What to do when things aren’t working

I’ve heard other people on blogs and in person express the sentiment that they’re trying everything they know how to do, and it’s not working. What do you do when nothing seems to work?

I’ve been struggling with feeling like nothing’s working recently and then feeling even more hopeless as a result. I’ve been having a tough time since my uncle and and grandmother passed away. I’m grieving and being reminded of past trauma and the recent trauma of their deaths in intrusive and unpleasant ways, all the while being apart from my family (away at college) and trying to literally survive and not fail my classes.

So what do you do??? I wish I had more answers than what I have, but I’ll share what’s getting me through so far, and if anyone has any other ideas, please let me know.

Validate yourself. If you’re trying everything you know and using all the skills you have, you’re probably trying really hard and dealing with some pretty hard stuff! Give yourself some credit and acknowledge that you are struggling.

Think about what you mean when you say “things aren’t working.” Sometimes the skills I use do work; they just don’t solve all my problems. For example, the goal of distress tolerance skills in DBT is to get you through the moment without worsening the situation. They’re not supposed to make you feel happy or to get rid of whatever was causing the strong emotion. If I hold ice up to my face (the TIPP skill) in place of acting on crisis urges, then the skill worked. Even if I am still really upset and the crisis urges come back soon, the skill got me through that moment. I expect that skills will help more than they are able to. Having more realistic expectations here would help, I think.

Make sure you’re doing the things that have helped in the past. Personally, I know that I have to eat enough and sleep enough and get exercise and see my friends and have time to myself regularly in order to maximize my okay-ness. Sometimes I get frustrated thinking, “But I slept so much! I ate three meals! I did so much good work and tried so hard! Whyyy am I not feeling better?” and maybe it’s because I’m avoiding my friends and haven’t had a real conversation with anyone in a week. Not doing one essential thing, even when you’re doing all the others, could be the missing piece.

Ask for and accept help from other people. You don’t have to do everything alone! Friends, family, strangers, online friends, old friends, therapists, doctors, etc. can all help! For example, my mom visited me at college this past weekend. She has offered to do this in the past, but this was the first time that I accepted her offer. She was willing to help, and I knew it probably would make me feel better and was desperate. Her visit ended up going great, and I felt much better afterwards deep down.

Still on the topic of asking for help, I sometimes know that I need help but don’t know what I need. When people ask, “What can I do?” or “How can I help?” I don’t know how to answer. I’m still working on learning what I need, but here are some things that I have asked for: a hug (many times), for my friend to let me vent, for my therapist to reply to my email, for an extension on an assignment, for someone to eat a meal with me, for a friend to send me something in the mail, to schedule an appointment with a doctor, to set up a time to facetime a friend. These are things I can ask for! People can always choose to say no, but asking doesn’t hurt and often helps a lot!

Maybe consider bigger changes in your life. I know that if I keep on feeling this badly, taking a semester or a year off of school is an option. Dropping some classes is an option. Going to an inpatient, residential, or day treatment center is an option. Changing my therapist is an option. Transferring schools or switching my major are options. There are lots of options!

Radically accept that 1) you are having a tough time right now, and that 2) there are things you can’t change and have no control over. This can allow you to see a situation more realistically and therefore make better decisions about the things you can control. I can’t change the fact that my uncle and grandmother died, but I can celebrate their lives, think of fond memories, and strive to embody the qualities I admired in them.

Have patience. I know that this can be really hard to do. But giving things time and just pushing forward can work. Hold on. Time may not heal everything, but it can help with a lot. I have a saying that I like: “There are good days and bad days. Keep going, and you’ll find both.”

Making therapy sessions better

Sometimes I leave therapy feeling worse than how I felt before it. But sometimes, therapy is really helpful, and I leave feeling heard, validated, hopeful, and knowing what to do when things get bad again.

So, I’ve been trying to think of what makes some therapy sessions better than others.

I think a big part of it is making sure I actually say the things I want to in session. If I don’t, I leave feeling disappointed in myself, frustrated with my therapist, and invalidated. This can spiral and I can start to feel hopeless and think “no one can help me,” “no one likes me,” “I’ll never get better.” Those are all-or-nothing thoughts and aren’t true.

I’m not entirely sure what the solution to this is, because sometimes I don’t know that I really wanted to say something until after I’ve left and realized I haven’t said it. It sometimes just takes me a while to get my thoughts in order.

It also takes me a while to remember stuff. My therapist will ask what was going on on x day before y, and I have no clue. I think this is partially because I dissociate, which interferes with memory somehow (I don’t know the specifics), and partially because I avoid thinking about bad stuff because it upsets me. Dissociation is essentially avoidance, so these are kind of the same thing at their core.

I guess a solution to this could be for both me and my therapist to be patient with myself during session and wait for my thoughts to come and for me to be able to say them.

I could also spend time before session thinking about what I want to talk about. Sometimes I write things I want to talk about on sticky notes and bring them to therapy. That is helpful, but I have to make sure that I do actually say the things I have written down. To do that, I have to overcome any shame or embarrassment and not feel too afraid of saying them (if they’re about upsetting things or trauma reminders).

Sometimes it’s helpful when I say, “I wanted to say something, but now I don’t,” and my therapist helps me through what’s getting in the way of me saying it, whether those emotions are justified or not, whether I need to do some grounding before talking about something hard, etc. So I guess in general it’s good to be open in therapy as much as you can.

It’s also good when I journal before going to therapy because then I know what’s actually going on and have already given it some thought. Writing things down generally helps me. Plus, if I’m avoiding saying something, I could just hand it to my therapist to read instead of trying and failing to say it out loud, or I could email it.

I’m working on it. 🙂