Sunday, 27 June 2010

Thinking About The End Of Psychotherapy

I'm not coping with this hot weather very well. I have lots of windows open but there is nothing much in the way of movement of air so it isn't helping me to keep cool. It's too hot to contemplate cooking which I probably couldn't cope with even if it weren't so hot, and I don't have anything that I can just throw in the microwave to heat up. Going without food is not a good idea so I have ordered a pizza to be delivered later when the temperature has hopefully gone down a little and the thought of eating something is not quite so unpalatable.

I think that it is unpalatable thoughts that have been part of the reason that I have started to go downhill into the depths of depression again. These thoughts invade my brain at any time that I am not actively concentrating on something else, and it is the difficulty of maintaining concentration that is inherent in depression that allows these thoughts in.

I live alone and spend most days isolated from the rest of the human race. Part of the reason for this is that I find it very difficult dealing with new people and have done for most of my life. The consequence of this is that I am alone, but that is not the same as being lonely. I don't feel lonely, just alone and as I get older this seems to get more difficult to deal with.

I have made efforts to change things. Recently I have joined the knitting group that meets at I Knit London a couple of times a week. It's not exactly local but close enough to home for me to make the journey at least once a week and sometimes twice. The ladies (and the couple of gentlemen) who meet at this shop for knitting, having the odd drink, and partaking in a lot of conversation, not all of it about knitting, are an incredibly friendly group and have made me feel very welcome.

My joining such a group would have been something unthinkable this time last year and I still find it difficult to believe that I have taken such a step. I still suffer great waves of anxiety when I set out to go to the group, but having to make a fairly lengthy bus journey to get to the venue does allow me time to try to relax. I know that I have most difficulty with group situations when I have to walk in on a group that is already present so I tend to arrive early so that the members join in ones and twos after I am already present and for me this is a more comfortable situation.

The strength to join this group has come about as a direct result of the psychotherapy that I have been undergoing since last December. This therapy was originally meant to finish at Easter but my therapist felt that further long term therapy, this time in a group setting, was needed so after having referred me to the mental health trust's psychotherapy services for assessment as to suitability for group psychotherapy, he decided that our sessions together should go on for longer.

This therapy is now approaching its conclusion. It will come to a close at the end of July, so with me being unable to attend one session because of my impending day surgery, I have four more sessions with this therapist. During our last session he asked if I was concerned about the impending termination of therapy. I replied in the negative, but I am now not so sure. I think that it is almost certainly one of the factors in my descent back into depression.

After such a difficult termination of therapy last year it is perhaps not surprising that the impending termination of therapy is playing on my mind. I know that it is going to be difficult, but I am being seen by a very experienced therapist, a senior consultant psychologist, within the mental health trust, and he is aware of how I was left feeling abandoned after my previous therapy. I also know that he is going to do everything in his power to ensure that I am not going to be left hanging as I was before.

I have made significant progress over the last few months. Psychotherapy is still something that I find difficult; I just don't like talking about myself and my feelings. However, we have worked hard on certain aspects of my behaviour and I am now much more aware of when I am moving into difficult territory and am therefore more equipped to deal with it.

I'm certain that I will still find the end of this therapy very difficult, but I know that it is only a matter of time before I enter a new phase of therapy, this time in a group setting. The talking therapies are regularly offered as the answer to so many of the problems that those with depression are faced with, but it is important that the therapist is well qualified, and because many of those who are most in need of such treatments have no means of paying for therapy and must rely on what little is available on the NHS, it is important that as many good therapists as possible work for the NHS.

In four weeks time I am sure that I will be sitting here contemplating my final therapy session with J. He has made a tremendous difference to the way that I am over the last six months and has helped me come to terms with so much that has happened in my life. I will, of course, thank him, but that seems so little when I consider what he has done for me.

1 comment:

Anonymous said...

I think it's great that you joined the knitting group. I believe that social isolation only encourages depression, so going to the group is being really proactive.

Was your therapy meant to have an endpoint? If it's helpful is there any way you can extend it? Or does it feel like July is a good time to conclude things?

I hope all is well, Madsadgirl.