Pgh Lesbian Correspondents

Pre-pandemic, I began seeing my counselor twice a week for therapy. We were starting to work on trauma and one session wasn’t enough. This was 2019.

Her boss resisted. My insurance did not, so after self-advocacy, I became a woman who went to therapy twice a week. Like psychoanalysis without the cocaine or sex.

I first started therapy at age 22 in 1992, working with an array of therapists at the student health center. I continued on and off depending on my health insurance status until 2003 when I began seeing a therapist specializing in mood disorders, I stayed with her for ten years. Then I moved to a clinic setting to access consistent psychiatric/medication support. I had seven different therapists in five years. It was less than ideal, but I made it work because I had consistent medication management.

It was a tradeoff only other therapy/medication clients can appreciate. It has everything to do with the systems – insurance, health care, mental health care, transportation, income, etc. And very little to do with us.

My therapist left that practice in Feb 2020, I went with her. Actually, 100% of her clients followed her. She had negotiated my twice weekly visits so we picked up with that.

When the pandemic hit, we continued to meet twice a week virtually. I worked very hard to process my childhood traumas and cope with adult life. I gained skills, I trusted her instincts.

In late August 2023, my world turned upside down. My therapist was part of the dialogue.

I had an appointment with my therapist the very next day. She reached out to me every day, offering me canceled slots. She communicated with my new psychiatrist.

And then she asked me to consider a third weekly appointment because it was just all so terrible.

So I became a woman who needed three appointments a week to navigate new adult traumas.

That was a little over a year ago. I’m still at three appointments. There’s no plan to cut back because I need this level of support.

Thus, my recent traumas added 52 additional medical appointments to my calendar. 156 total, just therapy. A third of the days in a year, I had a therapy appointment.

I’m lucky to have insurance that covers it, to have donations to help me pay my portion because my income of SSDI is skimpy.

What can you possibly do to fill three appointments? We review recent days, talking thru the ways trauma and anxiety manifested and how I responded. We monitor symptoms. We use a variety of processing tools to wrangle the trauma, including EMDR. Then, we verbally process that processing.

We plan my non-therapy days. What do I anticipate? Fear? Look forward to? How can I manage my anxiety, especially to get the crucial socialization I need?

We deal with crises like my father dying or being overwhelmed with my memorialization blogging when some detail hits home. We discuss medication side effects. She’s a trauma specialist, but understands that it is essential to manage my bipolar disorder as it presents the biggest threat to my welfare.

Sometimes we say nothing because I am very sad. She sits with me, both of us confident I will respond actively at some point.

Sometimes I talk about my cats, telling her their backstories and current antics.

Quite often we connect the dots between all of these things, rather I connect the dots and discuss with her – I’m considered a hard-working client who readily incorporates treatment tools into my everyday life.

Overall, it is a balancing of healing old traumas while coping with life as a person with mental illness.

When I was deposited at the Psych ER, I told myself repeatedly that my therapist would save me. I had the utmost confidence that she would know I did not need commitment BECAUSE we had just discussed my then-status and had a safety plan in place. She did step up and I felt validated that I was right, that my confidence in her was right and my awareness of my own status was on point.

Now, I need support to process these fresh traumas.

It’s not over or healed or better. There’s no silver lining. I’m not stronger for surviving. I’m just a survivor. I can list supports that keep me afloat, including therapy tools. I would be stronger, more resilient if I had not experienced the traumas or if my brain chemistry didn’t skew toward bipolar disorder. So I’m holding my own, but any ‘roar’ from me is grounded as much in my pain and despair as triumph.

I can also list the ways I continue to suffer, the new pain manifesting in my life. The ground I lost, the new demons. The extra expenses. The additional time I invest in my managing my daily activities. Yes, there’s a long list of challenges and struggles because of people like Sneaky Sue and her comrades.

I endured growing up in an extended family headed by a sexually violent grandmonster. It is a horrific story of abandonment, abuse, and neglect. I persevered through a combination of timing, luck, and magic (I think.) I begged to see a counselor, but was denied most likely to protect the mountain of family secrets and horrors.

Thus, I am grateful now to have access to as much therapy as I need to function and have a typical life. The idea that therapy must be confined to the smallest amount of time serves only mental illness deniers and insurance companies.

There’s inpatient, there’s outpatient, and there’s in-between modalities known as intensive outpatient (IOP) or partial hospitalization. Ideally, we provide each patient the right amount of supports they need to function at the highest level. That’s a good use of resources. I’ve used all of these tools at some point so I am well positioned to know what is the best fit for particular scenarios. For me.

Still, I am too often questioned (challenged?) about investing these resources in myself. Sometimes, I explain, and now I can point them to this blog post. Sometimes, I begin describing my childhood or review the Adverse Childhood Experiences assessment (my score is 9) tool to illustrate why I need so much therapy. As soon as I drop my phrase ‘grandmonster’ to describe my paternal grandfather, they suddenly get it. I’m expected to show my wounds, even bleed a little, to satisfy their anti-mh bias? Yes, I am.

Now I know that I was very right as an adolescent to ask for therapy. I should have started around age 12 and maybe I would have had a jump start on the bipolar disorder that manifested in my early teen years. Maybe I could have processed some of the trauma in the living years of my parents and grandmonster. Perhaps I could avoided piling another decade of pain and anguish, depression and anxiety onto my childhood experiences.

We could call it a trade and say I am owed 520 additional sessions by the universe or the insurance gods to cover that decade. That debt will have an impact on the quality of life for me in my third chapter. I get to decide now, at least until Medicare gets to decide. But that’s another blog post entirely.

If you need additional support, ask. It doesn’t reflect poorly on you. And you never known what can bee arranged until you request it.

My therapy is going to look different soon. I’ll be seeing two therapists for a total of three weekly appointments. It is due to the ebb and flow of therapist’s availability, but I’m willing to try so I can get my needs met.

I wrote this post to normalize needing more than one session a week. I’ve been in therapy consistently for 21 years and in general, for about 32 years. There’s no benchmark or date of completion. If you want to start counseling with the idea it will be short-term or situational, that’s fine. If you need more, that’s fine. Advocating and negotiating for what you need is so much better, so much healthier than denying you need help and struggling on your own.

Or, like my parents, denying that your kid(s) need help when they ask. Or even denying that they are asking.

Denial is for insurance companies, not for you and me.

 “The luck of the third adventure” is proverbial.

Elizabeth Barrett Browning