TW: Anxiety, OCD, GoT Spoilers
There is a fine line as a therapist between being an advocate for reducing the stigma around mental health and just oversharing about one's personal life. Because of this, I've always been cautious about how much I do or don't share about my own mental health history.
For example:
I share: "I've been to therapy!"
I usually don't share: "I'm bad at going to therapy!"
But, on a forum like this where the purpose is really just to share about my own life, I think it's important to normalize that not everyone is a fit for every therapist. Here is a little about own history of mental health services and why some therapists did (or mostly didn't) fit what I needed for my mental health care.
Why did you need to go to therapy?
Great question! A lot of reasons.
Nature
The first is that I've struggled with anxiety for most of my life. I remember having the thought as a really young kid- "What if every time I blink I'm actually leaving one dimension and reappearing in another and the mom that I left behind in the other dimension is sad?" Creativity is a double edged sword a lot of the same traits that make me a good writer and a creative therapist created some really wild worries when I was kid. Other worries child Ashley had:
1) What if I see something (totally benign- a red car, a bird chirping) but I can never forget about it? And it's all I can think about for the rest of my life? (Future Ashley would later figure out that I was having and was scared of intrusive thoughts).
2) What if I accidentally pledge my soul to the devil? (#raisedCatholic)
3) What if I see ghosts when all the lights are off? (Okay, so this one's a little more garden variety but it was still scary!)
4) A particular Italian restaurant because it wasn't well lit enough (see #3) and once I touched a plant there and became convinced that plant was going to grow out of my finger.
If you're wondering, 'wow, Ashley, did you have Obsessive Compulsive Disorder (OCD)'? I mean... probably. But I didn't know that and neither did my parents! I just spent a lot of my young life thoroughly freaked out and dealing with it the best I could by like, you know, compulsively repeating prayers so I couldn't accidentally pledge myself to the devil...(Seriously, how did no one catch this...)
A turning point for me in this kind of anxiety (the more OCD variety) was when I figured out that the anxiety would rise and fall on it's own. I distinctly remember thinking "oh, okay...it's like having the stomach flu...it's gets really intense and then comes back down." That knowledge helped me to soothe my more peculiar worries because I knew that eventually they would end.
Having successfully treated my own subclinical (probably clinical?) OCD at the tender age of 12 because I was too embarrassed to ask for help, my worries moved on to basically what you would expect for a white-presenting, middle class, oldest sibling, girl. I became perfectionistic, people pleasing, socially anxious, and hyper-focused on academic success. In dramatic teenage fashion I drew a picture of myself all in grey and titled it "I Am Not a Machine", I laid out in the snow in my backyard, arms and legs spread into a snow angel and felt sorry for myself. I drove my mom to the brink of her own mental well-being, I'm sure. My high school days were fun and filled with good times in a close knit friend group who all had a similar drive to achieve academically. But they were also filled with a haze of stress and perfectionism related worries. I left my house every single day and cried on the way to school. Should I have seen a therapist at this point? Probably! By this time my mom was catching on that something was wrong and she kept asking if I would see a therapist. But in perfectionist fashion nothing was wrong with me! I refused.
College was a relatively peaceful time anxiety-wise. I found my classes easy after all the Advanced Placement classes I'd needlessly pushed myself into taking in high school, and I fell into step with a group of friends with relative ease. The same for my first job right out of college. The main signs that my anxiety wasn't totally under wraps were my drives home from the school where I worked when I'd struggle to put "what if's?" out of my mind. "What if I didn't send this student's augmented alternative communication device home with them?" "What if I accidentally gave my student something to eat that they're allergic too?" "What if that parent thought I was disrespectful in my interaction with them and now they're going to call my boss and I get in trouble?" It sounds out of the ordinary when I write it now, but compared to the level of anxiety I had experienced in childhood and high school it was nothing. My anxiety was under control and I experienced a relative time of peace until I started graduate school.
Nurture
My experience in graduate school will be it's own post as soon as I feel up to writing about it. It's a complicated topic for me, and one that needs to be addressed delicately. For the purposes of this post though, graduate school put my mental health through a meat grinder. I entered graduate school an anxious but relatively optimistic person, with a belief that the world was basically a good place. When I left graduate school my subclinical worrying had blossomed into full blown, untreated, Generalized Anxiety Disorder (GAD). I had irrational worries that I hadn't had since I was a kid like worrying that I was going to be jailed for a parking ticket. More than that though, graduate school changed the way that I saw the world. I've always worried. I will always
worry. The worrying I could deal with. But in graduate school my anxious need to please others was so thoroughly exploited that it forever changed my ability to trust other humans. I left graduate school feeling like when given the chance people would always treat me like a product- not a person, that it was up to me to take what was needed to ensure myself and my loved ones had a safe and happy life, that no one was coming to help me, least of all the people whose job it was to do so. For a general sense of the vibe, please enjoy
the video to the right.
The therapists
#1- The Nice Lady
The first time I really knew I had to see a therapist was during my last year of graduate school after watching The Game of Thrones finale with my boyfriend. I left early and when he walked me to my car I burst into tears.
GAME OF THRONES SPOILERS BELOW
"She didn't deserve that!" I sobbed. "Danny trusted her advisors, and did what they said, and worked so hard, and she finally made it, and then he just killed her?? It's not fair, it's not fair!" I was inconsolable. (Look, we can debate my take on GoT later, I was pretty clearly projecting).
My intense, emotional reaction to the death of Daenerys Targaryen was the final straw that made it impossible to keep denying that something was wrong. I made an appointment with a Licensed Clinical Social Worker (LCSW) in town who took my insurance. As the title suggested, she was nice lady but she just wasn't the therapist for me. She used a lot of visual imagery, and talked about how I should imagine that there was a forcefield between my advisor's stress and my own. She just wasn't really able to understand the intensity of what was happening to me. It wasn't a fit. The one good thing she did do though, was insist that I should trial some medication. Do I think that she just insisted on this because she wasn't a skilled enough therapist to know what else to recommend? Yes. (I was nice before grad school, it is what it is). But as it turns out she was right, I did need medication to feel healthy, but I wouldn't get there for a few more years. I saw the Nice Lady for about 4 sessions before deciding to just not make another appointment.
#2- The Pompous, Odd, White Guy
I started seeing therapist #2 in the early days of the COVID-19 pandemic via telehealth. He was largely unhelpful because his therapy wasn't really evidence based. He tried to do hypnosis with me via telehealth by asking me to watch his finger move the across the screen and free associate words. So generally just kind of an odd guy- but, unlike the Nice Lady he seemed to understand the damage of my graduate school experience and was really validating of this. I made it through 5 sessions before I decided that Zoom hypnosis wasn't doing it for me and stopped responding to his emails.
#3- Almost Helpful
I started seeing my third therapist towards the end of my clinical internship. I was approaching my graduation from my graduate program and I was having a visceral response about returning for graduation. The idea of going back to the that town and that school, even for a weekend, filled me with dread. But it was important to my family. They had invested into this process too and they deserved to see me graduate. This therapist was the first one to use the term Trauma to describe the reaction I was having to graduate school. When I protested that a graduate education hardly met the criteria for Trauma she shrugged and said, "fine, it's a little t trauma." The ability to finally admit to myself that graduate school caused some "little t trauma" was healing. Even so, this therapist still wasn't the best long term fit. She got me through graduation but ultimately she was more of an advice giver than a listener. She talked more than I did in our sessions, and what I wanted was someone who was going to ask me questions and listen. Someone who was going to help me figure out what I thought about things. I went to 6 sessions before not scheduling another appointment.
What finally helped?
Medication! Truly, as a psychologist I know I'm supposed to be all about always pairing medication with therapy but I felt one million times better once I started a low dose of anxiety medication. I finally gave in and tried medication during my postdoctoral fellowship. My GAD symptoms were becoming more persistent and frequent. I was always worrying that something bad would happen to my patients and my family. Outside of the miasma of graduate school I could deal with it, but I just didn't want to anymore. I was over the feeling of constant discomfort that came from always worrying. Medication isn't the answer for everyone, but it definitely was a big piece of the puzzle for me.
What's next?
As you may have noticed if you've been reading this post carefully, this is a story about learning and growing through my anxiety disorder and eventually reaching a healthy place. But, like most adults, I sustained some additional damage along the way. I still haven't quite managed to work through the damage that graduate school did to the way that I see the world, or my ability to feel like I can trust other people. Some of this is adaptive, some of it is an exaggerated reaction, and over time I know I need to sort it through. I'm currently on the search for therapist number four to help me untangle some of the knots that medication won't fix. Stay tuned to see if lucky number four is the one that finally sticks!
Comments