I’ve had well-meaning people tell me that my therapy should be short-term and have SMART (specific, measurable, attainable, relevant and time-bound) objectives.
Let me assure you, all therapy is closely reviewed by insurance companies and every session is carefully monitored for just that type of progress. But seriously? It’s not that simple.
I’ve now been in therapy with the same person for 20 years. She’s a psychiatrist so she also prescribes my medication. Sometimes it has felt like a trap, like the only way I’ll ever get out of this relationship is to move. Once, when she wasn’t practicing in the area for a year, I realized I was more trapped without her support. But she’s not perfect and I don’t want to say that she is. There were two years when I left treatment altogether but I’ll talk about that another time.
The relationship is complicated, as all long-term relationships are, especially ones with significant power dynamics. She’s known me longer than most people, almost half my life. I trust her and I respect her and in many ways my life is in her hands.
I’m not ashamed to be in therapy, but I do feel ashamed that I’ve been in therapy for so long. I feel judged, in a general sense, and so this is not information that I offer up to people. You pretty much have to have preceded my doctor in my life to know she’s been there all along. Known me for seven years? The details of the last 20 are not your business. I’m pretty defensive about it as well.
No one “begrudges” a manic-depressive patient their medication. TAKE YOUR LITHIUM! is pretty much the universal feeling. And a twenty minute appointment once a month to monitor blood levels, get re-fills, and make sure you’re not even thinking about not taking your medication goes along with that.
But I’ve known people who believe they know me who have no problem telling me in one-on-one conversations that “society cannot afford long-term therapy for anyone.” Let me assure you that my bank account has felt every session I’ve had.
Once, shortly after I met Hubby, we were standing around with a group of people and they were ridiculing an acquaintance who had been in long-term therapy. It was the usual stuff: she should “stand on her own two feet.” “Long-term therapy isn’t good for people.” “She’s just weak.” “I don’t want my insurance premiums going up because she’s using her insurance coverage that way.” “She’s a dependent personality type and this isn’t good for her.” They were self-righteous and they knew it all.
“Y’know,” Hubby said, “Maybe this is as good as it gets for her. You don’t know what her life is like. Maybe she needs this to be a productive person. Maybe without it she couldn’t hold a job and keep a roof over her head. Maybe you’d be supporting her on disability if her insurance wasn’t paying for part of an hour once a week with a therapist.” And that from a man who’d never been to therapy.
So the answer to the question: Aren’t you better yet? Is: Not so much. The answer to the question: Will you ever be better? Is: Probably not your version of “better.” If only that herbal tea had worked for me in college!
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