I’ve been on a bit of a roll today, and I promise I’ll slow it down from here, but on my personal update the lovely jarlaxl said:
Stay hopeful! I’m very happy for you; my experience was… decent. How did you find your current T? Any tips for the rest of us to find someone good would be great.
And at first I thought “gee, I don’t know if I have any,” but then I realized that just sharing the process I tend to use might actually help somebody. So I came up with a few things that might be good for people to know, especially if they’re new to this and just trying to get their foot in the door on diagnosis. This is what has worked for me, and what I have learned over the past seven years:
First and foremost, PLEASE remember that you have no obligation to any doctor, therapist, or psychologist—ANY professional whatsoever. Just because they have an education doesn’t mean they’re inherently right, and it definitely doesn’t mean they can’t be ableist jerks. They can even just not be a good fit for you, and that’s fine too. Don’t ever feel like you can’t just get up and leave whoever you’re seeing for any reason. You can absolutely walk away, and if something is making you uncomfortable you absolutely should. Remember, you’re paying them to be helpful. You have essentially hired them to help you. If they are not helping you, then by all means fire them. Get the hell out of that office and spend your money on someone who is actually of use to you. I guarantee you’re not going to hurt anybody’s feelings, and I guarantee you’ll be MUCH better off when you realize that YOU are the authority in the situation. You should have control. Not the professional supposedly helping you. If a T or anyone tries to pressure you, or is rude or says something that makes you feel very unsettled, PLEASE GET OUT OF THERE. It isn’t a good situation, and you can definitely do better. Don’t settle for anything less.
I know that sometimes, though, especially for those of us who have gone through abuse, it can be very, very hard to separate yourself from someone you see as an authority figure over you, or as possibly smarter or otherwise “worth” more than yourself. And let’s face it, getting over that sort of thing and learning to not be intimidated by all the scary things that you have to confront when talking to someone like that is probably part of the reason you’re even trying to get help in the first place, and it isn’t easy to overcome anyway. There’s nothing wrong with that, but it can make walking away from a bad therapy situation nigh impossible, and can make getting help that much harder. In this case, consider finding yourself either a trained volunteer or someone close to you who you can trust to be your advocate until you learn to advocate for yourself. An advocate can make worlds of difference just by being there. Currently, I am advocating for a friend of mine who is going through her first round in the mental healthcare system, and in being her advocate I always check with her on her feelings, and then support her by saying or asking the things she can’t, or by just being a comforting backup. I know that for a while NAMI at least used to train people to be advocates, but I don’t know if they still do that or what. I wish I had a list of places for you, but I’m short on information on advocacy at the moment. I’ll see if I can’t come up with something at a later date. But yes. If you cannot speak for yourself just yet, choose someone to speak for you who you trust to do so adequately, and let them do things like make phone calls or confrontations or big appointments until you can manage to do it yourself. (Or, I suppose, just always have one for these sorts of things. It’s okay if you’re never quite able to do it all by yourself.)
Make sure you find somebody who listens. Above all. A good T will listen, listen, listen, confirm what they hear, and will not interrupt you, all before ever offering their opinion. This is probably the single most crucial fact about judging whether someone will be good or terrible that I have ever found. Everyone who was ever horrible to me was always the type who didn’t seem to listen. Beware the professional who interrupts you, who seems more interested in what they have to say than what you do, who rejects your concerns as unimportant, who acts like they know everything, who treats you like you know nothing, who acts like they know your symptoms and your problems better than you know yourself. Beware the professional who would contradict a single thing you describe to them in earnest. They cannot and should not dictate your feelings for you, or belittle your situation. Avoid people who don’t seem to listen at all costs.
A good T will also always ask you what you, personally, think it is you need, and what your goals are, and will often ask this early on in meeting them. If they make a point to make your therapy more about YOU than about a mere diagnosis or their own clinical perspectives, then they’re probably a T worth betting on. Unless they make you uncomfortable right out of the gate, it’s worth it to sit down and try out a T who makes it clear that your needs are more important than anything else.
Phone calls. Phone calls and references. I mentioned them earlier. When it comes to how I found my T now, I noticed that one of the major factors in my particular process is to make lots and lots of phone calls. If you are seeing a psychiatrist or have connections at a hospital, start there. If not, try calling a clinic or assessment center first. I recommend calling several different places for this. Ask someone there—preferably someone who has been working with you directly, but a receptionist can also usually give you a decent list—for recommendations and telephone numbers of specialists or whatever type of therapist it is you are looking to find. When you get those recommendations, begin calling each of them, and use your personal judgment to determine whether they might be worth your time. Ask questions and make notes. What kind of practice do they do? Ask them about their research or specializations. What kind of patients do they usually work with? What are their personal schools of thought? Tell them what it is you’re looking for, and what kind of help you think you need, and if you have a diagnosis already. Ask them about insurance, distance, and how often they usually see someone. How does scheduling appointments usually work? Pay attention to how they respond to all of these questions, and then tell them you might be calling them back soon. Mark anyone off the list who doesn’t sound like they would mesh with your personality, be a good clinical fit for you, or otherwise doesn’t sound like good news. (I’ve avoided some horrible professionals this way, because you can usually tell from just the first few questions if they’re the type who doesn’t listen.) Then, begin calling back anyone who is left on that list. You’ll likely have a handful of people you can start from to try and find a T who’s right for you, and you’ll be off to a good start. If someone doesn’t work out, ask them for references too, and continue until you’ve found someone who makes you WANT to make progress. This can take a while, but following this process, for me, has SIGNIFICANTLY cut down on the time I have spent searching for good help. This time around, I found a new T (and a specialist no less) in only three months. That… that just sounds impossible when I even type it out, but it’s true. I’ve been stunned this time around by how well that strategy worked for me. I hope it can work for you, too.
Also I know that especially for neuroatypicals phone calls can be reeeeeally hard and just absolutely suck, if not be nigh impossible. See if you can’t get an advocate to do this for you, or, if you can’t, try emailing your recommended professionals instead and see what they say that way. You won’t know if they’re interrupting you, but you can still see some of their reactions at least.
When you find someone you want to give a try, spend at least two sessions with them. That way, you’ll have time to digest and sleep on how they were in the first session before the next, and then you can take a better look at it. As I have found, however, if they haven’t really clicked by about the third appointment, then it’s likely they’re just not going to, and even if they’re nice you should move on.
Good luck, to each and every one of you! I hope this has been somewhat helpful, and I hope many more of you can find yourselves on a good road to recovery. I feel like I’m forgetting something, but for now I hope that these tips have at least given someone good ideas on how to find better treatment.