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A few days ago my therapist warned me that next week we will have to update my treatment plan and ANSA yet again. I groaned. In my post ANSAs to My Questions, I discussed the first update that was done, and commented "All those needs exploded everywhere", as compared to the original.  My therapist indicated there might be some improvement this time, but I honestly can't see where there would be.  I suppose there's a slight chance that my depression could be considered less severe, given that at the time of the last update I had two back-to-back inpatient stays.  Other than that, I almost expect there to be new needs added, regarding topics that had not previously come up in our sessions.

The treatment plan should be easy to update, and look essentially the same as the last one.  I recalled that the goals from last time were rather long-term, and we set deadlines 6 months away, despite the treatment plan needing to be updated every 3 months.  I suggested that we would just be copy/pasting the information from last time, including the deadlines.

When I got home, I pulled out my records to read through these documents once again.  I was reminded of something on my treatment plan that has nagged at me these past three months.  One of the listed therapeutic interventions was "Therapist will provide positive, unconditional regard for Donna*."  *Not my real name.

This made me laugh when I first read it, but as time has passed, it has become increasingly less funny.  I get frustrated talking to someone who I know is obligated to be nice to me whether I deserve it or not.  I don't trust that she actually means any of the positive things she says, because I know she's not free to tell me that she thinks I'm being an idiot.  In fact, I pretty much assume that it's all lies, which makes me wonder why I try so hard to be completely honest with her.  In all the times that I've confessed to skipping pills I should take, taking pills I shouldn't take, or otherwise being self-destructive, the closest she has come to expressing disapproval is to say "I support the idea of you taking your medication this week."

With my previous therapist, it was clear when she thought I'd said something ridiculous.  She could say, "Really, Donna?  Really?!" in this tone that instantly smacked sense into me.  Now I'm seeing someone with whom my weekly struggle is to figure out what the hell she thinks of me.  We have issues come up where I have no idea what her opinion is, and I can't figure out my own opinion because there's nothing there to agree or disagree with.

I can't decide how much of my annoyance here is from not knowing which statements to trust, and how much is from feeling that there's no possible way any of it could be genuine, because I don't believe anyone who really knew me would have anything positive to say.  I want to say that I'd feel better if she wasn't always positive, so that the times when she is would hold meaning.  However, it's equally possible that I just want her to criticize me because it's more comfortable to deal with.


Originally posted at https://stuffthatneedssaying.wordpress.com/2015/02/07/positive-unconditional-regard/. Please comment there.

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February 2015

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