公司一年前被收购，在各种资源合并流程中2024年9月员工们被强制更换医保。结果就是新的医保公司和我的医生所在的医疗机构没有合约，于是没有办法报销治疗费。在这个医疗机构做心理咨询，如果可以报销，一次三十美金，如果不可以报销，一次三百七十五美金。考虑再三，还是感到实在是负担不起每周三百七十五美金，所以只能和这位医生商量停止治疗。
我们在最后一次治疗中回顾了这两年我的进步。我和Dr Chan先后做了总结。有时候自己的进步自己是很难描述清楚的，所以很感谢他能帮我更好地了解自己。医生这两年最多用的治疗方法就是CBT(Cognitive Behavioral Therapy)并且混合一点DBT(Dialectical Behavior Therapy)。CBT是认知行为疗法，核心的原则就是认知可以影响情绪，所以通过改变认知中扭曲的地方，我们可以改进情绪。DBT是辩证行为疗法，里面我们用的比较多的是情绪调节技巧，通过更好地识别描述自己的情绪来克服阻碍健康情绪的障碍。总的来说，这两年最明显的进步有几点：
一，不忽略生活中的好事，不放大生活中的坏事。不总是盯着自己缺什么，也要看一看自己拥有什么、被给予什么。这世上并不是非黑即白的。在两年前刚开始治疗的时候，我的情绪处在一个低谷。虽然没有到以前抑郁严重的时候的地步，但是那个时候我已经很长时间没办法用“今天过得挺好”来形容我的生活了。我的朋友们分享自己近况的时候，有些人会说“I had a good day”（我今天过得好）。可是轮到我的时候，类似的话到嘴边却怎么也说不出口。
那个时候，我衡量一天的好坏的标准是给自己打的分数，如果是大于零，那就是还可以，如果小于零，那就是很差。打分的标准很扭曲很严格，用医生的话说就是太rigid，僵硬死板。做了一件有成效的事情可以加5分，但是有一件没有按照计划完成的事情，就减掉10分、20分。一件“坏事儿”配重很高，但是一件“好事儿”却值不了几分。每天这样加减下来，几乎天天都上不了零分。有时候一件很小的做的不好的事情就能把一天的好事儿都抵消。
但是人生不是这么算的，好和坏不是能抵消的。有几件做的不好的事情不代表做得好的事情就没有任何意义。这是一个常见的CBT的扭曲点——放大消极的，缩小积极的，还有就是非黑即白的思考模式。医生给我布置的作业之一是让我把每天的好事儿坏事儿都记录下来，让事实告诉我这一天到底有没有值得记住的好事儿。在每次的治疗时间，他都会让我锻炼自己来。在我只能看到不好的事情的时候，问问我如果我一个朋友这么想的话，我会怎么和TA说。当然，我们的治疗中还有更多的心理咨询技巧，我就不在这里一一赘述了。感兴趣的朋友可以上网查询一下CBT，里面有一些可以问自己的一系列问题，对调整自己的视角和情绪都很有帮助。
慢慢地，我开始正视自己能够做到的事情，不再去因为一件没做好的事情去极端地否定自己的一切。还记得小学的时候爸爸给了我第一本英文字典，是他被介绍了一首小诗，叫good better best, never let it rest, till good is better, and better best。我的人生就像是这个小诗的写照。永不停歇地找寻更好的，但是这也意味着I’m never good enough，我永远也不够好，因为还可以更好。这句话本身没什么不好的，但是当我的人生完全被我是不是the best定义的时候，那我就不再珍视每一个“good” moment。
二，我的自我价值从我能做成什么等外部来源慢慢向属灵等内部来源靠近。在国内长大的孩子们可能或多或少都会有这样的倾向，证明自己价值的方式从读书时期的成绩到工作之后的薪水到是否结婚生子到孩子是否优秀等等。我们和身边的人从小比较到大，仿佛我们的价值只能体现在与别人的差别上。我是不是班里的第一名，是不是上了最好的大学，是不是找到最高薪最精英的工作，是不是找到最好的男友，之后如若有了孩子，那是不是孩子也是周边最优秀的？
所有的衡量标准就像一座座大山，或者一根一根稻草，仿佛在等着审判，看看接下来的哪一根会压倒我这只骆驼。所有的事情都是我应该做的，我应该做到好的基督徒该做的，我应该做到孝顺家人，我应该多花时间关心我的朋友，因为这样我就是有价值的人。但是当我一次次因此而焦虑压力大，又一次次被提醒我的价值的来源并不是我的成就，而是神，我终于稍微从这样的大山下走出来了。我开始因为自己想做一件事而做它，而不是因为应该做这件事。虽然最后做成的是一样的事，但是心态已经不同。
三，用事实说话，更会使用CBT的工具来认知自己的思维误区。在自己因为各种原因陷入某种情绪的时候，是否可以暂时跳出来，审视一下自己的结论是否有事实依据。这是CBT一个主要的技巧。我也能更好地描述自己的情绪，从第三方的角度审视自己，把自己当成是一个朋友，当朋友有问题发生的时候，我会和我的朋友说什么？
四，增加的自我同理心(self-compassion)。善待自己对于我来说很难。我可以接纳身边人的过错，善待他人，但是轮到善待自己，我下意识地做不到。每每看到自己身上的缺点，没有达到预期的地方，对工作没有认真，对家人没有尽孝，对朋友没有关心，对陌生人没有友善。每当有工作压力的时候，我不需要做那个完美的人。我可以放松，可以学会拒绝别人，学会拒绝自己。
五，给事情优先级排序，承认并且接纳自己的局限性，因为这样的局限性而喜乐。从小我收到的教育就是–效率是什么？就是又快又好。在我脑海里，24小时要当做是48小时来用，只要还有时间，我就可以接着做事情。但是人不仅仅是时间有限，情绪和精神容量也是有限的。有时候虽然一天还有时间，但是脑子里已经没有继续下去的空间了。能够意识到原来自己不用每天都必须活成两天的模样让我轻松了许多。加上从属灵的角度，承认我的局限也就是在邀请神的大能来指引我的生命。我的有限正体现了他的无限，而他的无限的美会给我的灵魂带来安慰。
最后就是一些行为上的体现–做饭、运动、读经、祷告、和家人的读书会，和教堂的团契小组。从一开始的无法承认自己有一个good week，到现在能够更开心地和朋友联络，组织活动，真的变化很多。这些进步非常循序渐进，可能还有别的一些进步，等到哪天突然回想起来，那时我可能会再次编辑这篇文章。当然，我还有很多能进步的地方，就连上面说的几点进步也是反反复复，需要更多锻炼加深。也想要持续锻炼自己自我疗愈的能力，在心理上和属灵上都继续成长。我在治疗的最后还是问出了有些讽刺的问题，我们的治疗够不够好？Was my progress good enough?
在停止心理咨询之后，现在有几个月了。
一开始的时候情绪很复杂，各种交织在一起。有见证了自己的成长的喜悦，有对未来没有心理咨询的时光的焦虑。但要一定用一个词来形容我现在比重最大的心情，那就是grief。中文翻译成哀悼。每一次有人离开我的人生，无论是大到生死离别，或者是小到只是对方搬离我的区域，我都会哀悼，哀悼这段关系的结束。我们因为一段关系的停止而悲伤，是因为这段关系很美好。我们丢失的是定义我们是谁的一部分，我们可以是谁的朋友，谁的孩子，谁的亲人，谁的患者，每一个定义都告诉我自己是谁。当一段关系停止，就好像自己的一部分被剥离开来，失去了一个人、一段关系、一部分自己。哀悼是自然的。我的心理咨询师和我建立的治疗关系很多时候都是我的锚点。除了特别的情况，这两年每个周二下午，我们都会见面聊天。和他见面比和我的任何朋友，甚至是家人都要频繁，都快和我去教堂的频率相当。所以虽然这和与对象活着亲人离别的痛苦无法相提并论，但是我每周二的一个小时就这么消失了。我的另一位心理医生和我说，一段心理咨询的成功与否有50%在于你和咨询师是否性格合得来，那我真的是很幸运的找到了满足这50%要求的医生。
妈妈说我是恋旧的人。的确是。恋旧说到底是渴望永恒，渴望我们所珍视的热爱的永远不会逝去。恋旧也说明我们有可以去恋的“旧”，有美好的过去可以回味。但是，现实是所有人类之间的关系都会结束，或者是因为死亡，或者是因为分别。人类接受了生老病死是正常的，可是想想我们每个人内心深处对永恒的渴望，对光阴易逝的哀伤，不正是说明了我们打心里知道永恒应当是什么样的，所以这世上一切美好事物的短暂才显得总是缺点什么。或许是一次和朋友的交谈，思想的碰撞让你不想结束；或许是一次旅行，因为太过美好快乐你会嫌它太短；或者是一本好书，读完最后一章仍然意犹未尽。
我们哀伤是因为我们在潜意识的某处，知道我们本不应该有分离。哀伤是因为我们渴望永恒，渴望美好的东西永远不要逝去。神在造人的时候，是想着让人类永恒地在伊甸园生活下去，享受彼此，享受祂的荣光。所以即便不是基督徒，人类也会渴望永恒，渴望钻石恒久远，渴望happily ever after。
我的锚点本应是神。我因着耶稣基督的死成为了神的孩子，这段关系永远也不会改变，是我永远也无法失去的锚。它在我迷茫的时候会告诉我我究竟是谁。在我因为没办法彻底融入美国或者中国的文化而迷茫的时候，我知道我还是神的孩子，是基督徒。在我因为人与人之间的关系。基督徒相信，心理上的疾病既是生理的，也是属灵的。
在这次治疗的最后，Dr Chan和我说，我们一起治疗的两年对于他来说也很有意义，他喜欢我的性格，如果有可能，希望我们能治疗继续下去。我和他说，在我把自己放到心理治疗排队名单的时候，我不知道机构会分配给我怎么样的治疗师，所以我花了很久去祷告，而这两年就是神对我祷告的回答。This was an answered prayer.
我从14岁被诊断出焦虑症已经14年了（之后在大学被诊断出躁郁症，青少年的躁郁症经常被误诊为焦虑症，因为症状类似）。算下来我的人生有一半的时间是在和心理疾病作斗争。这14年，我尝试过很多治疗方法。去过不同的精神科医生，试过快十种药物，一直到今天，也每天服用四种。也去过很多心理咨询师，有过失望，也有过成功。最早的时候，我的心理疾病就是taboo，是禁忌，是羞耻，是我无法分享的人生污点。我不理解为什么一定是我要经受这种苦难，为什么别的孩子可以正常上学，正常生活，我却因为看不见摸不着的疾病在家里休学一年。这么多年过去，我还是会受到躁郁症的困扰，但是
这么多年过去，我也逐渐在神和周边的家人朋友以及医生的帮助下慢慢与自己的心理疾病和解，到现在愿意公开和大家分享，希望我和苦痛斗争的过程能给你安慰和力量。所以，最后的最后，想和看到这里的朋友说，无论你是否有被诊断出心理疾病，你都可以尝试心理治疗。人生总有不如意之处，专业的医生或者咨询师可以从第三人称视角帮你检视自己，用专业的方法引导你反思自己的想法，和你一起锻炼各种治疗技巧。当然，前提是如果找到一个好的合适的心理咨询师。我知道找到这样的心理咨询师可能会很难，心理资源贫瘠的国内或许更不易，中途也可能会遇到不合适的，我本人在此之前也有过不太称心的心理咨询经历，但是希望这篇文章可以帮助想要寻求帮助的朋友打破心理上的阻碍，迈出让自己的心理变得更健康的一步。我的观点是，我们都不完美，都有消极情绪的时候，所以每个人都可以有一位心理咨询师，在这些时候帮助我们积极应对。
希望这段哀伤不要持续太久。感谢神回应了我的祷告，赐予我一段美好的医患关系。也感谢Dr Chan，无论从专业性还是性格，都是帮助我成长的来源。我也希望所有需要帮助的人们都勇敢寻求帮助，所有没有心理疾病的人们都能接纳。
Below is a Google Gemini-generated English translation. I did not edit afterwards.
The end of November 2024 marked my last treatment session with my therapist, Dr. Chan. I was halfway through writing a summary when I suddenly became busy; I only managed to find some free time amidst procrastination to finish all the various articles that had been set aside for a long time at once.
My company was acquired a year ago, and through various resource merger processes, employees were forced to change their health insurance in September 2024. The result was that the new insurance company had no contract with the medical institution where my doctor practiced, meaning there was no way to reimburse the treatment fees. For psychotherapy at this institution, if it can be reimbursed, it costs thirty dollars per session; if it cannot, it is three hundred and seventy-five dollars per session. After careful consideration, I felt that I truly could not afford three hundred and seventy-five dollars every week, so I had no choice but to discuss stopping the treatment with the doctor.
In our final session, we reviewed the progress I have made over these past two years. Dr. Chan and I took turns making summaries. Sometimes it is very difficult to describe one’s own progress clearly, so I am very grateful to him for helping me understand myself better. The treatment method the doctor used most during these two years was CBT (Cognitive Behavioral Therapy) mixed with a little bit of DBT (Dialectical Behavior Therapy). CBT is Cognitive Behavioral Therapy; its core principle is that cognition can influence emotions, so by changing the distorted parts within our cognition, we can improve our emotions. DBT is Dialectical Behavior Therapy; we used emotion regulation skills quite often, overcoming obstacles to healthy emotions by better identifying and describing our own feelings. Generally speaking, there are several points of the most obvious progress over these two years:
One: Not ignoring the good things in life, and not amplifying the bad things. Not always staring at what I lack, but also looking at what I possess and what has been given to me. This world is not just black and white. Two years ago, when the treatment first began, my emotions were at a low point. Although it hadn’t reached the level of my previous severe depression, at that time, I had been unable to use the phrase “Today was a good day” to describe my life for a long time. When my friends shared their recent updates, some would say, “I had a good day.” But when it was my turn, similar words would come to my lips yet I simply could not say them.
At that time, the standard I used to measure the quality of a day was a score I gave myself; if it was greater than zero, it was okay; if it was less than zero, it was very bad. The scoring standard was very distorted and strict—in the doctor’s words, too “rigid.” Doing one productive thing could add 5 points, but having one thing not completed according to plan would subtract 10 or 20 points. A “bad thing” was weighted very heavily, but a “good thing” was worth very few points. Adding and subtracting like this every day, I almost never made it above zero points. Sometimes one small thing done poorly could cancel out all the good things of the day.
But life is not calculated this way; good and bad are not things that can cancel each other out. Having a few things done poorly does not mean that the things done well have no meaning. This is a common CBT distortion—magnifying the negative, minimizing the positive, and black-and-white thinking. One of the assignments the doctor gave me was to record the good and bad things of every day, letting the facts tell me whether there were actually good things worth remembering that day. During each treatment session, he would have me practice this myself. When I could only see the bad things, he would ask me what I would say to a friend if they thought that way. Of course, there are many more psychological counseling techniques in our treatment that I will not go into detail here. Interested friends can search for CBT online; there are a series of questions you can ask yourself that are very helpful for adjusting your perspective and emotions.
Slowly, I began to face what I could achieve squarely and stopped extremely negating my entire self because of one thing not done well. I still remember when I was in elementary school, my father gave me my first English dictionary. He had been introduced to a short poem called Good, Better, Best: “Good, better, best, never let it rest, till your good is better, and your better best.” My life has been like a portrayal of this little poem. Never-ceasingly searching for the better, but this also meant “I’m never good enough”—I was never good enough because I could always be better. There is nothing wrong with this phrase itself, but when my life was completely defined by whether I was “the best,” I no longer cherished every “good” moment.
Two: My self-worth slowly shifted from external sources, such as what I can achieve, toward internal sources, such as spiritual ones. Children who grow up in China might more or less have such a tendency: the way to prove one’s value ranges from grades during the student period, to salary after working, to whether one is married and has children, to whether the children are outstanding, and so on. We are compared with those around us from childhood to adulthood, as if our value can only be reflected in the differences from others. Am I the first in the class? Did I go to the best university? Did I find the highest-paying, most elite job? Did I find the best boyfriend? And if I have children later, are they also the most outstanding in the neighborhood?
All these measurement standards are like a series of great mountains or a series of straws, as if waiting for judgment to see which next straw will break the camel’s back. Everything was something “I should do”—I should do what a good Christian should do, I should be a filial daughter, I should spend more time caring for my friends, because that makes me a valuable person. But when I became anxious and stressed because of this time and again, and was reminded time and again that the source of my value is not my achievements, but God, I finally walked out from under such mountains a bit. I started doing something because I wanted to do it, not because I should do it. Although the final thing accomplished is the same, the mindset is already different.
Three: Speaking with facts and becoming more adept at using CBT tools to recognize my own thinking traps. When falling into a certain emotion for various reasons, am I able to temporarily step out and examine whether my conclusions have a factual basis? This is a major technique of CBT. I can also better describe my emotions, examining myself from a third-party perspective, treating myself as a friend—when a problem occurs with a friend, what would I say to them?
Four: Increased self-compassion. Being kind to myself is very difficult for me. I can accept the faults of those around me and be kind to others, but when it comes to being kind to myself, I subconsciously cannot do it. Every time I see the flaws in myself—the places where I didn’t reach expectations, not being serious about work, not showing filial piety to family, not caring for friends, not being friendly to strangers. Whenever there is work pressure, I don’t need to be that perfect person. I can relax, I can learn to refuse others, and learn to refuse myself.
Five: Prioritizing things, acknowledging and accepting my own limitations, and finding joy because of such limitations. Since I was a child, the education I received was—what is efficiency? It is being both fast and good. In my mind, 24 hours should be used as if they were 48 hours; as long as there is still time, I can continue doing things. But humans are not just limited by time; our emotional and mental capacity is also limited. Sometimes, although there is still time in the day, there is no more space in the brain to continue. Being able to realize that I don’t have to live every day as if it were two days has relaxed me a lot. Additionally, from a spiritual perspective, acknowledging my limitations is inviting God’s power to guide my life. My finiteness exactly reflects His infinity, and the beauty of His infinity brings comfort to my soul.
Finally, there are some behavioral manifestations—cooking, exercising, reading the Bible, praying, book clubs with family, and fellowship groups at church. From initially being unable to acknowledge having a “good week” to now being able to contact friends more happily and organize activities, it has truly changed a lot. This progress is very gradual; there might be other points of progress that, when I suddenly recall them one day, I might edit this article again. Of course, I still have many areas where I can improve; even the points of progress mentioned above fluctuate and require more practice to deepen. I also want to continue practicing my ability for self-healing and continue growing both psychologically and spiritually. At the end of the treatment, I still asked a somewhat ironic question: “Was our treatment good enough? Was my progress good enough?”
It has been several months now since stopping psychological counseling. At the very beginning, my emotions were very complex, with various feelings intertwined. There was the joy of witnessing my own growth, and the anxiety about the future time without psychological counseling. But if I must use one word to describe my current most prominent mood, it is “grief.” In Chinese, it translates to aidao (哀悼). Every time someone leaves my life, whether it is as large as a parting by life and death, or as small as someone just moving out of my area, I grieve; I mourn the end of that relationship. We are sad because of the cessation of a relationship because that relationship was beautiful. What we lose is a part of defining who we are—whose friend we can be, whose child, whose relative, whose patient—every definition tells me who I am. When a relationship stops, it’s as if a part of oneself is peeled away; a person is lost, a relationship is lost, a part of oneself is lost. Grieving is natural.
The therapeutic relationship established between my counselor and me was often my anchor. Except for special circumstances, we met to chat every Tuesday afternoon for these past two years. Seeing him was more frequent than seeing any of my friends or even family; it was almost comparable to the frequency of my going to church. So, although this cannot be compared to the pain of parting with a partner or a relative, that one hour of mine every Tuesday has simply disappeared. Another psychiatrist told me that 50% of the success of psychological counseling lies in whether your personality and the counselor’s personality are compatible; then I was truly lucky to have found a doctor who met that 50% requirement.
My mother said I am a nostalgic person. Indeed, I am. At its core, nostalgia is a longing for eternity, a longing that the things we cherish and love will never pass away. Nostalgia also shows that we have “old things” to be nostalgic about—a beautiful past to reminisce upon. However, the reality is that all relationships between humans will end, either due to death or due to separation. Humans have accepted that birth, aging, sickness, and death are normal, but think about the longing for eternity deep in each of our hearts and the sorrow over the fleeting nature of time—does this not exactly prove that we know in our hearts what eternity should be like? Therefore, the briefness of all beautiful things in this world always seems to lack something. Perhaps it’s a conversation with a friend, a collision of thoughts that makes you not want it to end; perhaps it’s a trip that you’ll think is too short because it was too beautiful and happy; or perhaps it’s a good book where, after reading the last chapter, you still feel you haven’t had enough.
We grieve because, somewhere in our subconscious, we know we were not supposed to have separation. We grieve because we long for eternity, longing for beautiful things to never pass away. When God created humans, He intended for humanity to live eternally in the Garden of Eden, enjoying each other and enjoying His glory. So even if they are not Christians, humans will long for eternity, long for “diamonds are forever,” and long for “happily ever after.”
My anchor should have been God. I became a child of God through the death of Jesus Christ; this relationship will never change and is an anchor I can never lose. It tells me exactly who I am when I am lost. When I am lost because I cannot completely integrate into American or Chinese culture, I know I am still a child of God, a Christian. When I am [lost] because of relationships between people. Christians believe that psychological illness is both biological and spiritual.
At the end of this final treatment, Dr. Chan said to me that these two years of treating together were also very meaningful for him; he liked my personality and hoped that if possible, we could continue the treatment. I told him that when I put myself on the psychological treatment waiting list, I didn’t know what kind of therapist the institution would assign to me, so I spent a long time praying, and these two years were God’s answer to my prayer. This was an answered prayer.
It has been 14 years since I was diagnosed with anxiety at age 14 (later diagnosed with bipolar disorder in college; adolescent bipolar disorder is often misdiagnosed as anxiety because the symptoms are similar). Counting it up, half of my life has been spent fighting against psychological illness. During these 14 years, I have tried many treatment methods. I have been to different psychiatrists and tried nearly ten types of medication; even to this day, I take four types every day. I have also been to many psychological counselors; there have been disappointments and there have been successes. In the beginning, my psychological illness was a taboo; it was a prohibition, a shame, a stain on my life that I could not share. I didn’t understand why it had to be me who endured this suffering—why other children could go to school normally and live normally, while I took a year off from school at home because of an invisible and untouchable illness. Many years have passed, and I still suffer from bipolar disorder, but after so many years, I have gradually reached a reconciliation with my own psychological illness with the help of God and the family, friends, and doctors around me. Now, I am willing to share it publicly with everyone, hoping that the process of my struggle with pain can give you comfort and strength.
So, in the very end, I want to say to friends reading this: regardless of whether you have been diagnosed with a psychological illness, you can try psychological treatment. Life always has its dissatisfactions; professional doctors or counselors can help you examine yourself from a third-person perspective, use professional methods to lead you to reflect on your thoughts, and practice various treatment techniques with you. Of course, the prerequisite is finding a good and suitable psychological counselor. I know finding such a counselor can be very hard—it might be even more difficult in domestic areas where psychological resources are sparse—and you might encounter unsuitable ones along the way. I myself have had less-than-satisfactory psychological counseling experiences before this, but I hope this article can help friends who want to seek help break through psychological barriers and take a step toward making their psychology healthier. My view is that none of us are perfect and we all have times of negative emotions, so everyone can have a psychological counselor to help us respond positively during those times.
I hope this period of grief does not last too long. Thank God for answering my prayer and granting me a beautiful doctor-patient relationship. Also, thank you Dr. Chan; both in professionalism and personality, you were a source of my growth. I also hope all people who need help will bravely seek help, and all people who do not have psychological illnesses can be accepting.
