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Old 04-01-2021, 05:23 PM   #211
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Old 04-01-2021, 05:42 PM   #212
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oh

but we'll get out of iraq someday, right

 
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Old 04-02-2021, 08:52 AM   #213
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I thought for a while I could get away with not having a social life if I was able to do work I really enjoyed that I could help people through. But that has not happened and I don't know if it would have worked anyway.
I legit asked my one friend recently how people make friends, lol. And he said the same thing my therapist did: You have to put in effort and do new things. Have to be willing to be uncomfortable and to look dumb. Which all seems true but I wish there was some other way.
I can hosestly say that alot of my favourite memories of my life have been when I've been by myself, doing my own thing. So I've never really placed that much value on having an active social life, which was kind of reaffirmed to me in my early-mid twenties whenever I did step out of my comfort zone socially, and 9 times out of 10 it would be what I would consider a negative experience and I should have just stayed home instead.

I guess the problem is you keep yourself to yourself for so long that you have no one/nowhere else to vent to exept an old 90's board about the squish squash

 
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Old 04-02-2021, 10:48 AM   #214
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Yeah I think the small sample size and the inevitability of having anxious experiences in new situations really makes it hard to keep doing it even when I do try.

 
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Old 04-10-2021, 01:57 AM   #215
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like a piece of SHIT

 
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Old 04-10-2021, 11:15 AM   #216
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just straight programming and being kind to my neighbors

24/7

 
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Old 05-02-2021, 01:44 PM   #217
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Who has tips for 1st time therapy sessions

Pretty friekin nervous about it. Not sure what to cover or “work on” or whatever. Or even what it will be like

 
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Old 05-02-2021, 01:45 PM   #218
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like a piece of SHIT
Thanks for reminding me of these laffs (which have been buried apparently under my neverending series of alcoholic blackouts of the aughts)

 
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Old 05-02-2021, 02:05 PM   #219
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Who has tips for 1st time therapy sessions

Pretty friekin nervous about it. Not sure what to cover or “work on” or whatever. Or even what it will be like
Will prob ask you why you decided to come to therapy, basically if there is a certain event you can pinpoint or if it's been slow burning, etc, or if it's a certain symptom

They may have you take a written assessment (multiple choice/true false type) but probably not.

Will probably ask about:
1. family history of mental illness
2. your history of all illness (mental/physical)
3. trauma history which can be short or extensive, including medical trauma/head injury along with mental/physical/sexual abuse and neglect, etc
4. substance abuse history (please be honest with this or at least don't deny you do smoke weed "sometimes")
5. sexual and spiritual orientations
6. current support system
7. if you talk about depression they will ask if you are suicidal or have ever been, if you talk about anxiety they will ask about panic attacks, severe trauma they will ask about flashbacks, basically all the extreme manifestations that would indicate a likely/easy diagnosis
8. if you've ever been arrested/convicted etc

They might ask you about specific symptoms (appetite, if you enjoy life, how your sleep is, if you ever feel really really good (manic), if you can concentrate, if you enjoy work, etc) if they don't come up organically.

It is really important to be compatible with your therapist. For me that includes liking them as a person. I think you can get a sense of this within the first few sessions. You are paying for them to listen but not to care, and there's a difference. They have to actually be a caring person to be good at talk therapy IMO with the possible exception of strict CBT.

So yeah I'd expect it to be general "so what brings you to therapy..." and based on your answers it will flow through all of those steps. It might take multiple sessions to get through them all and I'm probably missing some stuff.

I recently started seeing a new psychiatrist so I had a lot to start with and pretty much knew how to go through it all, first time is tough though for sure. Just answer their questions as best as you can. It's normal to feel overwhelmed and emotional or just the opposite. And this may sound dumb but you might lie and that's okay. Try not to but you will come out with stuff when you're ready. That goes for things you've done/bad habits (like drug use) and stuff done to you. Assuming you have decent health insurance or can otherwise afford long term therapy, you have a lot of time.

Last edited by reprise85 : 05-02-2021 at 02:12 PM.

 
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Old 05-02-2021, 02:16 PM   #220
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Proud of you buddy

 
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Old 05-02-2021, 03:21 PM   #221
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Will prob ask you why you decided to come to therapy, basically if there is a certain event you can pinpoint or if it's been slow burning, etc, or if it's a certain symptom

They may have you take a written assessment (multiple choice/true false type) but probably not.

Will probably ask about:
1. family history of mental illness
2. your history of all illness (mental/physical)
3. trauma history which can be short or extensive, including medical trauma/head injury along with mental/physical/sexual abuse and neglect, etc
4. substance abuse history (please be honest with this or at least don't deny you do smoke weed "sometimes")
5. sexual and spiritual orientations
6. current support system
7. if you talk about depression they will ask if you are suicidal or have ever been, if you talk about anxiety they will ask about panic attacks, severe trauma they will ask about flashbacks, basically all the extreme manifestations that would indicate a likely/easy diagnosis
8. if you've ever been arrested/convicted etc

They might ask you about specific symptoms (appetite, if you enjoy life, how your sleep is, if you ever feel really really good (manic), if you can concentrate, if you enjoy work, etc) if they don't come up organically.

It is really important to be compatible with your therapist. For me that includes liking them as a person. I think you can get a sense of this within the first few sessions. You are paying for them to listen but not to care, and there's a difference. They have to actually be a caring person to be good at talk therapy IMO with the possible exception of strict CBT.

So yeah I'd expect it to be general "so what brings you to therapy..." and based on your answers it will flow through all of those steps. It might take multiple sessions to get through them all and I'm probably missing some stuff.

I recently started seeing a new psychiatrist so I had a lot to start with and pretty much knew how to go through it all, first time is tough though for sure. Just answer their questions as best as you can. It's normal to feel overwhelmed and emotional or just the opposite. And this may sound dumb but you might lie and that's okay. Try not to but you will come out with stuff when you're ready. That goes for things you've done/bad habits (like drug use) and stuff done to you. Assuming you have decent health insurance or can otherwise afford long term therapy, you have a lot of time.
Thank u thank u thank u for taking the time to write this out. This really helps so much. Must spread etc

 
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Old 05-02-2021, 04:34 PM   #222
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I second all of that. Also idk what your world view is like, but for me, progres didn't really start happening til I started to get away from the idea of like "here's a doctor to cure my ailment" with respect to therapy. It's a very western, objective, reductionist form of thinking. You gotta do the work, and step number one is being 100% honest with your therapist but most of all yourself. Therapy should be relational and not too clinical. But ultimately if it works for you that's all that matters. It took me years just to acknowledge emotions from my childhood. Nothing super traumatic, just like general feelings of inadequacy and neglect rooted in German Catholic post-WWII upbringing

Like my guy doesn't even bother with DSM-V diagnoses (at least in my case), because complex PTSD isn't even in it despite overwhelming mountains of quantifiable evidence. It's still a very very young science highly driven by philosophy of individuals and insurance quotas

 
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Old 05-02-2021, 04:55 PM   #223
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my therapist has diagnose for reimbursement and yeah it was annoying AF when complex ptsd wasn't added to the DSM V, but it is in the ICD-11 which many insurances use

what's funny is my therapist used to not ******* one of my diagnoses due to its controversial nature and worrying about pushback, but in the last few years has changed her mind because she decided not putting it was adding to the idea that it is rarer than it is or not accepted or w/e. and that IS in the DSM. in conclusion, fuck the DSM

 
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Old 05-02-2021, 04:58 PM   #224
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also funny if you go by the DSM PTSD diagnosis I like barely qualify at this point but I totally have complex ptsd. like I don't have exaggerated startle response, in fact the opposite because i just dissociate at startle and appear to have no response (ok I looked at the criteria and i definitely fit PTSD still but i definitely fit CPTSD way better)

 
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Old 05-03-2021, 05:37 AM   #225
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Who has tips for 1st time therapy sessions

Pretty friekin nervous about it. Not sure what to cover or “work on” or whatever. Or even what it will be like
my 0.001 cent(s):

if at any point you find yourself feeling like something is not right with your therapist for any reason at all, as silly as it may be, feeling like you're not being fully listened to, or getting the slightest spider sense tingle of incoming judgement, or simply feeling no chemistry between the two of you, then cut your losses ASAP and move on. 2-3 meetings should probably give you a clear indication either way.

my unforunate experience with a toxic therapist really mortally damaged my outlook on the whole thing, and i haven't been back ever since. i'm not saying this to scare you off or plant seeds of anxiety - the takeaway is that it's vital that you feel absolutely safe, and nothing less will do. trust yourself completely, and do not compromise.

congrats on making the first step and taking care of yourself. good luck

 
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Old 05-03-2021, 07:30 AM   #226
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and if you have to pee, RUN to pee!
it doesn't matter if you're only two minutes into the session, or if the session is almost over. just RUN to pee!

 
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Old 05-04-2021, 08:23 AM   #227
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no. i completely disagree. for 150$ an hour? fuck that.

the best way to operate in that situation is to keep an empty plastic bottle on hand (also favorable for compulsive troubled water sippin mid-convo a-la Bruce Cairhann) and urinate into it while maintaining intense eye contact with your therapist and preferably grinning as you're getting your money's worth.

have i mentioned yet that my former therapist was abusive towards me?

 
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Old 05-13-2021, 12:30 AM   #228
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i did the person man woman camera tv test today (MoCA test it's called)

except mine were face velvet church daisy red (almost certainly were his words as well) and i only could remember two (i did fine on the rest of it, doctor said my score "isn't bad but [he] would expect it to be higher")

i'm getting an MRI and EEG and shit coming up here

not expecting to find anything but not opposed to there being a physical, measurable reason my dissociation symptoms won't get better

 
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Old 05-13-2021, 12:34 PM   #229
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yeah it's always best to rule out others causes. MRIs are expensive as shit :/

What's tricky is with some tests, it's like trying to photograph lightning. Your body might do a weird thing in certain situations, and you know it's happening, but then when you go and get imaging done, they're like "nah you're a hypochondriac". And of course panic and phobias just make it all more confusing.

The whole DSM conundrum is like a major philosophical rift rooted in the mind-body problem, IMHO. Other cultures are like "yeah, you can totally effect your body physiologically by just thinking about it" and here in America we're like "WITCHCRAFT, have some drugs brought to you by Carl's Jr." but also "ask Jesus to heal your stage 4 cancer"

 
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Old 05-13-2021, 12:53 PM   #230
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About 4 years ago or so, I operated under the premises that only the right half of this map of reality or whatever existed:



And naturally I started having existential dread and fear that CBT was unable to address, since you can't classically condition yourself to not be afraid of not existing.

I think a lot of people, particularly scientists and INTJS and the like, are self-ascribed reductionists, in the classical sense (minds are properties arising from and associated with brains). And if you look at American medicine, it follows that line of thinking as well. Which is probably a good thing, because without an objective anchor, you get anti-vaxxers and crystal healers and the like. But the flipside of that is psychology is inherently subject-specific. The circumstances of a given person's life and how their mind and body have been conditioned to respond to reality could vary wildly, even if we can identify general patterns (CPTSD, schizophrenia, phobia disorders, etc.). But I really view all those classifications as highly, highly generalized. And that's why in psych literature you'll see a lot of treatments having like 50% efficacy for treating X condition, if even. It's because there are essentially an infinite number of manifestations of PTSD and the like because each person's psyche is unique.

Anyway all of this is to say that on a societal level, at least in the USA, we try to treat psychological ailments using methods which correspond to the right half of the quadrants above (and CBT would fall there at least in part, because behaviors are objective, observable phenomena), when in many cases what people need is more emotional, relational, interpersonal therapy. They don't always need someone to just give them an SSRI, because the ailment is not necessarily physical/objective, even if there are physical correlates to the mental states of the person. And data is pretty clear that SSRIs have not made much of a dent in depression cases, collectively.

Sorry, I think about this quite a bit.


tl;dr -people in general need help acknowledging, processing, and making space for their emotions, feelings, sensations, and values. Neglecting or suppressing these aspects of reality can have physiological ramifications generally encompassing the fight, flight, freeze, or submit responses

 
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Old 05-13-2021, 01:08 PM   #231
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so... psychoanalysis then? i thinm psychoanalysis addresses your concerns, but the issue there is you're relying on the analytical skills of this one random practitioner who himherself of course is also only operating from one perspective.

i think this is why "mental health" is historically treated in the realm of religion because that branch of knowledge is more concerned with collective ontological questions of being and knowing and feeling. not a coincidence that the field of psychology grows in tandem with the secularization of society.

so what can we do in 2021? SHROOMS MAN, SHROOMS. jk idfk what to do. but i get my best psychotherapy from friends and family. they know me and my situation best; precisely because we share such a large section of reality together, they're able to help me get a better grip on being.

 
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Old 05-13-2021, 01:17 PM   #232
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yeah you touched on basically all of the important points there. Friends and family. Absolutely critical.

Shrooms are so fascinating. Like clearly they work for a huge number of people (https://www.nature.com/articles/d41586-021-00187-9)

But....how and why?

????????????

 
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Old 05-13-2021, 08:34 PM   #233
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Originally Posted by killtrocity View Post
About 4 years ago or so, I operated under the premises that only the right half of this map of reality or whatever existed:



And naturally I started having existential dread and fear that CBT was unable to address, since you can't classically condition yourself to not be afraid of not existing.

I think a lot of people, particularly scientists and INTJS and the like, are self-ascribed reductionists, in the classical sense (minds are properties arising from and associated with brains). And if you look at American medicine, it follows that line of thinking as well. Which is probably a good thing, because without an objective anchor, you get anti-vaxxers and crystal healers and the like. But the flipside of that is psychology is inherently subject-specific. The circumstances of a given person's life and how their mind and body have been conditioned to respond to reality could vary wildly, even if we can identify general patterns (CPTSD, schizophrenia, phobia disorders, etc.). But I really view all those classifications as highly, highly generalized. And that's why in psych literature you'll see a lot of treatments having like 50% efficacy for treating X condition, if even. It's because there are essentially an infinite number of manifestations of PTSD and the like because each person's psyche is unique.

Anyway all of this is to say that on a societal level, at least in the USA, we try to treat psychological ailments using methods which correspond to the right half of the quadrants above (and CBT would fall there at least in part, because behaviors are objective, observable phenomena), when in many cases what people need is more emotional, relational, interpersonal therapy. They don't always need someone to just give them an SSRI, because the ailment is not necessarily physical/objective, even if there are physical correlates to the mental states of the person. And data is pretty clear that SSRIs have not made much of a dent in depression cases, collectively.

Sorry, I think about this quite a bit.


tl;dr -people in general need help acknowledging, processing, and making space for their emotions, feelings, sensations, and values. Neglecting or suppressing these aspects of reality can have physiological ramifications generally encompassing the fight, flight, freeze, or submit responses
I have an interesting situation where I feel like nothing is really but am also an intensely rational person. I understand I have to act like things feel real or otherwise I will live in a catatonic stupor and that this feeling of unreality is essentially a delusion at this point (though my reality testing is in tact). In my case I think (but who knows) I'd have depression regardless of the PTSD stuff, just because it runs in my family. You know what else runs in my family, though? Trauma.

The medications definitely help me, as evidenced by the fact I've been able to go down on some no problem to a point but when I cross some kind of magic serotonin line I get preoccupied with suicide. This happens when try to go off one medication (from 7.5mg, when at one point I was taking 45mg) or another one (when I try to go from 200 to 150, when at one point I was at 400 mg). I've been able to go down on a mood stabilizer too from 400 to 250 so far without any issue. But of course, that doesn't directly affect serotonin like the others, either. Prob will go down to 200mg next week. But also none of these are SSRIs, which never helped me.

I do think interpersonal therapy (psychodynamic) is the only way through CPTSD (for me) though DBT groups have also helped (which ended with the pandemic). I don't really have close relationships, which I am sure would help me the most, because that is the biggest part of my life that is affected by PTSD.

 
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Old 05-13-2021, 08:36 PM   #234
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so... psychoanalysis then? i thinm psychoanalysis addresses your concerns, but the issue there is you're relying on the analytical skills of this one random practitioner who himherself of course is also only operating from one perspective.

i think this is why "mental health" is historically treated in the realm of religion because that branch of knowledge is more concerned with collective ontological questions of being and knowing and feeling. not a coincidence that the field of psychology grows in tandem with the secularization of society.

so what can we do in 2021? SHROOMS MAN, SHROOMS. jk idfk what to do. but i get my best psychotherapy from friends and family. they know me and my situation best; precisely because we share such a large section of reality together, they're able to help me get a better grip on being.
Yeah you really need to get someone who is good at being a therapist objectively but also who shares enough of a worldview with you to understand what will help.

Also I may do shrooms, my therapist is actually for it, but there's no paradigm to do it outside of clinical studies and 1) i prob wouldn't be eligible because of substance abuse history and 2) i would only want to do them with her there (or with no therapist. not someone else). And I of course would not want her to do something that could get her in trouble professionally.

Also 100% agree with your psychotherapy acceptance correlating with the secularization of society

 
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Old 05-13-2021, 10:55 PM   #235
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that sounds really lovely. i did shrooms once, it was surreal how serene it was. i remember playing along to, like, behold the night mare on drums, just grinning. i'd love to try it in a clinical setting but have no idea how to go about setting that up without looking sus or whatever the fuck. i'm actually doing EMDR for the first time next week - excited. even just following a YouTube video felt like it helped.

i've only recently realized i can talk to others and get better feedback than googling and overthinking lol. my friend said i should try a specific type of marketing class in college because the other kind would freak me out.

churches can feel so...intimidating. like, there's warmth and ritual and connection and love inside, but it's cloaked in these weird rituals - you have to dress up, but not too much, have to stand here, shake hands whenever they're passing the collection plate, etc etc. it's so challenging if you're broken and seeking religion to heal

 
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Old 05-13-2021, 11:03 PM   #236
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In my family of origin if u had a mood problem, u had a jesus problem

Or more specifically, a problem falling into line with the authoritarian narcissist who ran our family, who was basically god to us anyway

 
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Old 05-14-2021, 12:22 AM   #237
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that sounds really lovely. i did shrooms once, it was surreal how serene it was. i remember playing along to, like, behold the night mare on drums, just grinning. i'd love to try it in a clinical setting but have no idea how to go about setting that up without looking sus or whatever the fuck. i'm actually doing EMDR for the first time next week - excited. even just following a YouTube video felt like it helped.

i've only recently realized i can talk to others and get better feedback than googling and overthinking lol. my friend said i should try a specific type of marketing class in college because the other kind would freak me out.

churches can feel so...intimidating. like, there's warmth and ritual and connection and love inside, but it's cloaked in these weird rituals - you have to dress up, but not too much, have to stand here, shake hands whenever they're passing the collection plate, etc etc. it's so challenging if you're broken and seeking religion to heal
are you doing EMDR with online therapy? I did it some that way, it was pretty interesting. I used this youtube video: https://www.youtube.com/watch?v=VkCTfOSTSqc and listened on my phone with earbuds. I have done it in person as well but not very much. It just so happened I was ready to do it right when the pandemic started. The other times I've done it I used vibrating paddle things. I am not sold on the whole bilateral stimulation doing jack shit tbh but either way the technique itself seems to be helpful

it's kinda crazy where you can start and where it can go from there, how things are associated in your brain and processing one thing leads to something else leads to something else. i've started doing emdr on one memory and ended on something completely different from a completely different era of my life

i was thinking of getting some of the paddles for myself (my therapist has this one https://www.dnmsinstitute.com/theratapper/ but there are cheaper ones i see now, they were not there when i looked a year ago) but the audio worked well

 
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Old 05-14-2021, 12:29 AM   #238
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In my family of origin if u had a mood problem, u had a jesus problem

Or more specifically, a problem falling into line with the authoritarian narcissist who ran our family, who was basically god to us anyway
yeah u need therapy

have you gone already or is it coming up?

 
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Old 05-14-2021, 11:13 AM   #239
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yeah u need therapy

have you gone already or is it coming up?
Yeah couple sessions

It’s going ok, have a good feeling about it. It’s brought up some really painful things, but the new rx is helping me not feel overwhelmed by it, or need to shut down or like do macrohits all nite to feel ok

 
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Old 05-14-2021, 11:14 AM   #240
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Location: Th Word o th Lord 2 His Church stablished n deez th latter days as spake by mouths o His Prophets even Mt Zion who shall b th city o New Jeruslem + shall b built again @ th temple lot appointed by Fingr o th Lord in western boundaries of the State of
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Thanks for asking btw, and for the earlier tips/faves, it really helped

 
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