Anxiety/Depression

Recipe for an Anxiety Breakdown

By / March 5, 2016 / 3 Comments

Preheat the oven to 375.
Put two weeks of project push into a large pot and let it simmer.
Add in a hundred or more emails reporting site problems, many of them different people reporting the same problem, all of which must be answered or otherwise managed. Most of them are nice people trying to be helpful, so make sure you answer kindly and with individual attention.
Sprinkle in a few emails from angry people who have taken a personal affront to the site changes.
Stir constantly to prevent scorching.

In a separate bowl put in a dollop of paperwork that you thought was finished, but isn’t, so now you need to run an extra errand.
Add a big glop of realization that you’ve been out of milk for two days and the kids have eaten all the frozen pizza so they start coming to you with food decision woes.
Slowly stir in 48 hours of focused parenting attention for a child who needs to be assisted to manage a heightened level of anxiety.
Contents of bowl will begin to thicken and be harder to mix, keep stirring anyway.
But don’t forget that pot on the stove. Keep stirring that too. You’ll just have to bounce back and forth between the two.

In a third container, pour six hours of driving, sandwiched between two necessary business meetings.
Crack in two doses of fast-food calories and diet soda with caffeine. Make sure it is more caffeine than you usually ingest because you need to be alert and focused for driving.
Set this aside where you can see it, and it is a little bit in your way, but you can work around it.
Are you still stirring the contents of the pot and the bowl? Don’t forget to stir.

On a cutting board chop two days worth of time into pieces so tiny that they’re barely usable for creative tasks. Toss them into the simmering pot where they vanish without a trace and without making a noticeable difference there.
Is your arm tired from stirring the stiffening stuff in the bowl? Switch arms, keep stirring.

Fold in an email from a teacher which makes you check your kid’s grades and realize that many of them have slipped because you haven’t been applying consequences and this kid will definitely avoid anything that looks like unpleasant work unless there is some immediate reward or a looming consequence.
Be angry at the kid for a bit, but you can’t talk to him about it right now because you can’t stop stirring.

Splash some guilt everywhere, pot, bowl, whatever that third container is, your hands, clothes, the counter, etc.

Realize that you’re running out of counter space and now you need to blend up some email responses to event surveys, queries about creative projects, customer support questions.
Also blend in the knowledge that there are packages to mail.
And prescriptions you need to pick up.

Realize that you’ve neglected stirring, but somehow you now need at least three arms.
Don’t pause to realize that perhaps you need help with this cooking project. Instead just move faster to cover everything.
Realize the oven is on. Is this project baking or cooking on the stove? You have no idea. It is just uncomfortably hot in the kitchen now.

Dump contents of all the containers, blenders, and whatever else you have laying around into the large pot. Contents will likely be lumpy, hard to stir, and the pot is almost overflowing.
Turn up the heat.
Stir faster.

Add a tiny little event of miscommunication which frustrates the child who has been anxious. This event will be the catalyst that causes the contents of the pot to foam up, bubble over, sizzle in the catch pan on the stove, spill onto the floor.

Now there is a huge mess everywhere and it is obviously all your fault. Flee to room and cry.

Fortunately you have the formerly anxious child who comes and curls up next to you, pats your head and says “It’s okay mom, it’s okay.” and radiates calm comfort.
And another child who brings you the weighted blanket, which may or may not help you calm down, but the kindness definitely does.
And a husband who cleans up the mess, makes cooked food appear and brings it to you while you sit in front of a movie with snuggly children on both sides.
And another kid who’d been caught in the blast radius of the miscommunication and who brings you a drink to help you re-hydrate.
Let it all settle via a late night movie.
Sleep.
Have a better day tomorrow.

Saying No

By / February 21, 2016 / 2 Comments

It is time for me to start saying no a lot. My calendar for the next few weeks has large blocks of daytime work hours. There are no morning or mid-day appointments to disrupt the flow of my work. Afternoons are littered with many places to be, but they’re all regular events: lessons, tutoring, therapy. My only responsibility is to deliver children to their thing and then bring them home again. While I wait, I can be working on anything that I brought with me. I’m going to need every minute of those work hours. Deadlines have begun to loom close instead of distant.

I hit despair last Friday. The projects I have in front of me —work, household, parenting— all seemed like tangled and impossible messes. The only thing I could clearly see was that my available hours were insufficient for the amount of work I had assigned myself. “How can I help?” a friend asked me. He saw the front edge of my despair and wanted to take some of the business load. I couldn’t answer him, not in that moment. One of my weaknesses is that when I am under stress I hold tighter to all my tasks, expecting myself to just work harder. The more stressed I am, the less I can see what I should delegate and who I should give it to. Fortunately I have friends and Howard who have a better perspective. They pointed out a few things to me. It started my mind thinking about how to spread out the work more evenly and which things I can let lie fallow while I concentrate on other things.

I still spent Friday evening very sad. I didn’t like being that sad, but the sadness functioned as a shield which held off the blinding terror which howled around the edges of my mind. If I was grieving everything as a failure, then I didn’t have to be panicked about how doomed all my efforts were. I spent the evening hiding from sad thoughts. Around 1am I got out of bed and began to do the dishes. I hadn’t been sleeping anyway, and dishes were a simple thing that I could see how to do. I was inevitably doomed to failure, but at least I wouldn’t fail in the midst of dirty dishes. Then I began to fold laundry. By 4am I’d put enough things in order that my mind would let me sleep. Fortunately it was Saturday so I slept late. Then I put in eight hours on work projects, one small task at a time. Panic showed up periodically, usually when I was contemplating the project as a whole. Any time anxiety threatened to overwhelm me, I just reminded myself that it was obvious that I would miss my deadline, so there was no point in panicking about it. Instead I would just keep doing tasks one after the other. Then when failure inevitably arrived, at least I would know that I had done everything I could.

On one level, I’m aware that I’ve performed some weird hack on my brain. Doing one task after another is how deadlines get met. There is a part of my brain that has done the math and thinks that piles of hard work might still allow us to meet our deadlines. I’m trying not to think about that too much, because believing success is possible means I have to panic, stress, and push to get things done. The anxiety of pushing will cause me to freeze up and avoid the work. This has been an (unfortunately) frequent pattern in the past few months. But if I think I’m doomed to miss the deadline, I can work steadily and calmly. Shh, don’t tell my anxiety that I’m tricking it.

I made some lists today. One is the list of regrets I have for time wasted in the past few months. Pinning those regrets to the page pulled them out of my head where they were spilling sadness on everything. Another is the list of things that I should hand off to other people. The third list is discrete tasks that I can be doing next. I will follow my lists bit by bit, day by day. In order to do that, I have to vigorously defend the spaces in my days. I have to not let other people put things on my lists. I have to say no to opportunities. I have to say no to social appointments. I have to say no to teachers who want slices of my time in service of my children’s education. All these things can have my attention again once the deadline has been met or been passed. Right now I have to dive deep, ignore the internet, let calls go to voicemail, and work on the task in front of me.

Incoming Appointments

By / January 26, 2016 / 1 Comment

I should not have taunted the medical appointment spirits. Over night one of my kids spiked a fever, an OCD therapist got back to me which means I’ll soon be adding a weekly appointment to my schedule, and I’m now researching whether occupational therapy is covered by our insurance because that would be helpful for a different kid. Have I mentioned I get tired of appointments? Even when I know they’re important and helpful to my people.

Riding the Currents in My Brain

By / January 11, 2016 / 1 Comment

It was a great week, full of productivity and success, so I didn’t know why I woke up discouraged on Sunday morning, but I did. The feelings of discouragement were followed by significant grouchiness. I don’t think the grouchiness spilled outside my head much. I was pretty good at containing it, but it colored my whole day.

This morning the discouragement has ebbed because I’ve figured out what was causing it, and the grouchiness, and the dizziness which has been a plague since the middle of last week. These are all symptoms of discontinuing the medicine sertraline. I had been blaming the new medicine buprorion, and that may also be having an effect, but discontinuation is the more likely issue, even though I followed doctor’s instructions about tapering off.

This means my best course of action is to proceed as if everything is normal. I take my doctor prescribed meds on the schedule I’ve been given, and wait for my body to adapt to the new balance. Having to wait makes me feel a bit grouchy. I can’t tell if the grouchy is mine or just the result of out-of-balance brain chemicals. That makes me angry. It forces me to face the fact that so much of what I think of as me and my emotions are influenced by chemicals that I don’t really have control over. Thinking about all of that leads to more angry. In fact I’m angry with all mental illness, anxiety, depression, OCD for existing and making my life more complicated.

On the other hand, I had a great week last week, which seems to indicate that the medicine switch is likely to be beneficial in the long run. I just need to hang on until I stop feeling mad about it. So my job for today is to look at the dizziness and angry that are residing in my head and to tell them “I’ll attend to you later if you haven’t gone away. For right now, I have other things I need to do.”

Disorders in Hiding

By / January 26, 2016 / 6 Comments

Sometimes autism doesn’t flap arms or drone on forever on the infinitesimal details of one particular topic. Sometimes Autism can look like a friendly kid who calls his friends over and is the instigator of group play. Autism can be wearing the exact same outfit every single day because your clothes are part of who you are and you don’t feel like yourself in different clothes. Often this means duplicates of clothes. Autism can be standing in a group full of people who are all talking and laughing, wanting to be part of it, but they only talk about things you don’t care about. Autism can be refusing to go into the lunch room because it is too loud and ending up sitting in a hallway off by yourself feeling lonely. Autism can be feeling certain that you made an agreement with another person only to discover that they understood what you said completely differently from how you meant it. Autism can be being unable to do an assignment because you can’t wrap your head around how to begin. Then everyone gets angry with you because it looks simple to them. Autism can look like stubbornness and laziness.

OCD does not always flip light switches, count posts, or line things up in rows. Sometimes OCD is becoming actively uncomfortable and antsy if someone else is sitting in the spot where you expected to sit. This discomfort may cause you to lash out in anger. Then you have to face the consequences of your angry outburst. OCD can be carrying all of your books and school papers in your arms because that is the only way you can constantly be sure you have everything. OCD can be not throwing away any school papers and carrying them all in the ever-growing stack because it would be terrible to not be prepared should the teacher ask students to pull out an old assignment from three months ago. OCD can be wrapping every thought with a cloud of tangential and descriptive information which obscures the thing you want to tell other people. Only you can’t skip any of the information because it is all connected. And if anyone tries to interrupt the thing you’re saying, you get angry, because you weren’t finished, and the thing you were saying is important and must be completed. OCD can be correcting the pronunciations of the people around you because if a word is said wrong, your brain can not let go of that word until it is spoken correctly. One of these things is a quirk. All of these things together is a disorder that affects pretty much every hour of every day and every relationship in your life. OCD can look like disobedient defiance, rudeness, and disrespect.

Anxiety does not always worry about things. Sometimes anxiety is a heart that races and palpitates even though there is nothing going on and the person feels calm. Anxiety can be feeling antsy and agitated, like post-adrenaline shakes, even though nothing happened. Anxiety can be imagining a dozen possible futures and making plans to be prepared for all of them. Anxiety can be hyper-organization that other people praise, and which is actually useful, except that it never allows rest, vacation, or breaks. Preparation that never switches off. Anxiety can be needing to leave an event because there are too many people moving around and talking, making you unable to track everything. And you have to track everything, because if something goes wrong, you must be ready for it. Anxiety can be skipping work opportunities because they require face-to-face interaction. Anxiety can be checking up on other people’s work until they get annoyed with you, but you can’t not check because you have to be prepared if they didn’t do their job. Anxiety can look like a nagging and controlling personality.

ADHD is not always easily distracted. ADHD can be so focused on a project that suddenly you realize that people are standing over you angry because they’ve been trying to get your attention. ADHD can be the sound of pencils scratching on paper overpowering the thoughts in your head. ADHD can be deciding that today you will REALLY pay attention and make sure you get all your assignments, only to realize that you missed hearing an assignment because you were busy planning how not to miss assignments. ADHD is being lost in the thoughts in your head. ADHD can mean always feeling lost or out of step because everyone else knows what is going on, but you haven’t any idea what the instructions were. ADHD can be a jittery leg, all your pencils chewed to bits, and fingers that twist and play with whatever they touch, all without you intending to do any of it. ADHD can be lost items and missed appointments because at the important moment your thoughts were on something else. ADHD can look like chronic disorganization, negligence, and a person who doesn’t care enough to get things done.

Depression does not always stay at home lying in bed feeling in a pit of despair. It is not always dramatic or suicidal. Depression can be doing all the tasks that are required of you, but enjoying none of them. Depression can be feeling like things will never be better than they are now. Depression can be binge watching television shows on Netflix, because then you don’t have to listen to your own thoughts. Depression can be playing endless games of solitaire to fill the spaces between required activities. Depression can be deciding to stay home rather than go out with friends because being social sounds too exhausting. Depression can be having friends drift away because you’re not the person you used to be and you don’t have emotional energy to maintain the friendships. Depression can be crying at seemingly random times over things which wouldn’t normally cause tears, like a happy song playing, or the store being out of the cereal you like. Depression can be a messy house because you only have so much energy to do things and laundry didn’t make the list this week. Depression can be not bothering to brush your hair or change clothes because it is too much work. Depression can look like a person who is standoffish, slovenly, and unfriendly.

So if you have to deal with a person and they are awkward, rude, nagging, standoffish,or negligent, pause a moment before you condemn them. It may be that they do have the character flaw you perceive in them. Or it may be that the person is fighting a daily battle you can’t see, and they need your compassion instead of your anger.

Anxious Thoughts

By / December 28, 2015 / 2 Comments

One of my least favorite forms of anxiety is when there is an incident involving one of my kids and an adult from outside my house. The incident spawns a half dozen emotionally charged conversations which range between damage control and emotional processing. I then spend the next two days and nights with every spare cycle in my brain attempting to re-write it all. Could I have prevented it? I should have been more confrontational. I should have been more conciliatory. I should not have said that. Yes I should have, I should have said it stronger. Here is a thing I should have said, but didn’t. Here is a thing I think and feel, but didn’t say because it wasn’t constructive. Except maybe I should have said it. Here is another thing I should have made clear. Except I already tried to make it clear, didn’t I? Can I be blamed if the other party is incapable of hearing what my child and I are saying? I blame me anyway. Except I don’t because logic tells me that the incident occurred because the other adult overstepped bounds. Not our fault. But I should have handled it better.

And then there is the time that my brain spends trying to script out what I should say and do for imagined future conflicts. Because this isn’t over. More conversations will need to be had. And I dread them. Because I don’t expect them to go well. And I have to figure out how to stay focused on the important goals and not on venting feelings. My brain is really good at making up terrible scenarios where everything goes wrong from here and relationships crash and burn. It plays these scenarios out in the spaces between thoughts of conversational re-scripts. While I’m trying to be asleep.

The good news is that everyone inside my house is in accord about what happened. Conflict does not dwell inside my house. The other good news is that my child is more loving and Christ-like than I am in this. I may have to follow my child’s lead, which is right in line with scriptural instruction. More good news is that I have spoken to other adults in my child’s life and they are allies to my goals. I have not asked them to step into battle, but they will make sure that they take extra care to love and accept my child in the next few weeks. My child will need that.

Now if I can just get the noise in my brain to quiet down enough so that I can think clearly, that would be nice. I need clear thoughts to hear inspiration and guidance before I have any more conversations or take any actions.

Special Needs Scavenger Hunt

By / November 18, 2015 / 2 Comments

I’ve spent the last eighteen years participating in an educational scavenger hunt and I’ve only just now recognized that was what I was dealing with. By age three it was obvious that Link was a special needs kid. It was also obvious that he was friendly, happy, loving, and smart. With the first diagnosis of language delay, I began seeking for things that would help him. I made up games, bought games, and worked with Link regularly. All along the way we had teachers, psychologists, and administrators who were very helpful to us. They gave me pieces I needed and helped us find our way forward. Yet we still spent a lot of time stumbling around because for all the help we did get, there was other help that we didn’t get because we didn’t know the right keywords to unlock those options.

A year ago depression loomed large in Link. He was desperately lonely and overwhelmed with trying to manage a full load at public high school. It seemed like we were constantly readjusting his schedule, dropping classes, switching to different ones. We were trying to find a balance, a way that he could do homework before he left the school grounds so that home time could be free of school stress. When I finally was able to identify depression as the problem, I called for a meeting with his school counsellor. It was like the word “depression” was a key that opened up a cupboard in her brain. “We could put him in home health.” She said. Then she described to me a mode of schooling which was something I’d been trying to describe for at least two years. It wasn’t that she didn’t want to help me before, but until I said “depression” she didn’t make the connection I needed.

I know a lot of parents shy away from seeking diagnosis for their special needs kids. I’ve done it myself. There are so many fears attached to diagnosis and the worry that the child will be labelled or pigeonholed. That has not been my experience. Instead I’ve found that a diagnosis is a passcode that opens up options. It is a lever which pries open pathways. I thought that because everyone was so willing to help, that I was getting all the help I needed. But that became less and less true the further along we got in Link’s education. At the high school level, staff is compartmentalized and specialized. There are lots of options, but it falls to the parents to seek out the options and ask for them. Parents have to be advocates. This requires lots of work, and it is exhausting.

I really recognized the scavenger hunt when Link was diagnosed as having autism one week before his eighteenth birthday. The diagnosing doctor handed me a folder with the phone number of a parent advocate and information sheets on three different transitional programs which might help Link. At that moment I thought how naming depression had led me to scheduling an appointment with a psychiatrist. The psychiatrist had given me information about autism advocacy groups and had suggested that getting a definitive diagnosis regarding autism was probably worth the time and expense. He also referred me to NAMI, who runs education and support for mental illness. I went to a support group for the families of those with mental health issues and they suggested that I sign Link up for Voc Rehab and the WIA youth program. So we did that. Multiple places encouraged me to finally plunk down money with a diagnostician and say “Is he autistic? I’ve seen autistic things since he was little, but I’ve also seen distinctly non-autistic things. I’m tired of not being sure.” The answer was that yes, he definitely is, and the diagnostician was frustrated that it hadn’t been identified when Link had been in kindergarten.

This is how it goes. One piece of information leads to another. There is no central source that knows all the options. Or if there is, I somehow always manage to arrive there last instead of first. By the time I was in touch with the parent advocate, I’d already heard of all the options she mentioned. We’ve still got more hunting to do. At this moment we’re waiting on funding from Voc Rehab. I’m waiting for a call back from the school district about their transitional program. I’m also waiting for a call from an adult educational specialist who can explain the GED process to us, because maybe that is the way to go. We’ve accepted the fact that Link will not be graduating with his class, even though his school counsellor would really like for that to happen. Sorting it all is a huge burden in time and emotional energy. It always has been. I constantly feel like I could be doing more and simultaneously I worry that I’m over helping.

Last night I went to a Relief Society dinner. This is the women’s organization of my church. I spent quite a lot of time visiting with a woman in my neighborhood who also has an autistic son. We’ve known each other for years, but me speaking about Link’s recent diagnosis opened up a huge well of shared experiences that we spent an hour talking through. She listened to me and was frustrated on my behalf that I spent so long without access to autism-specific resources that would have made the journey easier. As part of the decorations for the dinner there were anonymous notes on the wall where people wrote about the kind things that others have done for them. One of the notes said that I’d pushed to get her daughter into early intervention. I feel like I should know who wrote that, but I don’t. It could have been one of a hundred different conversations that I’ve had with people about special needs resources.

Last week I got a message on facebook from a friend who had read my post on Finding the Right Therapist. She asked me questions about therapy and children. I gave her what answers I had, but mostly those answers were in the form of additional questions she should ask and some direction for whom she should be asking. Thus I become a stopping point on someone else’s scavenger hunt to figure out how to help a child who is struggling.

I must admit that I spent some time this morning looking back at my past struggle and grieving that no one thought to give me answers that would have helped. I went ahead and let myself feel that grief. I know that I don’t want to spend a lot of time and emotional energy looking back with regret, but I have to feel it before it can pass and I am able move on from it. Moving forward is what is necessary because the scavenger hunt continues. I suspect it will always continue for Link in one way or another as he tries to navigate a neurotypical world while being who he is. Though hopefully we can reach a point where the hunt is not a major feature of daily life, and the hunt is primarily Link’s quest, not mine. He needs to be empowered to find his own solutions.

Some days I can believe that we’ll reach an independent adulthood for him. Other days I can’t. This too is part of the hunt. I’m not just seeking resources, help, and answers. I’m seeking emotional balance, peace, acceptance, and maybe even joy. This year is better than last year. We’ll continue onward to see what comes next.

Battling with Anxiety

By / September 8, 2015 / 1 Comment

“I’m scared of earthquakes.” Gleek launched into this statement almost before she cleared the door to enter my room. Her face was pale, wide-eyed, and a little teary.

“Okay.” I said putting down my book and scooting over so there was room for her next to me on my bed. “What makes you scared about earthquakes today?” I always ask questions when my kids are mired in anxiety. Additional information helps me figure out which flavor of anxiety we’re attempting to manage. It matters because sometimes the anxiety needs to be laughed at and sometimes it needs to be sympathized with.

“I’ve been scared for days. My history teacher says there is a huge fault here in Utah and it is sixty years overdue for an earthquake. And now I’m scared that the earthquake will come and knock down our house and destroy everything.”

So we talked at length about earthquakes. I grew up in California and lived in the Bay Area during the 1989 Loma Prieta earthquake which knocked down a section of the Bay Bridge and collapsed a long section of the Cypress freeway. That quake had more than a dozen aftershocks over the next two years. I also remember the Livermore quake and its aftershocks. I was able to tell her what an earthquake feels like and that humans are much smarter about building structures that are earthquake safe. I told her about many different earthquakes and how mostly it was just an interesting (if unnerving) experience with little or no damage done. Then we talked about her anxiety disorder and how it makes her more afraid than she needs to be. Yes an earthquake might strike, but beyond some basic emergency preparedness there is nothing we can do about it. We certainly shouldn’t let our daily lives be affected by fear of earthquakes.

Gleek acknowledged all of this and said “Usually when I’m scared of things and the scared won’t go away, I have to talk it out.” I loved hearing the self awareness in her voice. She has grown so much and has developed a solid set of coping strategies. Her fourteen year old strategies are worlds better than the ones she was employing at twelve.

This is a thing I need to remember when Patch responds to stress by becoming uncommunicative instead of engaging with me to figure out where the stress is coming from. When he finally spoke with me (after missing his bus) we were able to determine a specific problem that could be easily fixed. Patch is still acquiring good strategies. I just need to put structural support in place and give him time.

Gleek wound down from her outpouring of earthquake fear. Oddly, the most comforting thing I said was that sometimes I’d only know there was an earthquake because I’d see the lights swaying on the ceiling. Gleek now has plans to hang some things from her bedroom ceiling so she’ll be able to see if there is an an earthquake and get under her desk. On one level she knows that this warning system does little to protect her from the real possibility of an earthquake, but it is a small tool she can use to quell the anxiety. “See the hanging things aren’t moving. We’re fine.”

The other thing I’ll do is go have a word with Gleek’s teacher and let her know that while I understand she has the responsibility to teach about hazards in our area, maybe she could do so in a way that isn’t going to trigger anxiety for the anxiety prone kids.

Parenting and Creative Life

By / September 7, 2015

I recently read an online article from Amanda Palmer talking about her creative life and her impending motherhood. My life has been so different from hers. I dove into parenting while still in college, so adulthood and motherhood were all tangled up together. For a long time all my creativity was absorbed into my parenting and homemaking efforts. It was only later that I began to create in ways that were shareable outside the walls of my house. Palmer’s fears about the impact of motherhood on her life are valid. All anyone can say for certain is that what comes afterward will be different than what came before.

I’m thinking much about the impact of parenting on creativity. I think about it often as I contemplate the novel I’m still writing years after I began it. I spiraled down into depression thinking about this over the past year or more as the needs of my children loomed and my creative spaces vanished. I thought about it now during the second week of school where we’d not yet had any emotional crises and I’d had several good work days in a row. I thought about it again after the third week of school where I did not have any good work days and emotional stuff spilled all over the place. I’m not fully able to judge if teens with mental health crises is more problematic for a creative life than infants or toddlers, (I wasn’t trying to maintain a separate creative existence during those hands-on early years) but I can attest the the toll that mental health during the teen years has taken. Though truthfully it was likely my own depression and anxiety which impacted my creativity more than the time taken by my children. Of course, my depression and anxiety were triggered by my children, so it comes to the same thing really.

I wish I had answers for this. Perhaps someday I’ll be able to look back and see how it all went together. From a distance I’ll be able to explain how all the things affected each other and maybe I’ll be able to draw a useful conclusion from it. Or maybe I won’t. Maybe being creative is always messy and complicated by the details of living. Either way, summarizing is not my job now. My job now is to make sure that I don’t hide from my creative work merely because I’m tired. I have to remember that creative time gives energy back to me in a way that down time does not. I have take time each day to pause and listen deep into my soul and ask the question “What is the work I should be doing today?” The answer to that question matters.

Finding the Right Therapist, or How to Recognize You Have the Wrong One

By / August 31, 2015 / 7 Comments

“It takes a few tries to find the right therapist. Don’t give up.”

I was told variations of this multiple times by multiple people. They were people who had struggled in similar ways, so I believed them. Except that it was repeated often, in almost the same words. Following this seemingly simple instruction turned out to be very difficult that I began to wonder. Is this just a platitude? A thing we say to offer hope in a hopeless situation? Ultimately I’ve come to the conclusion that it is not just a platitude. It is a fact and a necessary process. By the end of this post it will be clear why.

I had no good methodology for finding the “right” therapist. Sometimes I went on recommendations from friends, neighbors, or primary care doctors. Though most of those recommendations were “I’ve heard of this therapist and have a vaguely positive impression attached to the name.” The few times I got an extremely specific recommendation from someone who had worked extensively with that therapist, the therapist was invariably closed to new patients.

I was left with trial and error, which is not a great process for someone who is struggling with feeling hopeless. Unfortunately this mirrors the medication treatment process for mental health as well. So we spent a couple of years trying this therapist and that medicine before switching things around. One kid got better, but not in any way I could relate to the therapy sessions she’d had. Two other kids got much worse. Until lately they’ve been better at least partially because of our experiences with therapy.

I’ve now had direct experience with seven different therapy relationships across four family members. At this point I can tell you far more about how to tell when you have the wrong therapist than I can about finding the right one. It finally occurred to me that this is actually useful information. No one told me what should constitute “not working” and so I stayed in several of the therapy situations much longer than I should have. It is hard to make good judgement calls in the midst of emotional chaos. It is even harder to abandon groundwork that you’ve spent effort, time, and money to establish in order to start over with yet another complete unknown. The thought of having to start over kept me doing “one more session” for weeks. So I’m going to tell you the knowledge I gathered from my experiences. Then I’m going to tell you the stories of how the therapists we had were wrong. From the combination you may be able to glean information to inform your decisions.

Knowledge

My experiences are not universal, some of what I say here may not apply in your situation or may be wrong for you. Listen to your own instincts, which can be hard in the midst of emotional chaos, I know. Listen anyway. Only take the pieces of advice that help you. Discard the rest.

It should only take 4-6 sessions for you to build a rapport with a therapist and start doing emotional work that is beneficial. If you don’t feel these things, move on.

It is not rude to abandon a therapy relationship. You don’t have to apologize or even explain. You can say “this isn’t working” or you can simply cancel your appointment and go elsewhere. Therapy professionals will not be offended or hurt. They understand that some relationships just don’t click.

Your therapist should never make you feel judged. If you feel judged you are not safe to find out what you really think and feel.

If you’re helping someone else with their therapy, how they feel about the therapist matters more than how you feel about the therapist.

It is normal to sometimes resent your therapist, but if that is happening week after week, it is time for a different one. Resentment is a sign that you feel attacked, which means you don’t feel safe with the therapist.

It is easier to have a regularly scheduled appointment than to have as-needed appointments. If you need a non-regular schedule, don’t leave the therapist’s office without scheduling your next appointment.

A sign of a good therapist is that they’re willing to change tactics when one is not working.

One of the reasons it may take several tries to find the right therapist is because you don’t know what you need until you start dealing with one. It is an iterative process.

There are different methodologies in therapy, what helps one person will be ineffective with another. Sometimes the therapist is a mis-match because they’re most comfortable with a methodology that doesn’t work for you. (IE: cognitive behavioral therapy when what you need is PTSD focused therapy or dialectical behavioral therapy.)

The financial cost matters. Sometimes a therapist can be wrong for financial reasons, because high cost can give your brain yet another argument not to go. This stinks, but it is true. Many universities have low-cost clinics where their grad students get to practice being therapists.

The therapist should be respectful of the anxiety and emotional energy that goes into admitting help is needed. One who doesn’t answer phone calls or drops you as a client is the wrong therapist, no matter how good they might be when you actually have an appointment.

Stories

Therapist #1: For Gleek. The therapist was young, a grad student. I thought this would help her build a relationship with Gleek. But all the sessions ended up with me and Gleek together sitting on the couch. The therapist spent most of her time dissecting the parent/child relationship rather than digging in to find out the inner workings of Gleek’s thoughts which Gleek hid behind a shield of chatter. I came away from most of those sessions feeling resentful and judged. It is likely I was projecting my own self-judgements onto the therapist, but she wasn’t sensing or solving that. The therapy relationship ended because the therapist graduated and moved away.

Hindsight: The therapy format was wrong for what we needed. It was set up to treat the parent/child system and ended up giving me lots of parenting advice that I already knew and had already applied. The next time I set up therapy I specified individual therapy.
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Therapist #2: For Gleek. She was a woman in her fifties with a long practice dealing with children. I deliberately sought that out because I wondered if my reaction to the other therapist had been an inexperience problem. This therapist was recommended to me by Gleek’s church leader, specifically because the therapist did art and play therapy. I found the therapist good and easy to talk to, but Gleek became increasingly resistant to going. “I don’t like how nosey she is.” Gleek said. Ultimately Gleek was doing so much better (because of medication and changes at school) that the therapist and I agreed we could stop therapy for a time.

Hindsight: Gleek did not have the right rapport with the therapist, so the therapy was not working as it should. It is possible that the therapist and I could have banded together to push through her resistance. Instead we opted to give her some control. That turned out to be the right call. We did establish that if life gets hard again, back to therapy we’ll go. But we’ll pick a different one.
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Therapist #3: For Link. I chose to go through the comprehensive clinic at BYU in part because it was far less expensive than other options and we were paying out of pocket for everything. I also thought that a young male therapist might have a better chance to connect with Link. This meant a grad student therapist again. By week four the therapist was having trouble getting Link to open up, so he brought me in for a joint session. It went really well. Unfortunately this meant that the therapist always brought me in for all the sessions. It became relationship therapy between Link and I rather than the individual therapy that Link needed. He needed solutions which did not include me. Also I think that speaking with me was more emotionally rewarding for the therapist than speaking to Link. The therapist could poke at my pain and induce me to open up. He was completely unable to do the same for Link. I kept trying to keep him focused on Link, but we ended up talking about me half the time anyway. It took weeks of me being increasingly stressed and resentful of the therapy, and Link feeling the same way, before I recognized the problem and called the clinic to request a different therapist.

Hindsight: This was a similar problem to the one with therapist #1. We had different visions for what the troubles were. I probably could have had a meeting with the therapist and re-calibrated the treatment, but starting over was less work and Link was more likely to cooperate. Continuing to make Link go to a therapist he didn’t like would have damaged my relationship with Link.
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Therapist #4: For Sandra. This was actually the same therapist as #2. She hadn’t worked for Gleek, but I’d enjoyed talking with her. The interactions with Therapist #3 had forced me to see that I was struggling, so I made an appointment. It went well. So did another one. Unfortunately she was by far the most expensive therapist we’d gone to and everything was out of pocket. We finally got onto an insurance plan which covered mental health care (Yay Affordable Care Act!) and she wasn’t listed on the plan. I’d paid her prices for Gleek, but it was harder to justify paying her prices for me. So I’d delay between sessions until I was in crisis. Then I’d call for an appointment…and she’d fail to call back. I’d call again and she texted two days later saying “I have an appointment available in two hours, does that work?” It did not work. Also, I’d requested a phone call to make the appointment, not a text. Ultimately these communication issues were the reason I dropped her. If I gathered the emotional energy necessary to call and set up an appointment, I needed the process to go smoothly rather than stretch out for days adding stress to my life.

Hindsight: She was a good therapist, but her business running skills interfered with my willingness to go to her. My next attempt at therapy for me will be an office with multiple therapists and a full time secretary who handles appointments.
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Therapist #5: For Link. This was the therapist we were assigned after therapist #4 went badly. I’d considered changing away from grad students, but decided to give it one more shot. By this time I’d been told the advice about giving a therapist 4-6 sessions to connect, so that was the plan. Right around session four, the new therapist ran aground in almost exactly the same way as the prior one had. Link wasn’t opening up. He’d give answers, but they were mostly shrugs or “I don’t know.” This therapist met with me separate from Link and hammered out a new plan. He started playing games with Link. The whole goal was to connect first and then gradually use that connection to teach Link how to connect without games. Then they could get at emotional issues. It was a brilliant plan. I approved. I think it would have worked. Unfortunately about a month later the therapist made a personal decision that took him out of the grad school program. He worked to hand us off to another therapist, and was as conscientious as he could be, but it was still a big blow to Link and to me.

Hindsight: Not much useful to offer here, except that this process can be hard in unexpected ways.
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Therapist #6: For Link. This was the therapist that therapist #5 handed us over to. They had this nice transitional plan where the new therapist would attend sessions with Link and the prior therapist. She was a young and pretty grad student. Link met with her twice and told me that he wasn’t comfortable with her. I wasn’t surprised. There had been a young pretty female math teacher at school that Link had refused to go to for help. Talking to people is hard for Link. Talking to girls is even harder. I called off the appointments and put Link on a therapeutic hiatus while some other things settled down in our lives.

Hindsight: Link needed an older brother/ role model and a young female therapist was not going to work in the same way. An older, motherly or grandmotherly woman would probably be fine. Any future therapist selections for him will keep this in mind. I’m also likely to try a therapist with a different approach, such as dialectical behavioral therapy instead of cognitive behavioral therapy.
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Therapist #7: For Patch. I think we began seeing this therapist before Link’s good therapist quit, but I’ve put her last on the list because she’s the only one whom we’re still seeing. She’s a grad student at the same clinic as Link’s therapy. She and Patch hit it off right away. It helped a lot that I recommended that games be part of the therapy. (Having learned from Link’s experience that this can foster connection.) I can tell the therapy is working because Patch doesn’t resist going. Often he is excited or happy to go. Also the therapist usually brings me in for the last few minutes to let me know what they talked through and what would be a good focus for the week ahead. I know that they really are beginning to dig down in and untangle some of the emotional knots that Patch has been carrying around.

Hindsight: This is how you know when therapy is working, life feels easier. It is subtly easier so that you may not even be sure if it being easier is because of the therapy.
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I don’t have many concluding thoughts, except to say that writing up this post helped me to see why it is sometimes necessary to try multiple therapists before settling. Each therapy relationship helps you learn more about what you need and want in a therapy relationship. It is not a failure to need to ditch one therapist and try out another one, it is a refining process. I wish I’d known that when I first started, it would have made the process easier.