#therapyanswer

[2/2] I look at all the online resources & worksheets etc, and give up quickly as soon as it asks what I want out of treatment, or what my goals are (I have none). I saw a GP a few weeks ago about sleeping problems, she immediately saw through me & asked me to come back if I wasn't feeling better to put together a mental health care plan (I'm in Australia). But the idea of going through things with the GP, and then again with psychologist is such an unpleasant thought. IDK what I want or need.

Hey there. I’m so sorry for the delay in getting to your message, we are working through this now. I hope things have gotten better for you since you sent in this message. It sounds like you were having a really rough time. 

I know that feeling of being torn between doing what you know you should do and what you actually want to do is so so difficult and I can completely understand where you’re coming from. It is one thing to know what you need, and another to actually go do it. One thing that often holds us back from doing what we should do is the feeling that we aren’t ready for it, like you said. You know what though, most people aren’t ready for big change. Change is hard. Confrontation is hard, Admitting you have an issue is hard. But they say nothing worth doing is easy. 

Go back and talk to your GP, they have given you this opportunity to talk to them and you should take advantage of that. Don’t think about it too much or worry about what it means for the future- just take it one step at a time. Cross each hurdle when you get to it. You don’t have to do everything right now. Working through mental health issues takes time. 

Here are a few links that might help you out:

How do I make myself want to get better? 

What if I don’t want to recover at all?

How do I get professional help when I’m afraid of it?

Is there a way to ease avoidance of medical appointments?

I’m afraid of bringing up AvPD, but I still want help? 

Hi there! Good luck at your upcoming appointment, we hope everything goes well for you. Therapists admittedly vary in terms of how receptive they are to patients being upfront about potential diagnoses, so I don’t feel comfortable providing you with a direct answer since it really depends on a combination of your therapist and your personal preferences about how to approach treatment.

With that in mind, as a general rule, I would caution against insisting you have a certain disorder during an intake appointment; if you’re able to build a rapport with your therapist after a few sessions, a direct suggestion might go over better, especially since they will be more familiar with your symptoms. We have more on how to bring up AvPD (or any other disorder) to a therapist here. Having specific diagnostic checklists ready when you do have this discussion also seems like a good idea to me. Overall, building a solid foundation between you and your therapist is an integral part to receiving the best long term treatment. 

Personally, for your first appointment, I would encourage you to bring in a list of your symptoms (as well as examples of how they apply to you) and talk through them with your therapist. If you feel very strongly about bringing up specific disorders during your first session, perhaps mention that you’ve done a lot of research on your symptoms and have identified a few disorders that appear to have similar symptoms- this might help you gauge if they would appreciate direct diagnostic suggestions or not. I don’t think this is something you would necessarily have to do immediately though.

If anyone has any further suggestions or stories they would like to share that might apply to this situation, please feel free to reply.

Hopefully this advice helps.

Hey there. You’re always welcome to vent! I’m sorry to hear you’re having a hard time getting a doctor to take your request to be evaluated for AvPD seriously. That must be very frustrating. The existing stigma surrounding personality disorders can admittedly discourage many professionals from wanting to officially diagnosis individuals. However, for those interested in obtaining a formal diagnosis, a professional diagnosis often makes it easier for them to navigate their disorder and have easier access to proper psychiatric treatment. I hope you find a professional who is wiling to take your request for evaluation seriously. 

As a side note, we have a post from a while back (here) that talks about how to ensure you’re seeing a professional actually qualified to make a PD diagnosis, as many practitioners may be unqualified or too unfamiliar with AvPD to make a diagnosis. Perhaps it might be of some use.

Best of luck!

Hey there. 

Sounds like you’re going through a rough time at the moment, I’m sorry to hear that. I just want you to know that what you’re going through does matter and is valid. No one has the right to tell you what you’re feeling- not even your GP or doctor- you are the only person who can do that. 

If you experience depressive symptoms of any kind, no matter how mild you think they are, it is best to see a mental health professional. It is easy to fall into the mindset that you are not “sick enough” to see a doctor or that other people have it worse so you should ‘suck it up’, but preventative is better than curative. Depressive symptoms are serious and can worsen over time, so I really encourage you to reach out to a mental health professional. 

As for your GP, most GP’s are not trained in the specifics of personality disorders since they usually don’t specialize in any particular field of medicine. Although more well known PD’s are characterized by impulsiveness, AvPD is not. AvPD is considered a “stable” PD, it doesn’t generally cause any abrupt or “dramatic” changes, like outbursts or violence, in your behaviour. So your GP brushing off the possibility of AvPD due to lack of impulsiveness is incorrect. Please don’t let that discourage you from trying again. 

She told me I need to change and the way I am right now, I am just not ready for therapy. We said awkward goodbye. Now I just feel really shitty. I tried to get help, but turns out I’m either beyond help, or, just a shitty person in general. But the thing is, I kind of agree with what she said. I was not ready for therapy. But I don’t think I’ll truly ever be because of the way I am. And so my nightmare came true, rejection even from the person that was supposed to be able to help me.That’s the reason it took me years to find somebody in the first place. And now what? I am worse than before. However, my psychiatrist basically told me that she doesn’t think that my therapist is good, she literally said that she is a shitty one. Could it be true? Is there a possibility that it wasn’t my fault and therefore should I seek a new one? Or am I just really not a therapy material? I am sorry this was too long and whiny, but any advice would be greatly appreciated. Thank you, J.

Hello J! We’re sorry it has taken us so long to respond to your ask - on behalf of the AvPD Community, we hope you’re doing okay. 

I’m sorry you had such a negative experience with your previous therapist. I wholeheartedly agree with your psychiatrist that your old therapist was the problem, not you. 

While being receptive and open to therapy as a client is undoubtedly important, I believe you demonstrated that through reaching out and arranging your appointment. A (good) therapist’s focus should not only be to help clients with their struggles but to help them become more receptive to help in the long run. An adept therapist should also be aware of the best way to tailor their approach to each individual client. 

Sometimes finding a therapist that you work well with may take a little time, and you may need to go through multiple therapists before you find the one best qualified to help you.

To reiterate, it does not sound like the issue was you in this scenario at all. If you have not already, we encourage you to seriously consider seeking out a new therapist. Hopefully, some of these links might help as well: 

How to choose a therapist

What is good therapy?

Making recovery decisions worksheet

50 warnings signs of bad therapy 

Best of luck.

No, it’s really, really not. Your therapist should absolutely not be speaking to you like that. Learning about things and being excited about sharing them isn’t a character flaw. 

I’m autistic and so I often info-dump about my interests to people, and it can be annoying if the person isn’t in the right space to handle that information influx. And if you can try to control it, that’s good, and it sounds like you’re quite conscious of it and trying to only do it at appropriate times. I think that’s actually the best thing you can do, is to be aware of it and to make sure the person you’re talking to is okay with you info-dumping.

So your therapist is absolutely out of line in speaking to you like that. If you can, I would recommend seeing your GP and asking for a referral to another therapist.

Your therapist should absolutely not tear you down and make you want to self-harm. That’s the opposite of treatment.

I wish you luck in finding someone better to work with.

Many therapists are long-term! School counselors tend to be oriented towards fixing a specific problem and then kicking you out the door, in my experience, and that can sometimes colour people’s perceptions wrong about the purpose of therapy. There are plenty of professionals who intend to see their patients on a regular basis, up until the patient decides to end the relationship.

Whether you want to pursue one closer to home or school is up to you, and what is more easily accessible for you. Is it easier to get places within the city you’re living in, or is it easier to go somewhere where you are commuting anyway? I would go for where you spend more time. Even more than that, I would go for whichever ends up having better care. I don’t think there’d be anything to lose with therapist shopping in both cities.

If you’re unsure of how to find a therapist in general - we have a few resources about that here (link) and information about the actual process here (link) (search ‘therapy’), but also, try to connect with any city social media groups! I know that here in Toronto there are public groups where people share information and resources, it’s pretty common of larger cities. There might also be a state/province general one that people could help you out in. Good luck!

2/2 i don’t want them to think i’m “cr*zy” and use that against me. what should i tell them? further, i’m so embarrassed about the whole thing, i don’t even know how to make an appointment. do you have any tips how i could rationalize this situation to calm myself down? i know it is not the end of the world, but the mere thought nearly makes me want to die out of shame.

Hello. 

I think you should tell them what you told me- that you had a turning point and were honest enough with yourself to admit you need to see a doctor again. There’s no shame in that. In fact it’s a difficult and brave thing to do. Mental health problems, like any other health problems, can have ups and downs and need assistance to manage every now and then. That’s okay and normal. It happens all the time, even to the best of us. It is nothing to be ashamed of, I promise. 

Doctors are not there to judge you, they are purely there to help. So my advice to you is just to be honest with them. If they do ask you why you didn’t take your medication, be honest with them. You should be honest with your doctors. They may be able to come up with a solution to help you to stay on them in the future- if it’s money, there may be a generic option that is just as good. If it’s because they stopped working, they can change your dose. If you have a hard time keeping track, they may suggest tips on how to remember when to take them etc. Same goes for other issues you bring up with them. 

Here are resources that may help you from our Self-Help(link) page:

Preparing for a Doctors Visit Worksheet* 

How to Make a Doctors Appointment (HTGTFU).

How to Choose a Therapist

Choosing the right Service for you Work/Infosheet*

Making Recovery Decisions Worksheet*