December 5, 2021

Getting the Most out of Therapy: Easier Said than Done.


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Last month, my jaw dropped as I read an article in the Washington Post, entitled: “Tips for starting and getting the most out of therapy.”

Five years ago, despite being a middle-aged, fairly high functioning criminal prosecutor with an outsized amount of courage, I’m not sure I could have followed the author’s tips, even if I saw them in real time.

I know this now, because for over two years, I stumbled through therapy with two different practitioners who were each uniquely unsuitable for my situation.

The “thing” that knocked me off balance and pushed me to try therapy? A complete panic when my dad was accepted into hospice. This event forced me to face a future left alone to help my mother with symptoms of her borderline personality disorder (BPD).

The first tip is “Determine your needs.” Huh? All I knew is that I felt like crap all the time. I had learned about BPD through a friend who recommended the book Walking on Eggshells. I was both thrilled and pained to see my experience right there in print. But, beyond that, I could not articulate my needs as they related to my own mental health. I’d had that ability snuffed right out of me.

The second tip is “Pick your therapist.” I found my first therapist off the Psychology Today website. She was advertised as someone who specialized in BPD. In the intake assessment, as well as my first session, I tried to be as clear as I could be: I need a plan to exist without my father.

Several months passed. Because this therapist offered little more than apparent enchantment with my storytelling skills, I unilaterally reduced the sessions to once a month. In the meantime, my mental and emotional health continued to deteriorate until my back went out and I was facing surgery. Another friend told me about John Sarno and the mind-body connection between repressed anger and physical pain. I immediately scheduled an appointment with my therapist to get her feedback on this.

“You’re finally ready!” She proclaimed. This was after eight months. I accept that rapport building is an important component of therapy but…eight months?

The author urges us to “Engage with your therapist” and “Practice between sessions.” At the eight-month mark, my therapist finally gave me homework. This work wasn’t easy by any means, but at last…progress! As a naturally curious person, I devoured information on all things related to my condition. I was desperate to feel better. And I did feel better…physically. Emotionally? Not so much.

After dutifully showing up once a week for six weeks, I entered a session to find my therapist under the influence of something. I couldn’t tell what it was, but it sure looked like at least half a bottle of Chardonnay. I will never forget that churning of my stomach and pounding of my heart, as I watched her fumble with handouts on codependency. When I confronted her about what I was seeing, she began to tell me about her bad day with several difficult couples.

Mustering up all the courage I had in that moment, I walked out of the session. After speaking with someone affiliated with the clinic, I learned that my therapist was on an increased dosage of some medication due to a family tragedy. I’m pretty sure I should not have received that information, but there it was.

While I could feel some compassion for her, where did that leave me? The Post author opines that we should recognize when a therapeutic relationship isn’t a good fit. As someone who spent 50 years trying to “fit” with a mother who, due to her BPD, never attached, I always believed it was my responsibility to make every relationship work.

So, I tried again. This time I looked for someone who specialized in grief. My second therapist and I had good rapport, but she also listened more than she talked. I finally walked away from therapy, determined to get better on my own. But I kept the second one around for emergencies. She got me through my dad’s death. She also introduced me to attachment theory, which has really helped me understand my relationship with my mother.

Recently, I interviewed my second therapist for a book I’ve written. I could finally express that, at the time I first came to her, I needed therapy to help me change how I thought about things. Turns out, there’s a name for that: cognitive behavioral therapy.

My second therapist doesn’t offer that. Instead, she provides a safe space for people to express their emotions.

So not what I was looking for. I had (and still have) friends and dogs for that.

Thankfully, much has changed in five years. The pandemic compelled us to prioritize mental health care. The Post article is of great benefit in urging us to be proactive regarding therapy, as long as we have the capacity to understand what we need and advocate for it.

Easier said than done.

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