You Need To Be Able To Trust Your Therapist

And I Don’t Know If I Do

I’m having a dilemma.

I’m seeing a psychotherapist, we’re supposed to be doing general ‘talking therapy’ and EMDR — see this earlier piece:

Being as how I live in the UK, my therapy is covered by the NHS. I know how lucky I am, believe me, but it’s not all roses.

Aside from the fact our current government (best not get me started, that’s not what this essay is about…) are rumoured to be interested in breaking our incredible health service apart, perhaps selling certain services off to private (overseas) companies. Aside from the fact they are already pretty damn uncaring about the fact that the COVID-19 pandemic has been responsible for breaking a good number of wonderful NHS staff (and killing a good number more) — and the pay scales for most of those staff is utterly disgraceful, given they are risking their lives daily. Aside from the fact…..

Look I could go on for a while there, best saved for another time, but the point I was going to get to (eventually) was that while I can get free therapy, it’s limited to the handful of staff available in this area, which is rural, plus in my case I was referred for psychotherapy through the service which handles the other therapies (physiotherapy for example) for people with ‘persistent physical symptoms’ (PPSS) — ie. the symptoms of my chronic illness, pain and fatigue.

When I was first referred, I agreed to see a young woman who needed to do some clinical practice as part of her doctorate. She was actually amazing. We took to each other instantly and I was able to open up to her about some very difficult things that have happened in my life. I felt so comfortable sharing my issues with her, as we went over my general background and mapped out my needs for a continuing course of therapy. Unfortunately, the initial agreement had been that I would only be able to have six sessions with her, then I would have to wait for a regular appointment time to open up with one of the two ‘permanent’ psychotherapy doctors working within the PPSS to be able to continue with my treatment.

So after those first six, hour long sessions, I waited. Some weeks later, I was contacted to see if I would still like to continue and when I answered in the affirmative I was given an appointment for another few weeks hence. When I met the new doctor, she was nice enough, she obviously had access to notes taken by Therapist1 (T1), but it was very much a case of ‘getting to know you’ again. Until the fourth time I saw her, when I talked about my close friend who had completed suicide (after attempting but being thwarted by interventions from a handful of close friends — including myself). See the earlier essay I wrote about him here on The Personal Essayist:

This was the first piece I wrote for publication on Medium. It was important to me to start as I meant to go on, to open myself up and write about things I never talked about to anyone in my ‘Off-Line Life’ (I don’t like the term In Real Life) — except perhaps a therapist. I couldn’t think of anything much more important or immediate than the love I felt for that man, and the guilt I still feel over his death.

So starting to talk to Therapist2 (T2) about this was also a sign of faith, that we could begin to work together on my issues. I talked and I cried, emptied out feelings of anger, pain and guilt. When my time was up T2 said we could explore these feelings further in our next session — which, as it turned out, was never to happen. A letter arrived, saying that (“due to unforeseen circumstances”) T2 would not be able to see me any more.

At which point, I began to spiral into a panic state of self-doubt, self-blame and recrimination: why? what had happened? what had I said? this had to be my fault right?

Luckily, having had a look at my file and anticipated that this was likely to happen (in my head), the woman I came to know as Therapist3 (T3) called me on the phone the next day. I was so relieved when she revealed that T2 was actually now off work on sick leave (that sounds bad, obviously I wasn’t pleased she was ill..) and reassured me that it actually wasn’t my fault. T3 said she was happy to take over and arranged to see me a couple of weeks later.

In the end, I’ve grown to look forward to talking with T3. She’s brilliant and really succeeds in making me feel that we are a team, working together to combat my ingrained insecurities and guilt complex; beginning to move on to using EMDR techniques to tackle my night terrors. When the pandemic hit, we paused our sessions until it became clearer that this was going to be a long term problem, then T3 arranged for us to pick up again via video call. That worked fine, better than fine — I could do a video call even when physical issues would have prevented me attending an in person appointment (most of the time), or when my responsibilities as carer for my partner, P, have me needing to be home.

Then disaster struck.

OK, that’s an exaggeration I suppose. To be fair, it wasn’t a disaster, if I get myself together and see this with an ounce of perspective…but it was Bad News. A couple of months ago, T3 told me that she was moving over to a different role — therapy sessions for NHS staff to support them in the burgeoning mental health crisis which is growing out of the COVID-19 pandemic, a really worthwhile thing to be doing. Then came the bombshell. When she applied for that position, she told me, she’d thought she would be able to continue with our sessions (and with her other clients via the PPSS) alongside working with some staff members. It was all based at the same hospital after all. However, that was apparently not to be. T3 had been told that No, she would not be able to fill both roles at the same time. Which meant, my time with her as my therapist was going to have to end. She was so apologetic. She recognised that this was not ideal for my mental health, all the swapping and changing was feeding into my issues, exactly opposite to the desired effect….but, T2 is now back at work from sick leave, how would I feel about picking up with her again?

Well. I really don’t want to stop seeing T3 — but if I have to, then I suppose going back to T2 is probably the best option. I don’t want to stop my psychotherapy sessions altogether. I don’t particularly want to start again with yet another new therapist. Four within two years might be too much for anyone. Even clients who don’t have abandonment issues stemming from childhood emotional abuse.

The problem is, I don’t know if I feel able to relax and trust T2 again. She already let me down. On top of this, T3 assured me that I would be able to continue with video calls and said that she would have T2 call me herself after they had their hand-over session. The latter hasn’t happened and I received a letter through the post giving me details of an appointment at a health centre a few miles away.

Hence my dilemma. I need to be able to trust my therapist, however I’ve been switched around so much I’m struggling to know if I can.