Warning: Portions of this post may be triggering for some. Mentions suicide.
So, I met my new therapist yesterday. I really don’t know what to think about him yet. He is a psychiatrist with the provincial mental health system, the second in my lifetime that I have met. He didn’t have much time to talk with me (15 min) but he said that the purpose for the appointment was to meet me out of the hospital (I had originally met him in the hospital) and he wanted me to see his office and be comfortable with it’s location.
After a quick rundown of my next 10 appointments – dates, time etc.. and a little pep talk about how he was going to get me to a point that I never have to see another doctor about this ever again…. he sent me on my way. He’s a nice guy, don’t get me wrong, but I confess I am a little jaded and wary after knowing what I know about clinicians. I’m going to give him a chance though, he just may turn out to be the best one I have ever met, then again he might end up being the worst….who knows, time will tell.
I have had my share of chair time in a clinician’s office (psychologist, psychiatrist, social worker, mental health nurse, therapist etc…), and I’m sure you have too. And if you are anything like me you may have had a run in (or two) with a clinician (or two) that just didn’t work out. Please indulge me while I take you on a journey into the deep, dark forest that is otherwise known as therapy. This list is by no means exhaustive and you may see these types, individually in the wild, or as a combo pack.
Watch and shoot.
#6 The Miracle Worker
SA (Situational Awareness)
You are so happy you found them, it’s early in your treatment and you are not jaded and bitter yet. You feel that although you have fallen in a bucket of shit you will come out smelling like a rose. “I am so lucky to have found you,” you think to yourself, “someone must be watching over me for me to have you as my clinician.” This is what I imagined therapy to be. I will recover quickly, painlessly even, and I can put this all behind me and carry on with my life”.
TTP (Tactics Techniques and Procedures)
They greet you warmly, with a tinge of excitement in the air. Somewhere on their office wall you will see a picture of a road leading off into the distance, with some kind of inspirational quote about being brave while walking down it. Books abound on their shelves with titles like “You can heal yourself” and “how trauma breaks your heart”. They know how to help you, they will repeat the same treatment that has “worked” for their other patients no matter if they will think it will work for you or not. You are happy to participate as you have enough hope now that you will be able to get through this and it will all be worth it in the end.
Lessons Learned
The type of treatment that they offer is a one trick pony, you bought your ticket and are excited to see the show but after a while, when their specialty treatment isn’t working they will blame it on you and you will blame it on yourself, and you will walk out, broken hearted, a little jaded and somewhat worse for wear. It’s not your fault, you are more than a broken heart. Tell them it’s not working out and gently let them go.
#5 The Scientist
SA
You’ve had it with the touchy, feely bullshit, and you are ready for science to rule the day. You will deal with this logically, methodically, far removed from any feelings or illogical thoughts. Hope is pushed aside because hope is a feeling and we can’t have that. You are dealing with cold, hard facts and you will cut off and shut down any emotions that might interfere with treatment. You feel as if this illness will be surgically removed, with precision from your brain, like a cancerous tumor.
TTP
They greet you with a cold handshake, in a somewhat spartan office that is filled with clinical textbooks, legal-sized yellow paper pads and a whiteboard on the wall. They believe that if you remove feelings from the mix and instead talk about the technical aspects of your illness and the biology of trauma they may end up talking sense to you, enabling you to “cure yourself”.
Lessons Learned
Between the repeated clicking of their pen and the constant swivel of their chair you realize that you are screwed. It’s not working, you can’t shut off your feelings entirely, and again, you blame yourself and perceive your feelings as a weakness. You push them all inside, into that dark space in your mind, determined to never let them out again. “What’s wrong with me?” you ask yourself, why am I so weak, why can’t I control these sticky, nasty feelings. It’s not your fault, really it isn’t. You have to treat the whole person, not just one small piece. You are not a puzzle to be methodically put together, you are a person, with feelings AND thoughts. Fire their ass and keep looking.
#4 The Disinterested Party
SA
After dealing with opposite ends of the spectrum when it comes to care, you are assigned a new doctor, either by the military or by veterans affairs. You are tired from the last treatments you’ve had and are willing to try something new, however, you are a little jaded at this point. You are ready for a real professional, and they must be “the one” after all because they were given to you by people that have your best interests at heart – either by your employer or your case manager.
TTP
You are greeted as if you were just a number, they don’t remember your name five minutes after they meet you. They talk about their weekend activities and ask you about yours, although they don’t really care, they are just making conversation. The appointments eventually boil down, in time, to an hourlong conversation about things unrelated to your illness, like where they bought their new shoes or where they are going on vacation. Their office is a mess with stacked papers on the floor and chairs. When you ask a question about your illness and if you should be tested for it, they frustratingly rifle through their piles and dig out a wrinkled test paper and ask you to fill it out in the last three minutes of your appointment.
Lessons Learned
At the beginning, it was refreshing to have someone in your life that wanted to talk to you about things unrelated to your diagnosis. However halfway through your therapy, you realize that both of you haven’t done a damn thing to get you on the road to wellness. When you bring up why you are there, you are treated like a nuisance instead of a patient. It’s not your fault, you trusted them and they, in turn, showed you why you shouldn’t have. Eventually, you will become frustrated enough to fire them, and when you do you are terrified that the people who sent you there will be upset with you. Don’t stress my friend, you have to be your own advocate when it comes to your care, in other words – fire away.
#3 The Coward
SA
You finally found someone who cares and who seems to have their shit together. Their office is clean and comfortable and you feel you are in good hands. You spend months, even years, talking about everything, and they explain your illness to you in plain and simple terms. They “get” you and you are working hard, together, to be a more healthier you.
TTP
You are nervous from all of the times you have been fooled into thinking that therapy will work for you, but you needn’t be. You are in capable hands, they are familiar with your disorder and they have a full roster of people they help every day. You have even spoken to some in the waiting room and have heard nothing but praise about their ability to help even the toughest of cases. They are there for the long haul and they promise to never let you fall down the rabbit hole again. They have a big bag of tricks they can reach into to make you feel better. They have your back and they understand. You finally trust somebody and it feels good.
Lessons Learned
In time you notice that their bag of tricks “was” full at the beginning, but it has emptied slowly. After years of talking and hard work they quietly start comparing your progress to their other patients, eventually saying to you that so-and-so has been in therapy as long as you have and they only need to see me once every two months now. Maybe you should start looking for a different therapist, they say, one that can break through this stubborn illness that you have. They may even help you find someone new. Before you know it you are saying to yourself that you ARE better, and that in order to keep the coward in your life you make appointments that are two months apart. When you do talk to them you tell them that everything is great and that you are feeling better…see we CAN keep seeing each other. But mental wellness does not occur in a vacuum and before you know it, you are on your own again. They pretty much make you fire them, or the relationship dies from lack of care and honesty. You are in mourning of the relationship that is now gone and you feel truly alone and misunderstood. It’s not your fault that you can’t be like their other patients, nothing is wrong with you but something is wrong with them. Don’t blame yourself. It just didn’t work out.
#2 The Tired One
SA
You probably met them during a crisis and had to be taken into care. They were assigned to you during your stay and you are just trying to do some follow-up work now that you have been sprung. You haven’t had any professional care for quite some time (which is probably why you ended up there in the first place anyways), and are trying to be thankful for any help you can get.
TTP
Chances are you meet this individual at their office in the hospital. They provide a public health service and your provincial plan pays for them. You sit in a dirty waiting room full of seriously ill folks, and silently wonder if you even should have come because you’re not THAT sick. Once inside the office, you see the remnants of their microwave lunch and their take out coffee from that morning that they still haven’t had the time to drink. They want the correct spelling of your name for the prescription and now ‘off you go’, on your way home. You may manage to make a small conversation like – “how are you feeling?” ….” I’m having suicidal thoughts”…”you mean when you put your bread in the toaster for breakfast you say to yourself ‘I think I’m going to kill myself today'”? Yeah, just enough of a conversation that you wish you would have muttered a half-hearted “I’m doing well” instead of being honest.
Lessons Learned
The only thing worse than no help is cold, bitter, sarcastic help after a crisis, and trust me, the flippant remarks are a staple in this one’s tickle-trunk. It’s uncalled for but chances are any rebuttal will fall on deaf ears. They are poorly paid, exhausted and couldn’t care any less about how close to the edge you are as they can barely manage their current caseload. I mean how do you put out a smoldering house fire in 15-minute increments once a month. Get your behind out of there and work on finding someone else.
#1 The Genius
SA
So, you’ve found another clinician. Someone who is going to take some time to read over your chart and test you extensively. You sign all of the paperwork in order to get your previous files transferred because they want no stone left unturned. Can this be it? Did you find someone who truly cares? You wait for appointment #2 with anticipation and hope.
TTP
Their small, brightly lit office is lined with unremarkable books, and a framed mission statement and diploma hang on the wall. They are going to get to the bottom of this, you think to yourself, “Finally someone will be able to help me figure this all out.” Appointment #2 rolls around in a week and they have your answer, yes the previous diagnosis is correct and although it didn’t show up on the test scores you also have something else wrong with you, something completely unrelated and unreal. They just “know” it. You question them on it, they make their points, so you go home and do some research into this new disorder you’ve acquired. Do those shoes fit? No they don’t, and if anyone knows you, it’s YOU. You call them, hell you even call The Coward to ask them what they think and they tell you that, yes, you have it, they just somehow neglected to mention it during your entire time together. And they knew you were going to call, they were talking to The Genius just days ago and they had a long conversation about you. Yeah, remember those papers you signed, well whaddya think about them now.
Lessons Learned
This is not your first Dairy Queen, you angrily fire their ass and pray that the stigma of the new diagnosis does not follow you any further. You suddenly despise all clinicians, you don’t trust any of them and you give up trying. Careful, without care, you may slip down the rabbit hole again.
BONUS
The Unicorn: The One that you DO want
SA
The stuff of legends, this specimen has yet to be seen in the wild. The story goes like this….after you meet, your illness will never be unmanageable again. That’s it. Seriously. You will be learning so much about yourself, why your disorder affects you the way it does, and learning some much-needed skills to combat your symptoms like a pro. You will feel like you can see for miles into the future and the view is beautiful. Someone is ready to take on all of the guts and black stuff you have inside and all you have to do is follow treatment, be on time, be truthful and courageous. They aren’t going to bullshit you, no rose-coloured glasses here, they will give you the seeds of knowledge and care to help you help yourself when they aren’t around, but don’t worry, they aren’t going anywhere. They are here for the long-haul.
TTP
They greet you with a firm, warm handshake and introduce themselves by their first name. Their office is clean, quiet and organized. They have got it goin’ on. You sit in a comfy chair and feel confident with your treatment. No red flags, no house fires, no blame, no judgement. They lay out a plan for the two of you, No surprises. They may even give you their cell phone number just in case anything goes pear-shaped in your life, or when you just want to check in with them. They preach patience, one day at a time, and encourage you to conquer each day with the tools you now have in your pocket. Practice makes perfect and they want you to practice what you’ve learned, every day, so you get stronger and stronger until you are confident you can manage day to day life with this new learned behavior. They don’t hold your hand or walk in front of you on this journey, they walk beside you and show you the way.
Lessons Learned
You may search your whole life long for this rare beauty, but if in some instance you do find them, hold on with both hands because they are one in a million.
How about you? What therapists have you fired? Have you found your unicorn?
Special thanks to kindred spirit and fellow traveller Laura Burk for the art.
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