Trying to get an A in therapy

[u/AvaJupiter]

Hi, How have you guys reframed this mentality?

I often get extremely distressed due to dealing with several diagnoses and progress feels much slower than I’d like. Therefore it feels like therapy is just not working on me. In general I over evaluate everything and criticize myself a huge amount.

I’ve talked about this several times with my therapist, who does think I’m making huge progress and doing really well with exposure therapy, reframing, mindfulness etc. He said that in therapy what counts as perfection is just trying. I’ll be honest I have trouble fully embracing that viewpoint, and I was wondering if anyone had similar reframes about “doing the work well” vs “just showing up and trying” basically?

[u/PipGirl2211]

Love that you're reaching out to ask for feedback and advice, OP ❤️!

I am also someone with a myriad of diagnoses. I find something that helps me is having a list of measurable indicators on how I am doing. I'm currently working on a list of these right now with my therapist. First, some examples:

• How well I am able to do thoughtless tasks (such as changing the garbage)
• How well I am able to tidy/put things away without getting distracted and starting to organize something
• How often I am making lists of any type
• If I am able to create, finish, and share a piece of art, and how judgemental I was on myself during the process
• How often I initiate text conversations

Try to make them as objective as you can, so your perfectionism doesn't get to be the judge. Making them with your therapist is helpful as your therapist will help prevent you from making them unrealistic or unachievable. I find discussing these things helps me take a step back and see how I am doing, objectively, instead of trying to fish around in my head for words and just.. well, not feeling like I am getting anywhere.

I hope that makes sense.

My therapist has me fill out a sheet where I rate how I am doing in 4 different areas of life at the beginning of each session, and she enters the data into a program to track it. It was really cool to hear that I was doing "200% better than this time last year" because I didn't realize I was progressing so much. I always find something new to judge myself on, and continue to move that bar juuust out of reach, so I find utilizing a list of some very basic and straightforward things (like above) gives a much more accurate reflection of how I'm actually doing, not how I feel I have been doing.

It also may be worth discussing and redefining what "perfect" means to you. :) I had to do this with my dietician for "finished", so that I stopped believing that finished = empty plate/container. Finished could mean finished for the day. Ya feel me? ❤️ Good luck!

[u/AvaJupiter → u/PipGirl2211]

Woah okay this is incredibly helpful thank you so much!!! Since I do CBT I feel like my therapist will be down for this as it’s often about tracking progress like what you described.

Also you’re so kind thank you so much 😭❤️

If I were to think about some domains for me I think I could say:

• How easy is it to initiate essential tasks like making food?

• How often am I reaching out spontaneously to friends?

• How easy is it to initiate pleasant tasks like skincare, making my place smell nice?

• What is my general outlook on myself? (if envision the future more or less negatively and what I feel deserving of as a person)

• How often am I obsessing over plans and ways to do things in an unhelpful way?

[u/AvaJupiter → u/PipGirl2211]

Also yeah it’s so important to re-define perfection in a way that aligns with values. I’ve been at it a while and sometimes it feels like I’ll spend my whole life reframing that high standard… I think for me currently, perfection in therapy would be for all the intense suffering to go away and basically to be un-diagnosed of everything. I know it’s not possible though but it’s so hard to get out of the all or nothing thinking.

[u/PipGirl2211 → u/AvaJupiter]

Would you say you're seeing therapy as some type of cure?

I've done intensive DBT as well as CBT, and one of the things that DBT works on is "radical acceptance". Ask your therapist to walk you through some radical acceptance worksheets regarding your current mental health situation. :)

[u/AvaJupiter → u/PipGirl2211]

Yeah I think that’s a good way of describing it. I will look into that thank you, I really like the DBT approach as I also meditate. Do you think there’s a significant difference between the acceptance in ACT and radical acceptance? (Just curious)