I hesitate to write about this because I'm still processing it and don't really have an articulate summary thought out yet. Sorry if this isn't coherent, but it's weighing on my mind and I had to say something. In a nutshell, I think I'm getting fired from therapy. My appointment with R yesterday was...rough, to say the least. It was a weird, awkward mixture of him asking whether I found therapy helpful, and me trying to answer honestly without offending him, while also not exactly being sure what my answer even was. We talked about how my eating habits, my thinking regarding food and weight, and my rigidity remain almost entirely unchanged. That makes it seem like therapy has had zero effect on me whatsoever. Except that maybe I'd be a lot worse off without it, who knows?
Staying in treatment was a condition of my parents letting me come back to school this year, so it was never really my choice to begin with. But now that it's pretty clear I'm not improving, I'm mad and frustrated with myself for failing.
A major issue, according to R, is that we fundamentally disagree on the weight thing. Not about gain in general - I know that I should gain weight. But his goal is significantly higher than anything I deem remotely reasonable. He also flat-out doesn't think I can get there outpatient. History is on his side, considering I haven't put on any significant weight in eight months, but I flat-out refuse to go IP. There might be people who disagree with my position on that one, but it's nonnegotiable. I'm not giving up my life again, no matter how stubborn and dumb that may sound. I've been in semi-decline since getting sick over vacation, but I'm not in dire straits medically, and I don't think it's fair for him to force me into a higher level of care.
And okay, deep breath, this is the part I'm still working out: the shame. Just being in therapy gives me this deep-seated sense of inadequacy that I carry around constantly. Outside my immediate family, I think only two or three of my friends actually even know that I see a therapist, but it still feels like I have a neon sign over my head announcing to the world that I'm a wreck who can't keep her shit together without professional help. (I don't think this about other people in therapy. It's a purely self-conscious issue.) I walk around every day with this profound sense of failure, like I'm flawed and diseased, like something is fundamentally wrong with me. And I hate that. Sometimes it feels like therapy has destroyed my self-esteem. I worry that I can't function without it because I've been told over and over again that I need it.
I'm stuck somewhere between not believing there's any valid reason for me to be in treatment (because I'm not skinny, I'm not sick, and I'm perfectly functional in everyday life) and not believing that I'll be okay without a professional support system, simply because I've become convinced that I won't make it on my own.
Our conversation yesterday left me feeling really negative and defeated. R was sympathetic, but his position is that unless I agree to IP, or at least IOP, as per his official recommendation, there's not much else we can accomplish together. I should have seen it coming, considering how difficult I've been all year, so I don't really have any right to be upset. But still, it's hard to hear how messed up you are for eight months, and then get turned out on your own. I should make clear: he didn't officially fire me, but definitely addressed the possibility of us not working together anymore. We left things up in the air for now. I'm going to see him next week, the last time before a stretch where we're both out of town a few weeks in a row, and we'll make a decision then.