When Therapy Doesn’t Work, and When it Does

Trigger Warning: This article contains discussion of depression and mental health issues, and also self-harm and suicide.

When I was 16, my mother made me a doctor’s appointment to discuss my anger issues. Anything as small as the printer not working would send me into a rage; often throwing things across the room and screaming. I had already suspected that this was a manifestation of the depression I’d been experiencing, but at that point I wasn’t able to articulate what I was feeling well enough.

At the doctor’s I was asked to complete a mental health questionnaire; Do you ever feel as though you are worthless? Have you ever tried to harm yourself? Do you often think that your friends and family would be better off without you? Have you ever tried to act on these thoughts?

My doctor took one look at the answers and made me an appointment with CAMHS, the NHS mental health service for young people in the U.K. My first session was booked for the next week.

I was nervous, and plagued by the thought that I was wasting everyone’s time or being overdramatic. I sat in the waiting room, and promised myself that I would tell the counsellors everything. When they called my name, I left Mum in the waiting area and went into a nondescript room with three chairs, a cabinet with a jug of water on it and two counsellors.

For about half an hour I talked, and spilled out everything I could think of. I told them how pointless things seemed to me, how I felt on the edge of tears throughout the day; and how a few weeks earlier I had taken a handful of pills. How I had emptied out a few packets of painkillers, swirled them around making patterns, counting them. How I threw them down with a glass of water, waited five minutes, then burst into tears and ran for the bathroom to make myself sick.

After speaking for so long I felt exhausted, but also strangely liberated. I felt like this was something that might actually make me feel better. They asked if they could bring my Mum into the room to discuss further sessions, and I said yes.

“I never really felt like a person – just an appointment slot.”

Mum came in and sat down, and one of the counsellors asked the room, “Are we okay to talk about the pills?”

I was floored. I remember the silence in the room, and how we all just stared at her replaying the words in our heads. I turned to look at my mother. I wish I hadn’t; I will never forget the look on her face on hearing those words.

After that, I was in sessions for another six months, but I never opened up again. I don’t feel as though they were entirely pointless, because I did make some progress. But I could never forget what had happened at that first session, and I never really felt like a person – just an appointment slot.

I was transferred to the adult mental health unit; I sat down with a bored looking woman in a small room with no windows. She asked me how I had been feeling, and I said good. She asked me if I still had suicidal thoughts, and I said I didn’t think so. And then she asked, “Do you even think you still need these appointments?” Quite taken aback by the bluntness of this, I said I wasn’t sure. Surely as a mental health professional, they should be assessing my progress? They should have at least some input?

Honestly, I felt that I wasn’t done. I felt that my sessions at CAMHS had been lacking and I knew that I wasn’t ‘cured’ of my depression. But with this woman staring me down, making me feel like I was taking up her time, I said no. No, I didn’t think I still needed appointments.

And that was that.

I went a few years without any form of regular therapy, but my mental health continued to spiral downwards. It came to a crux during the start of my last year of university when again I found myself frequently having suicidal thoughts, self-harming and having panic attacks trying to leave the house.

The difference this time around though, was that I spoke to my family. Not in great detail, but I made them aware that I was suffering and that I needed help. I was very lucky in that both my parents were extremely supportive, and did everything they could to help me. My Dad paid for me to have monthly sessions with a private counsellor.

These sessions were infinitely different to therapy through CAMHS. Our sessions took place in a small home office behind my therapist’s house, with a big squishy armchair and a heater that made the place really cosy. I felt treated like a human being; she would truly listen, make suggestions that applied directly to my personality and situation, and I never felt like I needed to recap the previous session to make sure she remembered where I was up to, or even who I was.

“If you need support, don’t stop looking until you find what works for you.”

I feel like I worked through a lot of issues with her, and I was comfortable talking about things I’d never gone into with anyone else. I even spoke with her about my previous counselling experience; she was incredibly understanding about the fact I was naturally hesitant to open up again.

I understand that I was very lucky, in that I had the financial support to be able to attend private therapy sessions. I also understand that unfortunately, it’s those most in need of proper mental health care that would be less likely able to afford to go private, and would rely on the NHS. The good news is, even if you have a poor experience, you still have options.

You should report any issues you have with care to a practice manager and, within the NHS, PALS are available should you need to take anything further. The mental health charity Mind provides an info line and legal line for a variety of different issues you may need help with. They can direct you towards local branches or other mental health services, and you can speak to someone in person or over the phone. I’ve had experience talking to Samaritans, who talked me down from a critical state of mind and offered call-backs to check on me when I was at my most vulnerable. And if you’re uncomfortable talking on the phone, IMAlive is an online instant messaging services that provides support and help in the same way as the above charities.

The last thing I want to do is discourage anyone from seeking help, wherever they can get it. But I do want to let you know that if the first place you try doesn’t work out for you, you are not alone and there are other places you can go to get help. If you need support, don’t stop looking until you find what works for you.

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