The Therapy Games
When I saw the byline of an article in a newspaper recently, my mind instantly transported me to the single-stall bathroom at work, where I took a call from a psychiatrist who I was hoping to see regularly shortly after I moved to Chicago.
My psychiatrist who had been treating me since childhood told me that, once I moved, I should try to find another provider who would be closer. That way, I could have in-person visits instead of phone calls (good old pre-COVID days), and my medication could be evaluated in-person, something that I’ve needed in the past even if I don’t need it right now.
I started looking up psychiatrists in the area, and soon found the name of the doctor who wrote this article. I emailed him and he seemed professional, and he set up a phone call with me to explain how the practice worked and set up an appointment. I took that call in the bathroom of my office, the most private place I could get to in the middle of the day, and looked forward to what would hopefully be another good therapeutic relationship.
Instead, I was greeted with some of the most condescending language I’ve ever heard from a professional. He would ask me a question, I would answer, and then he would completely disregard everything I said, all the while talking to me like I had never heard of mental health before, had never been diagnosed with anything, and had not - like I told him - gotten therapy for over 20 years.
I distinctly remember getting a look at my face in the mirror as he told me, “Sweetie, you don’t need to be afraid of getting therapy for the first time,” right after I finished telling him about my psychiatrist back home. My face was completely blank and - a rarity - I was stunned into silence. He took this as confirmation that his theory was right, and kept telling me all about how he was going to fix me, all the while I bit my tongue and lip and anything I could think of to not tell him exactly what I was thinking.
At the end of the call, he pushed very hard for me to schedule an appointment, but I told him I needed more time to think. I heaved a sigh of relief as I leaned against the sink, but I was also distressed that I hadn’t been able to find a good psychiatrist.
“That’s just one bad apple,” I thought. “They’re not all like that,” I told myself as I scheduled more calls that ended badly, wrote more emails that never got answered, and searched the Internet deeper and deeper with no results in sight.
Eventually, I found somewhere else to try. This place was downtown, relatively easy to get to from work, and even though the person on the phone was all too eager to try to get me to sign up for hypnosis, I still tried an introductory appointment.
As soon as I walked in, I felt like the doctor was taking me through a Buzzfeed-style “Are You Crazy?” quiz with completely irrelevant questions that felt like he wanted me to answer in certain ways in order to be his patient. I realized, halfway through his thick sheaf of paper, that I was trying to be a perfectionist and answer the questions “right” rather than be honest about what was actually in my head.
Needless to say, I never returned to that practice - but the problem persisted.
I kept looking around, having similar experiences with any place that was willing to even consider that I was not a “beginner” in therapy. Many places rejected me outright, as I didn’t need diagnostic services or an intensive “boot camp”-like program where I would have to take huge amounts of time off of work and spend thousands of dollars to “get me started.”
I branched out, starting to look for therapists in addition to psychiatrists. I could see a therapist, I thought, and then if I’m not doing well, I could go to my internist (who I chose for her experience working with people with anxiety) and let her know to change the prescription. It would be a pain - if it even worked - but that opened a lot more doors, and I was able to eventually find a place down the street from me with availability outside of my working hours.
I felt like I had to go to the fringes to find a practice that was willing to work with me and both my mental and financial situations, and even when I found a therapist there, I was surprised by many hidden fees and by the lack of understanding in much of the advice I received.
“Just quit your job, it’d make you happier,” the new therapist said to me when I told her about a problem I was having at work. It was right after the pandemic started, and while my friends were losing their jobs left and right, I felt lucky to have my job, even though I was at the point where I felt miserable every time I had to step into the physical office. But I was quarantining at home - many states away, in fact - and quitting my job then would only have made things harder for me.
After a few sessions, I figured out what was rubbing me the wrong way: she was always very keen on encouraging my thoughts, which I like in terms of creative writing, but can be harmful in terms of actual life practices. If I feed too much into thoughts, whether positive or negative, I don’t end up in a good place, and this has happened enough that I can recognize it now. But if a therapist is telling me to follow these thoughts, I feel conflicted and make mistakes.
It got to the larger problem of her not really understanding me or what I was looking for, and although the office is certainly local and convenient, I don’t know if I’d be interested in going back. I feel like I gain so much more from a phone call with a psychiatrist who has seen me through all my ups and downs and doesn’t need to offer me generic advice or encourage my bad ideas.
The sad part of this is that many of my friends never had that stable therapeutic relationship that I am so thankful for and have now fallen back on. I can’t even say how many times I’ve been told by a friend that they know they’re not working with a therapist who can help them, but this therapist is either the only option financially or in order to keep the fact that they’re getting therapy a secret. Or, they’ve played the games I have and gotten so disillusioned with the whole process that they don’t even want to try again.
I keep wishing I could send my friends to my psychiatrist, but even if I could, that wouldn’t fix the problem that so many people are facing - it’s so hard to get into a good therapeutic relationship that people are suffering for no reason. I don’t know how to fix it, but as I read that article, I found myself wondering about the patients of the doctor who wrote it. Did they genuinely enjoy his advice, or was the relationship one of convenience?
I hope that, one day, I will hear more stories like mine than like my friends’. I know that my relationship with my psychiatrist is a major reason why I’m doing as well as I am considering the severity of certain things I’ve faced. It’s something that inspires me to fight the stigma, part of which involves getting people the help they need. If it wasn’t so hard to find therapists, and there were enough easily-located options that people could have a choice, I think the system could be reformed to the point where no one has to play games with their mental health.
Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.