After almost forty years of mental health treatment, I’ve finally found a therapist who “gets” me.
You’d think it wouldn’t have taken so long, or been so hard. It shouldn’t take so long or be so hard. The fact that it is, is, in my opinion, criminal. I’ve touched on this in previous blogs. The last thing a suffering person needs is to have to ascertain whether or not their care provider knows what they’re talking about, or whether they’ll be treated as a human being with an individual identity. This is especially important for people with mental illness, who often aren’t in any position to challenge providers or stand up for themselves.
To be fair, my last therapist wasn’t bad, and I stayed with her a long time. She did a lot for me, including actively involving herself in my disability case and taking me as a pro bono client when I didn’t have the means to pay her. Several of my therapists haven’t been bad, precisely. But they’ve been limited in their ability to understand me, because of the nature of their training, because of misapprehensions about mental illness that some theories of mental health actively encourage, because psychology and psychiatry are, in fact, fairly new disciplines and deal with matters that are hard to pin down. All the definitions change as knowledge increases. So, for about forty years, I’ve been in and out, grasping the rope when I needed it most and swimming on my own when the rope couldn’t help anymore.
The thing is, psychologists and psychiatrists tend to cling to whatever was the current model when they were in school. They were given a hammer, so everything looks like a nail. And a lot of them seem both incapable of recognizing evidence showing that some things are not nails, and reluctant to put down the hammer in favor of an impact driver or framing saw when necessary.
Aside: Some years ago, I considered going into Clinical Psychology. The program I was considering required GRE scores, so I registered for the test and picked up a GRE example test book in Psychology. Literally 75% of the questions were Psych 101 stuff–like, “Who is considered the founder of child behavioral psychology?”–and statistics. And I thought, “There is nothing here about helping people. It’s all about fitting people into boxes.” So I didn’t take the GRE, even though I’d already paid for it, and I never got an MA in Clinical Psych.
What makes my therapist so unusual? She listens, and she believes me. You might think that’s only to be expected from someone you hire to do those very things. I certainly did, forty years ago. I learned pretty quick it’s not at all the case. A lot of therapists don’t listen well. They’re too busy trying to remember how to show they’re listening–“It sounds like you’re saying you’re angry. Is that right?”–to actually do it. And even the ones who listen pretty well are not very good at believing what they hear unless it fits into their preconceived notions about you. If and when the two contradict each other, they decide you must be wrong about your experience and try to convince you they know better. They are so afraid of believing a lie or confabulation–things which happen seldom–that they’re prone to cast shade on the truth. If you come in with a diagnosis, anorexia nervosa, for example, they check what you say against the current theory about the diagnosis and disregard what doesn’t fit. People with anorexia are obsessed with control, they don’t want to mature, they’re afraid of female bodies, they lie and manipulate. Check. Don’t try to tell them otherwise. They know.
Sometimes, too, therapists are so uncomfortable with what you’re saying, or so unable to relate, that instead of focusing on your needs as a client they try to steer the conversation to a place where they feel more secure. This is why I stopped seeing my last therapist. In one of my last sessions with her, I said I was trying to come to terms with the fact that I’d probably never have children of my own. She asked me why I thought that was true. I said I was forty-six and not getting any younger, my menstrual cycle had simply stopped and no one would look into it despite my strong feelings that it wasn’t normal, that I was depressed and poor and my sex life was practically nonexistent. She said, “Well, those are all valid reasons. So, how are you doing on the financial front?” It felt like a slap in the face. And I knew without a doubt that she, a super fertile mother of four kids, had no idea what I was going through and could no more relate than walk on the moon. I’d been dissatisfied with our meetings for a while. That was the last straw.
I’ve been seeing my current therapist for almost a year, and she’s been there all the way. In setting up my treatment plan (which, by the way, is something I never had before, or at least something no practitioner ever shared with me), I mentioned my trouble with childlessness. She said, “Sounds like you have grief over that.” Nailed it in one go. One of our first sessions, I was trying to describe my eating disorder being about a need for something I had a hard time articulating. She suggested, “Control?” I said, “No, not that,” and she said okay, and that was the end of it. She waited for me to find it instead of putting words into my mouth or slapping on a convenient label. She lets me lead, and lends a shoulder when I need one. She believes I’m intelligent and articulate. She doesn’t talk down to me, or tell me my experience is impossible. When she suggests something I know doesn’t work and I tell her so, she doesn’t say I haven’t done it right or need to do it more. She respects my right to say, “Not now,” or flat out “No.” She’s been there all the way, and I feel safer with her than I’ve ever felt with a mental health practitioner. I can be real. I don’t have to evaluate every topic to determine whether that’s somewhere she can go. I can do my own work, because I’m not additionally saddled with doing hers.
Some of this may be possible because of my own personal growth. Last year, in this post, I said,
In over thirty years of trying to get support and help for my condition, I have been smarter and more knowledgeable about my experience than 100% of the mental health professionals to whom I’ve turned.
Once I owned that as fact, I vowed I would be up front about it if I ever went back into treatment, and when I did my intake at Mental Health this time around, I looked the social worker straight and the eye and said, “I am smarter than you. It’s likely I’m smarter than everyone in this building.” This is not something I would have been able to do before a few years ago.
That social worker said, “Okay. I believe you.” And now she’s my therapist.
When I went back to Mental Health, I didn’t intend to do therapy at all. I just wanted my medication managed. I’m glad, that one time, she talked me into changing my mind.