Analyzing Good and Bad Therapy

The above statement has a little generalizing to it, but there's good warnings there as well. Some therapists are good, some are bad and some are middling. I really needed a therapist a few years ago but was priced out of the running. Mental health care is far harder to come by in America. So when I couldn't afford therapists anymore,  I went into a peer group for around 5 years, I volunteered with them too. Sadly the good directors of the group moved away and while some of us tried to keep it going, it did end at a certain point. This group was a positive part of my life and gave me the strength to change things to begin with.

I still am interested in therapy now but with huge bills like our impending taxes and the price of food having doubled around here, it's still been put off. Part of me thinks, "What will the therapists do?" They can't fix the world. CPTSD/PTSD is a bad mixture with Covid. One thing that worries me about people is everyone has to act like everything is okay. I feel repressed everywhere. Like sometimes I want to talk about how crazy everything has become but there's no one to do this with. The Midwest is full of stiff upper lip types, where not everyone blends in with this. The world is burning but suck it up!

 Many friends have their own problems. People who have to go slog at some essential job probably envy someone on disability who can never leave the house. It's sad but outside of my husband, I am talking more to strangers online about life, than any friends. People are withdrawing, from depression and the rest. How many are becoming homeless or can't pay their bills?  I expect everything to collapse. Does this shock anyone here? At this point I do. I suppose it's on a slower slog then I dreamed. They will grind us down. One year of Covid, everyone's depressed, Two years of Covid? Who knows if we will have minds left. 

Therapy is really expensive. Even someone insured like me, has to come up with 70-100 dollars a session. The state run therapy place were I live is so overwhelmed unless you are ending up hospitalized or hallucinating on a daily basis, they don't have the resources to help. When I was younger therapy was far more accessible. Even in Chicago during the 1990s, I only had to pay a small fee based on a sliding fee scale. Mental health care was more widely available.

Pre-Covid, I felt like I had finally gotten a handle on my life long depression, leaving Christianity definitely helped with this.  Life was looking bright despite my health problems. The anxiety stuff is still a problem and worsened after Covid, but never has returned to the levels it was pre-no contact. It was ironic, that the year I finally was getting a grip on what could be called happiness, everything kind of fell apart. It's not good to get old and think well my life didn't turn out.

We even got a better car where we could finally take some day trips after years of being so limited with an older van I didn't dare take out of the county but Covid ended those plans. While I still didn't have any close local friends outside of my online ones, and so many friendships ended based on ACON recovery, deconversion and politics, I had cobbled together a life of sorts. I was involved with my community and groups that made me happy, this included a yearly art class, visits to a local art museum, local events from parades to shows,  zine conferences, stamp club and auctions, politics and protests, visits to the park book clubs, the gym, and most importantly of all my Unitarian Universalist fellowship. I still had my disabilities to deal with but with my husband, I was trying to make our life as rich and full as possible on very little money and with my limitations to deal with. 

I enjoy what I can in here, but the misery quotient for everyone now is so high, it's changed the world in some really bad ways. America had a serious enough mental health crisis going before all this. One thing that helps me with Covid, is telling myself, "You didn't choose this". I'm not sure what to think now. It's easier to deal to deal with the philosophy "Shit happens on this decaying rock" then "God has a plan" because then I would be crying over God wanting to drink more of my tears. Buddhist "acceptance" works far better for sanity than "God's punishing me yet again!"

Covid in general has not been good for anyone's mental health. How many people are cracking up? I joked to my husband maybe I am protected in the way that so much bad stuff has happened how does this compare? Singles and other are under the solitary confinement gun. Middle class people have seen careers, small businesses and dreams destroyed. Some people have lost loved ones, I know several people who had a family member or friend die of Covid.

I personally know poverty and impending homelessness are very bad for mental health. How many are in that boat? Some friends have withdrawn and gone quiet. I've gone more inward too. With CFS, I could sleep the day away easy though in my case I have to get up to stay alive and mobile. Medically life is on a required regiment. However sleep remains a nice escape especially in winter. I'm always exhausted enough to fall asleep whenever I want. Unlike some disabled insomniacs from pain, pain doesn't keep me awake. Then there's substance abuse. I suspect those problems have to be skyrocketing too.  In my case, I can't drink due to allergies, haven't touched the stuff in 30 years however that has to be getting worse as people seek an escape from the worry and trauma.

When I was in therapy on and off, some therapists found my life story to be an unusual one. I have definitely talked about some crazy stuff on this blog, but I shared enough of life with sociopaths and narcissists, that there were times, I did surprise the therapists.

Once one of them told me, "I just can't take it!" That was weird, where one's life was so messed up, a therapist was ready to chuck it in. At last three told me I had the most severe emotional abuse of any child they heard of. No broken bones or "Child called It" stuff, but my long time readers on this blog probably can guess at what freaked them out.  Contrary to my haters, I never got diagnosed with any personality disorders, my diagnoses centered around severe anxiety disorders. There was some time my hormonal disorders were added into the diagnostic fray. I connected with some therapists better than others. Some loved me almost like some my favorite professors, but some didn't like me either.

For some my weight was a major issue they couldn't see beyond. One therapist did think due to my fast weight gain history that I had a pituitary tumor or other medical problem and even had me talk to a psychiatrist about it. One thing complicating things, was because my weight was so severe and 50 more pounds could take me into immobility, anti-depressants were not as much of an option as they were for others. I had seen thin people turned easily into 300 pound people from antidepressants. One friend was even an ex-model who became fat for many years though she was able to later lose weight. A doctor warned me I was on so many physical meds, that I could be tipped over into problems just from being on too many medications. I know my complex medical problems were not easy for therapists to deal with.

In one online discussion group I am in we were talking about therapists. There was one therapist I hadn't thought about in years. These memories came up to me and I was talking about it with that group. She is the therapist I had back around 1999/2000 after escaping Chicago. We had strong rapport so much so we discussed befriending each other once my therapy was over, but I think she made the decision this would cross boundaries so we never did, though we would smile and say hello in my then small rural town.

She told me about Aspergers and I read books about it and she thought it described my problems and this was later backed up by two other therapists and a psychologist, so on that score she did improve my life quite a bit. However one thing she did do that led me on a 14 year journey to nowhere, is she sold "Christianity" to me as the answer for my problems. She was an evangelical working in a secular therapy office. She meant well, she was a kind person who meant no ill intent, and what would she say to me today if I had her before me telling me how the Christianity turned out? Chances are that she is no longer with us, as she was well into her 60s when I saw her 20 years ago.

I remember her giving me a book on Jesus to read, wish I remembered the title, and her telling me the Unitarian Universalist church was a spiritual dead end and that they taught "false things". My new rural town was a hundred miles from the closest UU church at that time.  

I am in the position now, if I am able to afford a therapist, that I would have to be clear to the counseling office, no Christians and no conservatives, this may offend a few people, but with the depth of religious issues and others, I would only offend most Christians except the most liberal ones. It's a boundary I would have to establish. 

 Even Catholic therapists can be a problem. One was offended when I spoke of leaving the Catholic church. Another one who was my husband's main therapist in a secular office and where we had joint counseling years ago, tried to convert him to Catholicism. The conservative Republicanism didn't help either. His office was plastered in pictures of the Virgin Mary. We live in a very conservative area, and our old town was even more conservative, so some may be shocked given that the view of most therapists is that the majority are liberals. Many here are very Christian, and two counseling offices in my area advertise themselves as "Christian counseling" centers. In fact if you are destitute and can't afford counseling, and don't qualify for the state run counseling center to take you, you will be referred to a local Christian college to their free student counselors. 

This therapist who led me to Christianity also while she admitted my abuse was some of the most severe she ever had heard, and diagnosed me with PTSD too, also gave me the message to reconcile and "forgive" abusers too. Obviously I would go down a ill-fated forgiveness journey that just opened the door to more abuses. Therapists who taught this weren't trying to harm us though harm was done from it. They were taught in their counseling classes to "improve relationships".

One thing you hear all over the place out there, is that too many therapists are failing ex-scapegoats or those who have faced narcissistic abuse, or even trauma in general. The therapeutic themes of reconciliation or that focus on "reuniting families" a la John Bradshaw were in vogue during most of my years in therapy from the last 90s into the mid 2000s. I hope things have changed for the better especially as ACONs are concerned. However in talking with people online, it seems ACONs are still facing some difficulties in therapist offices. Some have problems being believed, some therapists don't seem to understand how NPD works in family systems. We definitely need more therapists out there trained in how scapegoating works, and how to deal with abuse victims. Soon to be ex-scapegoats who are trying to escape the narcissistic pit, need a lot of support.

The misdirection into reconciliation, forgiveness and the Christian religion did not serve me well. I have the feeling it's probably done a lot of harm to others. If I was to look for a therapist now, how would I find one that knows enough about trauma/abuse, extreme health problems, a fundie past, religious trauma and won't try to push Christianity down my throat? How many offices will I offend saying NO CHRISTIANS? Some would find it a strange request.

One of the best therapists I had, was a young secular one, in 2011 or so, who I could only afford for two sessions, who announced to me, "You are trying your best". She taught the art of self compassion. That helped clear my head and actually was a positive moment for my life. After years of judgment and being told, "you are not enough", that therapist paved the way for me to know I was enough. 

Class issues can be a big thing when it comes to therapy. I definitely hope more therapists are being taught about class consciousness or what life is truly like for the poor or low income when they see more impoverished clients. Some class factors can impact therapy. I live in a very conservative region of the country where we do have some "bootstrap" types in the counseling office. They can do more damage than good.

If you offer clients advice where it takes money to get things done where said money does not exist, than that is a dead end. I also hope things have changed for the better too, as I am an older person and some of my experiences took place in the 1990s. I don't want anyone to forgo therapy just to be cautious of the quality and outlook of their therapist. I don't know if this is true anymore but I encountered some therapists who were influenced by New Age teachings, and affirmations to make things come true too. I think we should let people know what to expect in therapists, so they know the dangers out there and pitfalls.

Finding a "woke" therapist may not be easy. I know in my case, the ones who understand poverty and injustice and admitted they existed, were definitely easier to deal with. There is privilege in telling people to "be positive" and then their dreams will come true. Some have more serious problems to be dealt with and "inner work" definitely is an asset but having a therapist that understands systemic effects is important. People need to be given practical tools and coping mechanisms that deal with life as it is, not given fantasy or religious based answers to problems. Some therapists excelled at this of course.

Reality based therapists or ones who focused on coping mechanisms helped me the most. Here too I think of Christianity where there is privilege in telling people "God has a plan" and that their lives will "work out for the best". Christianity failed for me because it simply provided no guidance for my real life and why bad things happened. It's explanations simply didn't work in the real world. As one guy online I talked to said, "Chinese slaves on the railroad were definitely anxious and depressed." I met many people who had lives so much on the hard setting, where nothing worked out, that the religious descriptions of reality simply failed.

One thing that mentally helped me was jumping off the blame and shame train. The narcissists taught me to blame myself for everything bad that happened. Sadly religion backed this up too, insisting I pray all the time for "good" things to happen, and that if bad things happened, it was due to my lack of faith or spiritual errors. Learning other philosophies and coping mechanisms to deal with the "bad stuff" that happened helped me a lot. I am glad I deconverted prior to Covid happening.

American self-help culture has influenced therapy too. The self help world often taught that everything was under the control of the individual. What has Covid taught us but how much is beyond our control? The best therapists also analyze what needs are not being met. There's times I think the mental health world is full of people who simply need friends and someone to care about and love them. I have a loving husband but the world is full of many Eleanor Rigbys. "All the lonely people"..... Even before Covid, while I and my husband have plenty of online and faraway friends, I told him, we have to become less isolated we need to make local friends too. Covid increasing social isolation and disconnection definitely is not going to help people's mental health. Loneliness prior to Covid was an epidemic. What's going to happen now? I'm starting to feel funny from the isolation as a bookworm Aspie so what about the extroverts of the world?

I am not a therapist just a lay person making remarks on my experience, mental health is a complicated area, I can't claim to know everything about but these were just some ideas I wanted to explore. I do think Covid is massively impacting mental health and the therapists very much have their work cut out for them. Anyone who is a consumer of mental health resources, needs to be mindful of what kind of therapists are out there and some of the pitfalls. We definitely need more access to mental health care in the United States.