My Therapist

Many people don’t understand the role of a mental health therapist. Perhaps they have a priest or elder they trust. Perhaps their mental health issues were never identified as critical requiring professional assistance or were simply tolerated or ignored by their friends and family. Perhaps they didn’t have the financial resources or wherewithal to get help. I haven’t had that luxury since I was twelve when it was abundantly obvious I would never survive without professional intervention. That was over 50 years ago.

It’s not like it’s been easy.  In 1971, my school counselor helped me get an appointment at the county mental health center.  They don’t exist anymore.  (These centers were championed by President Kennedy and gutted by President Reagan. Don’t tell me who’s president doesn’t matter.)  At fourteen, she helped me get out of my parent’s clutches and into a child psychiatric facility.  Unbelievably, it was a gift, which certainly speaks to how bad either of my parents’ homes were, enabling me to finish childhood in my stable and caring grandparents’ home. When I went to high school, there was a conspiracy among school counselors to give me support. In junior and senior high school, my counselors scheduled a study hall period for me. It was unusual at the time. I don’t remember asking for one. In retrospect, I recognize it helped me cope with the out of control voices in my head enabling me to excel in school. I was so damn lucky.  With the immense shortage of teenage mental health resources, I’m not sure how that would have played out today. Without this support, I likely wouldn’t be here.

As an adult, I had to chart my own path for therapy.  Not all therapists practice the same methodology.  Nor do personal styles, locations, or god forbid, insurance options necessarily result in good therapeutic relationships. Bonding with a therapist is an act of trust between professional and client.  As a client and consumer, I have to work hard to identify my therapy needs when interviewing these professionals. Currently, it’s difficult to even get an appointment to see someone. It is intimidating and requires determination. I wouldn’t hire just anybody to remodel my home. I wouldn’t stand back with no plan and say, “Have at it. I’ll be back in six weeks with a check to see the results.”  It needs to be interactive. That’s how is should go with a therapist.  This is a process partnership.  Not to mention that now the bathroom is updated, I also want to do the kitchen, and by the way, I hate that popcorn ceiling. I want to fix that too.

Insurance is a huge barrier to finding a therapist. It’s also a problem for therapists.  I know.  I live with one.  Reimbursement rates by insurance contracts are crappy and summarily lowered with no appeal other than to stop accepting their insured. Therapists must code the issues and submit paperwork for insurance approval and payment. I hate the system. I’ve opted out. Instead of a monthly car payment, I self pay for therapy.  It’s that important to me.  I’d rather drive an older car than continue to use a mind without any ongoing repair or maintenance.  Mental health therapy shouldn’t be free.  Clients need to put out effort to acknowledge the importance of the service. (I don’t have enough eggs to barter.) However, it should be subsidized by all of us similar to public education. A populace operating out of trauma is just as destructive as an uneducated one. (Did the US have a mass shooting today?)

Once I establish a solid relationship with my therapist, I hang in for the long haul. The trust goes both ways. Am I honest about my struggles? Do I keep my appointments and agreements?  Do I fight the need to appear better than I am? This is not for the faint of heart. I’m inviting her to walk with me to look at my trauma, that is, the abuse and violence that caused me to operate out of destructive coping mechanisms including being self violent and suicidal.  These things don’t just go away with medication and dusting off my hands and saying, “I’m all better now.  Glad we took care of that,” and walk away.  It’s a process.  One that can’t be shirked by either of us. I can’t just cover my flaws with new drywall. I don’t believe in short term therapy or quick fixes. A response to familial violence that settles into long term unsafe behavior does not quickly resolve any more than an addict can continue dabbling in their drug of choice.  It is the work of a lifetime. 

I talked to a friend recently who’s facing devastating health issues about the role of her therapist.  Like me, she’s a lifer.  “At this point,” she said, “my therapist is a touchstone. Someone I can talk to outside of my life with no other connection to me.”  Ronnie and I have often talked of therapists being like priests supporting our lives as professional guides. Of course, priests and elders can help unless they too are abusers.

My therapeutic relationships last more than a decade when possible and they continue being helpful. Longevity assists but is not required to have continuity of purpose. We’re a partnership. I bring the crazy and she (or he or they) brings the grounding and skilled push to understand where the crazy comes from.  With luck, that practice leads to a mental map for traversing the brokenness and making it better.  Without that touchstone, I am lost.  I resist changing therapists and only do so where a barrier presents itself that brooks no debate:  a relocation, retirement, or in one terrible case, a death. The depth and breadth of the interminably slow changes I make have created deep caring and mutual respect while understanding the limits of the relationship and the reasons for them.

I am indebted to my therapists. I am indebted to myself for doing the work, accepting uncomfortable truths, and facing demons, all of which, has allowed me to get to a place where I’m safe, where I don’t hate myself, where I don’t wish I was dead, and where I can embrace the richness of my life.  I have been persistent and lucky. Many have supported me on this journey including friends that drove me to my appointments when I wasn’t safe or took late night phone calls when I couldn’t get through the night.

I am now in a place where I can explore the oxymoronic term Post-Traumatic Growth. Who knew there was such a thing? Seeking mental health is like editing my writing. I make a pass at improvement, followed by another and another and another, until the writing gradually gets better. It’s long and painstaking until finally, remarkably, I recognize it’s worth celebrating.

L’Chaim.

Joceile

1.28.23

[Pictures of faces:  Karen, Trish, me in 1972, Barbara, Steve, Kari, Jerry, Stacy, me in 2004]

[NOTE: If you or anybody you care for is suicidal or struggling with personal safety, the following resources are available 24/7: Suicide & Crisis Lifeline - call, text, or chat at 988 or 800-273-TALK or 800-273-8255. Crisis Clinic of Thurston & Mason Counties at 360-586-2800. If immediately life threatening, call 911 or go to the nearest emergency room. Keep calling. Do Not Give Up! Suicide moves the pain to our survivors—a cruel legacy. Enter these resources in your phone where they could save a life.]