Psychodynamic Therapy For This Post-Suicide Attempt Patient

It was session two this morning, of psychodynamic therapy with Dr T. He is maybe a few years older than me, pleasant looking, very well-mannered.

On my blog, where I first started writing online about embarking on this therapy, I introduce a bit on psychodynamic therapy. After this morning’s sit-down with my doctor, I decided to write more about my therapy journey, for myself and perhaps others might learn something too.

I am not sure how many psychiatrists specialise in psychodynamic therapy here in Singapore, but Dr T is the first one I’ve met. It so happens he is nice: he notices my body language when I am talking, picks up on the slightest cue if we are broaching a subject that triggers me emotionally. He will say the right things, and he truly listens — no interruptions while I am sharing, eye contact throughout our sessions.

Because he is someone I could connect with sufficiently for us to have a viable patient-doctor relationship, I knew that working with him on my mental illnesses would bear some fruit. Being able to communicate openly with any doctor is important for our health, be it with a GP or specialist.

I have also been unfortunate enough to have met many more doctors that are terrible, especially with their bedside manners. Most of them cannot even communicate to me that their agenda really is to make me feel better. This has been my personal experience with public hospitals' doctors, so Dr T is a rare find for me.

Of course, I did consult Google before I started working with Dr T.

Psychodynamic therapy is the oldest of the modern therapies. (Freud’s psychoanalysis is a specific form and subset of psychodymanic therapy.)

In my own words: psychodynamic therapy is like Freudian psychotherapy, where the patient shares what is on his mind rather freely. It is based on a similar premise as well: events that took place in our childhood, affect our behaviour, thoughts, and feelings today. As a patient, when we are in a safe environment to freely speak our mind, subconsciously we may end up bringing up things that affect us in a negative way. The therapist will then focus on that issue, to help the patient work through what was buried in the past and hidden from our consciousness.

Psychodynamic therapy is designed to help patients explore the full range of their emotions, including feelings they may not be aware of. By making the unconscious elements of their life a part of their present experience, psychodynamic therapy helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings.

The kind of depression I have, is not only chronic and severe, it is accompanied by anxiety, and the alternate diagnosis I have is that of chronic post-traumatic stress disorder. Not all PTSD is about a single large traumatic event, it could also be tiny traumas that occur repeatedly. They also need not be physical trauma — my traumas were mostly emotional. Repetitive emotionally traumatic events in my childhood led me to where I am today. I have been on medication for nine years now, and I also developed a chronic pain disorder. I have been at such low points in my life that I have attempted to end it all, many, many times. At the time of writing I have been in hospital for close to five months, because of a suicide attempt that cost me multiple fractures.

I am therefore quite resolute to make the best out of therapy sessions with Dr T.

Many doctors ask this when they do their inpatient ward rounds: “How are you?” But they never really pause to listen, or help if we reply that we are not fine. But Dr T asks the same question, and thankfully really listens, and so from that question alone I spin off into what I had been doing in the past week.

I shared that I was reading a book about burnout. Prior to attempting suicide in April this year, I had taken a sabbatical from my work leading an animal rescue organisation. I was burnt out. It did contribute to my decision to end my life. As I shared more with my doctor, I explained how my career burnout factored in.

Because I have chronic fatigue due to fibromyalgia, and constant pain from the fibromyalgia as well, I had very little energy and time to work. This fatigue and pain was at its tipping point, which was why I decided to take a sabbatical. Spending a few hours doing work made me exhausted beyond measure.

How was I then going to raise funds to pay my medical bills? My husband, who has been taking care of me since long before we were married, had said to me he couldn’t take it anymore, my medical bills were too much. I could try and raise funds using a crowdfunding campaign, but that needed time and energy, something I was totally lacking by then. Ridden with the sense that I needed to eliminate this burden on my husband, I took an overdose of sleeping pills, painkillers and tranquilisers with a beer chaser, and jumped off a bridge overhead of highway traffic.

I shared all of this with Dr T, and by then it was the end of our hour together. He wanted us to continue the same thread and focus on it next session.

I look forward to regaling you with more tales from my psychodynamic therapy sessions. This topic of my suicide attempt is emotional for me because it was driven by my idea that I was a burden to my husband. I always work to keep him happy, because I am so driven to please him. When he said he couldn’t pay my bills anymore, it meant I was being abandoned. I felt the same feelings as a child. So, we will be talking more about what I will be gleaning from it all.