You can’t just throw a person in a room with a therapist, and they come out and they’re cured, you know? It’s not a one-size-fits-all. We can’t have simple solutions to complex problems.”
Q: What was your first experience with therapy?
The first time I was in therapy, I was fifteen years old. My first experience wasn’t great, but it also wasn’t bad. I didn’t want to be there, I wasn’t invested. I think a lot of therapists want to adjust their treatment to the individual, so there is no clear roadmap in the beginning. They don’t know what you’re going to need, which is unfortunate for clients that also don’t know what they need. I’m a big advocate for encouraging people to get clear on their goals, assert their needs, and ask for those things. My first experience did not have a lot of direction, and there weren’t clear goals either. So, I didn’t feel like I got a lot out of it. It wasn’t bad, just underwhelming. More of a social support than anything else.
Q: When was the next time that you sought care?
Let’s see. I saw that first therapist for a few years, and then I was hospitalized when I was 18. So, I spent some time with a therapist while I was there. Something else that was impactful – I received a Bipolar diagnosis when I was hospitalized, but I don’t have Bipolar. I didn’t find that out until maybe three years ago. And I had known that that wasn’t right, because it just didn’t match my experience. But I didn’t know any better. So, the therapists I had seen up until a few years ago were all working under the assumption that I had Bipolar, because that’s what I told them. But depression and anxiety are the things that I’m struggling with the most. It’s not so much mood instability. So, I had therapists work with me on anxiety reduction techniques. That was mostly my experience with therapy: different therapists suggesting coping skills and teaching me how to manage symptoms. I didn’t get into trauma therapy until a couple of years ago, and it turns out that’s what I needed all along.
Q: How did you get into trauma-informed, trauma-centric therapy?
That was recent, that was just a few years ago when I met my current therapist. I should add – my boyfriend of five years is a therapist. He’s a licensed professional counselor, and he’s a co-responder with the police. He’s the reason why I started thinking about doing trauma therapy. A lot of the things I deal with are trauma symptoms. I see now, in hindsight – the things I struggled with as a kid – I’ve had trauma symptoms my whole life. I think there was some stuff in childhood that had a bigger impact than I realized. So, I sought out a trauma therapist, and I had never seen a trauma therapist specifically before. Which is another thing that’s frustrating, right? You would think that any therapist can be a trauma therapist because of how pervasive trauma is – everybody has trauma. But finding a trauma therapist is its own thing, you know?
So, anyway, I found this therapist – he is the best. He’s great. When I started with him, I realized that he’s very pragmatic, and I like that about him. That’s where he differs from the therapists I’ve had in the past. They were all relational, more focused on back-and-forth conversation. This guy is very much a blank screen. He doesn’t self-disclose, and he doesn’t offer much feedback. I feel like I’m leading more than I was with other therapists. He really gave me a platform to figure out what I am feeling and why. He’s really good at asking the right questions. I hadn’t quite had that experience before.
Q: Do you know which therapy models you practice with this therapist?
It’s like IFS, Internal Family Systems, but it’s called DNMS – it’s relatively new. It’s Developmental Needs Meeting Strategy. It really is a lot like Internal Family Systems, it’s just the details that are different. The whole concept is that there are different parts of the self that come about as a result of trauma and impactful experiences. In your formative years, you learn to react to things in a certain way, and that gets encoded in a part of you that you take with you when you grow up. Those parts are responsible for feelings and attitudes towards things that maybe your adult self isn’t necessarily on board with. It’s all about connecting with those parts of self that don’t feel good, or maybe behave in ways that don’t align with your adult self.
I struggle with acute anxiety – I used to get panic attacks. Sometimes I’m very hypervigilant, which is a standard PTSD symptom, but I even have some weird OCD-type thinking that is not normal for me. I would say that is a part of self. It’s a reaction to something, and I don’t always know what I’m reacting to, but I know that those behaviors are not typical for me. So, I have to figure out why I’m thinking that way. That’s what this therapy is for: asking questions to the parts of yourself that feel that way. My therapist always asks, “Well, how old is that part?” And just giving it an age and trying to determine when these thoughts and behaviors started is helpful. I can trace my anxious and obsessive thoughts back to when I was nine or ten years old.
Now, when we talk about those things, we address that ten-year-old part of myself, who is very anxious and hypervigilant and obsessive-compulsive, and it’s nice because it gives me some distance from it. I can kind of analyze those thoughts and behaviors more objectively. It’s also nice to put the age with it, too, because then you’re talking about a child. And that whole self-compassion comes into play. You want to talk to your child-self kindly, you don’t want to be mean to a child. It makes space for self-compassion in that way, because when you’re addressing these parts of self as younger versions of you, you are more inclined to be kind to them, and in turn be kind to yourself. That’s a big part of it – reparenting and not judging yourself. It’s easier to do when you’re able to get that distance and feel like you’re talking to someone else.
Q: I’ve been really looking into Internal Family Systems, and it seems good for reconnecting with your inner child and for fostering a sense of self-compassion for your younger self and your current self.
Yeah, very much so. I was super weirded out by the whole thing at first, because my therapist will ask me, “Can I talk to that ten-year-old part?” And I’m like, “Okay. I guess.” And it’s weird, and it feels unnatural at first, and it took me a while to get comfortable with expressing myself that way and allowing myself to think in those terms. But once I got the hang of it, everything made a lot more sense. It’s so much easier to untangle things when you separate them out like that. Now I can kind of talk myself through those feelings, and I can identify the triggers and remind myself that I’m not a ten-year-old, I’m safe in my apartment, and I have the capacity to stand up for myself, take care of myself. I know that I’m safe.
Another thing that I really like about this therapy is that it was designed from the same processing model as EMDR, so there are a lot of similarities between the two. The whole concept of a safe, calm place has been helpful, as well as the internal team of resources that I can mentally consult with. On that resource team is my adult self – and when we talk about the “adult self,” we use the term to mean who I am when I’m at my best, who I am when I’m thinking clearly and rationally and compassionately. So, we have that version of myself as an internal resource, and another one of my resources is my childhood dog. I use her metaphorically – she leads me to my safe, calm place in my mind. Even though she died a long time ago, I can imagine her as this mystical creature that can lead me through scary situations. Being able to use her as a support is really comforting.
“In the past, I might have thought, “There are no alternatives. The way I’m feeling is true, and my feelings are fact,” when that’s not actually the case. Being able to ask someone else about that, even though that someone else is me, has been extremely constructive.”
So, I really, really like the concept of developing internal resources that you can consult when you’re not feeling good, because that’s always what my therapist comes back to when I’m feeling dysregulated. He’ll say, “Well, what do the resources have to say about that?” And I can think about how my adult self would react, and it allows me to kind of hold two different ideas about something at the same time when that might feel inaccessible otherwise. The groundwork that is laid in developing the resources and this safe, calm place that you can retreat to when things get overwhelming is very helpful. That’s a lot of what this therapy focuses on: internal regulation. In the past, I might have thought, “There are no alternatives, the way I’m feeling is true, and my feelings are fact,” when that’s not actually the case. Being able to ask someone else about that, even though that someone else is me, has been extremely constructive.
Q: For me, I know I would benefit from more trauma-informed therapy. I’ve only done CBT for most of my life. While looking into other kinds of therapies, I realized I didn’t even know a lot of them existed.
That’s the problem! That’s why the peer movement is so important, too, because the people at the top – legislators, presidents, CEOs – those people will tell you that mental health is a priority, but they don’t understand how complicated, nuanced, and complex it is for people to get good care. You can’t just throw a person in a room with a therapist, and they come out and they’re cured, you know? It’s not a one-size-fits-all. We can’t have simple solutions to complex problems.
Q: I agree. For some people, maybe simple works, but for the vast majority – those people fall through the cracks. You can’t standardize a process as personal as therapy. You can establish ethics and ground rules, but the actual work of therapy will be adapted to the individual’s needs.
Your therapist – even if they’re a fantastic therapist – is not going to fix you. Because that’s the idea that we’re sold, right? You go in, you come out, and you’re better. But if you really want to get better, and you really want to make changes, then you have to hold yourself accountable. You have to take a lot of personal responsibility for what you’re putting into the process. But that’s especially hard for trauma survivors. Why should we have to fix something that someone else broke? Yeah, it can feel unfair. But the reality is, if you don’t put in the effort, you’re not going to get the result, no matter how great your therapist is. They can’t do the work for you.
Q: I think having informed clients and patients is a big part of it. Because then the client can take responsibility and say, “I’m going to do this work because I understand why I’m doing this work.”
Yes. Exactly. You need to give people a sense of purpose. One thing I appreciate so much about my current therapist is that he really explains what we’re doing. I think a lot of therapists don’t know why they’re doing some things. I think that’s a controversial opinion to have, but I think there are many therapists who don’t know what they’re doing. I say that having worked alongside them, too, and having watched them work with clients. I think a lot of them are just winging it. They’ve got their licensure, and now they can practice on their own, and they don’t need to have any kind of technique anymore. As long as they get people through the door, they can just sit there and talk to them for 50 minutes and call it good. I think a lot of them are writing it off, and that’s not enough, you know?
Q: What do you like about the therapy that you’re in now?
One thing that I really like about my current therapist is that he is very open to my feedback. I hate being told what to do with my body. If somebody tells me to close my eyes, I hate it. And I’m okay with it now, from him, but I wasn’t at the beginning. And he reacted as I think therapists should – he said, “Okay great, thanks for letting me know, and we’ll try something different.” I have had experiences in the past with psychiatrists and therapists where it became clear that they don’t want to be challenged. They don’t want you to challenge their expertise and their authority. I’ve gotten that sense from providers in the past – that I’m somehow insulting them by standing up for myself. My current therapist has never made me feel that way. He listens to what I say and understands why I don’t like certain things. He helps me find a new solution. It feels collaborative.
“The reality is, if you don’t put in the effort, you’re not going to get the result, no matter how great your therapist is. They can’t do the work for you.”
I think a lot of people have the experience of feeling like they need to please their therapist or get an “A” in therapy, and they don’t want to challenge their provider. But challenging your therapist’s advice and challenging their suggestions should be encouraged, because that’s how you figure out what you need. And my current therapist supports me challenging him. I appreciate that about him – it feels truly collaborative, and it feels like I can confidently challenge anything that he’s saying without being punished for it.
Q: I just have one last question: what have you learned in this whole process? What are some of your biggest takeaways?
Taking accountability is important. And being responsible for your own recovery. It can feel unfair at times, but it’s also empowering. If other people are going to be reading this, I encourage them to look at it that way. I’ve learned a lot about myself. I’ve learned a lot about how to ask for what I need and get those needs met. And I’ve had to do that by standing up for myself, and that’s not anything that a therapist can do for me. So, taking accountability and being dedicated to the recovery process – dedicated and active. It’s about understanding that if I’m not thinking about these things between sessions, I’m not getting as much out of this as I could. Making an effort to put into practice the insight that you get in therapy and then doing something with it – not just expecting that showing up is enough.
Being willing to try new things and understanding that it’s not a one size fits all thing. Knowing that going in is important so that you don’t find yourself feeling let down or disappointed when it doesn’t go the way you expected. Instead, you can explore other options instead of throwing in the towel on therapy altogether. It’s complicated, it’s nuanced, and that process of finding what works can be very long, and arduous and frustrating, but it’s worthwhile, and I would want other people to know that they’re worthwhile, they’re worth the effort. Thinking about it from that perspective, instead of wanting to give up on things. Thinking, “I am worth putting in the work.”
Q: I totally agree, I do think that we are worth it. Though it is jumping through endless hoops sometimes, it is worth it to try. Because we are worth it.
That is what I would want to leave people with. Even when it feels unfair, you’re doing this for yourself.