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The importance of choice – access to talking therapies

Monday, 02 December 2013 Al

Al blogs for us about the importance of choice and having access to the right talking therapy to suit you.

On the odd occasion that someone asks me about my experiences with talking therapies, I can never just give a short, straight answer.  My chronic anxiety has led me down various talking therapy avenues in my life, usually at the lowest points when I just couldn't handle the condition on my own anymore.  They have all given me different experiences. 

I've had five separate talking therapy courses in the past, all for various different elements of anxiety, that temporally go something like this:

  • NHS counselling: 1997
  • University counselling: 2006
  • NHS counselling: 2007
  • Private CBT: 2009
  • Private CBT: 2011-12

I was only 11-ish years old when I accessed the first course of counselling in 1997, so I'll bypass that for fear of not recalling memories about it coherently.  However, out of the other four, I can confidently state that only the most recent course was 'successful' for me. 

The university counselling, which consisted of just one session with the university's therapist, only came about because it took over ten months to see the NHS counsellor and I was simply getting impatient. I contacted the NHS for an appointment in September 2006 and didn't get to see the counsellor, after numerous cancelled appointments, until July 2007, by which time I'd actually come through the worst of the current situation myself, simply through the gift of time.

So not only was the counselling ineffective for this reason, but also because the counsellor in question was not very sympathetic, to say the least.  I appreciate it's not always sympathy you need when dealing with such circumstances, but it got to the point where he didn't appear to appreciate my situation or what I was going through.  I felt bitterly let down by this and consequently haven't been back to NHS therapy since.

By 2009, I thought that the majority of my anxiety had dissipated (although now I know it hadn’t, but that's a separate story).  However, I still wanted to conquer my fear of eating out which had persisted for many years.  It was crippling my social life and I needed to sort it out quickly, so I sought out my own help via the internet and found a local private Cognitive Behavioural Therapy (CBT) therapist. 

Sadly, successes here are also hard to tease out.  I saw her within two weeks of contacting, which of course was a huge improvement, but the therapist was more concerned with finding out why I had the eating out problem rather than trying to deal with it.  I've since learnt that I wasn't really getting CBT, and I knew when we spent one session purely focusing on dolphin noises that I wasn't getting anywhere useful with this.  Despite it being a private therapist, I was also limited to a maximum of eight sessions, which again I now know was nowhere near an adequate amount for me. 

My anxiety as a whole took an awful turn in March 2011 and so followed what was probably the lowest period I’ve ever had in my life – I needed help.  I knew going down the NHS therapist line wasn't going to help me and I was also more wary about the 'randomly selecting a private therapist' route.  I was in despair and spent ages searching for some sort of solace on the internet, which as with most things these days became the fountain of all knowledge.

That's when I stumbled across a charity that offered private therapy sessions.  The therapists themselves may work for the NHS by day, but some take up private clients out of hours, as was the case with me.  At the time, I was struggling to even make it out of the house and there was no local therapist.  So I utilised their option of therapy via webcam.  Within two weeks of contacting them, I had my first appointment arranged. 

So I undertook webcam therapy with a CBT therapist from Scotland, whilst I live hundreds of miles away in the Midlands, and although there were one or two restrictions compared to more conventional talking therapies, it was great.  One thing my therapist did say is that "I can't put you into a totally anxious state, lest I can't adequately get you out again" whereby inducing an anxious state is, of course, aimed to help with progress.  There were also one or two technical problems too, as you'd expect.  But overall, it was a success.

Although of course, the biggest success wasn't whether it was via webcam or not; the biggest success was the therapist herself.  We struck up a great relationship which aided my recovery as much as my actual therapy did.  I had around 50 sessions in total, which goes to show how much therapy I actually needed, but as you will gather from this, I was able to have as many sessions as I wanted.  We phased out the frequency of the sessions after about the 40th which meant it was a gradual close off rather than a sudden one, helping to minimise the likelihood of a relapse.  And most importantly, what I was getting was actual CBT, the treatment that I asked for, which made me realise that what I received before wasn't.

The therapy I received in 2011-12 has really helped to turn my life around.  When it first started, I couldn't see a way out of my lowest point, but with the hard work on top of the number of sessions I had, I'm now much more confident about facing my anxiety and, indeed, writing about it.  The only medication I’ve ever been on is beta-blockers; I’ve never been prescribed any anti-depressants, which suggests that one can gain real success from talking therapy without the need for medication.

I grant you that I had to pay for this therapy, which of course I appreciate isn't always an option for everyone. Overall my experiences suggest that spending a little bit of time - perhaps more than you'd like if you're at an extremely low point - is well worth the effort in the longer run, in terms of getting the best help for you. You can also contact your local Mind for support in your area or call the Mind infoline on 0300 123 3393.

Al’s experience highlights the importance of choice and finding the right support for you. Join our campaign for access to the right talking therapies at the right time.

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