To think that this suggestion of drug counselling isn’t helpful?

[feelingbloodyawful]

I’ve been on and off codeine for years and years due mainly to endometriosis with bladder and Bowel involvement, have got chronic pelvic pain and been seen by pain team etc . I’m usually prescribed it however have taken it over the counter many times .

I have also had anxiety and depression and found at times I was self medicating (always within prescribed dose - I was just taking two at bedtime to fall asleep as it is quite anxiolytic). I was honest with GP, who supported me to withdraw slowly and take only when absolutely essential ie on the floor in agony .

She’s also put a block on me buying it OTC (well, from local chemist) so that she can to some extent supervise how much I’m having and can help with that, eg if I’m needing it prescribed regularly then can investigate why I’m in more pain .

I’ve recently started counselling for the anxiety via zoom . I mentioned to the counsellor that I have had previous issues with self medicating with cocodamol .

She then said that I should be pursuing drug addiction counselling/support groups for addicts, handed me a number for local drugs charity and suggested that they’d be best helping me to keep clean (which GP and hospital have already pointed out won’t happen, at least not in the long run anyway, I’m 7 weeks without at the moment) .

When I said that I wasn’t sure they could help - as it’s
cocodamol/codydramol at low doses - she said any addiction is an addiction, whether it’s heroin or codeine doesn’t matter .

I’m a bit wondering if she’s misunderstood the situation completely ! I’m in a bit of a panic as I work in a public facing role and am now wondering if I’d be liable to lose my job, if they found out .

I’d never seen it as being an addiction as such - I don’t think GP did either - but she was adamant it’s all one and the same thing, and that I should join something like narcotics anonymous ...

Was the counsellor being U or am I? Should I ring up charity and see what they offer?

She's overstepped her mark a little there!

Maybe write it down clearly in an email and tell her that you will be led by your GP and the pain team in this matter.

Your work won't find out from her, she can't break your confidentiality, so don't worry about that!

Try to discuss it with her again, if she doesn't change her position then she is not the right counsellor for you. At the very least you need one who will discuss it much more before simply referring you on and being implacable about it!

Oh! And yes! You could ring the charity and see if they can help you at all. You are in a bit of an invidious position with the medical need vs. addiction. They may be able to support you with that!

Do you know what type of model the counsellor is following?

Do you consider yourself to have an addiction? I think if you do, it could be worth exploring additional support but NA isn’t for everyone. If you don’t think you have an addiction, then it wouldn’t work even if, in reality you do have an addiction.

It’s sounds like a tough one, due to the nuance of your situation & need to manage pain. You’ve taken a lot of action already, by seeking out your gp, being honest and by starting counselling. You don’t seem to be in denial or you wouldn’t have done these things.

I can’t see what harm it could do to check out NA. Perhaps that could help you firm up in your own mind whether you have an addiction or not. Ultimately, you are the expert on yourself and not your counsellor. You need to trust in yourself & be helped to make up your own mind rather than be told or directed what to think. To my mind, that should be the role of the counsellor with you.

I would trust the GP's advice on this assuming you've been honest with him/her. Addiction isn't all or nothing. You've identified that sometimes you've been using codeine inappropriately and you've taken steps to stop it before it develops into a real issue. It sounds like things are under control at the moment and you're being supported by the GP.

I would say even qualified counsellors aren't always great and can easily misread a situation. Take on board what she's said think carefully about whether you need further help but don't treat her words as gospel.

I’m not really sure what sort of counselling it is to be honest . It’s called life coaching, which I’ve never had before, but mainly seemed to be the counsellor telling me to come up with smart goals and then telling me to go and do them within a fortnight . Without any sort of real help as such .

It’s not via the NHS, I’m on an endless NHS waiting list for more structured support via clinical psychology, this was meant to be a stop gap as have been waiting two years now for any sort of help (have OCD and agoraphobia), but having had therapy on and off for years - having had the really good and the really bad - this is just coming across as not great so far .

I’m not sure whether it’s worth me phoning NA or local drug abuse charity; it was a bit of a problem and becoming an addiction - certainly if I didn’t have it I had horrendous withdrawal - however I’m off it just now, but have a semi open prescription for more with my next period, so it’s difficult to know what NA could actually do . To be fair GP is even less interested - has rung twice since March (despite previously being reviewed every four weeks for years) - so maybe it is worth ringing NA as they might actually have some advice !!

Okay. So this person is not a counsellor at all then. "Life coaches" have their place but they are not equipped to help you with MH issues.

I would stop seeing her and find someone on the BACP register who has solid counselling and psychotherapy qualifications and experience in working with clients on the issues you mention. Arrange intro conversations with a few and look for one you feel you can build a relationship with.

The BACP register of counsellors and therapists. www.bacp.co.uk/search/Therapists

But life coaching isnt the same as counselling is it? Is it life coaching that you are wanting, I thought they were quite different things.

A friend filled out an assessment for NHS counselling, and wrote that she drank to help her cope. She does not have an addiction. She got a letter back saying the NHS service was not appropriate for her and giving her details for AA. I think it's a way to get people off the waiting list.

Life coaching isn’t at all counselling, isn’t regulated and anyone with any random or no training can call themselves one. I’d definitely stop seeing her and find an accredited therapist as suggested above!

Is it not , to be honest I had/have no idea . It was a GP referral to local mental health charity; who told me they only offer that life coaching or peer listening, GP said it’s as good as I can get without waiting for nhs help .

I’m not sure what I want to be honest; I’ve had CBT twice before which was very, very helpful but have been told there’s very little chance I’ll get that sort of help again on the nhs, Gp said it’s charity, wait for an nhs psychology assessment or use online, self help cbt .

I’m virtually housebound at the moment with anxiety so I’m utterly desperate, would do anything if someone told me it would get rid of how I’m feeling .

can I ask, are you taking any medication to help with the anxiety? Sometimes that can be really helpful and then you might have more luck with the actual counselling when you get it.

Are you doing the self-help CBT? There are good apps for it. Are you taking medication? Does your GP know you are housebound by your MH?

I would pay for private CBT if I were you. There are lots of private CBT therapists on the BACP register and it'll be a lot more use than life coaching. Life coaching is basically, as you said, someone helping you identify and set specific goals and holding you accountable for meeting them. A good life coach can be very helpful for someone with decent MH and good resources who just needs some focus and direction, but they are not at all suitable for your situation.

This sounds like it's not much use for you and the person seems like they are trying to fob you off. I think you did have an addiction of sorts (many people addicted to prescription painkillers would not name it as such) but that's not the point. You took steps to deal with that already and it's not the current problem you need help with so NA type thing won't likely help you.
You want CBT for anxiety.

Is there no self referral psychology service in your area eg IAPT? I'm surprised if there isn't. Maybe check local mental health trust website.

If there really isn't then I think ask the Gp to re-refer/ expedite and explain it's so bad you are housebound.

Or is there a MH crisis line in your area like 111 option 2? They can expedite referrals if they deem that's required.

Don't necessarily dismiss the idea of online or workbook CBT either especially if you have done it before so essentially know what to do. I know it would be better to have someone to support you with it but these options can help if a person is motivated and capable of doing them. Might be better than nothing.

Your life coach sounds a little bit like what I’ve just qualified as. Different country though. Called a mental health support worker, here life coaching is a bit different

Roughly the idea behind the role is that we provide practical support to aid a person in their own recovery, which might involve planning some achievable client directed goals, helping someone identify things that have worked before and other tools they can use. Some incidental counselling, lots of listening and appropriate referrals.

Sounds like your life coach kind of jump on referring you to someone but it sounds like your already pretty well supported with your medication use and the fact that you recognised there was a issue and did something about it is a huge strength (which the worker should have pointed out to you). Her job really should be to help you identify your strengths to help you manage your anxiety

I'm shocked at the replies. I think you are in denial about your use. You say you use it to self medicate and the gp has placed a block on you getting it over the counter. I think you are downplaying the seriousness of this.
Addictions creep up you dont just wake up and drink 3 litres of vodka a day or whatever.
Life coach counsellor whatever, they have a duty to signpost. The GP may saw a different version of you, may have no told them as much as you have revealed to the counsellor and i suspect they see the extreme end of addictions so their threshold to refer is higher and probably only if you also want that sort of help. Occasionally gps misdiagnose and make mistakes so its not like they never misjudge.
You are with a pain team who will be aware of addictions starting from pain but continuing for other reasons.
You are all minimising it just because you have a thing against life coaches.

You are all minimising it just because you have a thing against life coaches.

I have no idea whether the OP has an issue with codeine addiction, but whether or no a life coach is way overmatched by the issues she has to deal with.

I have nothing against life coaches in the right context. They can be very helpful, although they can also be total shite because it's an unregistered term that attracts scamsters and the clueless. This is not the right context.

Once OP has a professional therapist, they are much more likely to be capable of assessing the degree of her issues with opiate addiction.

No, don't contact a Life Coach. They are unregulated, self defining and sell you the idea of control, all wrapped up in the latest gobbledegook and requiring the latest gimmick, super food etc etc.

I'd also more strongly query the qualifications if your counsellor based on that recommendation!

Take care of yourself.

Life coaches in the UK have no professional standing, not regulation etc. I spent 3 years 'Life Coaching' before the sheer audacity of colleagues with no qualifications just some workshops and pretty certificates persuaded me to stop using the term.

I do/did have relevant training, weight management, exercise on prescription, peer listening, sub CBT stuff all supported by the local PCT. I ran various interventions with GPs, reduction of prescribed meds, smoking cessation etc etc, but would never have referred a client on without going back through their GP.

@PillowPrincess

I'm shocked at the replies. I think you are in denial about your use. You say you use it to self medicate and the gp has placed a block on you getting it over the counter. I think you are downplaying the seriousness of this. Addictions creep up you dont just wake up and drink 3 litres of vodka a day or whatever. Life coach counsellor whatever, they have a duty to signpost. The GP may saw a different version of you, may have no told them as much as you have revealed to the counsellor and i suspect they see the extreme end of addictions so their threshold to refer is higher and probably only if you also want that sort of help. Occasionally gps misdiagnose and make mistakes so its not like they never misjudge. You are with a pain team who will be aware of addictions starting from pain but continuing for other reasons. You are all minimising it just because you have a thing against life coaches.

That's the thing though she is managing her use. When someone has ongoing pain, the use of pain medication and the management of use can be complex. Its not the same as someone who doesn't need it using. The Op is already connected to people and services who can recognise support and manage use. Speaking to addiction generally, referrals are only helpful if a person is interested in changing what is going. If they aren't then pushing someone that way can be actually be counter productive.

What's happened is the OP has identified something she does want to change (her anxiety) and any support should be to help her make those changes.

Pressed submit to early, her 'life coach' instead has identified what she thinks is the problem and has kind of lectured the OP in a way that has come across as a bit judgemental. Which isn't ok

Yeh I'd agree with that

No counselling or therapy modality ever recommends lecturing people or pushing your own ideas on them

Even motivational interviewing approaches for addiction are about encouraging the person to weigh up the pros and cons for themselves as it's well known that just telling people they have a problem is counterproductive

The counsellor should be helping OP work towards her own goals not telling her she has a different problem entirely and clearly making her feel worse.

seeing a life coach for anxiety when you have OCD could make your OCD worse. Find a proper therapist who understands your condition, some good advice here on how to do that.
www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-privately/finding-a-private-therapist/

She’s also put a block on me buying it OTC (well, from local chemist) so that she can to some extent supervise how much I’m having and can help with that, eg if I’m needing it prescribed regularly then can investigate why I’m in more pain .

So the GP thinks you are an addict?

@WillSantaBeComingToTown

She’s also put a block on me buying it OTC (well, from local chemist) so that she can to some extent supervise how much I’m having and can help with that, eg if I’m needing it prescribed regularly then can investigate why I’m in more pain .

So the GP thinks you are an addict?

Well not in as much as she pointed the finger at me saying so ...

She just said, would it help if she asked the chemist not to sell it to me? As that way I can’t buy it from them and when I need cocodamol - genuinely need it - she can prescribe a stronger more effective dose and I can’t buy it purely to help me sleep . All talked about with understanding thankfully and no judgments . Funnily enough I hadn’t ever bought it from that chemist anyway .

I have endometriosis, adhesions, chronic pain, have been admitted to gynae 10/15 times for morphine during a period . So it’s not a very clear cut situation . I do agree there was the beginnings of a problem but on a very mild scale - 8mg doses twice a day and having never eg stolen, hidden or lied about use . GP is absolutely 100% aware as are hospital team .

I did have a good talk with the life coach yesterday ... she is a perfectly nice enough lass and I’m sure that sort of help has its place and I’ve certainly nothing against her or her profession .... but I do think it’s very, very self led and maybe that won’t suit me - quite hard to get a conversation started really . GP is ringing me next week to discuss it all a bit thank goodness . I’m on propranolol and mirtazapine each day but that’s making me feel a bit weird/slowed down . Definitely helps me sleep though !

I’m not trying to downplay it - just k think it’s a bit more complex than saying, right I’ll go totally ‘clean’ . Having googled local drug charity 90% of their advice on their website is tailored towards heroin addiction, BBVs and that sort of thing . I’m not sure how much they could help if I phone saying, I take codeine for chronic pain but for a while I’ve also been taking it to help me sleep/for anxiety and I’m worried I’m dependant .

As it happens I’m seven weeks totally off it anyway, partly as they’ve whacked the dose of mirtazapine up and I’m worried if I took the codeine on top it might be dangerous/ I’d feel even more zombified!