Let's talk about therapy. and therapists.
One of the hardest things about a mental illness is recognizing the problem. Once that is done, the next step is figuring out what to do about it. Depression has a way of making you avoid all of the things that would actually help: exercise, eating healthy, drinking water, socializing, taking care of yourself, and especially getting therapy.
Once you make the decision to finally ask for help, it can be overwhelming to know where to go to find it. Anyone who has had to try to find a new doctor knows how impossible that task is. Finding a therapist can be just as difficult, but harder to overcome because you often don't have the mental capacity to complete the task when it gets hard.
How do I find a therapist? Where do I go? Will insurance pay for it? Do I go in person? Do I try online? How do I find the right therapist? How much will it cost? Will they like me? Will I like them? What if they can't help me? What if I don't have the right kind of depression? What if I'm not depressed, but I'm just lazy? I don't even know if therapy will really help.
This is not a paid advertisement for any particular service. I can only discuss the one I actually use, but my Facebook ads tell me there are many options, both in person and online. There are lots of options that have different formats, different payment options and different services. Everyone should find the service that works for them because we are all different. My mom still doesn't understand how my therapy could be effective without sitting in the same room as the therapist.
I ended up decided to try BetterHelp. There were two really important factors that led me to go down this path: 1. live chat sessions and 2. counselor matching.
I am very uncomfortable sharing my feelings and being vulnerable with live human people. I usually prefer to deflect those feelings with jokes. I don't really always know how to deal with people's feelings, and I definitely don't want them to see me cry. So having a chat option for live sessions was a huge draw for me. I am significantly more comfortable putting my thoughts and feelings into writing, where I can choose the words carefully and make sure I am expressing myself clearly and accurately. Having the person in the same room as me would make it much more difficult for me to express my true feelings.
I know that having the right counselor for the right person is hugely important (more on this later). You need to feel safe with that person so you can be authentic and share the things you don't want anyone else to know about you. But I also don't really know what to look for to decide whether they fit. How do I know what type of counselor, what specialty to look for? Where do I go to find that person if I do know what to look for? BetterHelp matches you with a counselor based on your answers to several questions, including your preferences (gender, faith-based, a specific type of counseling) and your needs (specific issues such as LGBTQ+ issues, marriage/family counseling, depression, anxiety, etc.) and some other items like location, as the counselor needs to be licensed in your state. But, it is also very easy to change counselors if the matching system doesn't get it right the first time.
Plus it is advertised on all the podcasts I listen to, so it must be good, right? Right?
I signed up for BetterHelp, filled out all the questions and was ready to go. So, of course, I panicked, decided therapy wasn't for me, and closed the browser. A full week later, I mustered up some courage, logged in and pushed the button before I could change my mind again. Once I pulled the trigger, I became very excited because I was finally doing something about my problems. It felt great to actually do something.
It took a little less than 24 hours to get matched with my counselor, who I will call Julie (not her real name). Julie reached out and requested some information from me and we scheduled our first session. BetterHelp lets you message the counselor as much as you want in between your sessions, and Julie would respond within 24 hours to my messages, so we started talking about what was going on. I was so excited. My session was in just a few days and Julie was going to fix me!
One of the things that you will hear repeatedly when you google what to expect in a first therapy session is that therapy is effective, but it often makes people feel worse before they feel better. Even knowing that ahead of time did not prepare me for what actually transpired.
The day arrived and Julie and I had a thirty minute live chat session. The session was very fact based and Julie asked lots of questions about my family, about my daily routine, etc. But she did not ask about my feelings or about what I wanted to talk about or work on. After it was done, I felt like we hadn't really accomplished anything and I was disappointed. I had worked my hopes up that this would finally help, and it felt like we barely scratched the surface on my struggles.
This is where my anxiety kicked in. "I don't think Julie likes me. Julie can't help me. I'm too depressed. I'm not depressed enough. This is going to take forever if the sessions are all like this. I should give up." I worked myself into a full-blown anxiety attack at work that day after my session. I had a fight-flight-freeze response. I felt an overwhelming urge to simultaneously hide under the desk and run out of the building. Since it is impossible to both at the same time, I tried each in turn. Hiding under the desk does not help at all. Leaving the building helped a little, but I think that had more to do with walking than with actually addressing the problem.
Now, I'm no expert at therapy, but my understanding was that you should be honest with your therapist about how you are feeling. So, I decided I should tell Julie how I felt after our session and to let her know about my anxiety symptoms. I sent her a message explaining that I was not criticizing her and that I appreciated her time, but that I was feeling disappointed about our session. I was very clear that I thought my disappointed was a result of my expectations being too high and that I was looking for help adjusting those expectations. Then I started typing a message explaining the anxiety I was currently experiencing. As I was typing that message, a notification popped up saying our next session was cancelled. I was confused by that and starting trying to figure out what I had done wrong, when a message from Julie popped up that said, "Kim, I think my style of counseling is not a good fit for you, so I am cancelling our session and sending you to another counselor." And then everything disappeared. Julie was gone. I didn't even get a chance to respond before she sent me on my way. It was devastating.
I have some abandonment issues that predate all of this, and I am always seeking approval from authority figures. Add that to the anxiety attack I was experiencing as this happened, and I felt terrible. I thought I was being brave to share my honest feelings with someone who was supposed to be safe, and this felt like a retaliation for those feelings. It felt like a punishment for being honest with my therapist.
Looking back now, Julie was correct. Her "style of counseling" was not a good fit for me. I'm grateful that it happened quickly so I didn't waste time with her. However, the way she did it feels very inappropriate. She didn't even check to make sure I was ok before she cut me off. Julie was not safe.
At that moment, I almost gave up. But I had already paid for a month of service, so I went back into the match pool. There is an opportunity to tell the potential new counselors about you while you wait to be matched again. I expressed my dismay at what had just happened. I was matched with a new counselor, who I will call Liz (not her real name). Liz reached out to me immediately (within 2 hours after Julie fired me) and expressed that she was sorry I had a bad experience with Julie. She obviously had no idea any of the context, so I explained what happened and how it felt, almost exactly how I described it above.
Liz was very kind and helpful that day. She helped me to adjust my expectations for therapy. She told me that it wasn't a quick fix and that it would take work, but that she thought she could help me and that things would get better. She explained that I didn't become depressed overnight, that I had been working on my depression for possibly years and that it would take more than a few weeks to reverse all that work and that I would need to work hard and be patient. She promised that she wouldn't fire me for telling her how I felt, but that she would always be honest with me.
Liz is still my therapist now. She is always kind and validating. She pushes me to work on the things I need, but she is patient and reassuring when I get overwhelmed. She hasn't fixed me, but she did give me tools to ground myself when I feel anxiety and to redirect my thoughts when I head down depression boulevard.
She tells me it really will get better when I feel like giving up and she tells me she is proud of me when I make progress. She can treat me with empathy, because she has been where I am and she knows the way out. Our sessions always feel productive.
One of the most helpful things Liz does is to clearly define expectations. She reiterates every week how scheduling sessions work on her calendar, what she expects from me, and what we can expect from her. She tells us she responds to messages twice a day, once in the morning and once in the afternoon, so I don't have to assume she suddenly hates me when I haven't heard anything. Her availability is clear.
Liz is safe.
Therapy is hard. and confusing. and frustrating. And it is a miracle. It has made a huge difference in my life and I am so grateful I was able to find Liz and start on a journey that will get me back to where I want to be. I'm not done, but I've come a long way so far. I see the light at the end of the tunnel. I am grateful to BetterHelp because it was a manageable way for me to find help. I don't think I could have taken that step in person.
Ultimately, the format or platform has to be the right one for you. Some people need the human contact of an in person session or the audio and visual cues of a phone session or live session. Whatever works best for you is the one you should seek out.
And we have work to do on breaking down the stigma of mental illness and the barriers to getting help, especially the financial barriers. I don't have the solutions, but I hope there are things we can all do to make it easier for people to get the help they need. Because we all need help sometimes.
If you have questions about therapy or my experience, let me know in the comments. Not everyone is comfortable sharing their therapy journey in public, and that is totally fine. Its a personal, private experience and no one need share if they are not comfortable doing so. I just hope sharing my experience can help someone else feel a tiny bit more comfortable reaching out for the help they need.
thanks for reading.