Therapy is killing me,it is a part of my problem

Hello doctor,i am 20 years old.I have been feelling very bad in the last 6 years.In the last year  i visited psychiatrists.Now i take zoloft 50 mg for 4 weeks and a there is a little improvement.Today i have been again to the doc and got 100 mg zoloft and he told me to try psychoterapy.The problem is i go crazy when hear about therapy,i start feeling very anxious,guilty,feel like throwing up and want to die,because my mind torments me with the thought that i should tell everything,even the most embarassing thoughts(like masturbating,or sexual fantasies,pervetions),i go crazy,i feel like the lowest person ever  who is too coward to tell everything and prefers to feel bad for the rest of his life instead of doing therapy,it makes me feel so depressed,guilty,mad,frustrated ,paniced,in crysis,feel like dieing,feel everybody is judging me,  i do not know  what to do to get relief,then after some time i calm myself.I try convincing myself that this are irrational thoughts,and that it is not my fault,and i do not have to tell anybody emabarrassing stuff,but comes a time when i just can not do anything,i am overwhelmed,by this feelings,and feel so bad,and then i calm myself again and then i get again overwhelmed.and want o die
Do you think i may benefit more from therapy,or from medication?

[Roger Gould, M.D.]

you should definitely  see a therapist and talk to him or her about your life.  You have the wrong idea about therapy.  It's not about disclosing all of your private fantasies.  Therapy is how you make your life work and your sexual fantasies and behaviors are really a very small part of that.  Your relationship with your family and parents and how you embrace your vision of the future are the issues that you will discuss in therapy.

[Jaquta]

Hi, not the doctor.

I think talking about how we feel is really important.  Although we may feel terrible, in that moment and possibly later, for sharing our thoughts and feelings with others it is actually the most helpful thing in the long-term.

I don't know what made the difference for me or what led me to become quite vocal.  Probably I got tired of being walked over and possibly I was hurt one too many times.

I think that you would benefit more from therapy but I think that at this time both are probably important.

I have followed some of your conversations with Dr Grossbart.  I don't think you have anything to feel guilty or embarrassed or ashamed about.  I think what you are experiencing now is due to your past (and your relationship with your father).  This is not your fault.  It is up to you to make changes now though.  I know that doesn't seem particularly fair but it is what will help you live your life and be happy.

[Jaquta]

Forgot.  If you don't think therapy is helping all that much you may like to try another therapist.  Do you get on very well with your current T?

[Jaquta]

The doctor is probably right.  I guess if we were to discuss 'everything' then we would be in therapy indefinitely.  Probably that is a little too in our heads for them.

The doctor's comments reminded me of how intrusive I found many T's questions, comments, etc.  Probably just walking into an office felt too intimate, too challenging.  This also reminded me of a comment a previous T made.  She said that as long as there was no therapeutic relationship (a good relationship between my T and myself) that any therapy would feel intrusive.  Or something like that.

To begin to work on yourself and your issues I think it is really important to have a good relationship with your T.

The sensitive stuff feels like the only part.  I guess this perception is quite distorted though.  Overall I guess it would only be a very small part.  I guess that's what people also mean when they talk about keeping things in perspective.

It's interesting how therapy can make you feel so self-conscious.
I have found it useful in that there aren't too many things I feel I need to hide from now.

Good luck with the therapy.  It can be a long process but it does help.

Most therapy is confidential and stays between you and your treatment team.  I guess it would be a bit like going to confession.  If nobody were there to hear you then you could scream this stuff as much and as loud as you would like.
Your T can handle what you choose to discuss with them.  They won't break.  If they are a good T they won't judge you either and will accept you for who you are and where you are.