Quitting therapy

[Slowhorses1]

I’ve suffered from anxiety for over 20 years. It was very bad in my twenties and early thirties, and I had disorder eating and obsessive tendencies, but I’ve always been “high functioning”. It doesn’t stop me from doing things, but it is always there and consumes a lot of my thoughts. I feel like I’m in constant fight or flight mode. I am terrified to get on planes, drive on motorways, get symptoms I might think are cancerous. But I still live life in a pretty functional way.

I had an awful year last year, was put on cancer pathway for a positive FIT test (all fine, thankfully) and had problems with my children. My anxiety was through the roof and I was feeling quite down, so I decided to try and do something about it and my GP referred me to talking therapy CBT.

I’ve been seeing the therapist online for 3 weeks. At the start of every week I need to fill in a questionnaire that basically rates my anxiety levels. Questions are things like “on a scale of 1-10 how much did your anxiety stop you working / socialising/ being with family).

Because I internalise almost all my anxiety I don’t score very highly on these questionnaires. As a result my therapist told me last week that if he showed them to his manager he would ask why I was being seen. He actually said to me, “what’s the problem if you’re standing there doing the washing up and you’re worrying, so what? You’re still managing to do the washing up”. He basically suggested that I was wasting their time. I tried to explain that I am consumed with worry but just internalise it, but he said I couldn’t be because if I was consumed with worry it would be affecting everything in my life.

I understand that there will be many people with way more complex and significant issues than me. But now I just feel like an idiot for even trying to get help, and feel like there’s no point in me continuing. AIBU to quit and free the space up for someone they think is more deserving?

Oh god, that's a terrible thing for a therapist to say op. The problem with NHS cbt is you don't get to choose your therapist - which I think is a crucial part of entering therapy.

Is there any chance you could afford to go private? And psychotherapy, not cbt.

You deserve to feel better op and just to validate - your problems are worthy of therapy

It’s your thoughts not your actions ime of anxiety.
Exhausting negative thoughts and worries, ruminating constantly rather than being in the present.
Medication could work.

I'm sorry to hear about your experience of therapy. I am no longer shocked by stories of NHS talking therapy, especially cbt. It seems they can often only work with behaviours and actions - how you are functioning rather than what's going on inside. They are trained quickly and work in a stretched service and this can make them dismissive and lacking in empathy.

Can you afford to see a private therapist? There are other types you could try. Integrative might work well. Have you tried medication?

The reason he is saying this is because the NHS service works by using these scores as a measure of success for treatment. So regardless of the situation, if you score low, he will not be able to say you've improved or got better. Their 'person got better' figures feed into funding. It's heartless.

Please don't take this as being what all therapy is like. Are you able to access private therapy at all? It sounds like a more person centred approach would work better for you.

Agree with @Ididntsignuptothis that’s an awful thing for the therapist to say. NHS cbt is very much a one size fits all. No allowance for nuance or for how people differ. The endless questionnaires are really a tool to enable easy auditing of the service IMO. I think they want a nice neat trajectory where someone comes in unable to manage their life, and leaves the therapy scoring much higher.

Living with anxiety is horrible. It doesn’t need to stop you from doing things to be a horrible thing to live with. You have every right to try and get help.

It might be that you’re on the wrong ‘pathway’ for your problems. Did you get a feeling for whether the therapy could be helpful at all? I would stick with it if you do, but perhaps be prepared to lay it on a bit thicker about how the anxiety affects you.

You deserve help and support OP. That therapist was wrong.

And as someone whose mental health is currently all consuming and affecting every area of my life, as he describes, the basic CBT that the NHS offers as a first port of call doesn't do a jot. Doesnt touch the sides. My point is, he's very unlikely to see someone like he describes, he likely can't help them.

He should be trying to help you, if he can. Maybe the problem is that he isn't qualified to, maybe your issues are more complex than he was prepared for or is equipped for.

You need to see someone else. Poor therapy can worse than none.

I would request a change of therapist before you quit. It is possible to change in the NHS; you're allowed one change of therapist (can't do it more than once). Then clearly explain to the new one how invalidated you felt.

He sounds terrible. I would ask to swap

I had NHS CBT ( not for anxiety) absolutely useless , a waste of money.
They gave me 6 weeks , if you're seeing a counsellor yourself you can go for months / years , although it's not financially possible for some people.

Also this. There is real iatrogenic harm done by bad therapy- it's such a shame this has happened, as now you still have your anxiety but also have to get over a fresh bad experience of being invalidated! Please do try to see someone else OP and don't let it put you off therapy forever- you deserve proper help

Oh god I had to do those rating charts newtly 30 years ago in NHS CBT. I had to rate 0-100 for every waking hour!!

Op the problem is the therapy modality and the therapist who thinks that humans are some kind of robots that need reprogramming if their robot actions are impaired.

I agree with the pp who suggested a more person-centred approach.

You can look too at something called polyvagal theory. There are some YouTube videos. It can help you recognise when your body is feeling stressed and then how to work with/counter it. Any video by Deb Dana is good, but there are others. The name sounds complicated but it's actually very simple. Always harder to put things in action rather than just understand them though! But it can be helpful.

Thank you so much for the advice. I was starting to think that I was the problem. Things are pretty tight at the moment so I’m not sure if I can afford private, but I’ll look into it.

I agreed maybe a different type of therapy is the way to go.

I’ve just felt so stupid. Finally got round to seeking out some help and wanting to change and then ended up feeling like a fraud.

He or she was clumsy and rude. I had talking therapy and understand what you mean about not scoring particularly high on some of the questions. If that is the yardstick for eligibility the it may look as if h don't need it. Shows flaws in system. Hope u find someone better OP

My brother had this recently. Was told by the state psychiatrist he wasn’t depressed. He’s been depressed all his life, and sometimes suicidal! It’s massively debilitating. It’s really set him back when he finally got on the road to getting help (in his 50s). I was so annoyed with that psychiatrist.

Are you on the ‘low intensity’ or ‘high intensity’ pathway?

are they following a treatment protocol for GAD based around intolerance of uncertainty and the function of worry?

I do think cbt is good for anxiety, generally more effective than say person centred but it has to be proper cbt with a formulation eg high intensity, which a lot of people don’t get offered as the first option.

can you talk to him about what he said and how just because you do stuff it doesn’t mean the worry isn’t distressing?

@CharlotteLightandDark Im not actually sure.

I’m so non confrontational, I just ended up nodding when he was saying it, although I did suggest they added some different questions to the questionnaire. I think I’d really struggle to ask him more about why he said it.

I’m really sorry that happened to your brother @OhFensa That sounds really bad.

He’s a terrible therapist and should not be saying those things, that goes against the ethos of empathy, understanding & unconditional positive regard to name a couple of therapy ethics. Please quit but also report him- this can actually do a lot of psychological damage to people at their most vulnerable time. I hope you find a better one OP. I would recommend either another CBT or try person centered therapy.

Can I just check that was a psychiatrist not a psychologist or counsellor? A psychiatrist is a fully qualified doctor who has gone on to specialise in mental health, assess serious mental illness and prescribe medication etc. whoever it was who saw your brother it is unacceptable but it would be a case of report to the general medical counsel and have this seriously investigated if he’s a psychiatrist getting the diagnosis wrong!

@Howbizarre22 he did say psychiatrist but it’s not in the uk. It sounded like a terrible appointment and he said he felt rushed out the door. I saw a psychiatrist when I was younger in a different country to his or the uk and my experience of state care was excellent. So I was surprised he was treated this way.

Oh op that's rubbish I'm sorry, you could ask for a different therapist, but ultimately the NHS provision might not be right for you. It wasn't for my DH, for the same reasons other posters have mentioned about the service. He found someone privately, we're not well off but could manage that extra outgoing for a period of time while he needed it:

I saw a psychotherapist in person who also did CBT work alongside traditional talking therapy. It was a good mix, just CBT on it's own wouldn't have been the right fit for me. Yes I have GAD, but I also have lots of childhood and dysfunctional family issues that the talking therapy really helped me understand. It was at the root of a lot of my anxiety, it was like putting pieces of a jigsaw together for me, seeing how my past and the ongoing family issues have shaped my mindset, and put me in a hypervigilant state my whole life.

It's worth going on the BACP website, they have a find a professional search function where you can find therapists near you, or many offer online / Zoom appointments since Covid. Some therapists offer subsidised rates depending on individual financial situations, and most offer a free 15 minute consultation to see if you think they could be the right person to work with you, there's no obligation. It's important to get the right person for you and your needs. Don't give up op, and try not to compare your needs with others, well done for getting this far as well as I know it's not easy