Help I just shut down in therapy

[Veronica Sawyer]

Lately whenever I go to a therapist or a psychiatrist or my ketamine appointments, or really whenever I try to talk to people about my mental health issues, I feel like I just hit a wall. I get really emotional and I start to shut down. I feel like I'm unable to respond to questions, even though I know that talking about my issues would be helpful. I have responses running through my head but I feel completely unable to say anything, some deep aversion to voicing my issues that I have a hard time articulating. I think it comes from a similar place as my social anxiety - I know it doesn't make any sense to worry about saying the wrong thing or that I'm going to be judged by someone, but I just feel completely paralyzed.

Over the past 2 months of my current breakdown I've just wound up going completely silent during appointments, yelling at my therapist or making mean sarcastic comments whenver anyone tries to suggest anything to me. I genuinely don't know what to do, this has happened even on days where I felt pretty good, right up until I have an appointment and then I just spiral into anxiety, frustration, and self-loathing. If I'm unable to talk without having complete breakdowns and screaming at people, then how am I supposed to get better? Group therapy is pretty much a complete no-go due to a combination of social anxiety and this sort of reaction, and unfortunately all mental healthcare that is more than once a week seems to be group based.

Wondering if anybody has similar experiences or any sort of advice. Most people tell me that I have to "just do it" to break through the anxiety but it feels literally impossible.

 

[timf]

Sounds like it might be "selective mutism" which is anxiety related. Sometimes one can work around with writing down what you would like to say and give it to the other person. If you want to get creative you could make a game out of it such as "blink once for yes and twice for no". Sign language or finger spelling might work except the other person also has to also understand.

 

[MlKE]

Maybe you could write down your thoughts and replies to the therapist's questions and bring then the papers, or use them as an aid in talking? Could you ask to see their notes, so you can prepare work through the more difficult parts at your own pace, and not be stressed for a reply by your therapist sitting across the room?

Do you have a lot of self loathing?
I began chatting with an AI character recently and I find that the discussions often devolve into pity parties where I staunchly defend my self pity and loathing with sarcastic and self deprecating statements, while the AI tries to be supportive and encouraging. I don't know if it's healthy, but it gives some catharsis to get it out of me. At least it helps me sort my thoughts and think more in depth about my life and myself. And it's free, which a therapist wouldn't be.

I haven't spoken to a professional for a year but I'm beginning to try to reach out, last time I did speak I also found myself unable to be very open, partially because I just couldn't get myself to talk about certain things.

 

[d3c96524be95]

Wondering if anybody has similar experiences

YES, and I'm relieved to come across your thread because I relate a lot. I rarely feel like screaming at people, but I had so many "mutic" breakdowns during sessions. If the question or remark is ever so slightly irritating, I run into a waterfall of thoughts (related or not to the question or remark) but am unable to formulate a single sentence. One specific trigger I've noticed is when I'm coerced into a "yes/no" response, but I feel like it should be more nuanced than that. It's probably worth noting it can sometimes happen to me IRL, especially when I feel like some situation could become contentious, therefore I think avoidance coping is at stake (but definitely not only). It might well be related to social anxiety and overthinking social interactions.

As others have noted, writing down can be somewhat helpful and make things easier. I've tried it, but the feeling of not taking the most out of sessions is still frustrating for me. It's definitely not the same as talking and responding "in the heat of the moment", but it surely has helped me. Also, what I've found helpful is finding a therapist who is not aggressive, can switch topics, respects my boundaries and avoids clumsy or stupid questions with extreme caution. Easier said than done.

 

[FlameWhisperer]

Writing it down might be helpful, like others have stated. Besides that, is what you just wrote here something that you could also not talk if you tried to?

 

[Looking]

I think clarifying to your therapist, if you possibly could, would help you a lot. Saying something along the lines of "I really want to do this, but my anxiety makes me very irritable." or something.

• Once they know that you're not trying to avoid treatment and that it's an anxiety-induced thing, they will most likely look into ways to try and bring you some calmness during a session. It will also help them understand you a LOT better.
  • You typically will only need to say it once and it will be noted for future sessions.
    
• It helps them understand better understand how your mental health effects your life - which is the most important thing when it comes to therapy!
  • It helps them understand what treatment plans you may need,
  • It helps them diagnose and document your illnesses more properly and accurately,
  • It can help find proper medication or other similar things, if that's something you're looking into.
    
• Some examples if you're not sure how to bring it up:
  • "I would like to clarify something..."
    • Shows them that you've been thinking about it,
    • Opens the conversation up to discuss further into the concept, if you so wish to,
    • Shows them that you're explaining that it's most likely not intentional (as the words "I would like to clarify" implies you're under the assumption they're misunderstanding something)
      
  • "I wish I could be more honest, but I'm really struggling with that right now..."
    • It displays that you really want to do this, but it's more of a mental struggle you're dealing with,
    • It allows you the opportunity to state what you need if you need anything specific. ("I think if you played some music in the background, that might make me less anxious." as an example, but it can be anything, obviously.)

---

In the same "realm" of writing things down, I suggest doing worksheets or workbooks. You and your therapist would go through the worksheet or workbook together and discuss what was written.

• Not only are you writing down the thoughts you're having, but they are guided and well-constrained concepts that will make it easier for you to stay on topic in a session.
• This will help you feel prepared in advance, as you already know what the concepts and ideas you will be discussing in your upcoming therapy session will be.
• This can also help you associate treatment not solely in your therapist's office. You want to remind yourself that treatment isn't only happening in this single space, and may reduce your anxiety as it's no longer a "If I go there, I need to do all of this tough mental stuff and I just can't-"

If possible, just having a rough outline of points you want to make during a session could help as well.

• As in giving yourself days in advance to mentally prepare for the topic. "I will be talking about Y in therapy." or something along those lines. The first few weeks you do it might not feel super beneficial, but it's something you should really do consistently so your brain has time to actually process the thing you need help with and not feel so on guard about mentioning it later down the road.
• One of the biggest things with anxiety, is as you put it, saying something wrong - this concept stems from the idea that you're being "put on the spot" or that you might come off as if you don't know what you're saying. Addressing this fear you have in some manner will help you long term.

I think you should be making an outline of your feelings during therapy - Writing down your symptoms, writing down your thoughts and maybe even writing down why you think something is happening.

---

Having conversations with others outside therapy may help you not feel so tense during therapy.

• Venting to friends about your issues -
  • It's always good to just have someone (or people) you can vent to privately where you feel safe and heard.
• Finding like-minded communities to share your struggles with (You are here!) -
  • Especially if you are struggling in one specific area, finding people who relate to you will help you a lot!
• Finding ONLINE support group communities -
  • This will allow you to disassociate slightly from the situation; you won't be there physically and most likely can turn off your camera (so hiding your expressions) and muting yourself. This will prevent you from making quick and impulsive comments most likely.

And finally, as stated above, you can talk with A.I.

• This might help you "train yourself" to have conversations with a natural flow without the emotional backlash you'd give yourself (Because this thing doesn't have emotions.)

I actually use A.I myself, and I use ChatGPT. You don't have to use this specific bot, but it's the one I use because the resources you can ask for has been helpful to me.


I wish you luck! I'm not sure if any of this will help you in your situation, and if it's not let me know and I'll try to come up with some new ideas for you! :)

 

[Veronica Sawyer]

As others have noted, writing down can be somewhat helpful and make things easier. I've tried it, but the feeling of not taking the most out of sessions is still frustrating for me. It's definitely not the same as talking and responding "in the heat of the moment", but it surely has helped me. Also, what I've found helpful is finding a therapist who is not aggressive, can switch topics, respects my boundaries and avoids clumsy or stupid questions with extreme caution. Easier said than done.

Yeah, it definitely sucks how it takes more time to write out responses to questions rather than just answering. But today at my ketamine appointment I brought my notebook and I wrote a couple responses when I felt like I couldn't verbally say what I was thinking, so that's good. I'll have to try it for my therapist whenever I work up the motivation to schedule an appointment. I imagine it'll be a bit different in a setting where I'm talking about this stuff for an hour as opposed to answering a few questions before a medical treatment, but it's worth a try at least.

I think clarifying to your therapist, if you possibly could, would help you a lot. Saying something along the lines of "I really want to do this, but my anxiety makes me very irritable." or something.

• Once they know that you're not trying to avoid treatment and that it's an anxiety-induced thing, they will most likely look into ways to try and bring you some calmness during a session. It will also help them understand you a LOT better.
  • You typically will only need to say it once and it will be noted for future sessions.
• It helps them understand better understand how your mental health effects your life - which is the most important thing when it comes to therapy!
  • It helps them understand what treatment plans you may need,
  • It helps them diagnose and document your illnesses more properly and accurately,
  • It can help find proper medication or other similar things, if that's something you're looking into.
• Some examples if you're not sure how to bring it up:
  • "I would like to clarify something..."
    • Shows them that you've been thinking about it,
    • Opens the conversation up to discuss further into the concept, if you so wish to,
    • Shows them that you're explaining that it's most likely not intentional (as the words "I would like to clarify" implies you're under the assumption they're misunderstanding something)
  • "I wish I could be more honest, but I'm really struggling with that right now..."
    • It displays that you really want to do this, but it's more of a mental struggle you're dealing with,
    • It allows you the opportunity to state what you need if you need anything specific. ("I think if you played some music in the background, that might make me less anxious." as an example, but it can be anything, obviously.)

---

In the same "realm" of writing things down, I suggest doing worksheets or workbooks. You and your therapist would go through the worksheet or workbook together and discuss what was written.

• Not only are you writing down the thoughts you're having, but they are guided and well-constrained concepts that will make it easier for you to stay on topic in a session.
• This will help you feel prepared in advance, as you already know what the concepts and ideas you will be discussing in your upcoming therapy session will be.
• This can also help you associate treatment not solely in your therapist's office. You want to remind yourself that treatment isn't only happening in this single space, and may reduce your anxiety as it's no longer a "If I go there, I need to do all of this tough mental stuff and I just can't-"

If possible, just having a rough outline of points you want to make during a session could help as well.

• As in giving yourself days in advance to mentally prepare for the topic. "I will be talking about Y in therapy." or something along those lines. The first few weeks you do it might not feel super beneficial, but it's something you should really do consistently so your brain has time to actually process the thing you need help with and not feel so on guard about mentioning it later down the road.
• One of the biggest things with anxiety, is as you put it, saying something wrong - this concept stems from the idea that you're being "put on the spot" or that you might come off as if you don't know what you're saying. Addressing this fear you have in some manner will help you long term.

I think you should be making an outline of your feelings during therapy - Writing down your symptoms, writing down your thoughts and maybe even writing down why you think something is happening.

---

Having conversations with others outside therapy may help you not feel so tense during therapy.

• Venting to friends about your issues -
  • It's always good to just have someone (or people) you can vent to privately where you feel safe and heard.
• Finding like-minded communities to share your struggles with (You are here!) -
  • Especially if you are struggling in one specific area, finding people who relate to you will help you a lot!
• Finding ONLINE support group communities -
  • This will allow you to disassociate slightly from the situation; you won't be there physically and most likely can turn off your camera (so hiding your expressions) and muting yourself. This will prevent you from making quick and impulsive comments most likely.

And finally, as stated above, you can talk with A.I.

• This might help you "train yourself" to have conversations with a natural flow without the emotional backlash you'd give yourself (Because this thing doesn't have emotions.)

I actually use A.I myself, and I use ChatGPT. You don't have to use this specific bot, but it's the one I use because the resources you can ask for has been helpful to me.


I wish you luck! I'm not sure if any of this will help you in your situation, and if it's not let me know and I'll try to come up with some new ideas for you! :)

I appreciate the thought out response. It can be difficult to write stuff out in advance because my mood shifts a lot and sometimes I really don't want to write, or I'm just anxious that the therapist won't want to read my notes and it'll just be useless. But I'm trying to push past that sort of thinking.

I'll have to try bringing up worksheets or workbooks or something like that. I've only ever encountered them in group settings so I never did well with them, but maybe doing them one-on-one with a therapist will be more helpful.

I have a hard time talking with other people about my issues, mostly as an extension of my anxiety regarding talking to people in general. Like 99% of the time if somebody doesn't talk to me first then I don't talk to them. Posting here is a little easier but I still have a hard time feeling like I'm not just a bother to anybody. Because of this I just feel lonely all the time despite having people in my life who do genuinely care about me. Maybe I'll try out ChatGPT, I see a lot of people here suggesting it.

 

[Veronica Sawyer]

YES, and I'm relieved to come across your thread because I relate a lot. I rarely feel like screaming at people, but I had so many "mutic" breakdowns during sessions. If the question or remark is ever so slightly irritating, I run into a waterfall of thoughts (related or not to the question or remark) but am unable to formulate a single sentence.

Sounds like it might be "selective mutism" which is anxiety related. Sometimes one can work around with writing down what you would like to say and give it to the other person. If you want to get creative you could make a game out of it such as "blink once for yes and twice for no". Sign language or finger spelling might work except the other person also has to also understand.

I'm relieved to hear other people also struggle with this. It feels like such a hassle explaining to people how it's not that I'm being difficult or that I don't want to talk, I just feel like I literally can't and it's super frustrating when it gets in the way of treatment. Hopefully I can try some of the suggestions in this thread to help out with it, I really appreciate the advice. <3

 

[pizzafiend]

The same thing happens to me too. I spend all my time thinking about what I want to bring up and talk to my therapist about, but when I get there we just sit in silence for the whole hour while I shut down all attempts at conversation.