SNRIs can sometimes be helpful for people who haven’t found any improvement with SSRIs)

EMDR and brain spotting are short interventions that can be helpful for some people in shifting stubborn nervous system responses and fixed beliefs.

I’m sorry it’s been so tough. It’s great that you have persisted and tried different things - keep going and think outside the box. ❤️

What kind of therapy is it? You mentioned homework – is it CBT? I’m not sure CBT is enough to deal with such deep-rooted issues.

I would try psychoanalytic/psychodynamic therapy if you really want to make sense of your low self-esteem, and think about how your mind works (and how it works against you). Worked for me.

Therapy will only ever go so far, in the end you need to do some very hard work on how you talk to yourself. That means recognising your thought processes and actively challenging yourself - not allowing yourself to talk yourself down, actively stopping comparing yourself to others, accepting the limitations your health brings (and grieving the losses that come with it. Therapy can give you the safety and the tools but unhelpful thinking and feeling doesn’t change without you making yourself change.

It’s like driving on a snowy day - your wheels stay in the ruts created by the traffic that’s gone before and it’s easy to follow along. Changing direction is hard, because you need to drive over and out of the ruts but each time you do it becomes easier. Your opinion of yourself is well rooted, so it will take effort to change but it can be changed.

One thing to try is asking yourself “what if I’m wrong!”, every time you compare yourself unfavourably to someone else - what if you’re wrong about that comparison, what if I’m not actually less than they are? Invite the possibility that your view of yourself isn’t accurate, born out of skewed thinking. What if you were worthy, how would you feel, what might you do, or change, who might you be. If it’s your thing write about it. The work in therapy mostly happens out side the therapy room, between sessions - how are you working on yourself to build on the therapy!

Excellent post from @Jellycatspyjamas — therapy done properly is brutal hard work.

Thank you for the responses everyone. They’re all very much appreciated. Sorry I meant to reply last night but got sidetracked and then fell asleep!

To answer some of the questions - some of it has been talking therapy where I suppose I have just talked to get it out. Some of it has supposed to have been CBT but I always thought that involved in me getting something to practise in between sessions to build on what we’ve talked about. And the sessions I thought were CBT have generally been talking too.

@Bumdrops that makes total sense. I suppose by focusing on the negatives it probably makes it all the more consuming. One of the reasons I avoid online support groups for ME and Fibro is they tend to be negative spaces, understandably of course, because people are struggling and they tend to only post when things are bad. Regarding feeling better after sessions, I think that’s more the fact that I’ve been allowed to offload, and it’s interaction from another human. I don’t have many friends since leaving work so, although I talk to the ones I do have about things, I’m also conscious of only talking about the crap stuff. And they have their own problems which I like to try and be there for them.

@VoltaireMittyDream thank you. I’m already on SSRIs. I have been since 2011. I had post natal anxiety - fixated on health and I also have OCD. I’ve reduced the dose over the years but then had to increase again around the time peri symptoms started - I very nearly got to an agoraphobic state - I didn’t leave the house for a couple of months - but I managed to put that in its place.

The therapist I’m working with now is one I had NHS therapy with in 2011 for my health anxiety and I came across her on the BACP website and chose her because she had really helped back then. She gave me homework back then like reducing the amount of times I checked my body for symptoms and then gradually increasing the time before I did anything about it. The homework I have now is more like an emotion/energy diary and there were a couple of exercises in the beginning where I practised using the worry tree approach. And also letter writing.

@gjkvdtj It was supposed to be CBT, though looking information about psychodynamic therapy, I think we did something like that at the beginning of my sessions with the latest therapist..I went back to being a child and ‘talked’ to my younger self. That said, reflecting on it all, it seems to have been a scattergun approach with no structure or consistency.

@Jellycatspyjamas thank you so much. This makes so much sense. My automatic thinking is always negative and my anxious brain is always ‘what if’ but those what ifs are always negative. My brain always goes to the worst case scenario which I assume is a sort of skewed protection mechanism.

As for finding something to do to engage my brain - I have no idea what really makes me tick. I have no idea who I am anymore really. I had my eldest son when I was youngish so my life has always been about doing jobs that pay the bills rather than because I enjoyed them. Before I gave up working because of the illness, I also had a small business making cakes but that is just too much these days.

Anyway, I’ve rambled again. Sorry for the long post! Thank you again everyone.❤️