Posted by Dr. Vollmer on June 28, 2012
“I am afraid to go to therapy. I am afraid you are going to make me feel so bad about myself. I am afraid I will lose all of my confidence if I start seeing you on a regular basis,” Zoey, thirty-three says as we discuss that psychotherapy may be an important addition to her psychopharmacology for her treatment of her mood disorder. “It is that fear that makes me think that psychotherapy makes sense. Confidence, that quality in which you feel good about yourself, is what is missing from your life. Your fear that psychotherapy could diminish your sense of yourself speaks to the fragility of your self-esteem.” I say, knowing that Zoey will click in to what I am saying. “Yes, that’s true. I see that.” Zoey says with her typical candor and openness. “Still, I don’t want to think I need that.” She says, implying that she is able to accept that she needs medication, but that her associations to psychotherapy are negative and scary. “Sometimes things have to get worse, before they get better,” I say, knowing that I am stating the obvious, but also knowing that the obvious helps us lay out the psychological barriers to treatment. Zoey changes the subject, or so it seems. She talks about how she is getting involved with a new political passion. “Maybe you have transitioned to talking about your new politics as a way of reassuring me that you are engaged with life and thereby not needing psychotherapy.” I say, thinking about how our conversation shifted. “Yea, you are right,” Zoey readily agrees. “I do need therapy. I just don’t want to think about that right now.” “I love your candor,” I respond, feeling a fresh breeze in the air.