"Therapist"

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Had my second session with "therapist" today. First was about 6 months ago then he went on sick leave for months. I waited in line for 2 years before getting to see him.

This session was as bad as the first - him saying he was not sure if he could work with me.

He's asking for "motivation" - despite my deep depression. "Motivation"? - I can barely get out of bed.

And he's asking for desire for change - despite me saying that I am change resistant and scared of change; probably because of autism.

He asks for "commitment", despite offering an unsafe environment.

I told him he is not offering a safe environment, I don't trust him, and that therapy should be about me - not him.

This is going nowhere fast. I get this a lot: mental health professionals who don't want to work with me cos I am presenting with the wrong kind of problem. I feel like someone going to an oncologist and being sent away cos they have the wrong kind of cancer.

Some mental health professionals are deeply lazy egoists.

Ask him for a referral to someone who is willing to help. You need help, and your motivation right now is just to survive. You can't worry about all that other crap when you aren't even sure if you'll be able to force yourself to do basic care taking things like eating and getting dressed that day. If he won't help you then he needs to get you to someone who will.

I'd say just bail and get someone else, but sometimes the situation doesn't allow that. If he's the provider dictated by insurance or the health plan or whatever then you just need him for the note in your file that says referred to a specialist. A referral should get you to someone else sooner than two years, hopefully. And if you're lucky, they'll be better able to help you.

Good luck and stay safe.

I've tried making this point to him but it's like talking to a brick wall.

I'm thinking he's a one trick pony with a very limited set of skills/tools, and he is only looking for clients that match his skill set.

Re-referral is not an option. This is Wales UK NHS mental health services and provision is dire. Decent people round here charge 40GBP - 62 dollars - an hour and I live on 100GBP a week.

He wants another few sessions of "assessment", and I don't reckon I have the emotional energy for that.
Current thought is to keep the next appt and demand he step up or walk. And if he walks I'll find someone higher up the food chain to report him to for unprofessional incompetence.

It really is a shame that decent therapy comes with a premium price tag attached to it, and that most government-funded insurance plans look upon it as being non-essential and not worth covering.

I pay $140 a week for my therapy. Medicare won't touch it. And I live off around $1,800 a month. And my rent is $700 - the price I pay for living alone. You get the picture.

There are decent therapists out there (I go to one of them myself), and it is a damn shame that healthcare systems around the world limit access to them due to the false belief that talk therapy is not a necessity for many people.

For the record, my therapist is also trying to get me to embrace the spiritual void in my life instead of throwing addictions at it. Sounds like I could hire you.

I'm pretty sure we could arrange something that worked out at less than $140 a week

And I have no real problem with addictions in moderation...

Currently I put 2 litres of cider a night down my neck. My "therapist" obsessed about that a bit in our first session, and brought it up a couple of times today.

Some therapists seem to think that their 1 hour a week is transformational, disregarding the fact that the rest of the week is about coping alone.

Yeah, my therapist knows that one hour a week is not enough for anybody. Which is why he gives me a lot of homework. He has been encouraging me to seek out volunteer work to help get me outside of my own head. Never really did much of that before, but I would rather take a risk than remain stagnant in depression, and my therapist caught on to that. The one thing I do not want in my life more of the same, because I am highly discontent in my life. The void will always be there, but that does not mean that I cannot kick things up a few notches to make things interesting. I think the combination of boredom and a spiritual void is something that nobody really needs.

Sounds like the therapist is using CBT, which isn't going to help one iota with depression. Ask him for a referral to a psychiatrist.

That's a good point - I've not asked him what he is offering. He asks me what I want and I tell him and he waffles and deflects.

I bet you're right - he's a one trick pony CBT monkey. I'll find out next time and then walk.

Already have a psychiatrist - he's empathetic, respectful, and good. But he doesn't do therapy - he's just a pill pusher.

Bad psychiatrists are pill pushers. Good psychiatrists talk about alternate routes along with the possibility that pills may help. My psychiatrist successfully pimped me into the world of 12-step recovery, and I thank him for that. He did suggest the possibility of using Anabuse, but I told him that I wanted to beat alcoholism without the use of drugs, and he respected that.

I think the best thing to remember is that psychiatrists and therapists are human. They have their own issues. Nobody is perfect, but perfect matches can be made between doctors and patients. If one doesn't work, try another if you can, and feel no shame about it.