When Therapy Doesn’t Work

I’m a firm believer that therapy has helped me a lot. It has helped me understand things about myself I didn’t know before. It has helped me move on and get closure from trauma. It has also been a space for me to be able to express all of my frustrations (without bringing down everyone else in my life). I have learned the so-called “tools” in therapy to help me cope with anxiety and bipolar episodes as well. In fact, I often suggest to people dealing with any issue they find to be overwhelming (not just mental illness) that they see a counselor or therapist to talk about it. Something about talking about our problems out loud helps us understand them better, so overall I think it is a win-win situation.

While all that sounds great (and it is all true), finding a therapist who is a good fit can be challenging. On more than one occasion I’ve found myself in a position where the benefits I was receiving from therapy was being outweighed by negative parts of the experience.

In the past I’ve had issues with the attitudes of therapists, whether that was from being aggressive (which was a turn-off for me), or being too passive (not seeming to care about my issues). I’ve had issues with therapists who had conflicting viewpoints from me (though rarely). I’ve had issues with therapists who didn’t know enough about the issues I was dealing with to provide a well-educated viewpoint.

The one issue I have had with therapists that I consider a hands-down deal-breaker is disorganization.

As someone who lives with Bipolar Disorder, OCD, and Anxiety, there is a certain level of reliability that I require from my health care providers. That includes my primary doctor, my prescribing psychiatrist, and my counselor or therapist. There are times where my condition requires emergency treatment, and I need to be able to rely on my team to get the help I need.

I always feel that I am in a constant state of reminding people that they should expect quality treatment from their doctors, therapists being no exception to the rule. You wouldn’t believe how many people I know who continue to see and pay therapists who do not act respectful to them, who don’t call them back in a timely manner, or who make them feel worse after a session than when they came in. Essentially, this is a situation where you are paying someone to provide support to you… if they aren’t doing that, what is the point?

The difficulty comes in finding the right match, and that many therapists have continued to have paying patients despite providing poor care. If people seeking out therapists aren’t demanding great service, how can we expect to find that great service without creating that demand?

At the same time, I understand that therapists are human. They’re human! Some of them have even gotten into their current field because of their experiences with depression or mental illness in their own lives, which I think is awesome. This is one of the reasons why I think there is a certain level of negotiation you can turn to when it comes to interacting with a therapist.

I’ve been having trouble with my most recent therapist since I began seeing her. I knew part of it was because I liked the one before her so much and we’d worked so well together, so when I reached the point where I was having trouble connecting with her (the new one), we talked about it. Since then I found she was much more attentive and empathetic to what I was saying, which really helped me feel more at ease.

Over the last year and a half, we’ve had ups and downs. For a while she was rarely on time, but began showing an active interest in fixing that, so I let it go.

What I can’t let go, however, was last week’s Lithium emergency. She told me on Tuesday she would contact my (potential) future psychiatrist about a prescription, and then never called me back. She also seemed wildly cavalier about the notion that I would suddenly be unmedicated… which is a big red flag for me. If one of the people on my healthcare team doesn’t care when I am experiencing an emergency, I know I need to shift that position to someone who will. Even giving her the benefit of the doubt (she could have been busy?) I would rather work with someone who has the time to help me.

Six months ago I was worried sick about the prospect of changing therapists, but now I think it is necessary. I am only hoping the clinic will allow me to switch to another person there, instead of having to reach out to other clinics in the area.

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10 responses to “When Therapy Doesn’t Work

  1. I went though a lot of therapists before I found mine. He is a LCSW at the local mental hospital and does therapy on the side. He understands bipolar because he deals with it every day. I always suggest therapist who has worked with bipolar patients. They get it.

  2. What stuck me immediately is that I was unaware that you have both Bipolar and OCD.. I too suffer from both, as well as GAD which I guess is a given. I had to look at your ABOUT to see where you lived, because it seems that overall you have a good team working with you. I have a HORRIBLE experience out here on the east coast. Been through countless doctors and therapists because of exactly what you mentioned. Their seeming to be “cavalier” (your words) regarding the brevity of the situation at times. Even the doctor I have now, I’m calling over and over as meds start to run out, and as you know, there are withdrawal symptoms to much of what we take. It’s horrible, and not something we should need worry about. Currently, I’m not with a therapist, but am with a psychiatrist, and not having much luck. It’s a long and dramatic story, that I’ll spare you 😉

  3. Nice post on the experiences with therapy for anxiety 🙂

  4. I’ve been having psychoanalytic psychotherapy for the past 6 and a half years (eek!) and in that time I’ve had two therapists. It took a long time to build up a relationship with both of them (the second in particular and I suspect it had a lot to do with her not being the first one) but that was part of the therapeutic process. There is a difference between working through relationship dynamics (helpful) and a therapist not performing their duties or being unreliable. Your desire to change therapists comes from her unacceptable behaviour, a healthy motivation for change as it shows you are recognising your right to appropriate care. I hope you can find a new therapist who can provide you with what you deserve.

  5. As someone who lives with bipolar disorder and who has an MA in psychology, I know that many master’s level programs do not prepare therapists to work with psychiatric patients. Therapists need better education in psychiatric illnesses, including the importance of medication management. Some of the best therapists for those of us living with mental illness are psychotherapists who have trained with a multidisciplinary treatment team with a psychiatrist, psychologist, social worker, and family systems therapist. Sounds like your therapist needs a reminder of the importance of uninterrupted medication for the maintenance of psychiatric stability.

  6. I have worked in the psychiatric field for 15 years so I am a horrible patient. I usually know when the person isn’t as good as me. I ask for a new therapist when this happens.

  7. I have nominated you for the Very Inspiring Blogger Award. Check it out here: http://stressesanddresses.com/2014/05/21/very-inspiring-blogger-award/

  8. Pingback: A Bittersweet Return to Psychiatry | bi[polar] curious

  9. I’m sorry to posit something negative, but here it is. Do Bipolar patients, many of whom have experienced childhood abuse, get that much better from therapy? Sometimes I just want to give it up. It seems it’s just a crutch for momentary crises. Right now, I am so disappointed in myself and my life. I acknowledge therapy helps sometimes, but should we go our whole lives? It doesn’t seem so helpful really. I know friends whose therapists are telling them the right thing to do, yet they keep choosing the easy thing for years. I’m betting I do the same. I sometimes see why my depressed brother is still so angry at my father. What is done is so hard to undo. Is it possible to have even a halfway normal life. My psychiatrist makes it sound like having BP ll, which most Bipolar people have, is not so hard to handle. Maybe the emotional abuse on top of it makes it unbearable sometimes? I know (literally) some of the dopiest people, making good money. I’m living like a fool making a pittance. All of this comes from stigma. Being told you’re damaged goods does little for self-esteem. I am 50, and in therapy with different people since I’m 22.

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