Current Book Project

Finding Peace — Manuscript Post #41

Adult Child of an Alcoholic, ACoA, Borderline Personality Disorder, BPD, Finding Peace, One Patient's Journey, Therapy For the Adult Child of an Alcoholic
Posted: November 16, 2015 at 3:00 am   /   by   /   comments (0)

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–Sessions: 29 of 53
Monday, August 3, 2009 4:00pm

We discussed my symptoms since the last session. Last Thursday I was really tired. Elsie says that unless I was not sleeping, not to worry. I didn’t realize how significant sleeping was as a diagnostic. If you aren’t sleeping you need to get help.

We went to a party with our sons. We didn’t know everyone there very well. One of the other families at the party had a college age student close to our son’s age. The parents put us down because my wife and I went to the University of California. They had gone to a very selective private college. They knew where my wife and I had gone. They described how many hours their students study, and in fact, they only sleep every other night.

I don’t understand the desire to tell stories that can’t be true. They also told us that their student didn’t have a laptop and this was a good thing. Our son needed a laptop to do his work at college. I wonder, when people tell stories like this, what they are hiding.

Elsie listened to my description of the party. When I told her about the comments about where we had gone to college, she said that was tacky. She also said she wouldn’t be attending parties like this but added that she wasn’t criticizing me.

I told her that on the drive home, my son pointed out, based on what the other parents said about their student, they were studying more hours that there are in a day. Elsie pumps her fist in the air. She was glad my son had called out the bullshit. She can’t explain why these parents were saying these things, why they felt the need to be so competitive and elitist.

She offers that she knows people that were friends, but aren’t anymore, because their students went to Stanford versus East Coast schools. We were visiting relatives once and we were told we had gone to a college “where anyone can get in”. The person who told us this had not finished college. Elsie says these relatives sound like “sick puppies”.

At this point, things changed. Elsie wanted to discuss something I said during our last session, specifically, I had said “I didn’t feel I had much to talk about this time.” She told me that fact that I didn’t have lots to tell her told her that I didn’t need to be here (in therapy) anymore. I was surprised, not upset, but I wasn’t expecting this. I had decided, before I had even found a therapist, that I would not try to control the process. I wouldn’t ask how long therapy would take, how it was going, or any form of “are we there yet?” And now, it appeared that therapy might be ending.

She said we could handle this in various ways. We could transition to a session every other week or once a month. I could go “live life” and come back when and if I needed to. She told me I was always welcome here (her office), that working with me had been a pleasure and an honor and that I was a quality person. I wondered what would come next. She then asked how many sessions my insurance covered. I told her that I had coverage for fifty-two sessions a year. I didn’t realize this was unusually good coverage.

She explained that part of her reason for telling me that I might have been done with therapy was her concern that perhaps I was running out of coverage, but my insurance coverage is better than most. If my coverage had been running out, she didn’t think I had to continue therapy.

Before I had been to therapy I was concerned that therapy, once you started, would never end. My mother had lots of therapy and never got better. Now that I had personal experience, I had a very different view. Elsie was conscious of the practical realities of my insurance coverage. She didn’t want me to feel I had to continue therapy if I didn’t have the insurance coverage for more sessions. She was doing her best to see that I got the treatment I needed within the coverage my insurance provided. I was impressed. At the same time, I wasn’t sure if this meant I would not be seeing Elsie anymore or not. Now that she knew I had more coverage she scheduled another session for the next week. I left this session not sure what was going to happen next, but I wasn’t worried. I was curious what would come next in my course of treatment.

–Sessions: 30 of 53
Monday, August 10, 2009 4:00pm

During our previous session Elsie had told me I didn’t have to continue therapy if my insurance coverage had run out. Since I do have ongoing coverage, she wants me to go to seeing her once every two weeks. This will be a transition out of therapy. To me this is a milestone. While I was formally in therapy I was going to a session roughly once a week. Now that I was transitioning out of therapy, the frequency of the sessions was being reduced.

It appeared that this was the beginning of the end of therapy so I had several questions. I wanted to be sure I wasn’t running away from treatment by reducing the frequency of the sessions. Elsie smirked, “I’m the one telling you you don’t need to be here…” she said.

I wondered if my symptoms will continue after therapy ends. Elsie said this was very likely. Remember that during one of my first sessions she had told me that the goal of therapy is to reduce or blunt the impact of my symptoms, but they wouldn’t completely go away.

I had been keeping lots of notes since the onset of my symptoms. I had written several technical books in the past and I’ve given many presentations over the years at work. I asked her about writing about my experiences. I was expecting a long conversation about this, perhaps covering what I should and shouldn’t say, whether I was qualified and so on. Instead, her response was very brief. “Yes, writing about it is highly recommended!” She remembered that I have written books before. She also said something that really surprised me, “And when you are done, I want a signed copy!” This told me she expected I could write about it and she wanted me to do so. This comment would come up again at our last session, and it kept rattling around in my head for the four years that would pass before I would start actually writing.

I wanted to ask her why some people seem to need therapy indefinitely. I had known persons that seemed to be unable to make even the smallest decision without consulting their therapist. Now that it appeared I had completed most of what I needed from therapy in less than a year I was curious why others needed so much more time in therapy. Elsie explained that if someone has no support other than therapy they may need to continue therapy for a long time. I had never thought of it that way. This helped me understand why people I’ve known needed to continue therapy for many years.

During one of our early sessions Elsie told me that I had a lot to be angry about. I hadn’t felt angry during the time I had been in therapy and I wanted to ask her what she thought of this. She said no anger is unusual, but not a concern. She had also told me, when we first met, that it can take several years to work through the issues surrounding ACA. I was curious why it hadn’t taken that long for me. She said you usually have to work through the anger before you can work on the cause. Since I wasn’t angry that reduced the time I needed in therapy.

I asked her for a specific diagnosis of what happened to me. She had offered a preliminary diagnosis of Adjustment Disorder with signs of depression and anxiety during an earlier session but I wanted to know what her formal diagnosis was after seeing me for thirty sessions. Her specific diagnosis was Adjustment Reaction with mixed emotional features of anxiety and depression. The words were slightly different but the point was the same. I had a strong reaction to a stressful event in my life. My sons leaving home was the stressful event. My symptoms were the strong reaction.

Periodically I would get offers to increase my life insurance. The forms always asked if the applicant had ever been treated for a mental illness. I asked her specifically how I should answer such a question if I ever had to. Elsie was very direct and very clear. I have never been mentally ill and I was never treated for a mental illness.

After this session, Snap called, he needed $100 for some issue with the license plates on his car. He needed the money because he had to buy food for our mother because she gets upset about the food at the nursing home. I deposited the money into his back account. She had an infection and won’t do the physical therapy asked of her. He thinks she will be able to return to her home early next month. There is some issue with Social Security wanting to be paid back $1100. I had no clue what this was about, and no way to find out. He will be going back to full time work at the end of this month. Again, I have no clue why he wasn’t working full time all the time. He tells me that since late 2008 he has been basically living with her helping with her care. He is getting paid to care for her by Medicare. I’m not clear if our share of the cost of her current nursing home stay has been paid already of not. I had paid a bill from the nursing home for $230 recently. I’m told that as of now there are no outstanding bills.

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