Being The Perfect Therapy Client

I know this is a bit like the London double-deckers; for a long time there’s not a single bus, and then there are five all at once. The Heinz Ketchup effect.. But, you see, one of my readers commented on the post I uploaded last night, and in responding to his comment I realised that it could well be turned into a blog post in its own right, so here I am again, updating my blog merely hours after my last offering. You’ve got to strike while the iron is hot and all that.. I hope you don’t mind.

Anyhow..
The comment was in reference to my mentioning that five years ago, following an initial psychological assessment, I was deemed to be too high risk and unsuitable for psychotherapy, and the commenter said that “From the posts I’ve read by you, you certainly seem like the sort of patient that therapists are delighted to have.” My initial reaction was to feel flattered by this comment, and I instantly thought that I rather agree, biased as I am; I do think I make a good client. I have a bit of a chequered past, quite a few things in my baggage – obvious material to work with so to speak – and I am also reasonably self-aware, rather analytically minded and fairly articulate. Not a bad prospect for a psychotherapist.

Then again, I am no different to any other psychotherapy client; I think we all want to see ourselves as good clients – interesting, intelligent people – who therapists are happy to work with. And we all wish to be the favourite client, the one our therapist is really looking forward to seeing, because we challenge them just the right amount without being burdensome or draining. [If you’re in therapy yourself, I’m sure you will know what I mean.]

Yet, having been turned down by the NHS for therapy I really struggled to find someone who was willing to take me on. Naturally I had to give up on the idea of getting free therapy on the NHS, but I figured that outside of The Service there had to be plenty of privately practicing therapists who would want to work with me.

In reality it took me quite a few months to find a therapist. I had to go to many ‘first appointments’ and found myself being repeatedly rejected. Many of the therapists I saw, said exactly what the NHS assessor had said; that I was simply too high risk, what with my recent serious suicide attempt and my habit of using self-harm as a coping strategy. And I can understand that. I imagine it can be quite challenging – scary even – to work with, and in a sense – be responsible for – a client who may well choose to down a litre of anti-freeze rather than turn up to session. Naturally, not everyone will be up for that. But, at the same time, the way I always saw it – and I would always make this clear at assessments – I’ve always seen therapy as the way forward for me, the thing which will eventually help me manage my past in a more positive way, and also – while I have many times become depressed while in therapy, I’ve never made an attempt to end my life when I’ve been in therapy or had counselling. That has only ever happened when I’ve not had a place to take my thoughts and emotions, when I’ve felt I’ve not been able to share what’s going on for me.

The other reason given to me, when therapists declined taking me on, was that they felt they simply didn’t have the experience they needed to be able to work with someone with such a complex background. There are quite a few aspects – issues, if you will – to work on; I was adopted, so a high potential for major attachment and abandonment issues and possible identity crises. I was sexually abused and suffer from intense flashbacks of this, and so more than one therapist said that I should probably look for someone who specialised in this area, perhaps a therapist trained in EMDR or TF-CBT. I have one parent who is gay, I have another parent who has struggled a lot with the rollercoaster that is bi-polar disorder. So lots of different things to work on in therapy, perhaps too many, for some.

I also suspect, although I don’t know this for sure, that I probably came across as someone who might be a bit of a handful to manage in session, because I happen to be ridiculously well read on the theory of psychotherapy, particularly psychoanalytic and psychodynamic therapy, which was also what I wanted to do. I am not someone who will hold back on commenting if I feel that the therapist is ‘text booking’ me. And also, there is a definite barrier to get through; the fact that I often, knowingly or unknowingly, intellectualise and theorise in order to not have to deal with actual emotions. Hiding behind my theoretic understanding of things, so as to not really have to deal with anything. I don’t do it so much anymore – in fact, these days I tell myself off if I notice that I am slipping back into this pattern – but five years ago, that was certainly something I did a lot.

In the end, having tried for a good few months to find myself a therapist and failed, I asked the house therapists in the therapeutic community I had recently moved in to, to set me up with one of their trainees, because I felt I would never be able to get anyone to take me on on my own.

Long-term readers of this blog with remember that this turned out to not have been a great idea, as the person who was ‘assigned to me’ wasn’t a particularly good match for me and the chemistry just wasn’t there. Having thought it through, I ultimately decided to terminate with her, as I felt that I could probably carry on seeing her for years and still never get what I wanted from our work together. It wasn’t a decision I took lightly, but, I always felt it was the right decision for me. I’m sure B. – my previous therapist – is a great therapist; she just wasn’t the right one for me.

As it turned out, I actually managed to find a therapist that seemed a good fit for me before I had even let B. know for sure that I was going to move on. Almost as if by magic, I had completely by chance contacted two different therapy organisations, both of which A. happened to be affiliated with, and already the first time I spoke to her on the phone, I felt she could be the right person for me to be doing this very important work with. Going for my first initial appointment with her I was nervous, but also felt decidedly positive. I had a good feeling about it.

I have since asked A. how come she decided to take me on – thinking about the many people who had turned me down – and, although she slightly dodged the question in her funny little way, she did say that she never considered not taking me on. I am still not entirely sure why that was, but maybe she saw it somewhat similarly to how I saw it; I seemed like someone she could work well enough with me to give me a chance.

We’ve certainly had our moments over the years, A. and I, and I know that I can definitely be more than just a little challenging at times, and not always in a nice way, but I do think that we speak similar enough languages to be able to communicate well and to work things through. I also know that A. can stand up to me, and that she won’t be cornered or pushed around by my intellectualisations or red herrings, something I really appreciate. In fact, only the other session, she was challenging me and I commented that she’s asking very difficult questions, to which she responded Good! and we exchanged a quick smile across the room.
And I think that illustrates our relationship quite well.

I don’t know if I really am that magic Favourite Client, and by now that doesn’t even seem all that important anymore, but I do feel that we have a decent enough relationship that I could be.

And that’s enough.

xx

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Powerlessness, Asthma & Echoes From The Past

Feel like I ought to be given some sort of medal or badge today. It’s been one week since my last therapy session, and so far it’s been manageable. Moments of feeling somewhat lower than usual, but absolutely within the range of what I can cope with without freaking out.

That aside, today I feel like a prisoner in my own home.

The last few Fridays I’ve not been attending our Friday meetings, because B. – a former therapist of mine, whom I chose to terminate therapy with – is doing a student placement as part of her training at those meetings. I have been trying to explain both to others and to myself why I feel so strongly about her coming here, but it’s really hard to put it into words, aside from stating the obvious, that I chose to end therapy with her for a reason, and to not want to have to see her again, even in a group setting, seems – at least to me – a not unreasonable request. I would have thought that most people would not be particularly keen on having to see an ex-therapist once they have terminated therapy with that person. No?

But, of course, it goes deeper than that. It’s not just having to see her; at a stretch I could possibly, maaaayyyybeee, cope with that. No, I think this is tied in to the fact that I’d not just be seeing her anywhere, but actually in my home. And I have a feeling that this is a large part of what is getting to me; that living in this therapeutic community I ultimately have no choice in who to let in or not into my own home.

Now, let’s put this into context of my own background.
I grew up in a house where I was put through some pretty severe abuse by people living in my home; my oldest brother and also, for a time, by a foster child placed in my family. At the time I didn’t feel able to stop it, didn’t know how to speak up [lots of complex issues, as anyone having experienced abuse will know]. In the end, the only way out I could find – and not before having already suffered through twelve long years of abuse – was to kill myself. It was the only control I felt I had over the situation; the option to live or to not live. So, at the age of 17, I opted to take a cocktail of painkillers and my mother’s various medications.

Needless to say, I didn’t succeed, and – in fairness – looking back, I can see that this was probably a cry for help, for someone to see that something wasn’t right.

To an extent it worked; the abuse came to light and it stopped. Would I call this a happy ending? No. Absolutely not. While the abuse stopped and things came to light; even went to court, I couldn’t call it a happy ending.

You see, even after all of this came to light, after by brother was convicted for what he had done, and despite the fact that everyone believed what I said had happened, I was still expected to carry on seeing him at family dinners and holidays, essentially giving the message that what happened to me didn’t really matter, and his place in the family was still more important than mine.

Me being me, having spent my whole life acting as if everything was fine, of course reverted back to that old habit of acting as if I was OK, as if these messages did me no harm. Not good.

Going back to the present situation, with B. coming into my home [even though this time I have expressly stated that I don’t want her here] it evokes in me the same feelings of being helpless, of having no power over who is let into my life; that what I want doesn’t matter.

Realising that the situation wasn’t going to change, that whether I felt OK with it or not, D. would be doing her placement with us, I was faced with a choice. A) To go to the meetings, reverting to the old pattern of pretending that things are fine, putting a brave face on it. Or, B) Not go to the meetings, feeling somewhat driven out of my home, as I don’t want to be around when she’s there, even if I don’t actually attend the meeting.

So far I’ve chosen option B. I say so far, because, of course, there is an option C) Going to the meeting, and not pretend that things are OK, but to speak up with her in the room.

Now, I can certainly see that there would be some value in option C), but – and this is a big but – I honestly don’t feel I am at a place yet where I would be able to do that. And as long as I feel that way, as long as I feel that going to the meeting would make me go back to acting OK, I simply don’t see how that would be a healthy choice. And so, for now, I do the second best; I preserve the boundaries I have set up by choosing not to attend the meeting. I accept that I can’t change B. coming to my house, but I don’t need to be around when that happens.

Except today.

Today is a beautiful, hot, sunny day here in London. Gorgeous, really. It is also the perfect weather for death-by-asthma. The government has even gone so far as to issue a smog alert for this bank holiday weekend.

Despite this, not wanting to be in the house when B. is here, I still tried to brave it this morning and went out. Unfortunately, I had to turn around and head back to the house, because I just couldn’t get enough air in my lunges; the weather and the pollution was simply too much.

So at the moment, I’m in my room, using my inhaler, feeling more than ever as a prisoner in my own home.

Oh well, at least I have the internet here, and I can spend my time exploring where my feelings stem from, and then plague the world with my findings in the form of a blog entry!

Happy Easter, Passover or Spring – whatever floats your boat!

All the very best and much much more,

xx

PS. The trick is to keep breathing.

Decision Time – An Entry About Trusting Your Instincts

Sometimes it takes time to reach a conclusion. I know this to be true. And yet, yet I find myself struggling with that. It’s not that I don’t have patience – I do – but it seems it’s a very specific type of patience I possess. I have near endless patience with children in particular and a reasonable amount of patience for people in general. What I don’t have is patience with myself. When it comes to me I want to know now. No waiting period, no trial and error. I want the results right away with no delay. Clear-cut and ready to serve.

Unfortunately that’s not the way the world works. Or maybe it’s more of a fortunate than an unfortunate? In some ways I think it’s probably a good thing to have a little frustration in your life. It gives you the drive to focus, to set goals – to strive for things.

I am now into my eighth week of therapy with my new therapist and I’m still very much struggling to come to a decision as to whether or not she really is the right person for me to be doing this very important work with.

Two weeks ago I finally plucked up the courage to actually tell B. (my new therapist) that I feel there is no connection between us, that there is something absolutely vital missing from our relationship, and that I’m not entirely sure whether or not we should continue working together. I held my breath, counted to three in my head and waited for her reaction. Only there was none. So I carried on, trying to quantify what it is I feel is missing, hoping that at some point she’d say something back to me. Which, eventually, she did. But only after I actually asked her what she thought of what I had just said. Only then did she spring into action, so to speak.

I think one of the things I find difficult with B. is the fact that she very much seems to be putting her therapist hat on (as opposed to just being herself, doing therapy for a living). It seems to me that she is often holding her own genuine reaction back in order to give me the ‘correct response’ to whatever I have just said. Now, B. is still in training and so I can understand the wish to do things The Right Way, that she may not yet have the experience to trust her instincts. Going by the book when you’re starting out is, of course, a lot safer and I’m sure that she will, eventually, find her own style – find a way to be more congruent and personal and genuine. But, the bottom line is that until she gets there I’m not sure that I want to be her guinea pig.

As I think I’ve mentioned before I went to see a few different therapists for initial assessments before being set up with B., and that I was turned down more than once, for various reasons. Having said that, regardless of their individual reason for turning me down (risk factor, not feeling able to offer what I need, being unable to find suitable timeslots on their schedules), they all seem to be saying this same thing – that I am a fairly challenging client and that what I need is long term therapy with a very experienced therapist.

So, here I am now, trying to decide whether or not it’s time to move on – yet at the same time worrying about what will happen if I do make that decision. Will I be able to find someone else who’s willing to take me on? What if I again feel that there is something lacking? Am I setting my hopes too high?

It’s not entirely a case of try and try again.
I mean, in many ways I suppose it is – but I am also very keen to not create a pattern of starting therapy with someone only to decide that that’s not quite right, either.

Even though I know that so far my pattern has actually been more in the opposite direction (sticking with something that isn’t quite right rather than face dealing with it) I am very aware that on paper it doesn’t take very many therapeutic Start-And-Stops to make it look like I’m not really committed to do the work, that I will inevitably always find a fault in order to repeat a pattern of moving on to the next bright thing.

Oh, I hear you all muttering that the solution here is pretty obvious, that sometimes you have to take a chance and that it is very possible that the next therapeutic experience won’t at all be a mere repetition of the one before, just like this one didn’t turn out to be a repetition of the one before. I know, I know.

I’m just a bit scared.
That’s all.

xx