I’m a fan of therapy. I’ve found it useful from time to time. Some people I’ve met during my life’s journey have been perpetual attendees of therapists offices. And, if that’s what they need to cope, then I’m not going to judge — we all do what we can to help make sense of our lives.
I, however, am not an eternal therapy patient. I’m a Use It When I Need It kind of guy.
My first experience with a therapist, a psychologist, was when I was fourteen, and I told my mother I thought I was gay. It was a week or so later that I found myself in therapy. The first session was a joint session, mom and I, talking to the doctor. My memory of that session is mostly of my mom talking about how I needed help to understand that I wasn’t gay, that it was just a phase, and that it had nothing to do with her being a domineering mother — she wanted my gayness to not be real, and, more importantly, to not be her fault. To his credit, and something I didn’t realize until much, much later, the doctor, Dr. Graham, never did try to cure me of The Gay. I remember talking about it once, early on, but, after that, it never came up again. In fact, after a few months, I stopped seeing him, because I was mad at him: I was mad because he didn’t want to help me not be gay. It wasn’t until I was older that it occurred to me that he had been trying to help me accept myself for who I was.
Over the years, I’ve seen a few different psychologists and psychiatrists, even a few social workers, one of whom, Leah, I’m particularly thankful to have seen. All the hours, all the talking, all the listening, all the sharing have helped me through rough times, through grief, and, most importantly, they’ve anchored me when I’ve been at my most depressed and despondent.
Yet, the world of mental health professionals is not always an easy world to navigate. People who’ve never had a need for therapy seem to think that someone can simply go to any qualified therapist and have their problems solved. It works that way for your autos, right, so why not for your mental disease? You bring your car to a good mechanic, all is fixed, and you’re back on your way.
Though mental health professionals and mechanics are not the same, there is an odd similarity, in that finding a good therapist is like finding a good mechanic: not everyone who’s qualified is good.
Finding a good therapist is, actually, much tougher than finding a good mechanic. You don’t really have to like your mechanic, as long as he’s good at his job. Sure, maybe he’s brusque, seems mad all the time, is rude; but, wow, can he fix a car quickly and for a reasonable price! Finding a mechanic can be easy too: you ask around, your friends, your coworkers, maybe the neighbor.
Therapists, however, aren’t so easy to find.
Sure, there are pages and pages of them listed in the phonebook. But, they’re not always accepting new patients; or, if they are, they only have appointments in the late morning, when most people are at work, and, of course, you can’t take the time off from work to go. So, you have to find one who is accepting new patients, and who are able to schedule appointments that work with your schedule. And, it’s tough to ask around for recommendations. I mean, do you really want to stop Beth from Accounting in the hall and say “Hey, I’ve got a mental problem, and I was wondering if you knew a good therapist?”
Then comes the first session, which, is not unlike a job interview. You, as a patient, are talking with the therapist, trying to determine if they’re someone who you feel comfortable talking to. You can’t open up to just anyone, you can’t share your suicidal thoughts with everyone who practices therapy. Sharing your deepest, innermost thoughts and feelings requires trust, and, believe me, I’ve met a few therapists with whom I had exactly one visit, because I knew there was no way we’d get along. Some therapists require a few visits before you realize they’re not quite the one for you. If the therapist doesn’t work out, you have to go through the whole process of, again, trying to find someone who will meet your needs.
Let me give you two examples. A few years ago, I felt the need for some therapy. The clinic I go to had a therapist on staff. I saw her four times. And, while she was nice enough, she liked to share her own experiences as a patient in therapy, sharing things that I don’t think I needed to know. Like that she’d been raped when she was in college (about twenty years earlier). Now, I’m not unsympathetic to her having been through such a heinous act, it was horrible that it happened to her. But, I didn’t know how it helped me with the issues I was wanting to discuss. If I’d been there because I’d been raped, I’m sure that the fact that she understood how one felt afterward could be helpful in therapy sessions, but, I was not there to talk about being raped. And, she agreed with everything I said. She didn’t ever challenge me. Yes, it’s nice to be agreed with all the time, but, sometimes, even if you think you’re right, a little challenge to your thinking is healthy. At least, I believe it is. Maybe there are those who just want someone to tell them that everything they think and feel is correct and proper. I need someone who, while they may believe that I am right to feel a certain way, will question why I feel the way I do, just to be sure my belief is solid. Finally, she wanted to talk a lot about the fact that I am an adopted child. It was as if she wanted to ascribe all my issues to being adopted. Maybe they are. I don’t know. But, I cannot accept that everything that is wrong with my mental state has to do with being adopted. It seems like a copout to just blame everything on adoption. So, after the fourth, or maybe it was the fifth session, I stopped seeing her. I knew it wasn’t working for me.
Last summer, I wanted to give therapy a try again. I’d still not dealt with my issues, and was having a very tough time. The clinic I go to now has a new therapist, so I thought I’d visit with her to see if she’d be able to help. I knew rather quickly that we would not have a successful relationship. I was her first appointment after lunch. She was twenty minutes late to the session, walked in to the office, Starbucks fancy iced drink in hand, closed the door, went to her desk, sat down, said “Hello. Just give me a minute to look at your file”, and turned away from me. Now, the fact that there was zero acknowledgment to her tardiness was pretty much a deal breaker right there. I get that people are late, I get that doctor’s can be late because they stayed longer with a previous patient. That does not give them the right to not give a simple “I’m sorry, but I’m a little behind schedule today.” There was no mention of her lateness, and she then spent the next ten minutes reading through my medical records, and the last fifteen minutes of the appointment asking me general information questions: had I had therapy before (it’s in my medical records that she’d just spent ten minutes reading); did I suffer from depression or anxiety (also part of my documented medical records), and, then suggested I should come see her at the Addiction/Recovery center she worked at, because she was certain that my issues were because I drank (she did see that part mentioned in my medical record). Yes, I had been drinking heavily (though it’s now been four months since I’ve had a drink) but, my drinking had little to do with the issues I wanted to discuss. I understand that she wanted me to quit drinking, but, I disliked that all my problems were being written off as drunken ravings. I’ve suffered severe, chronic depression since I was 14, and severe anxiety since I was in my thirties. I didn’t start drinking until 2006, and not heavily until 2010, so, while drinking was an issue, I know that my depression was not from the drinking (though, probably the alcohol did exacerbate it).
The meeting did inspire me to quit drinking, because I realized that as long as I drank, my issues would be blamed on the alcohol. So, I quit drinking, and, I’m still having the same issues that I want to talk about and try to resolve.
Last month, I tried again. There is a psychiatrist at the clinic, and, I’d seen him once before, to talk about antidepressants. I made an appointment because I liked him, we seemed to get along, and I felt comfortable talking to him. He doesn’t really see patients though, as I found out on this visit.. He’s got another practice, and just works at the clinic, as psychiatrist on staff, to deal with the medications for those of us with mental problems. He did agree to have a few sessions with me, though they may be four or more weeks apart, because of his limited availability at the clinic.
I go to this clinic, because it’s at the university hospital, at the HIV-clinic, and, because I qualify as indigent, because I have no income. Staying home to care for my 89-year old mom is a choice I make, but, it limits me in other ways, such as health insurance. Not having a job, and having a pre-existing condition make me pretty uninsurable right now. So, I’m indigent. At this particular clinic, I can go to the clinic for a $7 copay. And, because of The Ryan White Act, funded by the U.S. Government, I can get my HIV-meds for free, because I’m indigent. So, I get decent HIV-related healthcare, but, the mental healthcare available to me is rather limited.
I’m exploring options, with a couple of mental health counseling centers that work on a sliding scale, to see if I can find some help.
I look at myself, I look at my past history, I look at my current circumstances. I am a person with mental illness. I am lucky that I do not have a severe mental illness, such as schizophrenia, but, I have an illness nonetheless.. I’m frustrated with the lack of understanding among the general public about mental illnesses, I’m frustrated with a mental healthcare system that’s as strained and broken as our regular healthcare system is. I’m frustrated by people who, when they hear you are struggling with depression, say “Get some help.” Most therapy sessions go for $100-200 per session. As a person with no income, I cannot afford that. Even having a partner who is employed, we cannot afford that kind of money.
I’m doing what I can to get better. I’m trying to find out what other options are available to me for mental health therapy.
But, there are thousands of others, just like me, many with more severe mental health issues who cannot find treatment, who cannot afford treatment. We do what we can to hold things together, to seek out help that’s not always there. We deserve better than cheap platitudes from people telling us “Get some help.” We already know that. Telling a person with a mental illness to “Get help” is like telling someone with broken bone “Better get that set.” (Yes, I know there are people with severe mental issues, like being bipolar, like schizophrenia, and, often, they need to be reminded, even pushed to get help.) Depression is different. Depression is not an illness you are unaware of — you know you have it, and you know you need help. There have been times in my life when I have been so crippled by depression that I could not pick myself up off the floor. That sounds exaggerated, but it’s not. I’ve literally spend hours, laying on the floor, often in tears, hoping for death, unable to move, to get up, to do anything other than lay there and cry and wish for death. And, if you think that I am unaware in those moments that I need help, then you are sadly misinformed about depression. I may be depressed, I may not know why, I may not care about much of anything — but, I do know that I need help, and telling me “Get some help” is insensitive and insulting.
Maybe, instead, you should ask “What can I do to help?” Though we all might respond to that question differently, my response would be “Thank you for asking. Your offer of help does more for my soul than you could ever know. It tells me I’m not isolated and alone. What you can do to help is to just check-in, just so I know you’re out there.” Think about a time in your life when you’ve felt lost and alone. Think about how a random call from a friend or loved one can brighten your mood. It’s the same with many of us who suffer from anxiety and depression. Sometimes we’re so lost that we can’t see our friends, and we need our friends to remind us that they are there. It’s simple. It costs you nothing but a few minutes of your time, to call, to email, to text. They say knowledge is power. Knowing that someone cares about you is one of the most powerful forces in the world. Use that power. Tell someone “I care. I may not be able to cure your depression, or stop your anxiety, but, I care that you’re here, I care that you’re a part of my life.”
Yes, I’ve descended into a rant. We crazy people rant sometimes. Sometimes we crazy people can be a little scary, and it’s easy to sideline us. But, you know what? We are still people that deserve to be treated with respect and dignity.
End of rant.
P.S. If you’re wondering if this rant is directed at anyone in particular, the answer is yes and no. No, it is not a result of something that happened today, or this month. It’s not directed at one person in particular. However, it is directed at many people. It’s directed at people who’ve told me “Get help”, and it’s directed at others out there, others I don’t even know, in the hope that they stop to think before telling a depressed friend or loved one “Get help.”