My dysfunctional thoughts have returned!

Cognitive therapy helped me greatly, but I fell in love and now I'm falling to pieces.

Published March 28, 2005 8:00PM (EST)

Dear Cary,

I am a 27-year-old woman who has been dating a 25-year-old man for three months. "Ethan" is wonderful. After many short-lived and not-so-healthy relationships, I've found someone who treats me well, whom I don't have to take care of and who "gets" me. I am happy and I am in love.

And yet I'm also terrified. Everything has been going perfectly well, but in the past few days, I've fallen back into old habits. I have started to doubt myself and him. Negative thoughts fill my head: He doesn't want to see me, I'm too fat, I'm not good enough, he'd rather be working, etc. I'd been in therapy for depression and anxiety and spent a year working with cognitive behavioral therapy techniques. They worked really well. Right now, however, I can't seem to "think" the negative thoughts away. I find myself pulling away from him and trying to give him excuses not to see me. I think he's going to leave me. The negative thoughts seem to be winning.

Cary, of course there is NOTHING that he has done or said that tells me that my negative thoughts are based in any sort of reality. His voice still sounds excited when I call. He still says he loves me several times a day. He still wants to spend every night with me. He still calls me sexy and beautiful. He still misses me when I am at work, and I miss him -- even though we see each other every morning.

I worry about being honest with him about this. I've not kept anything else from him, but I'm scared that telling him about my thoughts will frighten him away, so I'm silent. Of course, he knows something is up. I don't know what to do. Am I sabotaging? Am I relapsing? Do all couples go through this? I don't want to lose him, but I don't want him to have to deal with me if I am indeed falling back into a depression. This is really the first healthy relationship I've been in. Could it be that I'm not comfortable with healthy and need to screw it up and get some drama going?

I can't think of anything that happened that "sparked" the negative thoughts. Should I talk to him? Should I just keep trying to "kill" the thoughts? Should I demand an emergency appointment with my therapist? Or take a break? Is my subconscious telling me to get away? Anything you can recommend would be greatly appreciated. I don't want to lose this man because of unrealistic thoughts.

Stranded in Thoughtsville

Dear Stranded,

If cognitive therapy has worked for you in the past, I would suggest revisiting it with a renewed energy and care, making sure that you are doing the actual exercises prescribed. For instance, if the original exercises involved writing things down, and you are trying to think your way through them, revisit the original, rigorous program. Be thorough. Write down these thoughts. Spend some time on it.

And why not contact your therapist, who has helped you so much in the past? Therapists are there to help in just such crises. That would be a reasonable thing to do.

If it helps any, I'll just remind you that life doesn't get cured. You don't just walk away from who you are. If these dysfunctional thoughts are a part of your adaptation to life, they're likely to recur at various times. Stress may bring them up. Novelty may bring them up. Or they may arise at times out of sheer boredom, as if your mind had nothing better to do than to torment you -- who knows? The important thing, it seems to me, is to remember that you have tools that work, and need to find the energy and commitment to use them. It may be harder now than it was at first to find the motivation; when you originally sought treatment, you had a clear goal. You may have been fiercely determined; you may have been desperate. Now you've had some success and may have relaxed a little. Good for you! Perhaps you felt, understandably, as though you finally had it licked. That's a great feeling, because it indicates real progress. But life does continue. You will always face new challenges. This is one of them. Finding love is a mixed blessing, as you see.

I don't think there's anything wrong with telling your boyfriend what you're going through. Keeping it a secret is probably adding to your anxiety. It might help, when you tell him, to put it in a clinical, impersonal context, however, so that he can understand it as your particular set of problems rather than as a problem in the relationship itself.

Yes, it may be difficult for him to accept what you tell him in a graceful and supportive way. We often don't know how to respond well when others reveal their private battles. So try not to worry about his reaction. Concentrate on doing what you know has worked in the past, and reassure him.

You will get through this.

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