Today I noticed that J and I follow a very predictable pattern in our sessions. It goes like this (and the time estimates are completely and totally my perception, not reality at all.)

1. J says, “What are we talking about today?” (2 seconds)
2. I fidget, squirm, look around, try to speak, say stupid things like, “What do you want to talk about?” (2 minutes)
3. I finally speak about whatever it is I plan to talk about, or give a list of various items. (5 minutes)
4. Question and answer session, where J tries to get more information about what I am talking about, to tries to delve into the issues. (15 minutes)
5. J talks and talks and talks. He gives his insights, his metaphors (lions anyone?), his interpretations, his personal disclosures. (23 minutes minus 2 seconds)
6. He says it is time to finish up, walks to his desk, still talking, I get up, say “Thank you” and leave. Sometimes he is still talking.

It’s nice having a routine.

So we began as usual. J said, “What are we talking about today?” And I squirmed, and fidgeted and looked out the window, and around the room, and said, “What do you want to talk about?” and finally I said, “I had an appointment with my psychiatrist and it was really great.” So he asked what was great about it. Then I pulled out the notes I had made. Kind of silly to do all of the squirming, when I had everything written down. I had written down all of the things my pdoc and I had talked about last week – it took up the fronts and backs of two index cards. The problem was when I was writing it I was wearing my reading glasses, and when I was trying to read it to J I didn’t have my glasses. All I bring in with me is my car key. Oops.

So I read through the whole list. Interrupting myself periodically to say, “It would help if I could read this,” or “This is in no particular order.” My voice was shaking and I was really anxious, and I was trying to just tear through the list. I think I was talking very quickly. I peeked at J every once in a while, and he was really good. He only interrupted a couple of times, I think he knew if I stopped I wouldn’t be able to restart. I made it through the whole list.

His responses were:

He agrees with 75-80% of what the pdoc said (I asked him what he disagreed with and he said, “I wasn’t keeping track.” Hmph.)

He was glad that she said all of those things to me, because if he had said them I would not have been as positive (absolutely true, and I told him so.)

He wanted to know why I thought it was great, and I said it was because I felt heard.

He wanted to know how her responses made me feel about my therapy with him, and I told him that I thought I felt better about our therapy.

He asked me why I was seeing a pdoc if I don’t want to take meds, and I said because I do want my klonopin, I just don’t want anti-depressants. I told him that I lied to her and told her that I take 1mg of klonopin per day, when I actually take .25mg per day. He wanted to know why I was saving it up, and what stash level I am comfortable with. I told him that I like to have 75 to 100 klonopins at any given time. He didn’t understand that. I told him about last December when I really needed some klonopin, but I wouldn’t dip into my stash and I waited two days for old pdoc to call me back and get the rx filled. He said that seemed strange to him. I told him that Advil is available in bottles of 1000 – and who needs 1000 Advil? He said those are usually meant for families. I said that even if every person in the family has a headache every day, it would take a long time to go through that bottle of Advil. He asked if I had 600 Advil, and I had a headache, would I take some out of the Advil stash, or would I go to the drugstore to buy some more Advil? I said that he couldn’t compare Advil to klonopin, because klonopin is a lot harder to get. He asked if I was planning to commit suicide with klonopin and I said no, definitely not. He asked why not and I said it is too unreliable, and I don’t want to end up a vegetable or have my stomach pumped. That would be way too embarrassing. If I am going to kill myself I am going to do it completely, and not make some halfhearted attempt to draw attention to myself.

Then out of the blue, J asked about the cutting. We haven’t talked about this in a long time. I don’t bring it up, and he never asks. I don’t know why he never asks and I don’t know why asked today. He mentioned the “flowchart” collage that I created a long time ago to explain the self injury cycle and he asked me when the last time I cut was, and what stage I am in now. I told him that I remember the last time I cut, but I can’t remember when it was. I know I was at work, and I used my boss’s knife. He keeps his knives very sharp, which I noticed because I frequently make my breakfast or lunch at his house, or cut up fruit for a snack. He rarely cooks, but he sharpens his knives. I never sharpen mine, and they would not cut me very easily.

I told J that I did feel the urge to cut after our “running” self-disclosure episode, but I wouldn’t do it because I didn’t want J to be the reason why I cut. He thought that perhaps I used quitting the hotline as a substitute for cutting, and did I feel that same sense of relief after quitting that I do after cutting? I told him that I don’t think I did, because the running issue has not yet been resolved, there is no closure. He asked me what closure looks like, and I said either I reach a point where I feel that the other person understands my feelings, or we agree to disagree. But right now I feel that we are still in limbo regarding this issue. He said that in a “normal” relationship if there is a conflict a person can leave to go for a walk, or go to the store, but in a 45 minute therapy relationship you have to stay to work it out. I think that in a normal relationship you can work things out as they come up, but in therapy you can only work on them during the 45 minutes you get, and lots of things stay unresolved.

Then he brought up how I take the responsibility and blame for every relationship conflict, or every mistake that anyone makes. Yes, I know this. I think he is really trying different ways to get me to stop doing this, and I appreciate the difficulty and frustration he must feel. Because I feel it too. He thinks if I could stop the “cycle” before I get to the self-hating phase it would be helpful. I do too. But I think my feelings of self-loathing and not being good enough are so deep, so ingrained in the core of my being, that anything I do will not be able to reverse this. I told him that I don’t want to be one of those people who never take responsibility for anything they do wrong, who always blame everything on everyone else. He said, “So you are erring on the side of caution and taking everything on yourself to ensure that you don’t become one of those people?” I know it seems black and white, doesn’t it? There has to be an area in the middle that is more, well, in the middle.

Then J told me that he was late for an appointment last week. He had to go somewhere at a time of day when he doesn’t normally travel, and it would take 30 minutes if it wasn’t a busy time of day, so he allotted 40 minutes, but it actually took 48 minutes. He called when he was on his way to say he would be late. He said he felt that he did the best he could, and that he wasn’t giving an excuse. He told me that his appointment was at 7:30am. When he got there he saw other people arriving late as well, and he thought that maybe they gave out the 7:30 appointments freely, knowing people would be late.

I told him that if it was me, I would be anxious that the office staff would think I was making up excuses as to why I was late, and that they would have a negative opinion of me after that. He said that crossed his mind, but he knew that once he showed up and that he was nice, they would realize that he was just caught in traffic and it was one of those things that couldn’t be helped, that it didn’t reflect badly on him.

He could have stopped the discussion there, but he had to go on to tell me that this was a medical appointment. I don’t know why he told me that, but at that point the thought that went through my head was, “Good! Maybe he got hurt in that 5K race he did and had to go to the doctor.” Ugh. Whatever was the point of his disclosure was totally lost on me then.

Sigh. One of the things we talked about earlier was that my pdoc said that therapy is talking about the little things over and over again, and how I feel that so many things J and I have discussed are still unresolved. So something I thought of is to put each of those unresolved issues on a slip of paper to put in my box that is in his office. We have only taken something out of the box once since we came up with the idea, but I have lots of ideas to put into the box. These things fall into the following categories:

Things that I haven’t had time to bring up (ie; J’s email from last week, the lion metaphor, etc)
Things that I feel we have discussed before and I feel like he doesn’t want to hear them anymore (the January email summarizing my whole year, that he dismissed after one session)
Things that I am too uncomfortable to bring up (when he searched for “sex” on my blog)

Yeah, I hold a grudge. It might feel good to get these things out, at least on paper and in his office. I wonder if he will check the slips of paper when I’m not there. Hmm….