Seeing Progress

Last night I had my final session with my individual therapist for DBT. After almost two years of 5+ hours of therapy a week, I’m starting to get really burnt out, and so after my full year commitment of DBT was up, I decided it was time to be done. I have one more group meeting, then I’ll be leaving. I don’t entirely feel ready to be done with DBT, but I am fairly certain that it’s the right decision at this moment. I need some breathing room and I really need more time to be able to do things that I enjoy. Right now my schedule is a fairly large stress in my life, and I feel like I’m often choosing between committing to therapy and committing to work, something I absolutely hate. So overall, I think that it’s a good choice, although I do wish I could keep learning more about DBT.

Part of moving on when I don’t feel entirely ready is that I feel I haven’t made any progress. It’s easy to do. Since change in mental health often comes slowly, we rarely notice the differences. Often it’s a lack of anxiety or depression that is a big change, and those are also harder to notice than something actually showing up (as an example, I made a phone call yesterday without anxiety, which is a huge change for me, but I didn’t notice it until I brought it up in therapy). Mental health is rarely a straight line upwards, and so there are peaks and valleys. Again, this can make it hard to see an overall upwards trend.

So as I’ve started moving out of DBT, I’ve been feeling a little down on myself. Anxiety’s been high lately, I feel I haven’t excelled at the treatment, and my perfectionism is high. But last night as I was talking to my therapist for the last time, she mentioned repeatedly how far I had come. She pointed out specific skills that I had become much better at. She pointed out my grasp of all the skills and my ability to figure out which skill is the right one to use in a given situation. I was surprised when she first said I had grown, and at first I thought she was simply saying it because that’s what a therapist is supposed to say to a client who is moving on. But the more I thought about the more I realized that I have been more level-headed in the last year, that I’ve made it through some really tough situations with little to no meltdown or target behavior, that I’ve figured out how to think critically about my feelings without invalidating myself.

By no means do I feel recovered or entirely healthy. I absolutely have struggled with a few bad bouts of depression and anxiety in the last month that have interfered with work and relationships. However with the help of someone else pointing it out, I can say that I have grown an amazing amount over the last year and made some serious progress towards healthiness.

I know many people who feel like they can’t find clear landmarks of their progress. Some can, and those things are wonderful, but many people wonder how they’ll ever get better and don’t see how far they’ve come. I think an important element of taking care of your mental health is checking in. Others are far more likely to see how far you’ve come than you are. Of course no one can define how you’re feeling but you, but if you haven’t thought about progress or how you’re doing in the larger scheme of your life for a while, it can be really helpful to have an outside perspective who can reassure you that they’ve seen changes and that they’re proud of you.

When in treatment, you often periodically check up on treatment goals or talk about whether you need to introduce new treatment. It’s great that this kind of check in is often built in to therapy. But I wish that it was just part of our relationships too. I wish that like getting your annual check up, each of us would periodically go through the inventory of our mental health with someone we love and trust to see how we’re doing and if there’s anything we should be worried about. Not only would this make it easier to talk about mental health in general, but it can be incredibly grounding when you’re trying to sort out your mental health by yourself.

I can’t say that I feel I’ve hit any big landmarks in my treatment. I still restrict. It hasn’t been a particular amount of time since I last purged or over exercised or self-harmed. I haven’t weaned off my meds (if I ever will. Still not even sure I’ve found the right ones). But despite all of that muddiness, it can be incredibly validating to see that someone else can point out what it is I’m doing better. What tricks do you use to measure progress and keep yourself motivated?

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