Therapy when you're not ready to change
May 12, 2020 4:09 AM   Subscribe

I have a lot of long-standing anxiety, depression and alcohol abuse issues. I've done a lot of things to try and deal with it on my own, and when that didn't work I tried a few different counsellors and medications, none of which have made a dent. I was in a bad place already when coronavirus hit and now it's obviously worse (I live on my own and the isolation is getting to me). I have very little optimism about the future, and things have been bad for a long while. I'm not getting any professional treatment at the moment but I would like someone just to talk to. What should I look for? Is it even reasonable to look for counselling right now when I have no motivation to change?

My experience of therapy, broadly speaking, is that someone will listen to you while you talk, then suggest ideas, strategies or changes that might help with your problems. So far nothing has helped beyond a very brief and temporary lift. Things have got gradually worse over the years to the point that I now don't have really any expectations for the future apart from more unhappiness. I have a lot of trouble reaching out to people I know when I'm having problems, for reasons which are complicated (and probably worth talking to a therapist about...) so at the moment I'm kind of keeping everything inside.

I would like to find a therapist just to be able to talk to someone about it, but in the past therapy has just seemed very action-focused, picking up on one particular problem and giving an almost boilerplate exercise or response, with little regard for the complexities that make action difficult or ineffective. At this point I'm not sure what counselling can do for me apart from being a paid listening ear. I don't really know where to go from here. I've looked up counsellors in my area and most bios sound like they were written for someone who's struggling and reaching out for help for the first time; for someone with complex ongoing issues it feels a bit alienating. What should I be looking for here?

I'm UK based, if this is relevant.
posted by anonymous to Health & Fitness (16 answers total) 5 users marked this as a favorite
One of the goals of good therapy is to get you to a place where you are open to change. Getting to that point can often be half the battle, and can take a good deal of work in itself. If you wait until you know you are ready to change, you will never go into therapy.
posted by Thorzdad at 4:26 AM on May 12, 2020 [13 favorites]

You can try out the response you're going to get from possible therapists by asking them exactly these questions - exactly as you have done here.

Sometimes you'll get no response at all. Sometimes you'll get bland boilerplate nothing-responses - in which case, they're off the list. Sometimes, maybe, you'll get a sense of there being a real person behind the response, who's providing something that you can engage with & respond to. Those last ones would be worth following up.

If you're open to remote therapy during lockdown, then in principle you have a bigger pond to fish in.

IME - good therapists are out there, but they're outnumbered & so a bit harder to find.
posted by rd45 at 4:46 AM on May 12, 2020 [5 favorites]

I've gone to therapists just to have someone to talk to, and have told them that that's what I needed. And even though my current therapist is pretty action-oriented, sometimes she mostly listens.

I wouldn't worry too much about what the bios say - try contacting a few and either emailing or making an initial appointment to talk about what you need right now. Do you just want someone to listen, do you want help processing/reframing what's on your mind, etc. Are you okay with them suggesting actions occasionally, is it currently too overwhelming for you (has been for me at times), etc.
posted by bunderful at 4:50 AM on May 12, 2020 [1 favorite]

I would recommend finding a counselor that has expertise in addiction even though you don't want to change, and be sure they know you don't want to change. Addiction counselors are very familiar with helping someone who has substance misuse and isn't interested in doing something to change it. You didn't mention that this is the area you aren't wanting to change but I would say almost any professional can help with depression and anxiety and addiction requires a bit more specialization, hence the suggestion. If you've never sought an addiction professional before that might give you a better experience than what you've had previously. Addiction professionals are well aware that change is an intimidating process with lots of complexity. The key will be to make clear what you want and don't want. A good counselor can accommodate the goals you have even if the goal is "I'm hurting and need to talk to someone but don't want to be told some boilerplate changes to make."
posted by crunchy potato at 5:36 AM on May 12, 2020 [9 favorites]

There’s 7 Cups of Tea, which sounds like it might be good for you. It’s not “therapy”; the counselors aren’t trained or licensed, but the idea is for them to be there for you to talk to. I probably wouldn’t recommend it for serious issues, but if you just want to get some things off your chest, it seems like a good use case.
posted by kevinbelt at 5:58 AM on May 12, 2020

i would recommend sending exactly what you have here to any potential therapists. you can also print it out or email to them.

the right therapist for you will know what to do with this info and find a rapport and way to engage with you on your terms.

wish you well right now and also totally understand where you're coming from.

(i've also tried some of the online apps like betterhelp and found them wildly frustrating and full of platitudes rather than what i needed. your experience may vary of course, to me it sounds like you should seek out an actual therapist. i've found mine in the past by doing what you've done - looking online and contacting the ones that didn't seem to "woo" or likely to want to discuss my inner child or chakras or whatever. i needed a person who i was not related to nor friends with to provide me with objective assessments of things i felt and thought etc. to make sense of it. i wanted to sort through the "stuff" in my head with someone who wouldn't judge or try to placate me. it did help when i found the right one for me.)
posted by affectionateborg at 6:07 AM on May 12, 2020 [2 favorites]

I am a therapist in the USA, and working with people who aren't ready to change is common in my work.

One point of potential difference, but if the NHS pays for therapy in the UK, they may have similar requirements that insurance companies have in the USA. I don't take insurance, but many of my colleagues do, and they say they are expected to document that they are making progress towards the resolution of a specific mental illness. Similar to how insurance won't continue to pay for physical therapy for an injury if a person isn't improving, insurance in the UK might not pay for therapy if someone isn't making progress towards a goal.

I bet a private-pay therapist would be different, if such exist in the UK.
posted by MonsieurBon at 7:02 AM on May 12, 2020

I don't take insurance, but many of my colleagues do, and they say they are expected to document that they are making progress towards the resolution of a specific mental illness.

In my experience, if they even bother to address it with you, the therapist will just be like "I have to put in a diagnosis for insurance so I'm going with "generalized anxiety disorder," does that work for you?"
posted by showbiz_liz at 8:20 AM on May 12, 2020 [2 favorites]

Therapist bios are awful. They're an ad, and often they're written to appeal to as many people as possible. I'd discount them a little...

Therapy is a service you are paying for, so I think if you're upfront about mostly just wanting an ear, there are probably therapists who would say fine, that's what we'll do. One thing about therapists is that they are people trying to make a living and so, while I'm sure some would say "I don't think that's going to help you so it's unethical for me to take your money," I just have to imagine some would say "therapy isn't just one thing." And, you know, just unloading can lead to other kinds of conversation, even without anyone steering you in that direction. It doesn't have to, but it might. One part of therapy is talking and hearing yourself and noticing what you are saying in a heightened way because someone is hearing you say it.

This feels like an incoherent answer but basically yeah, find someone whose profile doesn't put you off, send an email saying what you need right now and what you're not interested in and take it from there. It isn't about finding the right person on the first hit, necessarily, which is hard. Do a session or two, give people a fair shot (knowing that, like friendships, therapeutic alliances aren't always immediate) and then go with your gut and, if you need to, say : thank you for your time, but this is not what I need right now.

(Ok and it's worth mentioning that for good and bad reasons, there's some possibility they'll say "let's have another session or two to talk about that" and you can say yes or no, because you're paying for it.)
posted by less of course at 9:00 AM on May 12, 2020 [2 favorites]

I would like to find a therapist just to be able to talk to someone about it

Echoing what other people have said. If you can afford it or if someone else can pay for it, why not? Yes, do you print out your question and share it with potential therapists and see how they respond. Good luck!
posted by Bella Donna at 9:15 AM on May 12, 2020 [1 favorite]

With the caveat that most research shows that the specific school or modality of therapy is not as important as a person's connection with the therapist, I wonder if it might be looking into psychodynamic therapy. The psychodynamic therapist I had for a while was really not focused on change or advice - she was much more focused on personal insight and self-understanding.

In general, CBT therapy gets recommended a lot on AskMe, precisely because it leans more toward short-term change than many other modalities, so it might be beneficial to explore non-CBT modalities.
posted by Jeanne at 12:06 PM on May 12, 2020 [1 favorite]

Please don't give up; it can get better. You sound very discouraged right now so you might have a hard time believing you can do much to be happier in your life, but since you posted here, I think that's a sign that you do have some hope. I'm not able to tell much about the underlying issues with the information you posted, but some things you might look for in a therapist trained and experienced in providing:

supportive therapy (rather than change therapy)
motivational interviewing
stages of change work (Prochaska and Norcross)
non-violent communication (NVC)
attachment approach

The most important piece is finding a therapist who you feel gets it and understands you. If you have a hard time believing anyone can help, that's your brain lying to you. It may be you need to focusing on harm reduction with the alcohol abuse so you can get your brain working just enough better for other approaches to get a toehold. It might be you need to focus on working with a psychiatrist to find the right medication that will give your brain enough relief that talk therapy and a caring supportive relationship with someone else can work its healing "magic".

My very best wishes for you to find someone(s) that "click" with you and whereby your sense of safety and agency can empower you to take the positive steps you want for yourself. You really deserve that.
posted by dancing leaves at 7:51 PM on May 12, 2020 [2 favorites]

Looking for a therapist who does Motivational Interviewing or Psychodynamic therapy might be the ticket for you. Share this post at your first visit.
posted by shadygrove at 9:52 PM on May 12, 2020

A friend, who is a clinical psychologist, once posted on Facebook about overhearing the words "why aren't there people like sex workers who you go to, pay money and unburden yourself about your feelings -- like a sort of feelings hookers?"

A first step in therapy is acknowledging your humanity, that the basic state of being human is being observed in community. For whatever reason we're expected to be islands of our own individual brilliance but we're not brilliant and we don't get our good parts endorsed or celebrated when we're isolated. In contrast to this atomic human being, I like the translation of 'ubuntu' from the Zulu language (I think) that says 'I am [a person] because you are [a person]' and tells us that being in community is important and that whatever you're feeling right now is real and important to you.

Whether you want to change it can come later, but using the service of feelings-hookers to map out and acknowledge your present emotional landscape is actually a huge step in dealing with the energy taken by your anxiety, depression and drinking. (And it can be a relief when you trust someone who says "burn this godsdamn world to the ground, it's horrible right now.")
posted by k3ninho at 10:20 PM on May 12, 2020 [4 favorites]

YMMV but when I started therapy I was like "MY EXPERIENCE IS TRUTH YOU WON'T CHANGE ME BUT ALSO I HAVE TOO MANY THOUGHTS AND FEELINGS AND WOULD LIKE TO VOMIT THEM NOW" and lo, eventually I WAS CHANGING. Oops. It took a few months or years, but in the meantime, god it felt good to vomit. You gotta clean the fatburg out before you can replace the pipes.
posted by Grandysaur at 11:11 PM on May 12, 2020 [2 favorites]

This thread has some good advice about finding a therapist.
posted by counterfeitfake at 4:32 PM on May 13, 2020

« Older What are some good things to offer crows?   |   What is this donkey nanny hat? Newer »

You are not logged in, either login or create an account to post comments