Below is part of the transcript from episode 275, in which we answered an email about how to find a therapist:
Finding a new therapist is brutal. Brutal.
So for those who have not had this experience, let's literally just pause the emails for a minute and walk through this. Let me show you on our side of things as a client—as a survivor—what that's like. So knowing that I need someone who can help with trauma, and someone who can help with dissociative disorders, that's what I start my search with when I'm looking for a new therapist. And the easiest way these days, obviously, is to look online. You can look at the EMDRIA site. You can look at the ISSTD site. You could look at sensorimotor. You could find a particular modality if you really want something specific. Or you can just do a general search for trauma and dissociation therapy or something like that. Right? I don't usually search for DID therapist or dissociative identity disorder therapist, because it limits the results so much that it's you almost can't find anything because most people don't advertise that specifically. But they may advertise dissociative disorders or have that listed either on their Psychology Today profile—which again guys, those are not vetted at all, they're just uploaded by therapists, so you still have to be super careful—or they might have it listed on their website. Okay, so that's the first thing I search for.
And then when I find someone and I look at their profile or their website and it looks like not crazy and not creepy, because sometimes you pull up a profile or a website and there's like weird stuff in their office, or it looks creepy, or it's all dark, or you're just not comfortable for some reason. Like, for us, our agreement is to trust our intuition. So if something feels off just looking at the website or their profile, we definitely just skip that one. Because why go in person to feel something we can already feel just looking. So again, that may limit some of our choices, but it also protects us in a way of adding safety by paying attention to the signals we're getting. They may not be always accurate because there's not actually a lot of information to go by, but it's enough to pay attention. And as survivors, I feel like we're really in tune with that, if we will listen to it. So that's the next step.
And then out of the results that are left, it's a matter of matching, at least for us in America, it is matching insurance and availability. Like can you see me when I'm available to be seen, are you also available? And also can I actually afford to see you? Because therapy is expensive. And as a therapist, I also would like to get paid. And yes, there's so much paperwork that we have to do that is not within the 45 minutes or hour of our session time. And there are trainings we have to do and certifications we have to keep, plus paying for office or zoom or whatever. All of that overhead cost is legitimate. So I get it because I am a therapist, and I am trying to have an office and things like that. And all of those costs don't even count trying to feed my children or actually provide for my family. Like it's even just sustaining to keep the office open so that I can continue to be available for people. So I get that it's difficult. But also as a parent of six children with lots of medical needs, and eight people in our family, our budget is very, very tight, especially through the pandemic. One of our jobs was traveling for the refugee work and the war zones and the disaster sites. We can't do that during the pandemic. So that money is completely on hold, which was our primary income. And most of our clients don't pay us as much as they did before because also the pandemic has impacted them. But we still want to help. And so what do you do? It's a fine line of navigating all that, right. So the therapist’s job, though, is to negotiate the fees for their therapy services that they offer, according to what they are able to do. And then I have to offer what I can do and choose based on what I'm able to pay or not. And when that matches, it works out; when it doesn't match, it doesn't work out. And sometimes that's really hard.
Okay, so when it looks like there's a match for fees based on their profile or their website, and it's someone that I maybe could budget in, and they also see trauma and dissociation, then it's a matter of contacting them to see if they're actually available. The challenge at this stage of things is that the therapists who are really good, are usually really full. And so they have a waitlist, or it's difficult to schedule with them, and that can be really daunting. Especially if you feel like you're in a bit of a crisis and someone can't see you fairly quickly. It's really difficult. So let me read you some of the emails we have actually gotten back from people and why we chose to see them or did not choose to see them.
Okay, so my first example was a lady we contacted. And I'm not going to say any names. And it doesn't give you away because we had to see in the last year therapist in like a four state area, okay. And because of telehealth, that could be anywhere in those states. So I don't think I'm disclosing anything inappropriate. But let me share what that experience is like. So to be clear, for me because I am deaf with cochlear implants, when I contact a new therapists I have to do it over email. I cannot just call the office and them call me back. Like you can't play phone tag with a deaf phone. That's not how it works. I can call out with some special equipment, but it's very difficult and I usually have to have the husband with me. And so I don't do that very often. Although it's something I'm trying to practice a little bit, but it's very difficult. So for something like this, especially because I'm also extra anxious, I do it by email. Because you're doing it by email, and you're not actually signed up into someone's like secure portal or whatever yet, you don't want to give lots of information that is private. Like don't send them your insurance card over email. Don't tell them your birthday or social security card number over email. Does that make sense? But you can say, “Hey, this is me. I'm looking for a therapist on these issues, like trauma and dissociation. And I'm available on these days. Do you have any openings? Do you think you we might be a good fit?” Something like that. And then usually what happens, either they email you back, or they send you a link to their portal so that you can talk to them privately. Or you can set up a time to actually have a free phone consult where you can sort of talk on the phone and see if you feel like a fit and make an appointment. So there's several different things that can happen next, but generally, that's how it goes.
So let me share with you some of the emails. One email that I got back last year was from someone who said: I received your email. I would be happy to discuss with you my services. Are you available at such and such a time. I do work with trauma and dissociative disorders, and I'm also a nurse. So I have special interest in working with medical trauma. I have availability at the following times if you would like to schedule an appointment. Now, you guys, that was like an ideal email. And of course, I snatched her up. And I wanted to see her because she understood medical trauma. So I thought that would be helpful for Em dealing with our daughter and her medical needs. There were things that are difficult to explain to people that maybe she would understand right away. And so we connected with her. But then it turned out that she could not take our insurance and so we did not get to see her.
Another email that we got back from someone last year was really good example as well, said: Thank you for your email. I do take your insurance, and I also help with trauma. Unfortunately, my waitlist is until late March or early April. If you don't mind waiting that long you can call our office at this number and schedule an appointment and also get on our waitlist. I also work with families if that would be helpful to you. Let me know which direction you want to go. So she was very clear about when she was available, whether she took my insurance or not, and how she could help. This is the woman that actually ended up being our family therapist where we used to all go, all eight of us for the children, and just hang out there for two hours rotating everybody through. And she was amazing. And so one thing that was also helpful as she responded so quickly, and she was available by email, which I really need as a deaf person. I do not abuse that privilege. I do not send crisis messages to the therapist. So that one worked out, but for the children, not for us.
As the year progressed last year and the pandemic started, I also needed to find someone who specifically would do telehealth because I was not able to go into the office. And where I live, not everyone took it seriously in the beginning. And so some people were not available on telehealth. So since that was something I needed, that was something to ask upfront. So a good example of this response from a therapist that we actually saw until we moved was: Hi. Thank you for touching base. I do currently have a few openings. Let me know what days and times work for you. I do take your insurance, no problem there. I will be supportive of you in your healing journey and however you integrate your beliefs and family into that just let me know as we go. At this point, I'm doing exclusively telemedicine, I'm considering doing that long term, or with some in office after the pandemic. You can email me here and you can text my phone number at this number. So she was very clear about what is okay and what is not okay with her, her availability, and what she can help with or not. And I asked, I followed up with some more detail questions, and at that point moved to the portal so that I could ask more specific questions privately. And this person we saw most of the beginning of the summer until we moved. So this one really worked out and we only didn't get to stay with her because we had to move.
So those are some good examples. Let me give you some not so good examples. This person emailed back and said: Good afternoon. I do offer telehealth, but please call the clinic to schedule an appointment. They do all of that for me. Thank you for reaching out. So when at that point, I realized that this person was actually in a larger practice or some sort of community building, which I already know is too overwhelming for me. So I didn't even reply to that person. If they could not help me get an appointment scheduled and get me into the building the first time, they are not someone who can help me with some of our issues.
Another person wrote: Thank you for thinking of me. Unfortunately, I have a full caseload right now and do not have room for another client at this time. I know the agency I'm contracted with has several really good trauma therapist, and they maybe could help you. And then ask for so and so, she's great. I think she may have a staff meeting on the day you want. But she could call you back if you wanted. So this person was polite, but totally couldn't help. And if they're a contractor, like they revealed so much about their office dynamics, I just didn't, that was not going to work.
Another one wrote: Thanks for reaching out. What problems are you experiencing? But that's all that they said. No way to contact them, no way to talk to them privately, and no follow up as far as if they're available to help with some of that. And so that person we did not see.
Another one said: I use a sliding scale and I do help telehealth, but I'm not contracted for your insurance. I can only bill for children. You could try and then she gave me the number of a community mental health agency, which I appreciate. But again, that was not the setting that was going to work for us. We had already tried that and it was like a walking panic attack just to get into the therapists office. Which is really sad because the therapist was amazing.
After we moved, a therapist wrote: I am happy to schedule a mental health telesession with you. Are there certain days or times a day that are more open for you? The way we will get started is I will send you an invitation to join our client portal. After joining a client portal, you will find some intake paperwork and a questionnaire. That's also how we do billing. I am happy to answer any more questions you may have on the client portal to protect your privacy. Feel free to reply to this email or use the contact information below, but I will watch for you on the portal. I look forward to hearing from you soon. So this person actually that was an amazing response. It totally worked out. That's who we saw after we moved here until they change portal sites and we somehow got lost in the middle. Their email changed, and their portal site changed, and we just sort of didn't hear back from them. So that was a little bit traumatic because we really liked her.
Someone else wrote to us: Thank you for your email, I understand that you're looking for an appointment. I'm available for ongoing and consistent support. I do cognitive behavioral with trauma informed in parentheses if that is what you want. That is not what I want you guys, and so I did not reply to them.
Here's another email from a therapist who did equine therapy. And she was here after we moved. And so we contacted her to try to set the children up with her. And she sent us the link to the portal that worked really well. We filled out all of the paperwork, which takes ages for children's Medicaid, and six of them at that. And so I spent hours and hours and hours, like an entire day, filling out all the paperwork. I got everything signed, I emailed her back PDFs of that, and gave her list of our availability which she had asked for. And then we never heard from her again. And it was so frustrating because we spent hours filling out that paperwork and never heard from her. I still don't know what happened. Like I don't know if she got COVID, or if our paperwork was just lost, or she didn't want to see us after she saw the issues that children had. I don't know, but we never heard from her. So that's another example.
Here's another one that was really good. This one said: I just got your email, and wanting to send you an invite to my patient portal. You can have a free session so we can get to know each other a little bit and see if we're a fit. I'm also going to send you an invitation for Spruce, which is an app that we can text securely on so that your information is protected, but you can still get ahold of me if you need to, or just share what's going on. Sometimes that's important with trauma clients. We can do video sessions. And we can talk about scheduling sessions during the day. I absolutely have availability during the times you mentioned. And I can meet with you more than once weekly if that would be helpful. And then she gave me a list of her schedule of open times. And you, your choices for payment are these and she gave different ways that we could pay her securely and said, Here's an appointment. You don't have to pay for the first appointment so that we can get to know one another. And this is actually our therapists that we really appreciated this spring who passed away from COVID. She really had things set up in a secure way and we felt safe with her. So then we had to do it all again. When our therapist died from COVID, we had to go through this all again.
So one person wrote back: I'm taking new clients now, yes. We can do in person or telehealth. I can help you with trauma. It's actually something I really enjoy helping people through. My sessions are $250 out of pocket. Let me know when you want to meet. Yeah, you guys. That didn't happen. I don't have $250 a pop.
So the next one wrote back and said: I can help with trauma, and here are some of the trainings I've done and experiences I have that shows I'm able to do so. Which I actually really appreciated. However, I get several requests for telehealth, so I'm thinking I will move those to their own day. Do you want to do this day only at this time? So then she talked about her schedule, and we set an appointment, and that was fine. But then she emailed back and had to move things because she decided to move of her telehealth people to one day. And then she emailed again because she had to cancel for something else she was doing. Like, she was just too busy. So that one didn't work out.
There were other emails we've gotten that literally said: I can help with your issues. But I don't have time right now. Like, if you can’t squeeze me in for an hour, there's no way that you can squeeze me into your head space. You know what I mean? Like, if they don't have time to just schedule something, then they certainly don't have time to actually like hold space and presence with us. When DID is such a long term and intense experience, which I already feel guilty for. Like I'm going into therapy, feeling bad for what I'm going to have to put this person through just for me to get better. Like it feels so yucky and abusive, even if that's all not like entirely accurate thinking. Or even if the therapist can explain how it's done from their side of things. Which technically I understand, because I get in that role too for work, right. So it's really tricky.
The therapist we have now that we have been able to see five times in a row, we went ahead and set up with her because she gave us lots of availability times. She was careful about our confidentiality. She demonstrated that she understood about trauma and dissociation without being overly intrusive before we were ready to go there. And because she was available on telehealth and had a sliding scale that we could do within the budget of our family, even though we don't actually even have that money. Like it's really, really hard, right. But we can work extra and just do our best because being tired and worn out is somehow better than not making it. Right, so.
So we accepted an appointment with that therapist, and then going to the first session, and feeling how she talked about things, the respectful language that she used, this safety that she created in the rapport between us, even though clearly we have some serious therapy issues. And her capacity to sort of get some of that information out of us in a general way without being pushy, is what got us back for this second appointment.
The second appointment we're just going to call a wash, because we basically cried the whole time, because our other therapist was dead, and the therapist before that is just like a hole in our heart, right. And so there is that just pain. But it was coming out and it was coming out in a safe place. And it was coming out in a way that we were not alone. And so that is why we showed up for the third appointment.
The third appointment, she gave us some new resources, which we'll talk about on the podcast later. But some books we hadn't even heard of, although you probably have heard of them, but we hadn't heard of them. And gave us some homework to get these books and to read some specific things to talk about how they apply to us. And that is when we started learning and giving that framework of a way to ease back into therapy through a safe context, as opposed to jumping back into trying to establish a relationship with a therapist. Because right now that's where our wound is. And so that's not happening. There is no parade of altars. There no little showing up in therapy, even if it's to distract things. Like they are not coming. They are not participating. They are not going there. And we won't let them. Like, that it hurts too much. But having this framework of let's talk about dissociation, and let's talk about trauma through these books, and in a very safe window of tolerance kind of way, gave us a way to at least engage with the process and to attempt to hold on in a way that at least put some footing under our feet a little bit again. And that's why we showed up for the fourth appointment.
At the fourth appointment, she had all kinds of stuff ready that reminded us of things that we learned from like Christine Forner about the brain, and some of the things we've learned through the ISSTD courses over the last year. And so that was familiar enough that it built somehow on this safety through the books and that framework. It added a layer of familiarity, which helped us bring down those walls just a little bit. Not enough to engage, not enough to give any pieces away. And we spent the whole time crying again. So it was embarrassing. But she used some art, we did some art together. And she used some of the reading to help us put into words what was going on and noticing patterns of what was triggering these big responses that would get us so tangled with our friends, or so tangled from what happened in therapy before. And that at least was like a balm on the wound, even though it's so raw and vulnerable. And so that was huge. And that's what got us back to the fifth session.
And then in the fifth session, we somehow through conversations stumbled upon both of us knowing—like Bible knowing—I don't mean the actual Bible. But I mean, like our other Bible is the Wolves book, the Women Who Run With the Wolves. And she is the first person that we have ever met, who not only also knew the book, but like knew knew the book. Like we could quote something or reference something to try to express what we were feeling. And she got it. And you guys for whatever reason, that nailed it. Like it was out of the ballpark. It is the first time that we felt safe and comfortable and expressive in therapy in over a year, almost two years. It was so good. And it was so helpful. And she gave so much homework, which we're not thrilled about. But all of this we'll be talking about in other episodes to share what we're learning and how things are progressing. But yes, finally, things are going very well.
So I'm sorry to go off on all that tangent, but I'm saying I get it and finding a new therapist is exhausting. But also, when you find that therapist that knows how to help you and is accessible, and is available, and is respectful of your experience, and builds safety in that way. You guys, you've got to do everything on your end to do that work. To honor that opportunity. It is such a privilege space. It is such a sacred space. And there is hope there again in a way there hasn't been in a long time.
