Missing therapy sessions

[Hardly123]

Missing sessions

I'd love your opinion.

I've been with the same analyst for 3.5 years. For 3 years I had 3 x sessions weekly in the evenings. This is basically due to childhood abuse. I function ok, hold down a job and a relationship (just!) and friendships etc. But still find life a bit hard.

During covid I started a new job and moved my therapy sessions to mornings (7.30 am and 8 am) as my work often runs late into the evenings.

In the last six months I've changed to 2 x sessions weekly as I felt I was just covering the same ground again and again and not feeling any better. I've also been missing approximately 1 session a month, usually the 7.30 am session, usually cancelling the night before, but always paying.

For example this week I missed the 7.30 am session because I was having problems sleeping because I was stressed. At 3am the night before I was unable to get to sleep (had been trying since 11pm) and I emailed my therapist to let them know that I was cancelling the session - I wanted to try and get as much sleep as I could before starting work at 9 am (I have a stressful professional job and can make mistakes on little sleep).

Anyway I appreciate it must be really annoying for my analyst.

However in today's session he brought up that I 'don't feel like talking about things' and that's why I'm missing sessions and asked me if I still wanted to continue with analysis.

I think this annoyed me and made me feel a bit insecure. I do really struggle with insomnia sometimes and when I'm facing a night with little sleep I have to be practical about what I can do. I can't cancel my work commitments, but I can cancel analysis. I pointed out that it wasn't realistic or helpful for me to have a session when I've had a few hours sleep as I'm just not functioning properly - it's not about not feeling like talking, it's just fairly pointless and at that stage it's better for me to focus on resting so I can actually do my job the following day and not under perform at work. That is basically the reason why I cancel sessions. I've had insomnia on and off since I was a kid.

I don't really know what to do? I dislike it when people pretend that they must know the reason why I'm doing something. I genuinely believe that it's better for me to rest and try and sleep if I'm having problems sleeping. It's not that I don't want to talk. I feel like sometimes therapists are so focused on everything being about feelings that they ignore the physical reality of something like being sleep deprived and the genuine issues that can cause.

I also feel like the sessions should be to help me, not to make my life harder and that I should use them in a way that works for me. I always pay. But I do appreciate that it's annoying for my therapist if I cancel 1 a month.

What do you guys think?

Thanks in advance :)

Missing therapy sessions is a thing. In your case you feel it is down to lack of sleep, in other cases it can be down to a blockage or resistance. It is very common. It is part of the therapeutic role to challenge potential blocks to see if insight can be gained from doing so.
In psychodynamic therapy a great emphasis is placed on your interactions with the therapist and how your feelings and responses may mirror other significant relationships in your past. If you are feeling irritated by his/her challenge regarding the missed appointments, the most useful thing you could do is voice it. It might provide you both with extra material to work with. Good luck.

Complex PTSD: From Surviving to Thriving By Pete Walker is a fantastic book to understanding, sitting with and living with childhood based trauma.

It sounds like the times aren’t working for you. I know you said you now work late but doesn’t he have evening appointments?

I’ve never had psychoanalysis, but I’ve had lots of therapy, and I work as a therapist, and this feels like a situation that goes across the board in therapy. As the man himself said ‘sometimes a cigar is just a cigar’. Maybe you are just knackered due to the job and finding it hard to focus because of that. The analyst is going to check out if anything else is going on below the surface. The fact you are feeling so provoked by this might mean it’s worth talking about - as in how provoking you do find the questions. As far as I’m aware, analysis looks at the symbolism of our behaviour as well as subconscious drivers for behaviour. It might be that the dynamic with the analyst is playing something out from your past relationships (and my predictive text just decided your Id was playing out there! My phone is clearly a Freudian).

As a separate issue, I think analysis sounds fascinating. Sessions every other day sound intense but I imagine you dig down through an awful lot of material.

I'm reading this with interest as I found ending longterm therapy very difficult. However, mine was psychodynamic and not traditional analysis which sounds very intense.

A distant relative of mine is an analyst. I know her training took 10 years and she once told me that is the average length of a typical analysis. Accordingly, she does not take on new clients very often as they stay so long.

The early morning sessions would stop me getting a good night's sleep as I am a rubbish sleeper at the best of times. OP, I wish you the best going forward and would reiterate what others have said--that it's always best to take such issues into the therapy and hopefully talk them out.

I am in five times a week analysis - if anyone is curious about what it is like or considering doing it (sounds like some on here are) happy to talk about my experience - although an analysis is such a very individual experience it is likely to be pretty different for everyone.

My overall thought is that it is VERY hard work and a huge commitment, it is up there in my life with "getting married" and "having children" in terms of the significance of it. It can be very intense and also very dull. There can be great development and also week after week of nothingness and a feeling of going nowhere. It costs a lot and takes a long time and there is a real cost to it. But it does really help you get better in a deep seated way. I am just not the same person any more that I was five years ago.

When I read the OP I thought about how difficult it is when your analyst suggests something might be going on and you just think "NO no NO, it is just that I need sleep, there is nothing going on, stop trying to force me into your way of thinking" etc.

What I have found helpful is just to allow myself to "entertain" the idea that there "could" be something in what my analyst says. I don't have to agree with it straight off. I just have to allow it a bit of air time and entertain the idea for a while. Create a bit of space to think about it - you don't have to swallow it whole. After all it is an IDEA they are suggesting - they aren't saying they KNOW.

But when you are lying on the couch ... that is what you hear ... that THEY know, that THEY think they are the expert, that YOU are doing it all wrong, that THEY don't understand and never will ...

All the while they are just making a suggestion!

What is interesting is WHY we react like that. But that is another story!

@Analysand That's a huge time and money commitment. Especially when your own subconscious knows exactly what the problem is and how to resolve it.

Eyesopenwideawake If you could resolve deep seated trauma in 4 sessions as you say in your previous post, why would the NHS not be using the approach you use? Sounds like it would be an easy and quick solution to all the problems in the mental health services...

As for the time and money psychoanalysis takes - well, the cost of a life lived unhappily or not at all is immeasurable.

Because hypnosis is an unregulated therapy (I guess) But as shown by many, many threads on MN the mental health options on the NHS are woefully underfunded. It IS medically approved as an IBS treatment to relieve stress.

As for the time and money psychoanalysis takes - well, the cost of a life lived unhappily or not at all is immeasurable.

Absolutely agree. But if it can be resolved in a month why wouldn't you?

I have had courses of hypnosis 3 times in my life, for the same issue by 3 different practitioners. Not one of them made a jot of difference.

I've had CBT and it was fantastic for 2 ish years but I relapsed. I'm about to start a masters in it. I don't think it is the answer to everyone's problems and I don't like the way it is palmed off on everyone via the NHS but I do know it can be very effective when you need that relief.

Have also had a year of PCT which I have incidentally just qualified in. The PCT was kinda good.

I'd quite like to try emdr.

You raise some really valid points and I would definitely say it would be great to take them all back into therapy with you. Address it head on in the safety of your therapeutics relationship, who knows where it might lead..good luck!