I lost my temper with my therapist, now what?

[ExistingNotLiving]

This is going to be long so apologies for that.

Ok, so a bit of history - I'm 43 and live in Wales (I know that makes a difference with NHS options). I've lived with low mood, low self esteem and suicidal ideation near enough my whole life. I've also had severe anxiety and agoraphobia for the last 18 years. I'm pretty sure I have ADHD and potentially ASD too, both are present in my immediate family. I've asked for a referral but was told I would need to deal with the anxiety first.

In recent years I've developed various physical health issues which I've struggled to get help with because of my mental health - either because I can't access help because of agoraphobia, or because stuff gets brushed off as "just anxiety".

In the last two years my youngest dd, 20, who still lives with me, has also developed agoraphobia. She had to finish her college course from home and had to defer her university place until next year. I'm now facing the impossible task of trying help her recover when I haven't been able to help myself. I strongly suspect she has ASD but again we've hit a brick wall trying to get an assessment because of her anxiety.

About a year ago I hit a major low point and went to my GP to plead for some extra help. I was referred to secondary mental health who referred me back to primary mental health who offered me CBT or counselling with a long waiting list for both. I opted for counselling because I've had CBT in the past and while it helped in the short term it didn't help me to deal with any of the deeper issues which I've had since I was a child.

So five weeks ago I started my allotted eight weeks of "counselling". I use inverted commas because this was far more CBT than counselling. She talked far more than she listened and just went over the same old techniques I've been trying for years now - breathing exercises, challenging thoughts, setting manageable goals etc. Last week she lectured me for 15 minutes about diet and exercise. I do need to lose weight but that's not what I had been talking about - she completely changed the subject! I tried to stick with it and engage with the process but it's been frustrating.

Anyway, I went into yesterday's session feeling low and deflated. I'd had a bad week physically which had had a knock on effect on my mood and I'd struggled to complete the goal she had set me, although I had made some progress towards it. So I started the session with honesty saying that I was feeling low, I'd had a difficult week, explaining what had happened when she interrupted me and asked me if I was wasting my time, and hers, coming to counselling because I wasn't making progress. I'm ashamed to say that I saw red - I told her if she felt I was wasting her time then I'd leave and I ended the call.

Since then neither of us have attempted to make contact and I can't see how the sessions can continue. My mood has worsened and so have my suicidal thoughts. I've been physically unwell and I've hardly slept. I feel irrevocably broken and I don't think I have much fight left in me. I've asked for help from the NHS so many times and I've really tried to engage with everything but I always seem to end up back where I started, or worse, and I don't know where to turn anymore. I feel like giving up.

Sorry this was so long. If you made it this far, thanks for reading my ramblings. I know no one here can help, I just feel so lost and overwhelmed and I just needed to get my thoughts out.

I’m so sorry this happened to you. Who on earth is keeping you from an ASD diagnosis because of anxiety? They are two sides of the same coin!

Is the counsellor registered? She sounds terrible.

She was inhumane not just rude. I’m sorry you’re going through this and suffering to such an extent. There’s a wonderful book by Pema Chodron called WhenThings Fall Apart. It’s been my constant companion these 20 years. 💐

It's not ideal, but it's possible she's waiting for her clinical supervision to get advice on next steps (as an explanation for the radio silence since).

I'd call the service and ask to speak to someone and explain your concerns (they sound valid) and find out your options. You've already done your wait whilst you were on the waiting list, it would be a shame to end things now if there's a possible alternative.

You've not done anything wrong - your counsellor sounds unprofessional and unsuited to your needs.

You need someone with a better understanding of working with ASD and anxiety, and someone able to go deeper into the childhood stuff you mentioned. There are services through the GP that can put you in touch with other forms of counselling. Anything but CBT, really.

That person you saw was unfit to do her job. Absolutely pathetic. So sorry OP.

It sounds like you were referred to a therapist rather than a counsellor. A therapist is more appropriate in your case, but I think the issue here is that there has been poor communication which has resulted in you both having different expectations. You're expecting her to listen to you talk and then counsel, whereas she is expecting you to engage fully with the treatment tasks she sets you. Contact her and ask can you discuss what exactly the goals are of these sessions. It could just be she is not the right fit for you.

Go back to your doctor and tell them that your anxiety is very likely caused by having undiagnosed ASD and that it won’t be cured before you can be assessed.

Do you have anyone that will speak up for you on your behalf?

She just wasn't the right therapist for you. Go back to the GP and explain what happened. Or can you afford private sessions.

This all sounds really tough.

She was unprofessional, so contact the service, explain what happened and ask to be referred to someone else as your case is clearly quite complex and that isn’t suitable for this counsellor. Don’t engage with back and forth just insist. If they aren’t helpful put in a complaint.

However an 8 week course of counselling whether it’s CBT or talking based is going to be pretty basic. It’s not going to be enough time to deal with deep seated issues unless the person concerned is very aware and pretty functional in life, which (and I’m not being rude just practical) you aren’t right now - so you need to be practical about what you can get out of it.

Are you on medication for anxiety right now? If not I think they may help you to get out of this hole, so that that is something you should see the GP about, and insist also on the ASD assessment - they can’t just refuse, complain.

It will also help a re-referral to the counselling service if you are going onto meds, and once you are on them, it will be easier to engage with the help the NHS can offer.

Point out while you’re at it that your own difficulties are impacting on your daughter.

I'm a counsellor and I'd never say this to a client.

I've had clients who haven't engaged at all-usually the type whose wife/husband has 'made' them come to counselling, or their work.
With these I would often say something such as 'Look, I know you aren't really wanting to be here but as you've decided to be, let's not waste the sessions, let's at least try to get some things a bit better for you?'

But I'd never tell someone they were wasting my time.

The difference between a therapist and a counsellor is a nebulous line, but this really isn’t it.

Agree with this. Absolutely fucking ridiculous.

Anxiety is more common in autistic individuals than it is in neurotypical individuals (van Steensel et al, 2011, Lugnegård et al, 2011). The consensus is that around 50% of autistic people will experience anxiety that has a significant impact on their everyday lives (Simonoff et al, 2008).

The counsellor sounds crap unfortunately. What you need really though is a diagnosis. I think it's time you put your foot down and insist they refer you.

Yes I agree about an ASD diagnosis-however in my area it is at least a two year waiting list and in my colleagues area (North East) it is EIGHT! Disgraceful, I know. Not sure about Wales.

Do you think a diagnosis of ASD is a cure for anxiety???

Why do you think the waiting list is so long?

I have had lots of therapy.
I would complain about her.

I agree the ADHD/Autism needs assessing first.

Also I would try to find out the qualifications of the therapist, I suspect it's one of the very junior people in primary care. I would complain if you can, she was inappropriate.

She sounds awful. If it's any consolation, I also lost my temper with my therapist today, shouted at him and then hung up. The difference is that he reached out to me via email and we ended up going back into the session for the rest of the time and working through why I was angry at him. That seems to me like an appropriate way to deal with something that happens in a session that obviously means something.

A diagnosis of ASD isn't a cure for anxiety, but it does change the approach. Just been through this over the last four years with DD18. It made a massive difference, but we did have to go private. Which is a massive privilege.

I'm sorry this happened to you OP. You and this counsellor were clearly not a good match. I hope you find a helpful way forward soon.

I only managed to tackle the route causes of my anxiety when I started therapy. Therapy only works if you have a good relationship with the therapist and she's pretty much guaranteed you'll never have this with her.

I pay a very low rate for a BACP registered therapist, many of them do low rates depending on your income, I'd look into this.

CBT will only help with managing the anxiety it won't peel back the layers and uncover the route cause. In order to do deeper into these layers you'll need to build up a good relationship with your therapist and you won't be able to with the one you have after her behaviour. I hope you can see someone else or manage to see a private therapist who'll see you at a rate you can afford.

I would guess you need medication for your ADHD. Anxiety is a big symptom of ADHD. Request a second opinion. The anxiety is a symptom and without treating the source (ADHD) you won't move forward.
I would suggest bringing some support documentation with you to your GP appointment and request medication for ADHD. Source it from NHS website so they can't really deny it. Assess yourself against it and ask them to put it in writing that you don't have ADHD if they refuse to move forward and at least trial medication.

Just to second what everyone else is saying & I’m really sorry this happened to you OP. In my experience counselling offered via the NHS is very basic & tick boxy. I have found it very frustrating too plus being constantly asked to evaluate my progress via a questionnaire. I completely agree that it’s ridiculous to block you from being referred for an autism assessment because of anxiety. In my experience knowing that you have autism can help you to manage anxiety & triggers in a different way & connect to others that are similar.

I found NHS therapy no use at all. The therapist made me feel uncomfortable. I cancelled after the second session. They follow a script and try to push you to do things so they can tick the relevant boxes.

I'd consider making a complaint to her professional body; might be the BACP - look her up. It's not safe practice and needs stamping out in the NHS.

From the BACP website:

Therapy provides a safe and confidential space for you to talk to a trained professional about your issues and concerns. Your therapist will help you explore your thoughts, feelings and behaviours so you can develop a better understanding of yourself and of others.

A counsellor will not give you their opinions or advice or prescribe medication. They will help you find your own solutions – whether that’s making effective changes in your life or finding ways of coping with your problems.