From the perspective of the patient, Tim talks about his experiences in finding a talking therapy – and the obstacles and challenges along the way.
I saw my first psychotherapist in around 2002. I didn’t want to, but I went anyway. I didn’t like the idea and it wasn’t unduly helpful, either. Wisely, I let the experience colour me against that individual, not the profession as a whole. It made me selective. I wondered if you might like to learn a little more about that.
My First Experience
My first experience was funded by my employer’s private health insurance scheme, and I went because I’d been told I was depressed. The suggestion to seek help came amidst a vast load of turmoil in my life, and was triggered by my idiot GP who prescribed SSRIs at the same time that he was trying to treat what we must now not call impotence. To clue you in, the SSRI he used is also used in treating premature ejaculation. It delays or removes the male orgasm. Imagine being treated to correct lack of erection and being given a drug to ensure you lack orgasm! That is more than frustrating, it’s almost abusive! So I was somewhat bitter.
The door key to seeing the psychotherapist was a visit to a psychiatrist. That was my route because of the corporate medical insurance. Yours will be different, as my later routes have been. Even so, my routes have been more than a little frustrating, as you’ll learn. You see, the decision to see someone doesn’t stop folk putting obstacles in your way.
I turned up at a private and imposing clinic in an oldish mansion and met the psychiatrist. After five minutes we both agreed that I was not depressed. I’m bloody minded enough to battle my way through depression, and that, probably, makes me lucky. I’d fought my way through an emotional breakdown a few years earlier, but winning the battle also lost me substantial ground with my relationships with others and with my wife. If you’ve read Tales of the Unexpected, my first guest post here, you’ll have a clue about my distress, but I’m not going to digress into that topic except peripherally.
She, the psychiatrist, not my wife, decided I was suitable material to see a renowned and expensive gentleman who specialise in psychosexual troubles. Being impotent – I really must start saying “a sufferer from erectile dysfunction”, which is, apparently, better to say and hear, but not to pronounce – I felt him to be a reasonable choice. Anyway, she rang the till, trousered the cash, and referred me. Don’t I sound bored by the whole thing?
Well, I was bored, and this was before I’d seen him. Remember, I was, probably still am, an unwilling recipient of the talking cure. I don’t see why they need to know all about the nasty things I probably never saw in the woodshed, I feel uncomfortable talking about my inner hurts and fears, and I kind of just don’t like it.
Which is why I’m writing this. You’re probably similar to me in many ways. You don’t want to go either. Maybe hearing what someone else discovered will help you. Or, of it helps, you can laugh at me!
Two Weeks Later
Private healthcare is far faster than the NHS – I was in to see the man himself, in the same rather enclosing luxury private clinic, and he was not what I had expected at all. Ok, I’ve no idea what I’d expected, but he was not it. He introduced himself. I introduced myself, and we spent the next four or five sessions in a fencing match.
He was trying to reach me and I was trying to see if he was worth it. “Well, our 45 minutes is almost up. Shall we say the same time next week?” does not a relationship make. Nor did the screams from one of the residents who was being restrained in her room at one of the times I had an appointment make it an easy experience.
I surrendered, decided to trust him anyway, and I became the first homosexual man married to a woman that he’d met. Obviously his psychosexual counselling experience is now far wider than it was then. I even had to convince the bloke that I was not heterosexual or bisexual. I wondered how to do that, still do.
When the company’s insurance quota came to an end, so did the sessions. I learned nothing and he, I hope, learned something of value. But what he did not have was the ability to build the rather tricky relationship needed between the two participants. We, each of us, should have spotted this and stopped the farce. If your relationship with a therapist is similar, read that last sentence again.
I discovered that I have a new allergy. I became allergic to talking to therapists who do not define goals for the work and a putative end point. While the contract is a loose one that can, and should, be modified by consent at any time, it still needs to exist. Now look, let’s not be silly about this, one can’t define an end point until one defines the problem. There has to be some flexibility built in to allow two or three sessions to define the problem and agree an end goal, and one must recognise that this goal can shift and alter the contract as required. Being dogmatic about ‘we must have an end point before we start or we will not start at all’ fails, but one needs to ask one’s chosen therapist “I need to be as certain as I can be that we are working towards a goal which has a finite end. How do we achieve this together?” You see, I am equally allergic to paying someone else’s mortgage by having a cosy chat each week from now until, well, no idea when. This explains my reluctance to engage in such a relationship and why it took me some ten more years to try again.
10 Years Later
You now have to imagine a gap of ten years. You can do it. I have more grey hair, than I did then, and am slightly less slim. See, it was easy!
I went to my GP. This is a new GP. I’m 185 miles away from SSRI Boy. I have been distressed over the way I have made decisions in my life that have not turned out to be as good as I thought when I made them. I have, in fact, damaged myself emotionally quite severely. I can give you a load of reasons and tell you all about it, but the main one is my making incorrect assumptions and making the best decision based on those assumptions. Obviously that means bad decisions. And I have painted myself into an emotional corner. I needed help because I was hurting the girl I love, and hurting myself as well.
My GP referred me to some sort of NHS assessment centre. The assessment centre looked at me, my needs and their budget, mostly at their budget, and declared me to be out of their scope, bouncing me back to the GP.
The GP, wisely, knew that pills and potions will not do the job for me, and worked on a route forward. In my locality I’m entitled to six sessions with a counsellor, with a few more if the counsellor deems it necessary.
He deemed it necessary.
I had a few more.
The limit is nine. I had twelve.
I was outside his experience, too. I seem to have the knack of being the first homosexual man in a heterosexual marriage that most folk have seen, despite there being more of us than you can shake a stick at. Please do not shake sticks at us. We don’t fetch sticks and dislike being hit with them. My purpose appears to be educational with many in this profession. It is not the purpose I intended. I would prefer to see the road ahead instead.
He used a counsellor’s voice and the “and how does that make you feel?” question rather often. It has its place, but it makes my flesh crawl after the tenth repetition, and, used repetitively, it shows a lack of a listening ability. I want probing open ended questions, not, not, well, not that!
He Decided I Should Leave my Wife
There is a technical answer to this that rhymes with ‘rowlocks’, and I explained this to him. He then decided that I should be the one to decide. I did. I decided that I do not want a counsellor who gives advice. I want one who shows me routes, I have not thought of, and works with me to see whether they are useful or not. I want a guide who shines a torch onto things I have not considered and encourages me to consider them.
I decided, too, that he might be useful, so worked with him until he was. His use was not as a counsellor, and I think he is not a therapist. My understanding of the difference is vague. What he certainly was, was available on the NHS. And what he has done is searched for a route that might be useful to me.
He was useful, just as I had decided he might be. I sound scathing, but I’m grateful.
After quite a while, and through him, I met, by email and by phone, a psychotherapist who is still in training, who had the ambition to run a Men’s Therapy Group. There is not one within 100 miles of where I live, and there must, thus, be the demand for one. I had no idea what one might be or do. What I did know was that I was to see him for three private sessions to determine if I was a reasonable fit. After all, no-one wants the group to be like I’m Your Big Brother, Get me Out of Here.
My allergy to paying for an open ended commitment was thus assuaged at once. Three sessions is finite. And, when we met, we agreed a contract for what we were to achieve, and an end point. That met my needs, too. The conversation was direct. It also wasn’t important to him that I was, yet again, the first homosexual man in a heterosexual marriage that he had met. He took it in his stride, and recommended me a textbook he was studying. I read it.
The relationship he and I have is simple. He challenged my thinking during the three private sessions, and he encourages the Men’s Group to challenge my thinking. It isn’t a cosy relationship, nor should it be. It has a finite end point, scheduled for the end of September this year, it isn’t free, nor is it on the NHS, but the cash cost is low, allowing me to concentrate on the emotional issues I need to solve.
In the group we focus on each of other three members while giving voice to our own inner demons. We’re getting better at that as time passes. Guided by our chap, who acts as facilitator, not even as chairman, we talk to each other, share what we observe about each other and ourselves, and learn more about how others perceive us. It sounds simple, but each session is a challenge, primarily because we never know with precision what will come out. One or more of us can end up weeping, and that is good, because boys must never cry or show emotion, and we can in this setting and we can without much embarrassment. And yes, we are asked how that makes us feel, sometimes, but that works in this scenario. And it isn’t done in a counsellor’s voice!
I’ve learned that one doesn’t have to take the first route thrown at one. One can choose. It’s like shopping for a really nice item of clothing. I had to try some on for size before finding one that fits. I also had to recognise that this is not like shopping for a really nice item of clothing. I love paradoxes, but I suppose I’d better explain this one.
After choosing the route I found I had a responsibility to myself, I think I’d always known that, I just hadn’t taken it to heart. My job is to choose to work well with the therapist so that I have the chance of making the changes I need to make. It’s a collaboration, not the therapist doling out a cure. Equally I must trust that the therapist is working ethically, knows what they know, and admits what they do not know. I and the therapist are equal partners in the relationship. I bring the issues, they bring the torch to shine on routes that may be useful. You can see that I have not been part of that relationship in the past. Today I am. I had to acknowledge my own responsibility to work hard at, well, at things. There is no magic bullet. I’m getting there.