446 - Finding therapy

Grab a cuppa, 1,510 words hereafter. 

It's Mental Health Awareness Month again and for this, I decided to discuss some topics I seldom addressed - starting with a very important step : finding therapy, and my next entry will be about asking for help and support. 

I say that, because I know how it feels to suffer for many years, all alone in my corner of the world, wherever I was, even before having any diagnosis - which is itself an important milestone for any sufferer, as it gives a word, label to what "you" are suffering from.

Diagnosis etymology is Greek : diagignōskein  means ‘distinguish, discern’ ;  from dia ‘apart’ + gignōskein ‘recognize, know. Thus, the first help you may need is a diagnosis, or, diagnoses, the plural form. 

Why ? because having it is knowing (if correctly assessed and understood by the medical professional you consult) what causes your pain/s, difficulties, struggles and any other symptom you may suffer from. In turn, these help both the doctor/therapist in finding the tools, medication, and method in helping you, and also yourself in understanding why you feel the way you do, what may have caused it, and to better ascertain with your medical professional the course to take towards healing - be it full or partial, any alleviation can make your life better.

So, the first thing you may need, if it's not done, is finding what kind of medical professional ; when it comes to mental health, that would normally be a councilor or therapist. No, actually, the first that you need is to accept that you need and deserve help, and the second is finding it. 

You may have to 'shop' for a therapist and find both the kind of therapy you need for your particular case, and for the person you click with - as, after all, we don't click with all medical professionals the same way, some are better suited to us, others not so much. 

In many cases, depending where you are, you may need to talk and get a referral from a GP - your family doctor, that General Practitioner whose knowledge on mental illness might be very partial but whose opinion and letter may be important for you to find your therapist. 

I suggest that if you can, when you make the phone call to book your appointment, and provided the GP didn't direct you to a specific, limited therapist, to ask questions on their method and specialty, based on what you need. 

I'll illustrate my own case : I didn't get to choose my therapist, as I didn't know anything about this. I came back to my birth city as told in entry 258, I was a wreck, my mother brought me to a therapist as it was evident that I needed it, she was there for the first session to explain what she knew, and I supplemented in that first and all the following sessions in the course of 12 or so years. 

Sadly, during those 12 long years, having a session every 3 or so months, with a therapist of "the old school" wasn't very profitable for me : she would listen, take notes and never actually gave me the necessary diagnosis terms which would have helped me. I was the one to read about thins on my own and ask her 'is this what I got?' and she'd answer, but never volunteered the terms herself.

So, to come back to the above statement about asking them, based on what you need : do you need this kind of old school approach of a passive therapist or a more modern one, interactive and giving you the terms of diagnostics as well as medication (if needed) and coping tools, advice and so on ? this is the case of my second psychotherapist, who took over the office of my first, after she retired. 

Nicole posted about ways of talking to your doctor about your mental health, here. She lives in the UK, so some of her advice may or may not be applicable, but her entry is very well written and should be easy to adapt. 

So, remember to ask, for example from this list of questions published on Harvard Medical School's website and adapt to your own needs and local health system you have. (ie, the question about their cost and your financial calculations for it may not be necessary if your health coverage takes care of that fully). 

Speaking of coverage, I'll add one more possible question, not in that list : how many sessions can you have? I say that, because I know some UK friends have a limited number of sessions the NHS will allow, and this might be true elsewhere. So, find out how many, either in number, or duration, that you can be in therapy, and try to maximize and perhaps prioritize what you discuss, if you feel that you don't have enough time in each session, or not enough sessions. I'll also suggest having a dedicated notebook so you can note what you wish to discuss, prior to each session, and add the advice and 'homework' if you have any, so you can trace everything and not deal with the stress of forgetting and asking again. 

Whenever possible, I suggest following several sessions, trying to establish the trust you need with the therapist, but if it doesn't work, don't just give up on yourself. Remember that you need and deserve help, and that if it's not this therapist, it could very well be the next one who could bring you solace, advice and tools to progress in your healing path. If it's not one type of therapy, it could be another - just find out which are valid, out of all that exists, and the therapist that does it and whom you can access - either in person, or via online sessions, a practice common to this period of covid19 pandemic. 

Examples of therapies include psychotherapy/talk therapy, cbt, dbt, emdr... psychology today lists and details them here. 

So, you've accepted you need and deserve help, you may have talked to your gp, gotten a referral and managed to choose a therapist, based on your needs and types available... Those are great first steps, but you may find yourself on a waiting list.

Or, you may already have an appointment, set some time in the near or not-so near future, and feel this period is tough and that you need help and support whilst waiting for that therapist, his or her diagnosis and everything else that comes with it. 

Let me state a few points, which might be evident, but that I feel need saying:

Don't let anyone dictate or direct any stigma towards you for reaching out to get therapy ; it's the kind of doctor needed to treat mental illness/es, much like a podiatrist is a foot doctor, about whom there is no stigma, why should there be/ or why should it be accepted to stigmatize the doctor for the brain? 

The job of a medical person should be about helping others, in a non-judgmental way. That tends to be known. 

After my horrible experience with my first CBT therapist, I'll add that their job should also be devoid of condescension. Either make them respect and talk to you accordingly, or switch. You're  not an imbecile for being in therapy VS their diplomas. They are humans with diplomas and shouldn't treat you like they know so much more than you, that it'd be impossible for them to explain their methods to you - that one is very important, how can you know if they'll suit you if they hide behind condescension?! 

Therapy is tough, there I said it. Some days you may cry, during or after your session. Some sessions may be so tough, that you may wish to give. That's ok. Stick with it, remember the reason/s why you're going there for, and that way, you'll continue to go, by self motivating, and reminding the main goal or goals you've set yourself on this path for. 

You may feel the need to talk about your struggles, and/or get feedback from others during the entire process, even once you actually start therapy - perhaps even more so. 

In my opinion, It's totally ok not to depend solely on therapy. In fact, I'd say that as important as having therapy can be, it's also important for you to ask for help and support from others and, that'll be the subject of my next entry - so, stick around for that.

Let me finish this entry , and add that If you're in crisis, and need immediate support, before finding therapy or between sessions,  you can contact a number of charities and hotlines. I'll share here again the same link as previously, Nicole's ultimate directory for my UK readers. 

For USA readers, NAMi's list. 

Every country has their own, so you'll have to find them if you're not in UK/USA, I simply couldn't list all possibilities myself. Use search engines, yellow pages or whatever the phone book's called in your country, and get the help you need.