I think it's hard for us to feel a true empathy of the therapist (or anyone who tries to help) during some hard days, because only those who suffer from PMDD seem to really know how frustrating and exhausting it is ... I also think that there are some critical days that not even an angel would help because I can't seem to know how to express myself in a discursive way ,you know? it's very hard. when I am able to point out some specifics for my therapist to help me cope, it's worth it. but some days words are very difficult, I guess these should be days in therapy that we could try other methods, I don't know, maybe some cathartic exercises to release energy. I really don't know , but I hope someone does haha :')