How To Tell When A Therapist Is Right For You

How To Tell When A Therapist Is Right For You

Some of my friends who are new to therapy don’t understand how I got to my place of extreme comfort with my psychiatrist back home.

I would tell my friends that it’s like Dr. H. could read my mind and knew what was making me anxious before I even told her what’s on my mind. She knew every little bit of my history, medical and otherwise, and always knew exactly what to say. I always left her office with a series of practical action steps to figure out everything I need to do to feel better. And, thanks to her guidance, I’d spent years only going to therapy a couple of times a year, something that helped me feel more normal.

But ever since I moved to Chicago - nearly three years ago - my parents have urged me to find a local mental health professional. My psychiatrist is uncomfortable with prescribing medicine across state lines, and she’s also not super comfortable with virtual appointments over years instead of as a special case in the pandemic. Even so, I put off the search for a very long time, afraid of having to form a new bond or being unable to find someone just like Dr. H.

After enough nagging, I started looking for someone new. I did introductory call after introductory call, getting increasingly disillusioned, and before the pandemic, I finally settled for a therapist I didn’t really like, if only to feel like I got my family’s pressure off my back.

The new therapist told me to give up whenever I asked her about anything. If I was frustrated at work, she told me to quit my job. If I was having trouble with friends or family, she told me to distance myself from those people or cut ties entirely. She never encouraged me to work on things, only to avoid what I didn’t like, often in unreasonable ways. And even though avoidance often feels good in the moment, it’s not good in the long run.

When the pandemic happened, and I ended up adopting and later returning a puppy, I knew that she wouldn’t be able to understand my mixture of guilt, shame, grief, and relief to have given up my puppy. So, after that incident, I made the decision to not return to her again.

That put me back at square one. But unlike last time, I utilized a resource I should have thought of right at the beginning - No Shame On U. I reached out and asked for a recommendation, and sent a short paragraph about my diagnoses and current things I’m trying to overcome to the doctor I was recommended to contact.

The doctor called me back right away, but with bad news. She said that I was too complicated of a case for her to handle and then gave me a recommendation for another doctor at a different practice.

I almost didn’t trust her. Why should I trust her word if she made me feel like all my hard work to be as normal as possible wasn’t enough? But I looked up the new doctor because she had a name that reminded me of Lord of the Rings. Corny, I know, but I sent that same paragraph in an email, already doubting that things would work.

But for the first time, they did. I did an introductory call with the nerdy-named doctor running the practice, and she made me feel valid in my concerns and like she could actually help me. She used a system like I had encountered when I sought emergency help in my breakdown seven years ago - she assessed me over the phone and matched me with a therapist.

I was wary - first of all, because I liked the doctor herself, and that was so rare. I was also nervous to see a therapist instead of a psychiatrist even though there is a psychiatrist with the practice who could help me with medication changes if I need that help. I was also wary because of the way she described the therapist she matched me with, D. - about my age, enthusiastic, with plenty of experience in trauma but not done with her degree.

In the end, I decided to trust this doctor and set up an appointment for an appointment with D. - and it’s been one of my best decisions in a long while. It’s been years since I’ve been to what I consider non-emergency therapy - the kind of therapy where I can talk about everyday problems on a regular basis instead of only seeking help instead of in the middle of a crisis. And it’s taken a few weeks of seeing D. for me to realize how much I’d missed it.

The first session had some of the awkwardness I was afraid of, some of the getting-stuff-wrong because D. didn’t know my whole history like Dr. H. does. But even in the first session, she was saying things that resonated with me. I started taking notes that first week and have continued the process ever since, and after a month of therapy, I’ve got a nice assortment of new ideas to try and things that work.

D. has a very different style than Dr. H. A session with her feels more like a conversation than me monologuing about things I’m worried about and then receiving solutions. D. is creative, knows new therapeutic techniques I haven’t seen before, and is full of gardening metaphors and knowledge about the brain to explain exactly why certain thoughts are happening.

Because I’m not seeing her as an emergency case, or only once every several months, I am able to talk about the little things that bother me. I’ve realized that, for me, wellness doesn’t mean ignoring the small things and waiting until they turn into huge things. I’ve felt so much calmer over the last few weeks since I’ve been able to tell D. so many things about daily occurrences that I used to brush under the table. She is able to see patterns in these occurrences and draw lines between them that I’m unable to do on my own, and instead of offering me general guidance about how to battle my negative thoughts, she walks through my thoughts with me in real time, so they don’t have a chance to build up and become terrifying.

D. is different from Dr. H. in a lot of ways. She’s peppy where Dr. H. is subdued, chatty where Dr. H. prefers to let me fill the silence, learning new techniques along with me. I realized that what I didn’t need was a copy of what has worked before, but a therapist who understands me at this stage in my life and is willing to help me get through the trauma I’ve faced and the negative thoughts I have on a consistent basis.

As for how to tell when I found the right therapist, I found it just as easy to know that D. was right for me as I knew that other therapists in the past were wrong for me. Everyone has their own style, and just because a therapist is right for one person (a coworker of mine loves the therapist I was seeing previously and didn’t like), doesn’t mean that they’re right for everyone. What’s important is to try different introductory calls, learn about different therapists and psychiatrists, and do it while you’re not in an emergency situation so you’ve got someone to go to when the shit hits the fan.

Even though I’m not at the point where I feel like D. can read my mind, I have gotten so comfortable with her that I have shared all sorts of things I didn’t think I’d be able to talk about with someone new. I’ve asked her some of my big scary questions, and she’s offered to help me with some things Dr. H. said she wasn’t the best person to consult about.

I’ve now seen D. once a week for a month, and I want to keep this new schedule. It helps me, during the week, to know that I don’t have to ignore things or bottle them up. I know I’m getting good help that works for me, and that my life is improving as a result. 

I can’t offer any generic recommendations. Everyone is different when it comes to therapeutic preferences, but I encourage people reading this to try to see what you like, and be flexible, and hopefully it won’t take long to find the right therapist for you.

Ellie, a writer in 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.

An Unusual Therapeutic Technique

An Unusual Therapeutic Technique

TW: Emetophobia

This week, I went to T.J. Maxx and bought a new purse for everyday use. Whenever I buy a new purse, I always spend a good deal of time transferring things over from my old one before hanging it up in the closet: my wallet, Ventra pass, keys - and three little pill bags, each with one bright yellow pill inside.

I use these pills maybe once a year. They often expire before I can do anything with them, and then I request another prescription. You see, these aren’t like the pills I take every day for my OCD or my blood thinners. They’re more like my Epi-Pen: not designed to be used on a regular basis, but kept around for emergencies. The only difference is that these are primarily for my mental health.

Specifically, they are antiemetic pills - which means that if I am feeling nauseous, I can take a pill and know that I will not throw up. I don’t get nauseous very often, probably thanks to my incredibly rigid diet, but whenever I do, I quickly spiral out of control. I return to every horrible memory I have of every time I threw up (which I could recount right now with photographic accuracy), and once I’m that far out of control, it’s very hard for me to get back to normal.

So, I have the pills. On the off chance that I am legitimately feeling nauseous, I don’t have to think about the reason or what could happen. I just need to take one pill, let it dissolve on my tongue, and firmly believe that it’s working before moving on to a distraction until I’m better.

It’s been a long time since I used one; I’m pretty sure the last time was on the way home from getting ice cream with my parents when I had eaten too much food at once and wasn’t feeling well in the car. When my mind started to return to the time I threw up in the car on the way to a pediatrician appointment as a child, I took the pill and felt better both physically and mentally.

When my psychiatrist first presented this solution to me as a way to help me start trying more new foods, I was doubtful. After all, we’d been working on this phobia for years, why hadn’t we tried this earlier? But I quickly realized that if I had access to these pills as a child, I would have been taking one every five seconds and would have become completely dependent on them, as I thought I was constantly about to throw up. Instead of physical symptoms from my stomach, I was listening to my fears in my head, so I would always think I was in dire need of the medicine.

 Nowadays, I am very proud to say that I entirely listen to my body for fears of throwing up, except in very specific circumstances. I would only take a pill if I either feel nauseous in my stomach or have accidentally eaten meat (which I believe would make me throw up as I have never eaten more than a bite or two by accident before).

Even so, whenever I put a new purse together, I always make sure I have a few pills in there. A few, even though I maybe use one in a year. And I have a few more at home, which I keep around to let me know when they are going to expire. I am never far from these pills, even if they are usually (thankfully) far from my mind.

 I keep them around because they help me be brave. I can convince myself to try a new food or a familiar food in a new restaurant if I know I have a fail-safe. If I know that I am guaranteed to not throw up, I am willing to do a lot more than if I had the threat of that hanging over my head. Even without using the pills or even seeing them, just knowing they’re there provides me with a deep sense of security and confidence.

 When I think about this pill system, I think of how far I’ve come since the days when I always thought I was on the brink, just about to throw up if I didn’t do a particular compulsion a certain number of times. Nowadays, I am able to listen to my body and prevent something that would harm my mental health with a simple pill that has no side effects and doesn’t interact with anything else in my body.

Part of me wonders if the pills would be just as effective if they were sugar pills or placebos instead of actual anti-nausea medication. After all, I start to feel better long before they would actually take effect in my body - it’s the idea that I am not going to get sick that shuts down the panic in both my head and body and probably helps to stave off symptoms of sickness. I’m basically using my head against itself, which might sound like an unusual technique, but it certainly works for me.

Ellie, a writer in 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.

I'm a Good Pretender

I’m A Good Pretender
TW: Disordered eating

I’m not usually ashamed of who I am.

One of the circumstances that makes me feel this way is when I go out to eat with people. My close friends know that I’m a very picky eater and accept that, but even around them, I feel ashamed. Even though they know that trying new foods is an ordeal for me and I am not always up for facing my fear, I still get embarrassed when I want Italian food, pizza, or ramen yet again.

It’s even more embarrassing when I’m with someone new. I can’t just jump into my life story and explain why it’s so hard for me to eat new foods, and I don’t want to seem high maintenance or weird by insisting on a place I can eat at. Which is why, when I was on a first date recently, I agreed to go to a Mexican restaurant.

I have nothing against Mexican food - except that I’ve barely tried it. I was afraid to try it after my mom said she’s gotten sick from it before, and I had never eaten any Mexican food except chips and salsa. And trying a new food is one of the most anxiety-provoking experiences in my life.

When I found myself sitting down at Broken English Taco Pub, not sure whether to be more spooked by the fact that I was eating inside a restaurant for the first time in so many months or that I was eating in a Mexican restaurant, I settled for scanning the menu QR code on the table.

I was planning to listen to a suggestion from my psychiatrist, who said that in these situations, my best bet was to find something on the appetizer menu that I was comfortable with in different kinds of restaurants. I’d done my research, and the only Mexican food I had ever eaten before was chips and salsa. I was determined to order that, say that I wasn’t hungry if he asked me any questions - but then something happened that I hadn’t thought of.

He ordered chips and salsa for the table, then asked me what I was going to get.

I hurriedly looked down at the menu, actually reading it seriously for the first time. I couldn’t order chips and salsa as my entree if he ordered it for the table, that would look so weird! I had to actually order an entree, I decided, and eat it to the best of my ability.

I bought myself a little more time by asking him what he liked here and what he planned to get, but nothing appealed to me from his list because nothing was vegetarian. I looked down the menu hurriedly and found the only taco labeled as vegan, called Cauliflower Al Pastor. I had no idea what Al Pastor meant, but I knew that I find cauliflower slightly more tolerable than broccoli, and that was somewhere to start.

Luckily, the ingredients were listed on the menu. The taco I was looking at was filled with roasted cauliflower marinated in chile guajillo, charred slow roasted pineapple, pickled onion, and cilantro. All I could remember about these ingredients was that I had roasted pineapple at my Nana’s 90th birthday party, I’d never tried pickled onions but I love onions and pickles, and according to Silmarillion fanfiction I’d read a few days before, some people thought cilantro tastes like soap.

Strangely enough, this last fact got me curious. Was I one of the people who was going to taste it as soap? I was already starting to accept the idea of ordering this taco. I didn’t know what guajillo meant, but when I Googled it, I did my best to convince myself that I had eaten peppers before and this one was not going to make me sick.

So, when the waitress came back, I waited politely for my date to order his chicken tacos and mustered my courage before ordering a single Cauliflower Al Pastor taco.

The chips came first, much to my relief, and there were two salsas: a red one and a green one. I tried the red one, comfortable with the flavor I’d tried many times before when I was trying to get used to different regional cuisines. My date said that the green sauce was even milder, and asked me which I preferred. I said red, but it was soon obvious that he wanted me to try both of them right there and then and give him my opinion.

I dipped a chip in the green dip, not sure what was in it, and my heart hammered in my chest as I ate it. It was milder, and had a flavor I’d never experienced before, but it wasn’t bad. It was actually kind of good, which I told him. I decided to try to work up to the rapidly approaching taco by trying the red salsa, which I was most comfortable with, and the green, which didn’t seem to do anything to me when I ate it.

Before too long, the tacos arrived. My date got two, which was the typical order size; I got one, because that was about as far as my courage would take me. It arrived folded next to his tacos, but when I copied what he did and put my taco on my separate plate, it flopped over. It was made on two round tortillas that were affixed together, and I was determined to get through the experience by using my observations instead of my judgments.

It’s another therapeutic technique I use - if I can observe what I’m panicking about in a rational manner, I can stop myself from panicking, at least overtly. So I looked down at the taco, poked at the seam between the two shells and noticed that as I did so, some orange sauce spilled out. It was a nice shade of orange, and it covered the cauliflower. On top, the onions were a lovely shade of pink, and a single cilantro leaf looked nice against the pink background.

I was so determined to look normal that I watched how my date picked up one of his tacos, folded it, and bit it from the side. I did the same thing, warily at first, trusting the tortilla more than the fillings. I quickly discovered that there is no way to take a bite of a taco without eating the filling, and soon encountered several flavors that I had no idea what to do with.

Somehow, I didn’t panic. I chewed and swallowed, trying to dissect the flavors in my mouth. Thankfully, my date ate slowly, which gave me time to take small bites and figure out that the onions were my favorite part (not unexpected as they’re my favorite vegetable), the cauliflower stalks tasted better than the tops, and the pepper sauce was spicy but not actually bad. Nothing in this taco was bad, and nothing was hurting me or making me sick.

My confidence increased the more time went by, and by the time we left, I’d eaten half of my first-ever taco. It might seem like a small step, but I was thrilled that when I walked out with my date, he had no questions about how I had eaten.

I had eaten completely normally, and nothing I said or did revealed any of the panic or fear in my head. I pretended to be fine until I was fine, and for the first time in my life, I tried a new food in a much more extreme way than I would usually do (I usually work up to things a lot) without getting any questions or comments.

It felt wonderful, and who knows - maybe one day, tacos like this one will be another food I’m comfortable with and fall back on as I try something else new!

Ellie, a writer in 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.

A Change A Long Time Coming

A Change A Long Time Coming

In a few days, I will do something I haven’t done for over a year: work in my office. Just the thought of it makes me nervous, and I’m not thinking about COVID at all.

I know that I’m vaccinated and that the company I work for has done everything possible to make a safe environment for its employees. But at the same time, when I think about going back, I recall one of the first emotions I felt when I first heard about the pandemic - relief.

I was terrified of catching COVID at the time, even more terrified of my family (especially my 92-year-old Nana) catching it. But in terms of my daily life, I was so relieved that I wouldn’t have to go to the office anymore.

As someone who needs to keep mentally busy to stay afloat, especially since I started my current dose of my OCD medication, working at a job where I have basically nothing to do is horrible. Every day at the office felt like an endless slog of staring at blank computer screens, staring at walls, surreptitiously staring at my phone, and most of all, staring at any available clock, so I could tell when it was time to go. I was so miserable with this pattern that I was desperate for any way out, and working from home was an incredible solution my company had never allowed before.

When I started working from home, I immediately noticed that I had so much more patience for things like chores, exercise, and cooking healthy. I was actually happy to get out of bed in the morning. And in the middle of all of this, I was getting the same amount of work done, and probably better quality because I was in a much better mood.

Many friends have commented to me that I’m lucky to be so bored at work, but I only started to feel that when I worked from home. At home, I can manage my time in a way that I choose; if I finish work early, I can take a walk or go grocery shopping or tidy up a bit, and then those chores don’t pile up on my days off. Unlike when I’m in the office, I can manage my time in a way that makes sense to me, and not have to constantly be aware of the fact that my desk is in the middle of the hallway and people are always (politely, but very consistently) looking over my shoulder.

After two full years of begging for extra work, I’ve given up the idea of actually being busy at my current job. Instead, I focus on doing what work I get assigned in a timely manner and do the best I can to fill my spare time. At home, I can do things I enjoy while waiting for more work to come in, but next week, I am going to the office for my first day.

It’s not a permanent situation - we’re going to be remote until sometime in the fall, with occasional days to help people get used to things again. I like the idea of weaning back onto the schedule, and especially, I like the fact that I will be in the office 3 days a week and at home 2 days a week - I can balance this a lot better than my previous schedule.

Still, though, the idea of going into that space again where I spent so much time being so thoroughly miserable and stuck in my head is not exactly a pleasant thought.

When I think of going back to the office, even if things have changed, I can’t help but remember the endless days of staring up at nothing, taking countless walks around the office just to stand instead of sit, overeating just to have something I enjoyed during the day, and constantly being aware that if I tried to do anything to distract me from the mind-numbing boredom, I would be found out instantly, as I had no privacy whatsoever.

Getting ready for next week is more than a little bit intimidating. I have made a few plans to snap me out of this funk - planning my commute, organizing some cleaning supplies to help me get rid of the year-old dust and food still sitting on my desk, setting up my bookmarks on my Internet browser, and mentally preparing myself for the team lunch (something that always makes me anxious).

Many of my friends have had to go back to work before now, or will return to the office before the fall. I feel lucky that I have had so much time to adjust, but now that the time is getting closer, I’m finding it harder to keep my spirits up. I just know that there will be a point where I will get through all the cleaning and chores - and any minimal amounts of work I can save for myself for that day - and I will be sitting at my desk, feeling like I’m right back where I started.

This thought is an example of the “pre-worrying” I tend to do about events that make me anxious. My workplace is not particularly mental health friendly, so I can’t really talk to anyone at work about how I’m feeling. It’s a problem I’ve tried to solve so many times with so many different attempts to get extra work, and at this point, I think I need to reframe my own thinking instead of expecting the situation itself to change.

Here’s what I’m going to tell myself when I wake up next week knowing that I’ll be back in the office for the first time in a very long time: This is easier than it was before. I may be out of practice in terms of boredom, but I can do my best to guarantee I won’t be bored by saving work from at-home days and bringing it to the office. Several of the people who particularly enjoy nosing into my business are no longer working for the company. My boss is supportive of my mental health, even if others aren’t. And most importantly, I worked in this office for a full year without the remote time, and I can do it again.

Thanks to the way my thoughts cycle, I’ll probably repeat this to myself dozens of times in the next week. I hope it works, and that I can adjust to yet another change in my routine with so many other things during and after the pandemic

Ellie, a writer in 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.

Winning the War

Winning the War

It started with a conversation with a group of friends who also love Lord of the Rings.

As new friends, we were trying to get to know each other better. One person started a conversation by saying that he gave both of his children middle names from Tolkien’s books, followed by almost everyone saying that they had named a pet after a Lord of the Rings character. A cat named Eowyn. A dog named Samwise.

In another world, I could have said that I have a dog named Elanor for Elanor the Fair, Samwise Gamgee’s daughter.

At moments like these, even when I know that things have happened that were out of my control, even when I know I made the right choice, I still feel horrible.

The puppy I loved dearly but couldn’t keep is just one of several experiences throughout my life that, if I remember them, I feel immense shame. These aren’t like regular moments of embarrassment, which I also have plenty of. These are different because they are intrinsically rooted in my war against OCD.

They are markers of battles I lost.

I remember the pride I felt in a special honors class in college turned to immense sorrow when I realized I’d failed due to reasons related to my recovery from my junior year breakdown. Even though it didn’t make a difference in the level of diploma I received or my later success in academia and my career, I can still barely think about it.

These times are moments I can’t defend, even if I have a valid defense.

Many of them I’ve blocked out, or just remember vague things. I remember certain talks in middle school, the way people turned away from me my junior year when I sobbed in the dining hall and the way my theater professor gave up on believing my “medical related” excuses for missing class.

I had a chance, after finding out that I’d gotten a B+ in that honors class in college where only an A- or above counted as passing, that I could have a chance to explain myself to a committee. It would be after graduation and wouldn’t change the little marker missing by my name in the commencement pamphlet or the way several people in the class came up to me to express their condolences. It would be a chance for me to speak, and I initially said yes, only to chicken out later. What could I possibly say to justify myself when I didn’t even believe my own excuses?

Then, there was the time in grad school when I was told I would be able to receive my degree as I had completed my coursework, but I wouldn’t be certified as a teacher due to my very anxious performance in the classroom. I had no words to explain myself as I cried in the dean’s office, and no words the next morning when I felt like a huge weight was lifted off my shoulders and I could finally pursue a career in writing.

It is only now, years later, that I have found my voice about my mental health journey in this blog. Now, I am able to talk to my friends openly about the things I am still ashamed about. Most days, the memories don’t even crop up, and I live a very happy life.

But sometimes, I need to remind myself of the steps I’ve taken when I encounter moments like the Lord of the Rings pet names conversation. I need to remind myself that I will have another dog one day, when I am no longer living alone, and I can have the pet I want so badly even if I have to do it in a different way than many of my friends. I need to remind myself that I legitimately earned my master’s degree, even if it’s not in a field where I’m interested in working, and that degree helped me get steady employment over the last 5 years.

In other words, no matter how ashamed I am of these moments of failure, they don’t dictate the course of the rest of my life. I can try to learn from these mistakes, and even if I make different ones going forward, I won’t make the same ones.

My psychiatrist taught me to think of these moments as battles in a larger war. Any war in history - as well as the ones I’ve studied in Tolkien’s works - has victories and losses on both sides. What matters most is strategy and keeping up the fight, never giving up. I’m still fighting, and even though more of these moments may join the others - even though I am likely to lose more battles in my life - I know I can win the war.

Ellie, a writer in 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.