this post was submitted on 15 Nov 2024

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Mental Health

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To what extent should therapy hurt? (self.mentalhealth)

submitted 6 days ago by python to c/[email protected]

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Heyo! Stupid question, but I've been double-guessing myself on this and would love some external input on things.

I've been in group therapy since October (so like, 5 or 6 sessions so far). It's an open mixed group, so people of any type of mental illness are free to come and go. The general aim of the group is Behavioral Therapy and it's led by two psychologists. Sessions consist of a short powerpoint presentation followed by worksheets to be filled out in groups of 3-4 people. Generally I think the topics of the sessions, like time management, emotional regulation, stress management etc. are chosen well and do cover a broad spectrum of knowledge.

But, my issue is that I just get completely emotionally flooded and on edge whenever I go there. Which is normal for me, I start crying every time I get put on the spot about my feelings anyways (I've cried every single time I have ever had to talk to a doctor about anything regarding my mental health). But I kinda assumed it might get better? Like I can choke down the crying for the session at least (if I don't get asked about anything bad), but I always cry on the way back home and it's starting to be pretty distressing. Like I consistently lose the latter half of the day to headaches and recovering, and the amount of times I wake up due to nightmares definitely has gone up significantly since starting therapy.

Another thing is that a new person joined the group, and she has a particularly dramatic inflexion in her voice that sounds exactly like my mother whenever she's fishing for sympathy and being the victim. It's really not this person's fault that they talk like that (she's probably a perfectly fine person!) but I do struggle to not flinch whenever she speaks. Recently we also got put into the same group and I completely zoned out and went unresponsive when she tried talking to me 😅 I didn't mean to offend her really, and I'm not sure why I would react like that, but it just kind of happened..

I'm really trying to work on this kind of emotional reactivity, but the part I'm missing is that within therapy, they've explained the model of [situation -> thought -> action], so being aware of situations that bring you into a specific thought pattern and then re-examining that thought pattern can help shape different actions. I'm neither sure which situations upset me like this nor am I sure what sort of thought would contribute to it, as I don't really have any thoughts when I choke up like that. It just seems like a random bodily reaction that floods me with bad feelings (and I can't even elaborate beyond "bad", even if I know all the emotions I can't really name specifics that I experience).

I know it's dumb, but like, maybe there's a type of therapy that could work better than behavioral therapy? Or do I just need to stick it out and continue going? My insurance has approved weekly sessions until April. There's also the issue that I did get an Adhd diagnosis recently and am currently calling around to find a doctor who is willing to prescribe meds (it's complicated here in Germany). So my struggles might just be an adhd thing?

How have your experiences with therapy been? Are you supposed to feel better after every session? Is it supposed to be bad at first but get better with time?

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[–] [email protected] 19 points 6 days ago

Firstly, if you're worried about this, speak to whoever is running the sessions. I could speculate as to what works and what doesn't, but if you are in contact with a trained person who has seen you many times now, they can probably give you better advice than internet strangers.

I see a counsellor, which I know isn't the exact same thing, and I've definitely broken down and started crying in some sessions. And yes, it feels like shit. And yes, it hurts. I have a habit of retreating and hiding from stressors, and having to face them is rough.

However, anything you talk about is likely already in your head anyway. Taking about it lets it out in a safe way, because otherwise it just kinda builds up and festers... Which is even worse.

If you are neurodivergent though, it might be worth looking for a specialist that handles adhd therapy. I know at least for autism, regular cbt doesn't work. Don't know if that's the same for adhd and whatever therapy you're doing.

[–] [email protected] 11 points 6 days ago

I would have a 1 on 1 conversation with one of the psychologists running the group about what you're going through. Maybe this something you can work through or maybe this kind of group therapy isn't for you. In any case, it is better to talk about what you're experiencing.

[–] [email protected] 5 points 6 days ago

It sounds like you might not be ready for behavioral therapy just yet, especially in a group setting. Behavioral therapy, IMO, is sort of the last step in the process, where you already know what you're doing wrong and are just trying to correct your behavior.

Before all that, you may need a period of validation. CBT is extra hard for people who have been invalidated their whole lives. You may need to figure out which of your behaviors are "you" and which are just maladaptive coping mechanisms. You need to be able to identify your emotions for CBT to work. It sounds like you don't have the time/space to really feel and explore the emotions that are coming up in these group sessions.

I would ask the session leader if you could do some one-on-one sessions before going back to the group. Everyone's different, and if it feels like this isn't working for you it's ok to step back and take a different approach.

[–] [email protected] 3 points 6 days ago

You can't blame yourself for how you feel or how it affects you. You might, like me, be too tough on yourself.

The only real advice I can give is to make sure you reflect on all the positive things you gain from therapy. Think about stuff therapist have recommended you to do, do them and think about how it improved your life. Even if it's just a minor improvement.

And always remember it's okay to not be okay.

Me. I have days where I can't see the end, can't enjoy things I used to like. But I force myself to go outside, go to the supermarket or whatever. Just this tiny walk every day has made the number of horrible days so much less. The days thermselves still suck really bad but they are further apart. On this day, I allow myself to feel sorry for myself and try my best to act cheerful for my wife and get out of her way quickly so that my negative mood doesn't affect her too much.

Bottom line: just think about how therapy has had a positive effect on you. I have no experience with group sessions, but considering one of them has an effect on you, try to find out if any of them have experienced positive effects from your input. You might feel better about therapy itself if you know you're helping others.

But as a final thought I'd like to second what was said in the other comment. It is imperative that you talk to one of the therapists and explain what you are experiencing. Maybe in a few months, you'll be able to share this with the group and explain how you got through it.

Keep at it and focus on the positive.

[–] [email protected] 2 points 6 days ago

Hard to tell without context, but it sounds like you have a lot of things bottled up inside of you that may need 1 to 1 sessions with a therapist. Therapy in general obviously makes you confront the things that you may carry with you, the things you shoved in some dark corner hoping you'd forget them, but that's of course not how it works. Your group therapy likely scratches those things and pulls on them a little, which is what causes your distress. Crying is not bad though, it's a good way to let some of those bottled up emotions out.