Questions after today's therapy session.

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I recently started therapy and I had my second session today. During the session last week the therapist mostly talked about the method he wants to use (CBT) and how that works. Today the actual work started. We had a double session (1,5 hours) and we talked a lot about my need for control and about some compulsions I've got etc (we talked about more than that but those were the things we sort of focused on today). Among other things he asked me what I'm so afraid of. He wondered what would happen if I didn't control things (obsessive planning, avoidance, other coping mechanisms that have to do with control). I told him I'm afraid of chaos (among other things). Then the therapist wanted to know what chaos is and how I define it, but I couldn't explain it. I know what it is and I know what it's like in my head but I don't know how to explain it. I'm terrified of chaos and I was even afraid as I sat there.

Now I feel exhausted and low. It was a good therapy session (really) but I can't help but feeling low anyway. It was a very psychologically challenging session. I was planning on studying today but I'm too exhausted to do anything but watching TV-series.

I'm not really sure why I'm writing this. I think I just wanted to tell someone about all of this. I guess I'm also wondering if anyone else is utterly afraid of chaos and if it's normal to feel low and exhausted after a session? I find it quite difficult to express certain thoughts which I think might be one of the reasons I'm so exhausted after the appointment today.

Yup. I always left therapy sessions feeling much worse than when I went in. I found them completely unhelpful, and stopped them altogether after about a year and a half. YMMV, though. I hope it works for you.

Also, I'm not sure I'm afraid of chaos, but I do like to plan everything. I get thrown off balance and very grumpy if someone/something alters my plans.

I can relate to the fear of chaos. What I mean by it is less external, but internal chaos. I fear and try to mitigate it because it leads to me feeling scattered, reactive, and not in control of myself. I definitely need recovery time from it.

Does this sound similar to how you define it?

I've tried therapy once before but that really didn't work out with the therapist so I quit. I think the new therapist is quite alright actually and I really hope this will work out.



Umm, I'm not sure. Just like for you it's some sort of internal chaos (which might be caused by external chaos) but I'm not sure how to explain it. I really wish I could express what I'm thinking. Wish I could put it into words. It's really frustrating.

I think what you're dealing with is anxiety. I've been through CBT and received the "what's the worst that can happen" treatment. I have to say I think it's a bunch of malarkey and I think it will continue to make you feel bad and frustrated. What CBT therapists don't understand is that there is no logic to it, it is purely physical. The only way I found to deal with it is medication.

I'm not quit so sure how you mean chaos; however, yes some therapy sessions where i have to deal with stuff I don't really want to face have left me feeling exhausted and if it didn't come out the way I expected, I would feel deflated. Like somebody let the air out of my tires.

But when I think of chaos, for me personally, it's just another word for turmoil. Turmoil for me is usually caused by fear or anxiety. Most of the time that is also rooted in anger or feeling powerless. So, trying to set my life up in order to reduce the possibility of feeling that way is ludicrous because I'm not God. I can't control every little thing.

I'm in AA and that's part of the 1st step.

I admitted I was powerless over ____ and that my life had become unmanageable.

It was really hard for me to admit that I couldn't manage everything.

My AA sponsor was a retired social worker. And when I was anxious or feeling full of turmoil I would go to him.

He taught me the value of learning about choices and consequences.

The first lesson was, what were my choices? He'd make me list all of them, even if I didn't like them.

The second lesson was, If I choose this choice, rather than the other one, what's the worst thing that can happen? Then, can I live with that?

I learned that process and it helped reduce my stress and turmoil quit a bit. It kept me from being paralyzed in fear but it took me a lot of practice to be able to go through the process on my own rather than freaking out.

The result of learning that process

Hi,
Good to read your post. I think I know what you mean by chaos - internal chaos - I have experienced a few different forms of that. One the psychiatrists called thought disorder, when you can't hold a line of thought for more than a couple of seconds and everything comes out jumbled; you can't plan or execute any idea. Another kind of chaos is when my thoughts are out of character, either depressive or manic. It IS very hard to explain, these psychologists should really know better than to put pressure on you like that. I don't think that one had much empathy for you at that stage, just doing his thing. Anyway, what you are afraid of may not be what frightens me.
I have had a couple of rounds of cognitive behaviour therapy in the last six years of my illness and it has overall been a useful tool. I think that learning the CBT was the beginning of developing more insight into my condition; insight is the key to managing bipolar so even if I don't directly use the CBT techniques, I learn to step back and to make a judgement about what I am thinking or behaving like; I can know when my moods are changing and to an extent I can control my behaviour.

If you're getting good therapy, one of the signs will be that you come out of the session emotionally exhausted, but feel better in the long term.

Unfortunately, with most of my therapists, I came out feeling exactly how I did when I went in. And in each case, I made absolutely no progress.

If the problems is with your emotions, then treating it is going to drag up those emotions.

Of course, if you're getting bad therapy, you will come out feeling worse for a different reason - because instead of dredging up existing emotion, they elicited new negative emotion.

I really wish I could explain. I think it has to do with not being in control of things and about finding things that are not predictable very scary. It's like my whole brain shuts down and I just don't know what to do. That's not all though, but I can't explain it.

I don't necessarily think the therapist didn't have much empathy for me when he asked me about chaos and what I'm afraid of. I think he just tried to understand.



I tried therapy once before and each time (I only went there about 3-4 times) I left the therapist's office or whatever I felt very low. However, it wasn't the same low as I felt when I left my current therapist's office. When I had seen my previous therapist I felt low and angry and very annoyed with her but this time I felt low and exhausted. Exhausted because he had challenged my way of thinking which I've never experienced before. I think that's a good sign, though I hope I don't have to feel low after every appointment. Anyway, I'm going back there on Monday morning. We're having another double session. The therapist said he thought it was needed because "there are so many things in your head that we need to 'stir up' a bit".

Also, this might be a bit off topic but how do you get to the point where you're ok with facing your biggest fears? CBT is all about exposure and changing the way you think, right? But how do you even get to the point where you're ok just thinking about maybe facing the things you fear the most, without panicking like crazy?

There is a saying in AA that God will never give us more than we can handle with Him. If I try to go it alone without that support I can't do it on my own.

I honestly don't know how people that don't believe in God can get through that because before I came to believe, I never could get through it. I'd either run away from it or get drunk over it. It was a vicious cycle and the escalation was horrendous. Drinking almost killed me.

But again, I had choices to make. If I didn't like the consequences of trying to go it alone then the other choice was to believe in someone better able to handle it. For me that was/is God.

After 22 years, that still works for me.

I was in CBT while studying and it really did help me. I wouldn't have been able to (almost) finish my studies without it. I suffered from severe panic attacks, social anxiety and I was more or less psychotic after the first year in there (started the therapy on the second year). I felt really exhausted after the sessions. And it didn't feel good. But after a while I started to notice a change in my fears and reactions. I did it for three years and in the end I wasn't panicking nearly as much as before. It was in that therapy where my AS was mentioned for the first time. But it was a psychologist so I didn't get a dx that time.

After the therapy I started noticing the weird stuff other people did... and long story short, I have an AS-dx now. I've started going to CBT again, based on my difficulties nowadays. I really like my therapist, he knows what I'm trying to explain. I guess he's had aspergers as patients before, so he knows more or less of what I'm going through. Before that I had a really bitchy nurse I had meetings with. After talking to her I felt angry and low, but in a personal way, towards her. It's effective only if your personalities match with the therapist you see.



Sorry for my grammar

CBT is not a framework I can deal with, it just provokes hostility & rage in me.
I found the sensory perspective of DBT "distress tolerance" skills (for borderline personality disorder) to be more accessible & relatable,
as it prescribes sensory means to deal with sensory upsets, such as seeking or avoiding types of sensation-
which is more up my alley, what with the extreme sensory disturbances I have with Asperger's.
CBT just rubs me completely the wrong way, and doesn't dovetail with my way of understanding my mind.
Which is not to dis CBT, if it works for others, more power to them-but there are *some* folks it's just *not* the right thing for.

If you start panicking, you start panicking. If something is strongly associated with fear, you cannot get to it without accepting a certain level of fear and going through it. This includes accepting that you may fail, that things will go wrong, maybe badly. Realizing that you can make mistakes and still lead a good life (and that this is the norm, not an exception). As long as you expect yourself to never make mistakes, as long as you tell yourself the story of "if I just had tried harder, I might've done it and things would be OK", you're making it unnecessarily hard for yourself to take action.

If you're panicking, it means you're feeling threatened by the possibility of failure; this is where you begin. A large part of this threat is internal, i.e. the fact that you're harshly critizing and chastising yourself whenever something goes wrong. You're being too hard on yourself and treat yourself worse than you would anyone else.

You can work on anxiety with rational thought (typically done in CBT by fixing distortions in your thinking, e.g. catastrophizing or generalizing), but ultimately you also need to acknowledge the fear and focus on what you want to do, what is in line with your goals and values, despite how uncomfortable it is (which includes gradual exposure, but also the realization that you can endure the fear and that doing so is ultimately in your best interest, and that being kind to yourself is more effective than beating yourself up for mistakes). You consciously shift your attention from the anxiety (while acknowledging it, i.e. this doesn't mean "ignoring" it) to what you want.

Well, the 'exposure' in CBT often starts out highly indirect. For example, if you have a spider phobia, you usually won't start out by seeing an actual spider - instead, you'll talk about spiders. Then maybe read a book about spiders. Then look at a picture of a spider. Then, maybe, you can handle seeing a real spider in an enclosure.