Why is any thing worth talking about?

So my www.powex.co.uk/therapies blog has raised some interesting questions!  I’m pleased that people have found it useful!  I guess though, the next step once realising you could benefit from therapy.  Is, how do I get it?

If you’ve had a look at the different types of therapy on my link, what next?

I guess right now, in COVID lockdown land, there are pros and cons to the world of therapy.  Many therapists who normally would not offer online therapy are.  That is not to say that everyone should do online therapy.  There is value and good reason for in person therapy and some therapists may not shift their view on that.  That is not because therapists are annoying, its because the experience in the room is important.  Having done zoom sessions with my NHS clients, I can tell you, therapy is possible, but it’s not always easy or the best way to engage someone properly. (Thanks wifi glitches and bandwidth restrictions 🙂 )

Maybe you have actually felt completely ‘at one’ at home while in lockdown and difficulties feel easier? Is your home set up is where you prefer to be?  Do you prefer to avoid anxiety, social situations and difficult thought processes attached when out and about.  This COVID lockdown could be some people’s perfect storm!  But any theory of anxiety will tell you – avoidance only fuels anxiety further.  So I would be careful if this is you and make preparations for ‘back to normal life’ sooner than later!

There are lots of ways to manage the day to day of mental health which I have talked a lot about in my @melissa_powex instagram posts.  However, accessing therapy is not actually that easy, even if you know what you want.

Emergency talking –

If you feel things are too difficult to manage in the here and now and you need help very quickly.  A&E, 999, Samaritans, online apps/chat lines is where to start.  If you feel in crisis and can’t see a way out.  https://powex.co.uk/mental-health-emergency

Therapy through the GP –

So this is where things can become complicated and convoluted.  Due to the lack of funding to the NHS and more specifically mental health services, the access to therapy through your GP is limited.  There are huge waiting lists and people who need emergency help (like above) will be accessing a service like mine.  Teams in every local area work with the most risky and unsafe mental health difficulties regularly and ongoing, this has not stopped as it is a critical service.  Reaching an emergency crisis however, is not the best way to get therapy.  Some people are unable to engage in therapy because of their early childhood trauma’s, behaviour patterns learned through abuse and sometimes because they are just too embarrassed and feel ashamed of their difficulties.

If you feel you need to talk and you speak with your GP, they will refer you for therapy.  They are very unlikely to be doing an assessment on the right therapy for you but they may offer you medication.  Many GP’s go straight to the IAPT/CBT model (see my therapies blog).  This is based simply on the fact that there are more therapists in this service because it is seen to be a ‘quick’ route to get a problem fixed according to the Government.  The numbers that come out of rating experiences in IAPT are fed to the government to prove that it ‘works’.  You do not need to take medication if the Doctor offers it to you.  Psychiatric nurses and Psychiatrists are available in mental health services to discuss medication further if you want this.  All medication should be considered alongside therapy, not on its own.

My advice if you feel you need psychotherapy or a specific type of counselling is to ask directly for this at the GP.  They will have to refer you to the appropriate service.  It shouldn’t really make a difference to the GP because they are not assessing you. Their job in this circumstance is to make sure that your referral reaches the right team with the right sort of therapists.  Be specific.

Private therapy –

You can find a list of private therapists in your local area to where you live or work.  You can look through the list and google them to see what is or is not online about them.  It is likely that the less there is about them online, the more ‘strict’ they are to the model in which they work.  The new wave of therapists being open on social media about their own struggles is quite unusual historically.  However, sometimes knowing that you are talking to someone you think will ‘get you’ has great value.  The difficulty with seeing a therapist who also ‘has battled’ your same battle and you know about it, is that you might not feel confident in their opinion if you feel differently to them.  Nothing is ever straight forward right?!

You can look for any therapist you want online and as long as you feel they are right for you, get in contact.  Call them up, ask for a discussion to think about whether therapy is right for you and whether they are the right match for you.  In simple terms also, the therapist you like may not have space, so finding out how quickly you want therapy is key too.

Private therapy can be extortionate and for good reason, it takes years to train and is a highly skilled, emotionally demanding job.  There are significant risks to working as a therapist, particularly if a patient struggles with thoughts about ending their life, which is not uncommon.  However, that does not mean you can not talk about cost with the therapist.  You are able to tell the therapist that cost is a concern and they will be able to discuss this with you.

Reduced Fee Scheme –

Again, mentioned on my therapies blog.  This may sound like ‘the budget’ version of therapy and yes, it is.  However, reduced fee schemes are great because they offer intensive therapy (3 times a week) for a significantly reduced price based on your ability to pay.  The draw backs are that you must attend 3-5 times a week, depending on the requirements of the specific organisation.

Another factor to consider which may be a drawback to some and not to others are that reduced fee schemes are often made up of trainee therapists.  I would say that unless you are really specifically looking for an expert for a particular reason, there is no reason why a trainee is not good enough.  Trainees are not straight out of uni, they have done an extensive amount of study and training already to be a therapy training.  Trainees are actually supervised and supported more than your private therapist who may not have supervision very often.  Subsequently, if there are tricky bits in the therapy, the trainee is actually going to seek advice to help you.

Reduced fee schemes also normally require a commitment of a certain number of months to years also.  This is because trainees need to see patients for a particular period of time to be able to qualify.  However, this does not mean that you have no choice to stop.  You will of course be encouraged to continue and helped to work through difficulty.

What’s best for me?!

Well, this is a tricky question.  Everyone is different, has different journeys, stories and traumas to deal with.  If you have no idea where to start, a consultation with a private therapist might be a place to start to give you guidance on next steps.  Your GP may have an understanding of mental health services, but my experience is that many don’t.  Some people use friend recommendations but this is normally a bit weird for people if they share the same therapist.  Do your research and ask questions.

If your GP is unable to give you much information, ask for the information of the team they are referring to and call them up.  Every locality has a mental health service and their aim is to offer support and advice to all.  Call them up?  Ask for advice.

Therapy in lockdown –

I’m not currently in therapy but have been working out when the right time is to get back to it.  I previously was in 3 times a week psychotherapy as part of my training as a child and adolescent psychotherapist.  Let me tell you, 3 times a week therapy, whether you think you have difficulties to face or not, is hard.  My reasons for not accessing therapy for me at the moment, is because I do need the ‘right’ therapist to be able to take me into my training again and that involves a more complicated process than above.  Now having a child to factor in, things are of course more complicated to navigate.

In lockdown, I have enquired about online therapy for certain aspects of my life that are not just about me and there is a lot of good stuff out there happening.  However, I am active, I go out a lot, I put myself in new situations often and find that my work and lifestyle keep me ticking along, managing the difficulties that my life has presented me.

My experience in lockdown –

I felt overwhelmed with social media during the lock down, however I managed that, and re-engaged in media and social media.  My habits returned pretty quickly, going back to more mindless than mindful, which of course I am trying to work on.  But why has the mindless scrolling come back?  For me – I didn’t stay in an overwhelmed state.  I made a change to feeling overwhelmed and felt good about the change.  I reintroduced the thing that overwhelmed me and then I actually started to feel quite flat about the COVID situation.  A new experience for me in the pandemic.

My feelings of ‘shut off the media to make it more quiet’ when feeling overwhelmed turned into, ‘lets look at the media to see if anyone else is feeling this flat?!’ I needed to feel the flat.  This is part and parcel of life right now.  Lockdown is making people feel more, and feel more intensely, even those of us who might seem to have their shit together a bit more, or who have used therapy well in the past.

You should know that whatever you have tried to manage, it will not be exactly the same tomorrow or the next day.  Whatever you have tried to avoid thinking about probably hasn’t gone away.  If you think that this lockdown has made a lot of things worse, you may be right.  But, there are a lot of things that can make it feel more ok, because things shift and change all the time.

While in lockdown, maybe start making calls to your local mental health services or a private therapist?  Figure out who feels right for you?  No one has to manage difficulty on their own.

 

@m_az @unsplash