My therapist, a psychologist, is scaling back his practice as he nears retirement. Because of my difficult insurance provider and my lack of progress — decline even — during the 8 years I’ve been going to therapy with him, he says I need to find another counselor. My options are not bountiful in this mid-sized Bible Belt town. After going to treatment for so very long with so little improvement, I feel weary of therapy and no longer hope it can help me feel any better about my life. I’ve been depressed and suicidal since my separation and divorce 10 years ago, which was a traumatic end to a dramatic and painful relationship. I have had to stay and live in my ex-husband’s hometown as my children finish school. Career options have been very limited here, and even professional jobs are very low-paying, so staying and living in this community for my children’s sake has been a huge personal sacrifice that will affect my standard of living until I die, which I hope will be sooner rather than later. I’ve been hospitalized three times during the past decade and have been diagnosed with PTSD and GAD. My family physician thinks I am bipolar, but my psychologist doesn’t agree. I don’t know. I have become an atheist during the past decade, but I live in a radically conservative town. Many of the counselors here were trained at one of the three evangelical universities here, and I don’t relish interviewing for a new therapist. Despite all the unhealthful habits I’ve dropped, I’m more miserable than ever. I spend weekends in bed crying. I have no motivation or inspiration to create any short-term or long-term goals. Indeed, after 10 years of life as a divorced woman and mother, I still cannot find any hobbies or purposeful goals to replace the broken dream of marriage and family. I am slow to trust people. In fact, after 8 years with my current therapist, I’ve still haven’t been able to talk to him about the things that happened during my marriage. I dread the long slog of building trust with another counselor, but I do worry that I would commit suicide if I don’t see pursue treatment of some kind. I don’t want to damage my children, and my youngest child is just entering high school. I would prefer to wait until he is grown to kill myself. Or, perhaps, too much rumination and therapy has made me more miserable? Maybe I need a break? I cannot stress enough how limited my options are in this place. Health care of all types is tough, especially specialists. It’s too far (3 hours) to any large cities, by the way, or I would commute to a therapist.
A: I’m sorry that things have not improved for you over the years and hope that you can find the right combination of treatment and self-help techniques to improve your condition. I’m surprised that your current psychologist didn’t give you some recommendations for a new therapist. If he hasn’t, this is where I suggest that you start because he knows your clinical picture and might be able to steer you toward someone in your community who might work well with you.
Otherwise, I checked a few therapist referral sites, and though the results are limited, there are some options. I would suggest that you first get a list of approved providers from your insurance company then cross reference that with the “find a therapist” links on sites like Psych Central and Psychology Today. This way, you can read their profiles first to see if you feel there might be a good match. Building trust might not take as long as you think if you click with someone quickly. In my experience, even Christian counselors are trained to respect the beliefs of their client and typically do not bring these issues into therapy unless it is wanted. But I encourage you to voice your concerns up front in the screening process. If you cannot find a local therapist whom you feel that you can work with, you might look for someone who does counseling over the phone or via video conferencing. You might even look into a certified life coach for this reason.
The other thing that strikes me about your post is that you have not made significant improvement during your years in therapy. However, you also admit that you have not shared some of the important details of your life with your therapist. We can only work with the information we are given, so I would suggest that you be brazenly honest in your next therapeutic experience. It is the only way to get better. I would also suggest that you get a thorough medical evaluation, including blood work, because sometimes there can be underlying physical problems. Here’s a good Psych Central article on this topic: “6 Conditions that Feel Like Clinical Depression but Aren’t.”
The other thing that I would recommend is to broaden your treatment approach. I have personally received good results by taking a holistic approach to therapy and incorporating all sorts of techniques, such as EMDR, EFT, and guided imagery. I also collaborate with other types of providers such as massage therapists, energy workers, and acupuncturists. I typically encourage clients to practice meditation (and/or prayer), regular exercise and other self-help activities such as support groups, yoga, and reading books geared toward your own personal struggles. You are ultimately responsible for your healing journey and if what you have done in the past isn’t working, try some new approaches.
Finally, I sincerely hope that you will work tirelessly on getting better so that you do not leave this world through suicide. I have seen firsthand the devastation suicide brings to a family, especially the children of the departed (and it doesn’t matter if they are adult children). You obviously love your children very much and have made sacrifices for them. The best thing you can do now is find a way to get better so that you can enjoy the rest of your years. You have suffered enough, now it is time to live.
All the best,
Dr. Holly Counts
Counts, H. (2014). Therapy Advice. Psych Central. Retrieved on May 5, 2016, from http://psychcentral.com/ask-the-therapist/2014/08/14/therapy-advice/