Transcript: Episode 275
275. How to Find a Therapist
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[Short piano piece is played, lasting about 20 seconds]
[Note: The contents of emails being read in this episode are in italics.]
Okay, guys, three things you need to know right away.
Number one. We got our second dose of the COVID vaccine. And it was just fine. We did not have nearly the problems we did with the first vaccine. And so we seem to be doing okay. And it's been three days. So I'm super grateful. And it sounds like our triplets are up next for their vaccines. The end of quarantine his insight. And that's super exciting. Except also maybe not because of everything else going on. But we'll see. We'll see.
Number two. The other thing you need to know right away is that books are shipping. By the time you hear this, you may even have already gotten your book. So be sure to take a picture and tag us on social media, if it's safe for you to do that, or send it to us. Or you can just write in on the podcast website at systemspeak.org, and let us know what you think.
Number three. The big news is we have had the same therapist for five weeks in a row. I know right? I'm not even kidding. So at least as of the time we're recording this, we maybe have a therapist that is maybe working out. And so we'll be sharing more about that later. But for today, we have emails to read.
The first one is from Teresa. Teresa says: Hi, I recently started listening to your podcast, I have DID but wasn't able to really progress until I learned the people who caused me harm were dead, incapacitated, and moved far away. The world opened up to me and I feel like I almost magically discovered many online resources and podcasts. Thank you all for all that you do. Aw, thank you Teresa. That is so true. We had a similar experience in that there was a lot we could not really directly address until the parents had passed away. And there is still some overshadowing from an abuser that is still alive. But for now they don't live anywhere near us. And so we are trying our best to balance our freedom and our adult level safety, and also still being cautious just for good measure to keep ourselves and our family safe. But I certainly understand some of those pieces. And that's a big deal. It's a big deal. Welcome. I'm so glad you have found some resources.
Julie says: Thank you so much for everything you have and are doing to reduce stigma and support other survivors of trauma You are so important to us. Oh my goodness. That's so kind Julie. We are trying to be helpful. [Laugh] Sometimes we are more helpful than other times. And sometimes it's just like a fine line between studly and stupid, and whether we are sharing too much or doing it the wrong way. And we certainly do not at all intend to cause harm. And always please take care of yourself while you listen to the podcast and after listening. But knowing that that is your responsibility, and having those boundaries there sort of frees us up to be able to share in the best way we can. And trying really hard to be authentic and vulnerable, while also holding on to the hope that drives us and motivates us to keep trying to get better. And I think that's really important because everything kind of depends on it. Yeah? So thank you Julie for your encouragement because it really means so much.
Crystal says: Just wondering for the algorithms, is it better to listen on the website or a podcast somewhere else? We always just go to the website. But what helps you the most, if you know? We wouldn't even know this at all. Okay, I got this email and actually had no idea what you're talking about. So I had to look it up and figure out what you meant. And so you're talking about the algorithms and ratings and things like that, and it's actually irrelevant. You can listen to it however is easiest for you. We don't track the algorithms at all. We don't track ratings at all. We don't make any money from ratings. And we still don't have any sponsors. So it's not like it makes a difference on which modality or which format or which platform that you listen to. So just enjoy, however it works for you. But that was a good and fair question. Thanks Crystals. We love you all so much.
Michelle says: I'm thinking about you again today, as I'm listening backward to your episodes and catching up on more of your journey. I only got started listening a couple months ago, but you keep me company every day now. And it makes me feel less alone. You are a beautiful person. And it's so comforting to me to hear what you share. I wish I could comfort you in return as you're needing to find yet another therapist. I hate finding therapists so much. Anyway, I hope your people in real life are comforting you. You deserve to be comforted. Oh, so many layers to this. One is that, as I shared, I think we have a new therapist. And we are trying really hard with that. But also, it is very difficult to engage. I don't know how we are going to get people to cooperate again. I don't know how we're going to get people to participate again. But for now she's keeping it super safe. And we are doing therapy about therapy. And trying to decide what is healthy and good. And part of it is that there's sort of this ongoing trauma between people who tell us that we should or should not be speaking to certain people, or should or should not have contact with certain people, or we should or should not be involved with certain things that all relate to different therapy experiences in the past. And so it gets pretty complicated. But for privacy, I'm not going to talk about that right now.
But part of what has been such a struggle is that the trauma of it has been ongoing. Through the pandemic, we have not been able to like have a conversation. And the two times that we've tried, like everything just backfired. Like it didn't work. It's so difficult. And it's, and there's so much pain that it may really just be healthier to let go of all of it and start over. But I don't know how you start over when the patterns are the same, or the betrayals are the same, or the hurt is the same. And I think spending the pandemic, and spending our time in quarantine, while caring for the outside kids. But also, writing the book helped us get an outline where we are at least on the same page of knowing the general outline of some of the things that we need to talk about, even if we don't remember it directly. And even if we haven't talked about it yet, there are at least words on the page. And that's a starting place. But yes, 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.
So Michelle, I don't mean to speak to your experience. Because I know yours is unique and I'm sorry it's been so painful. But know that you are not alone in that being a painful experience. I feel ya. It has been a brutal brutal year and a half for us, two years, trying to find another therapist. And the grief involved in letting go, the messiness of what that letting go is supposed to look like or not look like and how to let go of the monkey bar to swing to the next one just so that we can stay alive. Like I get it. I get it. It is so so brutal. Thank you for sharing with us.
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Thank you for listening. Your support really helps us feel less alone while we sort through all of this and learn together. Maybe it will help you in some ways too. You can connect with us on Patreon. And join us for free in our new online community by going to our website at www.systemspeak.org. If there's anything we've learned in the last four years of this podcast, it's that connection brings healing. We look forward to connecting with you.