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Gayle McGrath: Therapy is difficult, often painful, but sticking with it is key to success

Editor’s note: Gayle McGrath of Lexington is a client at Access Wellness Group. A significant part of her therapy for bipolar disorder is writing, so after reading a Wellness Matters column on KyForward about the bravery necessary to seek therapy, she decided to write a description of a client experience. McGinnis encouraged McGrath to share it with us here at KyForward and, with her permission, we are sharing it with you.

It’s 1:45 a.m. and I’m watching It’s Complicated. Merrill Streep’s character just left her psychiatrist’s office. She’s having an affair with her ex-husband, Alex Baldwin, who is now married to the harlot he was sleeping with while he was married to Merrill.  

Meanwhile, Steve Martin plays Merrill’s architect, who has a wild crush on her, and to whom is she attracted. Ms. Streep wanted an emergency therapy session and baked some sort of fancy pastry just to get 20 minutes to talk with her therapist. She knew she shouldn’t, but she begged him to tell her what to do. Should she continue to have the affair or should she pursue this possible relationship with Steve Martin?

I know what that’s like – the pleading – not the affair. I’ve made a call or two pleading to see my therapist on an “emergency” basis. My mind gets so jumbled – the thoughts spin so fast – that I cannot grab hold of just one word to put it in a place so that I can put others around it to make some sort of order out of all the words. Desperation or panic set in. All I want is for my therapist to tell me what to do.

But that’s where the similarity ends. Ms. Streep’s therapist told her to abandon caution to the wind – to continue with the affair to see where it took her. As it turns out, it took her to a good place – she was able to get the closure on her divorce that she thought she already had, which let Steve Martin start seriously thinking about all the chocolate croissants (and a killer chocolate cake) that could be in his future. (Sadly, Alex Baldwin’s harlot/trophy wife kicked him out when she realized he was sleeping with Merrill, so when Merrill arrived at her “good place,” Alex Baldwin had no place to go.)

My therapist, on the other hand, would sooner chew through his bottom lip than tell me what to do. We don’t even weigh the pros and cons of what I might think I want to do. My therapist would want to know why I think I want to do what I want to do – or, more likely than not, he would identify why I think I want to do something, usually in terms of what it is I’m trying to avoid doing. Then we would discuss that.

In the end, he would describe some study that would predict the usual outcome if I did what I was contemplating (he can cite a study for just about anything, including adultery) and then tell me what he “wished” for me; but he never, ever, would tell me what to do. Sometimes his refusal makes me so angry, I swear I will never attend another therapy session. But then I show up for the next appointment. Still, I might see if I can get a referral from Merrill Streep.

Of course, most therapy sessions are not emergencies. I started going to therapy just over six years ago, after I was diagnosed with bipolar disorder and a depression so severe I often was unable to function. In the beginning, I think my therapist’s goal was to partner with my psychiatrist, checking to ensure I was taking my meds and monitoring the severity of my depression. He was teaching me behaviors and strategies to help me stabilize my mood (hint: good sleep, hygiene, healthy diet, exercise).

Now, sessions have a lot to do with emotions – my specific reaction to a stressor. Usually, I come in with a specific topic in mind or we talk about what’s been going on since the last time I saw him. If I don’t have anything to discuss, I sit down on the couch (yes, he has a couch), and just look at him, and he will start my session with something like, “Tell me something I don’t know” or just “Well?”

In those sessions, he might guide me to what he believes we should talk about. Those usually are the most painful sessions because he knows that I don’t like to talk about certain topics – topics that are probably at the top of the list of what I should be talking about. He’ll keep nudging me toward the topic, and on any given day, I might be able to explore it or I might not.

There have been many painful, teary discussions during which my therapist has guided me through a thought process that prompted me to confess fears and thoughts I never have spoken out loud. It’s scary to trust someone and to make myself unilaterally that vulnerable to any other person. It’s like root canal – I know it’s what I need to stop the impediments to my good mental health, but that doesn’t necessarily mean I like the procedure.

I suppose that’s one of the reasons I keep going back. Sometimes I can wade further into the water than other times. We can delve deeper into why my thinking causes me to feel the way I feel. For example, I always want to be in control – of everything. But guess what – I cannot control other people. I can control only how I respond to what they choose to do. That seems intuitively obvious to even the most casual observer. You might be thinking, “Really? You need a therapist to tell you that?”

It’s true – it is absolutely logical – even obvious – that I cannot control someone who has free will. But how many times have you had a go-to-pieces because someone didn’t do what you wanted him or her to do? Therapy taught me to recognize when I am falling into my “control behavior” so I can stop it. I can hear my therapist saying “You want to be in control of everything and you cannot do that.” (That’s the kind of definitive statement I can expect from my therapist. He’s not Socratic. It’s usually delivered a little stronger than his conversational tone, but it’s not loud.)

Now, I usually hear him in my head repeating that admonishment (and maybe even see him leaning forward in his chair), and my reaction to the situation, which is what I can control, is much more measured. You have no idea how much better I feel now that I don’t waste energy on something I cannot control.

So with all of these wonderful new skills, why am I still in therapy? The simple answer: it’s all about me. Once I was willing to trust my therapist – to make myself vulnerable, I found the only place where I can be safe to say whatever is on my mind without feeling like I’m being judged. In fact, before I realized he wasn’t there to judge me, I was downright mean to my therapist – but, he didn’t react. Had our roles been reversed, I know how I would have reacted.

Don’t get me wrong. I’m sure my therapist has impressions. After all, despite his behavior during my sessions, he is human. He just has never reacted to what I say by imposing his own values on me. He’s a good therapist and a good therapist doesn’t give advice (e.g., go ahead with the affair). I can say what I need to say out loud. If I need to cry, I can cry. If I need to be angry, I can be angry. If I need to be dramatic, that’s OK, too. He allows me my emotions. For an entire hour (really 45-50 minutes), I am my therapist’s sole focus. He knows me well enough at this point to determine my mood from the look on my face. He knows me better than any other person on the planet – bar none – and that enables him to move me through my thought processes. It can be quite liberating.

I do have one frustration about therapy. Sometimes my “hour” isn’t enough. I never run out of something to discuss before I run out of time. Sometimes we have to back-track. Many times, my therapist concludes a session before we really can get to any type of resolution. There are times I suspect he purposely manipulates the hour, so it will end without resolution because he wants me to go home and think for a while.

Recently, my therapist moved to another state. My new therapist has a different approach to things. We don’t have the rhythm that comes with six years of open, frank discussions, but talking with her has given me an opportunity to reflect on the experience with my first therapist. And though I sorely miss my first therapist (which, if I’m going to be honest, is an understatement), the transition might be a good thing for me if I give it a chance. I just need to be patient, be an experienced client and keep going – oh – and don’t expect her ever to tell me that I should stay in an extramarital affair.

Gayle McGrath practiced employee benefits law for 24 years prior to retiring in 2008. She now works as a substitute teacher in middle and high school and volunteers with an active community action group. 

(Thumbnail photo from National Institute of Mental Health)

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