How do I find a private therapist for complex needs?

[ThisAmpleCritic]

I am at a complete loss of where to start when looking for a privately funded therapist. In the past whenever I’ve been referred for counselling/CBT/whatever through the IAPT, NHS or private medical insurance (which I no longer have), I have always been given 6-10 sessions and then “completed” the course. This is never enough, just as I’ve got to build trust and rapport, scratched the surface of the issues, it’s finished. Invariably I’m left worse off than when I started. I think I want to try and find a privately funded therapist long-term therapist that I can work with in the long term to try and address my long-standing issues… How do I go about doing this? I need someone that can help with counselling in the traditional sense to help me make sense of my past, complex MH history with several diagnoses, trauma/CPTSD type stuff, as well as neurodiversity. Someone has previously suggested DBT and someone else has recommended EMDR… is it possible to have one person that can help with all of these things? I feel like I’m beyond help

You are absolutely not beyond help, but you may be under the impression that mental health issues invariably need to take a huge investment of both time and money to resolve; which can make it seem like an impossible task.

You mention "...to help me make sense of my past". Another way of looking at that is to accept that there may be no sense to be made, allowing you to move forward.

Trauma/PTSD happens because the mind is trying to make sense of the things you experienced or witnessed; accepting that there's no resolution, but equally there is no danger (from those events) to prepare for, is enough for the mind to let it slip into the past with no emotional ties.

@Eyesopenwideawake that needs to be everywhere on these boards, sometimes no sense can be made of the past.

I’ve tended to work off personal recommendations, and talk to a therapist first on the phone before seeing them, but I realise that’s no help for you.

Honestly I appreciate this so much. The thought of trying to “unpack” my past and work out what has caused me to be the way I am is so daunting. I’ve started reading this book about Childhood Emotional Neglect and I think this rings very true to me, but I also feel immense guilt for even considering that my parents could be “blamed” for things that they had no awareness of and they had best intentions always. Then I think back to all the other things that have happened outside of the family home and the trauma wrapped up in that… it’s all just too much. And I’m trying to parent my ND children and find myself probably emotionally neglecting them and it’s making everything feel impossible. But to think that actually he past is the past and what matters is how I move forward goes against everything I’ve ever been told about healing? Now I’m very confused 😵‍💫 not your fault, just my useless brain pulling itself in every direction as usual

Have you tried to access these things through the NHS? EMDR, DBT etc are very commonly offered therapies in secondary care, and if you have complex mental health issues you would normally be under a CMHT

I am under CMHT but the Dr has said he wants to “optimise” my medication before considering any psychological therapies. I have contacted them several times in the last month due to MH deteriorating, they are slow to respond and no additional support has been offered.

@ThisAmpleCritic The two questions I ask every client;

1. What do you want to change about the way you think, or feel or behave?
2. How will this change your life?

We often spend so much time thinking about what's wrong and what we don't want that the things we DO want get lost in the whirlwind.

That sounds difficult, but they’re not wrong to do this. Ideally you should be in as stable a place as possible before starting any psychological therapies. When is your next CMHT appointment? Do you have a care co? Can you ask whoever you’re seeing next to be referred for DBT (it’s not just used for EUPD, it’s suitable for lots of different mental health issues).

Edited to add: it would make sense to refer you now as there’s often a significant waiting list, during which you can be stabilised on meds.

There’s a website called counselling directory, and the various psychological associations have lists of members, but I ended up finding someone by googling “therapy near me”. I was in a very similar situation to you, and feeling I needed something a bit longer term. It was a slow process, but ultimately utterly transformative. I no longer have any contact with mental health services at all, after years of long hospitalisations and medications.

No care coordinator, and next appt not for 4 weeks. I have tried asking them to bring it forward but nothing doing.

@Eyesopenwideawake I don’t honestly know the answers to these questions without taking time to think. Mainly I want to stop this constant cycle of low mood/depression which seems to come out of the blue and affects all aspects of my life for months on end. I want to have better self-esteem, be a better and more present and tolerant parent, use alcohol less as a coping mechanism…. Just generally know myself better , be more content, and hate myself less. This would change my life as I’d generally be a better person, more reliable and consistent, and improved relationships with everyone.

ETA: and not feel suicidal for no reason at all

I think it depends. Things like EMDR can be helpful in relieving the impact of trauma, things like DBT can be good for managing their impact on you day by day, more relational therapies can help heal difficult relationship patterns by providing a stable, boundaried relationship in which to work things out. Some people really do need to have their experiences heard and accepted to make sense of them in their own mind and find a place of acceptance.

Therapy isn’t about ascribing blame though. It’s wholly possible to recognise your parents were doing what they thought was right, or was acceptable parenting in their day and also recognise it impacted you.

I work with trauma. Some people see me for a few weeks/months and feel they’ve got what they needed, they’re able to make the changes they want to and feel in a steadier place. Others see me for a long time because they need to work out their relationship to themselves and others in the safety of a therapeutic relationship. Both ways of using therapy are equally valid and valuable.

I’d also say that therapy isn’t a magic pill, merely talking about what happened isn’t what helps people heal. It’s very hard, challenging work which involves the client being able to yes talk about what happened but also to explore their thoughts and feelings, to have them challenged by the therapist, to work on themselves outside of sessions (which is really where most of the work happens). To find a place of acceptance because most things really are beyond understanding, but making sense of its place in your story can help you understand yourself better, forgive yourself and to become someone that you recognise as yourself. Recognising you have the power to move forward is an act of bravery in a world that tells you you’re damaged beyond repair.

Merely talking about the stuff isn’t helpful because, as you’ve found, you just dredge stuff up but are no closer to putting it to bed.

It sounds like you need a lead therapist to be your support who then has access to colleagues to provide specialist services as and when needed. Think through what you want to get from therapy eg for some it’s having someone to talk to, who listens etc and gives you the space each week/month you need, for others they are looking for a therapist with specific training in different techniques, more interventions etc. My dd has tried both styles and prefers the former because what she really needs is space each week (she’s autistic) to unpack her life

Merely talking about the stuff isn’t helpful because, as you’ve found, you just dredge stuff up but are no closer to putting it to bed.

Yes, which is why I’m hoping to find a therapist that can combine talking, exploring, finding acceptance, behavioural therapies, etc… all of the things together that might help me to overcome the persistent battle I have with my own brain. Definitely not looking for a quick fix or magic pill!

Thank you! I will have a look.

I’m sorry, I didn’t mean to imply you were looking for a magic pill, just that merely talking about it can leave people feeling even more stuck than before. I’d honestly say that word of mouth is often the best way to find a good therapist with experience of working with trauma. Do you know anyone who has been in therapy with someone they would recommend?

@Jellycatspyjamas I know you didn’t, sorry if I came across as short! I don’t have any close friends really so no one I can ask for recommendations.

That's OK, they are big questions and take some thinking about. You did pretty well though!

As I said in my first reply, don't automatically assume this is going to be a/hard work b/long-winded and c/expensive. It doesn't have to be. In my experience working with trauma it is one of the easier – and most rewarding – issue to work with, because once your mind stops looking for answers, when it knows there are none to be had, it lets go of the search. You don't forget what happened to you, you just stop caring about it.

@Eyesopenwideawake can you be my therapist? 😂

Would you recommend I continue reading my Childhood Emotional Neglect book and do some journaling about what it brings up for me? Maybe that will be enough to bring it to the light and make it easier to let go?

Good luck! Most therapists will offer some kind of introductory conversation or trial session to see if you both feel you can work together. I was very upfront about the severity of my problems, because having just come off a section I was worried I would be too much. I wasn’t looking for a specific type of therapy (I didn’t know exactly what I needed, just that I couldn’t go on as I was), but I ended up with an art therapist who had experience with trauma, dissociation and autism. I hope you find what you need x

The problem with 'seeing what it brings up' is that memories are not reliable and that you will only ever have the perspective of the age you were then at that time – not the wisdom and understanding of the adult you are now. Also your mind always wants you to be right in what you think, so by reading about a particular condition you could (inadvertently) convince yourself that it's an issue.

If you want to see if I could be your therapist have a look at https://www.mumsnet.com/talk/AMA/4559328-im-a-hypnotist-remedial-not-stage-ama?page=1

My advice, as someone who works in private practice with clients who have a similar experience to yours, is to worry less about the type of therapy, and to think about what you want from the person. E.g. do you think you would feel most comfortable talking to a man or a woman, someone older or younger, someone who shares your ethnicity, or sexuality, someone who challenges, someone who reflects your experience etc. do you want to be in a room or online? Identify key words that you’d like to see.
Then, starting with the UKCP directory, or counselling directory with a UKCP filter on, look for someone who sounds like a good fit.
UKCP psychotherapists have done a very extensive and robust training, with loads of their own therapy, and quite often work with complexity in the way you are describing. They will be working with you, not the specific diagnosis. Speak to a few, see who you feel comfortable with, and who describes an approach that feels most helpful to you.
you aren’t beyond help. I wish you well.

I agree with @eyesopenwideawake,the problem of reading and journaling is that you don’t have anyone to unpick your thoughts and to help you sense check your memories. Our brains play tricks on us, the look for patterns and things that confirm our existing thoughts but that aren’t necessarily real. Journaling in and of itself can be really helpful, James Pennebaker has a good book that gives creative journaling exercises that can be helpful in processing trauma but I’d work with your current thoughts and feelings rather than the book you’re reading just now. It doesn’t need to be a long, drawn out painful process to make a difference nor do you need to examine every situation and incident. There’s a school of thought that picking one or two situations and processing them can be really transformative if you can use those to symbolise the various hurts you carry.

@therapist78has given good advice on finding a therapist - research indicates the therapeutic relationship matters more than the mode of therapy, so finding someone you “click” with is a good place to start.

Thank you everyone for your kind words of wisdom and support 🙏 I’ve contacted a couple of local people and will see how I go. I’ll also take a look at the James Pennebeker book.

@ThisAmpleCritic
is it possible to have one person that can help with all of these things?

The answer to this isn't one that can be answered abstractly. I'm in the middle of overhauling our local mental health offer and the biggest hurdle is the narrative that, "this therapy for that problem"

Unfortunately, experience suggests that I/we could direct you to the right therapy/set of therapies, but only if we spend the time to get to know you. 12 sessions of EMDR will work for some people, others really thrive with TF-CBT, others need years of psychoanalytic psychotherapy, and it is all down to the interplay between your personality, your trauma and the specific way your neurodivergence presents.

@Weyoun15 but one therapist could be trained in several different therapeutic techniques and get to know the person and use them as appropriate?