How do I new therapist?

November 29, 2016 5:27 AM

My therapist became seriously ill suddenly and can't work with me any more. I need to find a new one but I can't face the thought of having to bring a totally new person up to speed with everything that's wrong with me.

I've read this question and this one, but neither really addresses my biggest issue, which is how to start over with someone new when it's not my choice, when I was in the middle of a good rapport and making progress etc. with someone else.

My relationship with my now-ex therapist wasn't perfect, but it was good enough for the work we were doing, she was very supportive and we made some good progress over the last couple of years. Something that was super helpful for me was the fact that I could bring up a thing (a behaviour, thought pattern, fear, etc.) that was bothering me right now and she already knew the relevant bits of my backstory - we were both on the "yeah, that's probably about your/my dad" page immediately without me needing to explain a ton more.

It took me a good 6-12 months to get comfortable enough with my former therapist to start opening up about bigger stuff, and the thought (not to mention the cost) of having to do that with a new therapist is overwhelming and offputting to the point where part of me doesn't even want to try. I don't have a lot of inner momentum/motivation and I tend to drop out of stuff easily if it doesn't carry me along (e.g. I stopped going to physio even though it was helping because the physiotherapist was sick one week and I had to call to make a new appointment, and my phone anxiety has been bad enough for the last few years that I...just didn't [and my back still hurts]), and I'm worried about that happening here too.

My instinct (and this is telling in itself) is to write out a bunch of background stuff, but I'm also aware that that might be unhelpful. When I first started working with my previous therapist in 2014, she asked me for some brief written background on what my issues were and what I sent her was apparently so overwhelming she thought I was potentially being difficult on purpose to challenge her/put her off (I wasn't - I just thought it was important to explain myself as thoroughly as I could, and I have a ton of complex problems). I would rather do anything than have to explain all my dreadful shitty problems to someone out loud using my own mouth, but writing them out is not guaranteed to have the intended effect.

This seems massively daunting and overwhelming as a task, and I don't know how to make it easier on myself. I've been having a not-terrible-but-not-great time mental health-wise lately anyway (some winter depression & world despair), so I'm not hugely motivated to do...anything. But at the same time, my therapist is frequently the only professional who's keeping an eye on my mental health at any given time (I'm bipolar but not currently seeing a psychiatrist or other doctor for reasons to do with how UK healthcare is structured - as long as I get a lithium test every three months my GP never mentions it), and that's valuable for me as I tend to be very avoidant about self-care and interacting with the medical system, plus there's a ton of emotional work I know I still haven't addressed.

I can feel already that I need the support (I haven't had therapy since October due to my therapist's illness). Relatively few people in the UK seem to do long-term therapy, so I'm not getting a lot of social support/understanding from the people I've shared this with in person so far, even though for me it's the abrupt end of an important relationship for reasons that are no one's fault.

So I'm in the position of needing a new therapist but not wanting to do any of the shit that comes with getting one. How can I make this easier?

posted by terretu to Human Relations (6 answers total)

Your previous therapist should have a means to send a summary of your work together to a new therapist. Even if they are ill, ethics rules usually dictate that you have someone who is taking care of your records. That piece can get the ball rolling.
posted by goggie at 5:55 AM on November 29, 2016 [8 favorites]

Your old therapist will have made notes, right? And someone (such as the person who informed you about the old therapist's health problems) can help in the handing over of such notes to a new recommended person. There will be a process designed to help in these circumstances. Follow it (but speak up where you are unsure) and you might well get where you need to be.
posted by hawthorne at 5:58 AM on November 29, 2016

When I first started working with my previous therapist in 2014, she asked me for some brief written background on what my issues were and what I sent her was apparently so overwhelming she thought I was potentially being difficult on purpose to challenge her/put her off

This was not really an awesome thing for her to say to you (despite the fact that she turned out to be a good fit), and I'd be surprised if another therapist said it (or, really, even thought it).

One thing you could try is to write the information down, than take it with you and read it. I think you're getting the best of both worlds that way.

Finally, I will say: it can actually be really good to start over with a new therapist, especially after a few years. It's easy to fall into a routine with a therapist, as in any other relationship, where eventually you're sort of spinning your wheels and not getting anything done. The kickstart of building a new relationship with a new person, who will have a new perspective on you and your issues, might be very helpful to you.
posted by showbiz_liz at 6:01 AM on November 29, 2016 [11 favorites]

This is a lot like the feeling one has when starting to date again after a break up. "Oh my God -- going out to dinner and asking how many brothers and sisters do you have, I can't take it!" But you wouldn't write out a list of biographical facts for new dates and for the same reason you shouldn't think of it all as just a repetition of laying out a bio with the new therapist. The details of your life will emerge differently next time, with some totally new insights and often quite different emphases, in the context of the relationship you build with the new therapist. You are not just a list of facts. Your memories and stories aren't really fixed, and you might find they change in helpful ways as they begin to emerge in your therapeutic conversations with the new person.
I've been in both starting over situations (dating and therapy) and have realized that something new actually forms in the person starting any new relationship -- it's never just a rehash of who you are already. And that can be really productive.
posted by flourpot at 7:05 AM on November 29, 2016 [4 favorites]

As a therapist, I don't feel that it's the client's responsibility to catch me up on their whole life in a session or two. I encourage people to start telling about what is going on now and then I'll ask questions when relevant to begin to weave in the past. Also, it's the therapist job to identify themes which can be done without hearing every detail of past experience. You should just go in and tell the therapist about how you are doing now and rely on the therapist to ask the questions about the past and tease out the bigger issues. If you don't find that happening after 3-4 sessions, find someone new. Also, it might be helpful in the first session to just say out loud that there is a lot to the past but hopefully it will come out over the course of a few sessions so you don't feel pressure to explain every detail upfront. Hope this is helpful!
posted by rglass at 1:14 PM on November 29, 2016 [1 favorite]

Therapist here (also person that has been in therapy.) You definitely don't have to feel like you have to spend a massive amount of time right at the beginning "catching up" your new therapist. I usually gather information from folks at the first session and then allow more of the story to unfold more naturally as it needs to. Also third ongoing that whoever is managing your previous therapist's practice should not only be instrumental in providing records to your new therapist, but also should hopefully be able to directly refer you to someone recommended by your previous therapist. Most folks have a plan for this, or should. Good luck and be well.
posted by fairlynearlyready at 9:43 PM on November 29, 2016