“Someone’s therapist knows all about you.”
Dominic Riccitello
I was talking to a good friend the other day who is going through a rough time. They have been afraid of going to therapy to deal with some trauma; afraid of what they would find or remember. They reached out last week and said they were really ready to start looking for a good therapist, but they were overwhelmed and didn’t really know where to start. As I started info-dumping on her all of my knowledge and experience, I realized that I should post about it.
My journey inside the mental healthcare system has been long and arduous, as I’ve said. Somehow, about 3 years ago, I walked into the office of an unknown therapist. I was exhausted and frustrated; she was going to be my third therapist in as many years. But I knew I was unwell and I wasn’t ready to give up on myself. I tried again. I have never been happier to have taken a shot. That appointment all those years ago led to a life-changing revelation about my health.
As always, I want to preface this by saying that I am in no way a mental healthcare professional. This is just my take on my experience. Instead of looking at it as advice I’m giving to you, let’s say it is the advice that I would give to my younger self. 20-year-old AmBoBean, being ravaged by my illness for the first time; realizing that there was something majorly wrong inside my head. If I saw her, standing at the starting line, these are the things I would tell her. The first one is most important and the rest are in no particular order.
So, look. I know therapy is not an option for everyone. Some of my readers live in different countries than I do, but I know they are often faced with long waitlists; sometimes waiting years to get a formal diagnosis. Some of my U.S. readers don’t have insurance or can’t meet the financial barriers. There are so many. I have really great insurance, but I pay $625 a month for it. I’m super lucky and privileged.
Some people aren’t ready. Ten years ago, I wasn’t ready, either. I don’t know what I would have done with the knowledge or if I would have even sought knowledge out. When you’re ready, you’ll know, and help will always be there. I would never want any of you to feel like I was pressuring you on your path. We all move and heal in our own time. Your choice is valid.
For everyone else…
🎆GET A DIAGNOSIS🎆
If you already have a therapist, ask them on your next visit. If they say no, find a new therapist. Keep asking until someone agrees. I asked once in my 20s and then I didn’t ask again until I was 38 and I’ll regret that for the rest of my life. When I brought it up to my therapist, I didn’t have a diagnosis in mind. I knew something was wrong. I had discovered information that I identified with while researching ADHD for my daughter, but I still didn’t know enough about ADHD to even consider it an option. I just wanted help and finding out what was wrong seemed like the first right step.
She mentioned ADHD and told me to check out the YouTube channel How To ADHD. That channel was a revelation, so I started digging and found ADHD Twitter. By the following week, I already knew for sure (100% certainty) that I had ADHD. But I found out so much more when I got my diagnosis; about how trauma had affected me and about how my brain works. I understand myself in a way that I didn’t even know was possible.
This has allowed me to educate myself (which I highly suggest doing) and become more knowledgeable about how and why I do things. It makes it easier to redirect the behaviors that I want to improve. But, most importantly, it allows me to forgive myself. I am not a perfect human being. I can only work with the brain I have and this brain…it’s difficult, sometimes. But I do have to work with it. As frustrating as it can be, it’s also pretty extraordinary too.
Getting a diagnosis also helped my therapist better guide my treatment. She and I have started focusing on overall recovery. She then referred me to an ADHD specialist and a trauma therapist. She was able to help me find a primary care provider who has been working to get my medications right. We are all working as a team to try and get me better. Without that diagnosis, I wouldn’t be on this path.
This brings me to my next piece of advice…
Ask your current therapist or GP for referrals
If you currently have a therapist but don’t know where to start in getting things worked out, just ask them. Therapists often don’t mind sharing the load and often find themselves working with other providers to make sure that their patients get the care they need. You might find that your therapist has qualifications you don’t know about and could have been helping the whole time…all you have to do is ask.
I realize that not everyone can have 3 therapists and a GP. I can barely afford it with insurance. But try to build a network; even if you have to stop seeing one therapist while you work with the other. There are great therapies out there for a vast array of mental illnesses; learn about them, ask about them, seek them out. Be active in your journey. You deserve it.
If you have access to an Employee Assistance Program, USE IT!!
A lot of companies offer an Employee Assistance Program, or EAP, to their employees. This is often free or discounted services of different varieties. My company offers assistance in financial planning, legal consultations, mental health, and more. For mental health, they offer 5 free therapy visits.
Admittedly, some of the providers in the EAP roster are not great. I have to kiss a lot of frogs if you know what I mean. That said, I also found Dr. W through the EAP and she is the best therapist I’ve ever had. She changed the game for me; literally, changed my life. You have to be willing to keep trying until you find the right fit.
Which brings us to…
It is perfectly okay to “fire” your therapist, at any time.
“Fire” is dramatic, but it is perfectly fine to move on from a provider and find one that you feel is a better fit. You want someone who aligns with your ideas for what your recovery path should look like. A therapist who doesn’t believe in ADHD (yes, they are out there…in abundance) wouldn’t be of much help to me, a grown woman who is riddled with severe ADHD-I.
I once saw a therapist for 2 full years before I realized that she wasn’t helping me much. She was very nice and I liked her a lot, but it wasn’t about how much I liked her. I was well ready to get better and I knew I wasn’t going to do it in her office once a month. That decision is what brought me to Dr. W’s office and the rest is history.
Make sure you feel comfortable being honest and clear about what you need.
This was hard for me. They are doctors. I am just a crazy lady begging for their help. They’ve been to school for this; I barely made it through high school. Here’s the thing…they know medicine better than you, but you know you better than they do. Doctors are not infallible or all-knowing. They are also not mind-readers. You have to get vocal about what recovery looks like for you and how you think you can get there.
You should always have a say in where you’re going; you’re treatment and recovery should be person-led. This is your destiny we’re talking about. Take charge. Grab the bull by the horns, if you will. Actually, that’s a pretty excellent analogy for mental health recovery. Hmmm…
Look for someone who does more than listen.
As in my example above, you want to find a therapist who is ready to take action, WHEN YOU ARE. Make no mistake, you probably don’t want someone who is going to pressure and push you before you’re ready. You also don’t want a therapist who will let you stagnate. Therapy is about forward motion; getting better. The main goal of any good therapist is to get you to a point where you don’t need them anymore.
They should be able to provide you with tools, strategies, and resources so that you can be learning and improving your life all of the time. The goal is to thrive instead of just surviving. It can be nice to go into your therapist’s office and unload. To be sure, I do it all of the time. Just try to find someone who will help you make therapy goals and who will then work with you to reach them.
Try private or small practices over group or corporate practices.
Honestly, this is a completely personal preference but, in my experience, I got better care when I was going to smaller practices. I’ve also gotten really shitty care at smaller practices, but in a different way. I find that the larger practices often have a higher turn-over of staff, meaning a higher chance that you’ll get a new therapist at a moment’s notice. This is never easy and can really lead to drops in care.
They do provide a one-stop-shop…psychiatrists to prescribe medication, therapists, specialists. Sometimes even in-patient services. That said, the money-making nature of the business seems to turn you into just another number. No one really seems to care about what is happening with you all that much. They’re there to get their paycheck and vacation days. It was very depersonalizing.
If you can, try to find a therapist that specializes in your disorders or issues.
This is another time when accessibility comes into play. Some people just don’t have a choice in the care that they get. Insurance only covers certain providers or you live in a rural area with no choices; no matter the reason, some people just don’t have a lot of choice in who they see. However, if you do have some flexibility, I highly recommend finding providers that specialize in your disorders (if you know them) or whatever issues you may be dealing with.
This could be anything from a relationship counselor to a provider who specializes in a specific trauma therapy, like EMDR. I currently see therapists who specialize in relationships, ADHD, grief, and trauma. If you have several issues that you need to work on, but can’t find a provider that specializes in them all, work on one area at a time to cut down on the cost of visits. By finding therapists that specialize, you can specialize your care in the areas that you need the most help.
So that’s it. That is the advice that I would give a younger AmBoBean if I knew her now. I hope that it helps you in some way; whether you’re pondering therapy for the first time or currently in therapy and not sure where to go next. It’s just advice, take it or leave it. Either way, good luck in your journey. I’m proud of you for taking the steps needed to get better. You deserve it. You deserve care and you deserve help.
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Love and light. Keep fighting the good fight!!💜💜
Great post! It took literally decades to identify my illness (can’t afford a formal diagnosis right now), but now that it’s identified, I’m working on building a team. One of the struggles I face in therapy (as well as the rest of my life) is that I don’t assert myself well; my mother was so controlling that when I did assert myself, which usually went counter to her ideas, I was discounted or ignored. The only way I could survive was to be passive, and I find myself stuck in bad relationships because I so can’t say what I want. (Mom’s a retired therapist, which makes it even more difficult. Mom one demanded to see my therapist, “to work on our relationship.” Therapist wisely said “no.”)
My next session is tomorrow, and you’ve given me some strength to figure it all out. Thank you so much!
There are so many barriers to getting real help. I’m sorry for all that you’ve gone through. I tend to be very passive as well…in all aspects of my life. I avoid confrontation at ALL costs. I realized, though, that no one wants me to get better more than I do and that I needed to start advocating for myself. If I am to be an effective advocate, I need to be able to at least speak up for myself. It’s still tough sometimes and I still have severe anxiety before every doctor’s appointment, but I’m getting there. One step at a time.
I hope your appointment goes well tomorrow. You’ve got this. You are strong and amazing, I have no doubt that you will get this thing whipped!💜💜
This was a great & insightful read to those who are seeking professional help. keeping our mental health in check is so important & its great people are more willing to break the stigma of needing a therapist.
What a valuable post Amber!!
So beautifully articulated. It can take some searching to find the therapist that resonates well with you.. Because while they’re all well trained, they’re still ppl with their own personalities to take into account. Some you just won’t gel with, but for someone else they will be perfect!
Thanks for sharing this piece, it’s a gem!
It can be quite the journey to find the right provider, but once you do…it can also be so life-changing. I just encourage people to keep going and not give up. The right person is out there for them! Thank you so much for reading!
What a great post! When you wrote “they know medicine better than you, but you know you better than they do,” I felt that! There are so many barriers and things that stand in the way of going to therapy. It’s frustrating how difficult it is, but thank you for providing a blueprint for folks who haven’t been before. It’s also helpful for me, since I’m on yet another search for a therapist that works for me.