As I walked to work this morning I re-read my post from last night and laughed at myself for being so full of contradictions. For someone who is in training to become a counsellor, I sound very against therapy for myself, don’t I?
I think you need to know some background before you can understand where I’m coming from on this issue. I think the right therapy at the right time can change and even save lives, and my last therapist in particular was a perfect fit for me. I am such a believer in the benefits of therapy that I have decided to make it my career. However!
Over the last decade I’ve seen (for time periods varying from 6 sessions to eighteen months) many counsellors and psychologists. One CAT, one psychodynamic, one CBT, three humanistic, three DBT, ten assorted mental health nurses, social workers and psychiatrists who all use (or SHOULD use) counselling skills, and one lovely eclectic private therapist, who was humanistic by basic training but also used TA, DBT and CBT. Phew. At age 17 I thought the first CAT psychologist was my saviour until she did something rather unforgivable and unprofessional at the end of our time together. The psychodynamic trainee was a lovely person, but lost me somewhere between trying to balance my chakras and bringing out Freud’s theory of sexual development, which I thought was pure balls even back then. The CBT psychologist was wonderful, but was limited by the fact that I’d been sent to the wrong mental health team, and could only offer me twelve sessions, none of which ended up involving any CBT. The humanistic therapists were mostly university counsellors and were very eager to help, but obviously I couldn’t see them long term as I kept having to leave university. One of the DBT therapists was a trainee, and drove me up the wall by insisting that everyone, including herself, had borderline personality disorder. Even after checking with my psychiatrist of the time that this diagnosis hadn’t snuck into my notes when I wasn’t looking, AND getting his complete backing in my insistence that I didn’t have it, she wouldn’t let up. Another DBT therapist was helpful half the time but spent the other half of the time telling me off if I wasn’t making progress fast enough. The third DBT therapist was great, but I got thrown out of formal DBT after a few months when my BMI got too low.
Over the years the way I have used therapy has changed drastically. To begin with I really bought into all of that “looking at your childhood will solve your mental health problems” stuff, and I approached it with great enthusiasm (anyone who remembers me from my something-fishy days will attest to the epic melodrama I bought to the task…). It didn’t change a thing. After my first eighteen months with the child and adolescence services I proceeded to fall down a large gap in the services. It took me two years to convince my psychiatrist to refer me for any more therapy as he thought CAMHS had given me enough (never mind that CAMHS dumped me five months after being raped, when I was still too traumatised to even say “rape” out loud), another three months wait for an assessment, another nine months on a waiting list, a meeting with aforementioned CBT psychologist who told me I was too complex for their service and needed to be referred elsewhere, another three months for an assessment, then fifteen months on a DBT waiting list, by the end of which I was busy being suicidal in the local psychiatric hospital. The DBT seemed like the sort of thing which would have helped me four years previously, but by that point my weight was too low for any sort of therapy to help. However, I did decide at that point that the three main things I wanted out of therapy were a) general support, b) help learning better coping skills and c) some sort of trauma based work, as PTSD was kicking my ass.
Finally, fast forwarding past all the time I spent being told off by the DBT therapist attached to the ED unit in Dorset, I found myself without the option of NHS therapy in 2009 and decided that, since I wasn’t paying rent or bills, I could just about afford to pay a private therapist out of my disability benefits. Julie was the third therapist I interviewed, and I stuck with her for a bit over a year. Julie was different to all of the other therapists I’d seen for many reasons. First of all I was seeing her privately, so she wasn’t constrained by NHS budget problems, targets, waiting lists or time constraints. I made an initial appointment with her, told her about myself and started seeing her regularly from then on. Secondly, she could really tailor her approach to me as an individual – she had gone through training in several different types of therapy, and she used each of them skillfully. During the initial stages of weight restoration she just supported me and helped me with basic problem solving, because that was all I could cope with or take in at the time. Next she helped me learn some healthier coping skills. Finally, once I was at a healthy weight and had coping skills coming out of my ears, we did some trauma-focused work. She pretty much fulfilled all those things I had decided I wanted from therapy years previously. And finally, I really felt while seeing a private therapist that I was in charge of the process. I knew she wasn’t going to ditch me after twelve weeks so I felt much more able to open up to her. I also knew that if it wasn’t working out, I could find someone new without having to go through a year’s worth of paperwork, assessments and waiting lists.
I think I was spoilt by private therapy. I mean, it was really tough on me financially and I wouldn’t have been able to afford it at all without the welfare benefits I was getting at the time, but what I got out of it was exactly what I needed for my recovery. Even better, thanks to Julie I know exactly what sort of therapist I want to be (when I grow up. Sorry, couldn’t resist 😛 ).
So now I need my money for rent and food, and private therapy is not an option. I am wary of the NHS given my past experiences – yes, I know I should be grateful to have universal health care, and occasionally my treatment DID go well, but the rest of the time was spent stuck on waiting lists or being on the receiving end of therapists who seemed to have more issues than myself. The last helpful thing I got from the NHS was my CPN, who was an angel. I saw her for three years, she gave me weekly/fortnightly/monthly support depending on how I was doing, and she always knew who to phone if I was having problems. That was all I needed or wanted, and it’s all I really want now. After ten years of being in and out of structured therapy I’ve just gotten a bit sick of it. It’s not like I think I know it all or that I have nothing left to learn about myself, but I don’t want to sit in an unfamiliar room with a total stranger and tell them about my soap-opera-like history again. I am happy to work on my self development by myself. What I DO want from the team in my local area is some general support. I am hoping this won’t be too much to ask.