“Let’s Find Out What Disorder You Have!”
Thoughts on finding a (good) therapist.
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After nearly a decade together, my beloved therapist retired. Eva’s been through everything with me—texting for hours late at night to calm my anxiety, multiple hospitalizations, psychotic breakdowns, being fired from jobs, bringing me back to life after a suicide attempt—and she’s never given up. She’s one of the good ones. The kind of therapist that’s so hard to come by, I think they may no longer exist. And with Eva’s retirement, it is possible they’re extinct.
Okay, that’s an exaggeration, but it is what I thought when I heard I needed a new one.
Finding a therapist can be a nightmare.
Many don’t accept health insurance and charge hundreds of dollars for a single appointment. (Check if your insurance reimburses for out-of-network providers! A pain in the ass, but worth it.) Even if you can afford therapy, it takes time and energy to find someone, let alone someone you like. In my experience, they never answer their phones and will call back roughly 3% of the time. (I’ve had better luck with email.) If they do respond, they’re probably not accepting new patients, only do virtual therapy, or have a waitlist longer than lines at the DMV.
These are some sites where you can search for therapists:
GrowTherapy.com (online only)
TherapyDen.com (online only)
BetterHelp.com (chat/online only, insurance NOT accepted)
FindTreatment.gov (federal/state programs if you don’t have insurance)
I shopped around for months while Eva was preparing to retire—she stayed with me to critique the candidates until I could find someone acceptable, and boy was there critique!
Multiple therapists refused to take me on when I admitted to having suicidal thoughts or bipolar, claiming I needed someone “more experienced” in those areas. It’s this phenomenon where providers are only willing to do what I call “therapy lite.” They refuse to treat patients with anything more severe than mid-level depression or anxiety because they don’t want to deal with the potential challenges or liability.
The worst was this guy who had 24 pages of policies, including that he was unwilling to fill out forms or write letters. Ever. And an arrival of 7 minutes late meant a cancellation and fee of $125. He sounded okay over the phone, so I showed up to his office. And you bet your ass I was 30 minutes early.
This man spent the first half of our appointment reviewing the 24 pages of policies I’d already read. The rest of the meeting he made me verbally review the generalized anxiety disorder and depression forms1—one question at a time—explaining why I chose each answer for the last two weeks and how my response would change based on my whole life. I wanted to slap him. Before I left, he almost jumped out of his seat, exclaiming, “So next week we’ll take out the DSM and find out what disorder you have!” I laughed and said, “You’re joking, right?” And, completely serious, he goes, “No, of course not, everybody who sees me needs a diagnosis.” I don’t know how I kept a straight face.
But not all therapists suck.
After several months of searching, I finally found someone with potential. I’m happy to report we’re still meeting. These are questions I asked when we first met:
What experience do you have with therapy?
What led you to specialize in [area I’m hoping to work on]?
What would a typical session with you look like?
Do you assign things to do outside of therapy sessions?
Are there any particular issues or diagnoses that you’d be uncomfortable working with?
How would you feel about working with someone who has suicidal thoughts?
What are your strengths and areas in need of improvement as a therapist?
What are you looking for in a client?
How long are your sessions?
Are you available for extra sessions if needed?
Are you ever available outside of session hours?
What’s your cancellation policy?
I made sure to share what I was looking for in a therapist, my treatment goals, and anything else I wanted her to know about me, like personality quirks.
Sort of like dating, I think it’s better to be upfront and direct about what I need so I don’t end up with a bad match.
After a few appointments, I considered questions like these:
Was I comfortable around this therapist? Was I nervous?
Did I feel like myself with them?
Was I honest with them? How easy was that?
Did they give constructive feedback or just criticize my behavior?
Did this person make me think and reflect on things? Or did I act defensive?
Have our sessions felt more natural or awkward?
Did this therapist talk too much or too little?
Did our session time go by quickly or slowly?
Did I feel good after the sessions?
Even though I’m happy with my therapist now, if she ever does something that makes me uncomfortable or bothers me, I plan to tell her right away. Nobody’s perfect, and she can’t change her behavior if she doesn’t know what she’s doing wrong. And if we can’t fix the situation, I’m allowed to change therapists! So are you.
Three things I do for my mental health besides therapy:
Dancing awkwardly and singing badly to loud music. One of my favorite songs recently is Lizzo’s About Damn Time.
Attending peer support groups like Alternatives to Suicide, which I wrote about in my last issue.
Reading outside in my hammock, though it’s a bit cold for that at the moment. Right now I’m reading Tomorrow, Tomorrow, and Tomorrow by Gabrielle Zevin and The Life-Changing Magic of Tidying Up by Marie Kondo—doing some decluttering!
I’d love to hear from YOU!
What things do you do for your mental health? How has your luck been with therapists?
If you read this far, you deserve some cheese.
The PHQ-9 form evaluates depression and the GAD-7 screens for anxiety.
To answer your question, I do everything for my mental health. If it’s dishes (not on my life a machine) I do so mindfully. Ditto cleaning, laundry, gardening, driving. I’ve been told I’m a bit OCD. I was for decades told I have intractable anxiety. Bipolar 2, then 1, drugged right into neurotoxicity.
For my health I slowly got off medication, one substance at a time. The more I got off, the better I felt.
Joy is everywhere; you have to choose it, you have to work at it, it ain’t always easy, but it is so worth it.
I’m glad you found someone and I wish you well with your Substack.
I am being treated for mild depression, so I tried to find someone to talk to recently.
There are very few choices in my area. I found one doctor, but the price would be $400, maybe more. I couldn’t afford it, so for now I let my GP prescribe medication.
But that prescription under current GA law requires visits every three months. The last visit was $260 because I’d already been to the GP for a routine visit this year.
What a pain!