“Our identities are built on the stories told about us and that we tell about ourselves and experiences. And healing comes from re-storying our self-narratives and importantly, also, from sharing them: We need our stories to be witnessed in order to heal.” -Dr. Lydia P. Ogden
The single most important thing I’ve ever done is embrace therapy. It’s not only been a lifesaver in times of crisis, but over the years, I’ve developed a tool kit that is useful in every situation. Do I always use those tools? No. I don't always remember, and sometimes I choose not to. But I have a robust varied toolkit just the same, and it has saved me over and over, time and again.
Are my problems solved in therapy? Well, that’s an interesting question. No, not really. Breakthroughs sometimes happen during a session, but mostly there’s so much to consider, to ponder after a session. That’s usually when things get really clear and really real.
Furthermore, I suffer from Bipolar I – and I mean I suffer. Mental illness is a chronic lifetime condition that can be managed through therapy, drugs, and constant attention to one’s mental and physical health, but it is incurable. Some may say avoiding triggering people and situations is helpful, and that does work sometimes. But triggering people and triggering events don’t usually announce themselves in advance, they ambush you. When that happens, it’s critical to have that tool kit ready to go – that tool kit that you build in therapy.
Therapist shopping abso-fucking-lutely SUCKS. For a number of reasons. First, there is an incredible shortage of licensed mental health clinicians – and that’s been my experience in big cities and rural areas. The need for mental health services is at crisis level, there simply aren’t enough services available to those who need them. I moved to Portland a year ago and struggled to find a therapist. I went through the Psychology Today website twice, sending out – I’m estimating – 50 email inquiries each time. And then the return emails started coming in: NO, NO, NO, NO, NO, NO, and that’s only from those who opted to respond. Either they weren’t taking new patients because they were already at or over capacity, or they didn’t take my insurance. Often, both. I email yelled at a few of them to keep their fucking profiles updated on Psychology Today. I explained how DEVASTATING it is to not be able to find a therapist and to have those denials start rolling in ("denials" is a good descriptor – so is "rejections"). I even wrote on my inquires “If you aren’t taking new patients or you aren’t contracted with my insurance DO NOT EMAIL ME BACK.” I still got a ton of rejection emails. It absolutely SUCKED.
One day, after a few months had passed and I decided I was mentally stable enough to try again, I happened upon Portland State University Counseling Services. I was rather overjoyed, to say the least. I’d have to work with someone new each school year, but hell, I could deal with that. I don’t go to therapy because I’m trying to resolve a short-term issue. I’m way beyond that level of care. I have an ongoing, long-term need for therapy. It keeps me on track, there’s an accountability factor to it, although I’ve never had a therapist shame me for being inconsistent. But therapy works for me, so I’m usually very consistent. They also accept payment on a sliding scale. I thought I’d have to submit paperwork to determine what I would be charged, but much to my surprise, they take what you are comfortable paying based on your own assessment of your income. Because I was able to set that rate at a comfortable amount for me, I’m able to pay every week. I don’t have to worry about not being able to get therapy because I can’t afford it, and I don’t have to worry about racking up a bill. They also don’t bill insurance, so there’s no danger of those “Surprise! Your claim is DENIED!” situations. I asked to work with an older woman, if possible, although I am flexible. I don’t think that someone is necessarily more effective because they’re older in age, and I don’t think someone is necessarily less effective because they aren’t familiar with my particular flavor of trauma. They matched me with a woman in her 50s who is pursuing a second career. It’s been very helpful; we’re a good match. It’s very comforting to know that I’ll be checking in with someone on a weekly basis who is as invested in my mental health as I am.
What is it about a therapist that makes therapy effective? I've been asked this so many times and I've thought a lot about it. A good therapist will ask you questions until you get to the heart of the matter, until you identify the root of the issue that is causing you distress. They don’t give advice, but instead, they partner with you, asking you questions to help you peel away the layers of protection that really aren’t protecting you at all. As you work with your therapist to identify those assumptions you’ve made about yourself, your life, and the world that are hampering your growth, the realization you can view yourself in a different light gets you unstuck.
The greatest benefit of therapy is how it facilitates your ability to develop a clear sense of who you are. Self-awareness is important to quality of life, in fact, I believe it is the key. Self-awareness means you’re aware of the things about yourself that aren’t working for you. Yet, instead of self-shaming, you embrace who you are - all of who you are - the good, the bad, and everything in between. And that is SO HARD. There are so many things I’ve accomplished, so many important ways I’ve improved in how I view and treat myself and how I approach living. But there are some areas I really really do not like. They’re not really blind spots, because I am acutely aware of them. But they are areas that I haven’t been able to get on top of. One of them is my weight. More on that later.
Personal growth cannot be rushed. You can wish the things you don’t like about yourself away, but they don’t go away that easily. It takes diligent, persistent, dogged determination to make the changes you want to make. It’s difficult not to self-shame when you don’t feel you’re making the progress you need to make. The thing is, there is no set timeline to wellness. Furthermore, there is no one standing over you keeping score – especially not your therapist. (If they are, FIRE THEM IMMEDIATELY!) There is no one who is waiting to bash you over the head if you don’t reach a specific milestone according to an arbitrary timeline. I say, “arbitrary timeline”, because it is YOU who sets that timeline. Goals are yours to set, timelines are yours to fix and control. As you learn and grow, as your self-awareness expands, flexibility is critical. You must be willing and able to alter your goals and timelines to fit with the person you are becoming.
The bottom line is, only you can systematically address those things about yourself you want to change. Others may have opinions, but you get to decide how much of that information you want to take in and make useful to your situation, and how much you want to ignore or discard. And that's true even about your therapist! No one knows what’s best for you except you. It may take time for you to trust that fact about yourself, but it is indeed a fact. It’s your life. Don’t give your power away. Claim your power. Own your power.