I had to go see a clinical psychologist for an assessment not very long ago; I needed a statement to say something about my mental health. It’s a long and rather convoluted story why I couldn’t simply get A. to write this statement, but in short: it was An NHS Thing and for whatever reason psychotherapists simply don’t rank very highly within the NHS. It doesn’t matter how long you’ve been seeing them or how well they know you, it doesn’t even matter if they are both UKCP and BACP accredited, the only letters that matter within the NHS are N, H – and you guessed it – S.
So, in the end I was given a number to call in order to book an appointment with an NHS affiliated clinical psychologist, who would clearly possess almost magical levels of insight, as she would apparently be able to conduct a full assess of my mental health in thirty minutes flat, having never met me before and knowing absolutely nothing about me, my background or my mental health history.
I had resolved to stay calm, but the second I was given the address to the place where the assessment was to happen, I realised it was where I had gone for an assessment five years earlier, where they ultimately deemed me too high risk and unsuitable to be in therapy.. [Being rejected by the NHS is the reason why I had to go private; while I agree that I was very high risk, there was no way I was going to accept that I wasn’t suited to be in therapy..]
Either way, I rolled up at the place with plenty of time to spare, giving my anxiety abundant opportunity to hit the roof and then proceed through it. This wasn’t helped by the fact that Dr NHS Clinical Psychologist was an hour [yes, an hour!] late.
But – eventually – I did get to go in for my assessment and as it turned out Dr NHS Clinical Psychologist really wasn’t too bad. It’s just that, when you meet someone for the first time and you have thirty minutes to talk about yourself, your background and your mental health history, well, what do you say? where do you start?
We covered the usual ground: I was adopted, I was sexually abused by my oldest brother for twelve years and for a year by a second person, I have a complicated relationship with my whole family, my parents are separated, my father lives with his male partner, my mother is bi-polar, etc etc etc. We then moved on to more recent times, talking about previous suicide attempts, self-harm as a coping strategy, the flashbacks, the recurrent depressions and so on. I have to give Dr NHS Clinical Psychologist some credit here, because she also allowed some space to talk about the more positive aspects of my life; my relationship with my sisters, my amazing friends, my studies, my volunteering, but, coming out of the meeting, while I felt that she had listened to all I had said, I really wasn’t sure what she would actually write in her statement.
It’s a strange thing when you are asked to summarize your whole life and your entire being in a very short space of time; it really highlights something, forces you to really think. And it’s exhausting.
So, the next session I had with A, was spent debriefing. It’s quite hard to look at the different parts of your life in this very concise way. It’s almost a bit of a shock to the system to go through it all like that. I mean, none of these aspects of my life are things I haven’t spent hours in therapy thinking and talking about, but there is something quite extraordinary when you have all these life stories mentally bullet pointed before you.
There is one part of me that thinks that considering all the things I’ve been through, all the unorthodox aspects of my life, I’ve actually done quite well to not be completely broken by it. And at the same time, there is another part that chokes and goes “It’s going to take a looooong time to make some sort of peace with all of this..”
But, thankfully, in spite of that assessment five years ago, I am in therapy and I will continue to give it my best shot to somehow make sense of it all.
From the posts I’ve read of by you, you certainly seem like the sort of patient that therapists are delighted to have.
Thanks for the comment! Of course I’m entirely biased, but I think I make a pretty good client, too; somewhat complex background and a fairly analytically minded personality. But it actually took me quite a long time to find a therapist who was willing to take me on. Most said they either felt I was too high risk, which I can understand – it’s not easy working with clients who are suicidal. Others said that they simply didn’t feel they had the experience they needed to work with someone who had so many challenging issues to work through.
Hm.. This feels like it could become a blog post in it’s own right, so thanks again for the comment and the inspiration. Look out for the next update, it may well be on this topic!
While I would agree that a responsible therapist should decline a new client when he feels overmatched or insufficiently experienced, it is a bit foolish for any clinician to forever steer clear of those who have risks. Dealing with what is difficult and challenging is part of what comes with the job; and frankly, part of what makes it interesting and worthwhile. I’ll look forward to any more on this subject that you care to write.