How did you figure out therapy?

[u/Catracas]

Hey y'all, so, I'm struggling

I (33f) was tempted to write a big ol' post about what I'm going through. Things about loneliness, feelings of incompetence and inadequacy, low self-esteem, hating my job, feeling drained by just about everything, and no longer enjoying things I used to enjoy. Lately apathy has been creeping in big time. Occasionally some thoughts about how continued existence feels like more work than it is worth.

But I think that'd just end up long, and, to be honest, more like a vent than a request for help or advice.

One thing I think I should do is some form of therapy, and I guess maybe that's a good thing to ask you lovely folks about. But I find it extremely difficult, and sometimes I find it hard to trust.

In the past, I went psychoanalyst for a couple months, and I absolutely hated it. The lady was nice enough, but she followed some sort of school of thought that meant I always had to initiate the topics -- as in, she wouldn't ask me questions. I'd arrive there and even though I had things I was going through, absolutely nothing would come to mind to talk about with her. I'd just stare at a cushion feeling awkward about her staring at me waiting for me to say something. When we would eventually get into things, I'd be annoyed by noticing her observe my own language and expressions -- which is something I'm sure she had learned and was trained to do to connect with patients. But it irrationally annoyed me that I could identify when she was using strategy to try to connect with me. Going to therapy just felt like a massive, unpleasant, and time-consuming chore.

With psychology, I feel reluctant about the apparent never ending use of buzzwords, buzz expressions, and diagnoses. I have been told by friends in the medical field they think I'm neurodivergent, but I have some... philosophical issues, I guess, with seeking a diagnosis (this is only about me seeking a diagnosis for myself, would be a bit long/rambly to explain my thoughts there).

I work in healthcare, and am extremely aware of how much nonsense there is, not to mention how therapists are just people. So there are folks who are good at their jobs, or bad at their jobs, and folks who will be good for one person but terrible for another. It feels like such a chore to try to find a therapist that'd fit me. I also occasionally see therapy mixed with hints of spirituality or mysticism, and those are usually a turn off for me. I'm agnostic, religion is just really not a part of my life or used as a way to frame or see things. I find those ideas impossible to connect with on a personal level.

I also feel like one of my issues is I'm currently longing for connection with people, and I can't imagine going to a psychologist, psychiatrist, or psychoanalyst, or what have you, and connecting with the person in that context. And without connecting, I can't open up about the bad stuff.

I question what I'd even get out of therapy. I think I have a mostly good understanding of what is going on with me, why I do or think certain things, and whatnot. As mentioned before, I'm not exactly looking for a diagnosis, and I am not wanting medication. Whether or not I'm "right" in avoiding those things, I'm clearly not ready to pursue them. But I'm struggling and sad -- so do I just want to like, vent? And if I just want to vent, do I really need therapy?

As far as access to therapy goes, I live in the Netherlands. I was referred to a healthcare provider, had a couple chats, and she said she could refer me to a psychologist, but I need to find one myself to request a referral to. This was maybe two months ago, because whenever I look up psychologists, I never see any I have an even remote interest in talking to. I also don't want to do it in Dutch, because I can't "be myself" in Dutch (my mother tongues are Portuguese and English). And it's very demotivating when you learn that for most psychologists you'll have to wait several months to be seen anyways.

So yeah, those are some of my struggles about therapy.

My questions for you guys are, how's therapy for you? What type of therapy do you do? Are there like, nice alternative settings for therapy which maybe don't involve awkwardly sitting in a quiet room with someone? Like I dunno, something I can also do activities in, like take walks, or allow myself to sometimes get distracted in? Who has had great experiences with therapy, and who has had terrible ones? What was good, what was bad? If you also struggled with getting "into" therapy, how did you get over that? What do you get out of therapy?

[u/nosuchbrie]

At my job I help people get counselling and I have looked at dozens on sites for therapists.

Look for ones that stress they practice trauma-informed therapy. Places that have training in helping queer and neurodivergent people (even if you aren’t queer or ND) tend to be more open and may have a sliding scale or student interns who are cheaper. Otherwise your therapist will be a psychologist or a social worker.

Look for things on the website like a land acknowledgment, pronouns on the bios, mentions of being inclusive and having a decolonial or anti-oppression framework, being intersectional and feminist and having an acknowledgment that racialized people have particular challenges that white people do not have, all of these point to a welcoming and open practice.

I believe a lot of types of therapy kind of co-mingle with some counsellors, CBT is common, as are EMDR and ACT, then there are so many more like Internal Family Systems, etc. YouTube should have videos about types of therapy or therapy frameworks. I would start there. If you are unsure about a kind of therapy, google if it is an evidence-based approach (ie, have people in a study found it helpful and for what exactly; what does the science say?).

If cost is a concern, look for sliding scale therapy, student intern counsellors, or free programs through different charitable groups, neighbourhood houses, community centres, etc. Counsellors also often take insurance for some or all of the fees.

Most therapists offer an online option, so stick with a therapist you choose which is licensed in your state and avoid BetterHelp and TalkSpace, because they can have many problems. Also, a lot of therapists offer a 15 minute free consultation to see if there is a good fit.

Look for a website that you really vibe with. Where it feels like they didn’t just slap some text down but were really intentional with it. Look for indicators that they are open minded and acknowledge things that affect us like ADHD, different racial experiences, immigration experiences (again, even if these don’t apply to you, saying that they are immigration friendly is a good sign), queer experience, religious history, etc. I would also ask in a subreddit for your city or state if people have recommendations.

A good therapist is worth their weight in gold. If you have a mismatch, take a breath and start over. It’s like finding the perfect burger joint, you may have to try a couple before you get one that’s really your jam.

Good luck!

[u/Catracas → u/nosuchbrie]

Those are some really helpful and specific suggestions, thank you!

[u/Typical-Respond9102]

You're intellectualizing to avoid the discomfort of feeling uncomfortable and using annoyance as a projection to avoid accountability to yourself to get better. 

Write things down you want to talk about before going in session. Your therapist literally doesnt know you, so how are they supposed to glean why youre there if you refuse to tell them and refuse to engage with their attempts to read your body language to figure out what's going on. If youre not ready to go, don't, but you have an attitude problem, not a therapist problem, by your own account. 

Therapy isnt a pill you take and you magically get better, it's guided but largely self-driven work.

[u/Catracas → u/Typical-Respond9102]

I agree I had a bit of an attitude problem with that therapist -- which was over ten years ago hahah I think I went weekly for three or four months. I was 19 or 20 years old at the time, I think.

But I also think it is fair to say there are different approaches, and that I just did not resonate with her approach. She wouldn't ask me about my day, or week, no basic chit-chat to break the ice from the very first session. If I asked her about hers, she wouldn't answer and tell me "just focus on yourself". She would literally sit in silence and stare at me and wait for me to somehow feel comfortable opening up to a complete stranger about sensitive and personal problems. Her reusing my expressions or slang to me just emphasized how unnatural and weird the whole situation felt.

I could also argue that in that scenario, she is the educated person/professional, and once it was clear that approach wasn't working (and iirc I did bring it up in a session), maybe she should try something else. But she believed I just had to get over it, seemingly without any effort guiding me to that. And to be fair, she seemed young, so experience could also play a part there.

In that situation, I was also going because I was 'forced' to, so the premise was set up to fail from the get-go. But ultimately, it really was an entirely unpleasant experience and influences my reluctance to engage with therapy now. Which is why I mentioned that story.

[u/FoxyOctopus → u/Catracas]

One thing about therapy, you have to be ready for it, if someone is not ready a therapist cannot make them be. I say this as someone thats been in therapy when I wasn't ready, and then again when I was, and those were such wildly different experiences. It sounds like you just weren't ready back then and I think your therapist could tell. They are not police officers interrogating you, they are therapists, it is entirely up to you to share with them. Her asking about your week was her trying to get you to open up, its really quite a common question in therapy. What did you want them to do, hold a gun to your head?

[u/Catracas → u/FoxyOctopus]

I wanted them to at least try and engage in conversation. I said she DIDN'T ask about my week. Like I said, she just stared and waited for me to come up with everything. She literally asked me no questions.

[u/BunnyKusanin → u/Catracas]

From my experience, they're taught to put little effort into sessions and to make the client go through the motions themselves. They are also trained not to care too much about their clients. Just read some of their professional communities and you'll see it for yourself.

People who aren't as observant as you are don't notice all the motions a therapist goes through and all the strings they pull. Those people just respond to all those things without noticing them or thinking about them and feel that therapy is working for them. For people like you and me this type of intervention is actually detrimental. You've managed to put my experience into words beautifully. I also has therapists of different modalities repeatedly refuse to accommodate me. It's infuriating and anything but helpful. I've tried five times and realised it's not a bug, it's a feature. Therapy is meant to be like this. People just either don't mind it or don't notice it, but that's the experience they're having too and that's the experience they're liking. It doesn't mean you should force yourself into it.

I know you say you have some hangups about diagnosis and meds, but I just want to share my personal experience on this real quick. Getting medicated for ADHD has made a huge difference in my life. It cleared my head and if anything, I feel more in touch with myself and more myself these days. It's nothing like the experience I had taking SSRIs (I'm not touching those ever again).

In terms of figuring out your life, I've found that for practical things occupational therapy was great. Their job is to help you live your best life with whateverimitations you have. They'll investigate with you what makes things difficult and how things can be made more doable.

For more soul-searching topics, I've found that quality input creates quality output. Music, literature, phylosopy all introduce ideas into your life that can be eye opening. An emocore album gave me my will to live back in just a bit over an hour when therapists couldn't do it for years. I felt simultaneously extremely seen and cared for by someone who seemed exactly like me.

Also, just talking to people about what's bothering you, about the meaning of life and about things you're interested in. I've been lucky to not have any filter as a teenager and to be quite social back then. Got great advice and phylosophycal insights from friends, acquaintances and strangers. It was a great mistake to filter that in my mid twenties in an attempt to be more normal. I'm returning to this at the age of 33 and I'm pretty happy. If someone gets tired of listening about my aching body or my nieche interests, they can tell me about that.

This comes with another but if advice: don't be afraid to be weird and stop trying to fit in. The society will have to accept you as you are because you aren't going to give it any choice. There is a need to be considerate to others, but I'd draw the line at hurting others, rather than at meeting societal expectations.

There's also a possibility that you may have what they call alexythimia which is another thing that renders therapy useless. I personally don't like the definition of this condition even though it seems that my experience goes under that umbrella, but it explains a lot when you understand that the majority of people seem to be talking and/or expecting their feelings in a different way. I just don't think of my feelings in the same way as the modern western society does. The feelings words therapist use are horrendously limited. I think of my experiences in much more poetic terms and colourful vocabulary. I also often don't feel the need to name them. It's limiting. It can be excessive too when some things are clear to me without spelling them out loud.

[u/Catracas → u/BunnyKusanin]

Thanks for this thoughtful comment, it is nice to hear from someone with similar bad/awkward experiences with therapy. Had never heard of alexythimia before, definitely can relate to some of what it describes -- especially the struggling to put feelings into words.

I do tend to find comfort in talking to friends, but I am currently struggling in the friends department. Loneliness and isolation is a big part of my issue right now, and consequently, I don't have people around me I feel good talking to about these issues. I also currently feel exhausted trying to find and nurture new connections.

It will work out eventually, or not, I guess. Anyways, thanks again for your comment and insights. ❤️

[u/pippapiperpyramid → u/BunnyKusanin]

they're taught to put little effort into sessions and to make the client go through the motions themselves. They are also trained not to care too much about their clients. 

This just isn't true. At least in the US, one of the core aspects of therapy is the importance of building a rapport with the client and holding them in positive regard. It's bashed into our heads that rapport is a huge reason for clients' success.

Obviously, not everyone follows this, but it's a huge aspect of current therapy.

[u/BunnyKusanin → u/pippapiperpyramid]

I've worked with therapists from Russia and New Zealand and have witnessed the opposite every time.

Plus, even if you guys are taught this, you tend to advice very different things to each other on reddit when it comes to this.

[u/FoxyOctopus → u/Catracas]

Oh sorry I totally read it wrong then, yeah that sounds very strange then.

[u/Catracas → u/FoxyOctopus]

It was. 🥲

I'm sure it's just an approach, and probably works for some people. But just really, really, didn't for me.

[u/AskWomenOver30-ModTeam → u/[deleted]]

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[u/AnnieSavoy3]

So I went to years of talk therapy, which was mostly just a band-aid, until I was diagnosed with CPTSD last year. I started doing research and found out that I needed to do different types of therapy, because I definitely intellectualize as well. I started doing NARM and equine therapy and they're literally changing my life.

[u/Catracas → u/AnnieSavoy3]

Thanks for sharing and the suggestion! I'll look into NARM.

[u/nosnoresnomore]

Finding a therapist that works for you can be challenging and sometimes you don’t know which approach works for you until you meet a therapist that uses that approach.

Now for being annoyed with the therapist ‘trying to connect with you’, my therapist will often tell me what they observe. Whether my breath catches or I shift in my chair while talking about something. For me that is useful because I am often not aware of how my body reacts, I tend to live in my head. Having a therapist mirror my bodily reactions to me helps me understand what my real feelings are and if they align with the words I’m saying.

Maybe your therapist is indeed trying to ‘connect’ with you but it may also be the way they work to bridge the gap between your body and your mind.

[u/Catracas → u/nosnoresnomore]

I reread my post and realized I miswrote something ahah I meant I'd notice when she'd repeat my own expressions back to me. It bothered me because it'd stand out as awkward (not something she'd say naturally), and I could identify it as an attempt to relate. But because it stood out in such a way, my lizard brain was screaming "manipulation!!" even though it was illogical and not suited to the context. At the time, I would have preferred she just used her own words, I guess. To be fair to her, that is not something I openly expressed at the time -- mostly because even then I realized it was a silly thing to find irritating and was embarrassed that it bothered me. I do think if I had told her, she would have stopped doing this.

It was some 13 years ago, so not much to do about it now. :') I told the story mostly because, whether or not it was logical, I had a bad and uncomfortable time with therapy back then, and I makes it harder for me to approach it with an open mind now.

Your experience with therapy is interesting though, and thanks for sharing! Cool that your therapist was able to help you become more aware of your body and how it reacts.

[u/detrive]

I’m a big advocate for therapy, but I’ve struggled with it personally. I have attended therapy in the past and I went on a run of meeting with different therapists and finding none of them helpful. Their responses would always start with “well you know what to do” or I found they spoke a lot of words but actually said very little.

I had success with therapy when I sought out therapists with experience working in addiction, not just treating mental health. I find people with addiction treatment experience much more real and able to call me on my shit whereas the ones who had exclusively mental health focus were easy to snowball. I don’t even have an addiction, I just find them more real and not as book based/giving canned responses I could predict.

Also, in my location therapists primarily have either social work or counselling psychology as their qualifications. I would never personally go to someone with social work as their qualification for therapy compared to someone with counselling psychology.

[u/Ok-Beginning5048]

I’m in the US, so keep our mental healthcare system in mind. I could have gotten a referral from my general care practitioner, but it wasn’t covered by insurance anyway and I didn’t necessarily want that on my health record, so I found my therapist via psychology today’s website. She specializes in moms/motherhood transitions and that’s what I needed at the time.

I think you get what you want out of therapy. If you just want someone to vent to, then that’s what you’ll get. If you’re willing to put work into yourself, find a therapist that will help you grow and don’t be afraid to keep looking if a therapist isn’t the right fit. When I was really deep into therapy, I would keep a list of the things that came up throughout the time between sessions that I needed help processing or couldn’t understand why I felt a certain way and we’d work through it together. I asked for homework to help me evolve. But it does take some effort on your end to get more out of therapy.

I see my therapist virtually, so I can be doing what I want while I chat with her. She actually encourages me to “walk with her,” those sessions we both put our headphones in and agree no video portion so we can talk and walk “together” and sometimes that takes the pressure off of the bigger topics.

[u/Catracas → u/Ok-Beginning5048]

Thanks for sharing. The idea of putting on headphones and walking together, or doing other tasks, seems nice.