Making Progress (and Private Therapists?)

[Echo]

@Lucycat - fantastic that you can have that on the NHS. It looks like provision is different in Scotland for you than down here in the south.

 

[Deleted member 20280]

Devon really is rubbish. I saw a CPN and he made a referral to the head psychiatrist for the Trust. He decided on the basis of the CPN's observations I was 'Fine'.

Luckily my GP is a specialist in trauma related issues and supports me 100%

 

[Kas_Can_Fly]

I have been told my therapist "can" diagnose so can my social worker, but they both prefer to do it through a psychiatrist or in a joint session with one, just to clear up what I meant there! In my case, I had to be referred to a psychiatrist to be diagnosed with PTSD and "a dissociative disorder" before I was allowed to be referred for therapy. Now my therapist is analysing what she thinks the dissociative disorder is during my therapy and we've also been talking about a personality disorder, then she will be sending me back to the psychiatrist for confirmation of the final diagnosis. In the mean time my notes are available to all of the Mental Health Services locally. Sorry if that was confusing! :)

Different charities do things differently but I understand if that's not the path for you. I don't know how old you are but psychiatrists in the UK will practically refuse to diagnose depression and anxiety disorders if you are under 18 and even more so under 16. So don't take it too personally that you have been essentially ignored over this - although I completely understand how invalidating that could be for you. Unfortunately like many mental health service, keep pushing for the thing you need/want and eventually you will get there. But long term counselling (psychologist) and diagnosis/medication if you need it (psychiatrist), in my experience are likely to come from the local Mental Health Unit which needs a GP referral. Short term therapy usually isn't through the MHU but more likely your GP.

About feeling out of place asking for therapy with a diagnosis - many people do this and that is how they find out what their diagnosis is. If a family member died, would you think it weird to seek grief counselling, I doubt it, so if you've experienced sexual assault or something life threatening why would you feel any different, except for the fact that it's more personal and therefore daunting. Also your private therapist at your say so, can share information with the NHS and your GP to say that think you have PTSD and why, which means if it is referred on to a psychiatrist to diagnose for any reason, there will be another trained professional to back you up. A private therapist should do an assessment, but some don't like labels and would rather treat you as a person with a real history, rather than with generic terms and as an acronym.

Good Luck

 

[Hashi]

I'm not particularly interested in charities, the few that I have gone to have been very condescending and a bit too blunt with me which I told them and they told me that was how they did things.

I don't know the charities or who you were dealing with, so this may not be relevant. I just thought I'd say that I HATED the counselling co-ordinator at the charity I went to. (In my case, it was a RASASC - rape and sexual abuse support centre.) She was rude, inconsiderate, unreliable and just horrible to be in the same room with.

Because of her I initially rejected them, but after three months for various reasons I was desperate enough to go back and go through the waiting list an then the starting process. The administration and "how they did things" around me getting to see a therapist was awful. But the therapist was fantastic, and once I'd gone through the starting process it was just me and her.

The charity I went to was pay what you could afford, and in my case that was £5-£10 a session, but I know my counsellor charged £40 an hour in her private practice. I wasn't allowed to continue seeing her when my time at the RASASC was up (another issue with the administration/way of doing things, although they did give me an extension on that thanks to my therapist's intervention). Afterwards, I found another great therapist in central London - probably as expensive an area as you can get - for £60 a session. I understand that any fees are hard for you, but if you're going to try to manage it I do want you to know that the fees you're talking about are very high and you don't have to pay that much to see someone really good.

Also, a lot of private therapists will be willing to reduce their fee if you're hard up, even if they don't advertise that fact.

To be lucky with the NHS is possible I think, but you would have to be very lucky. Most of us aren't.

 

[Hashi]

you need a trauma therapist (who will be a psychologist not a psychiatrist), not a psychiatrist, unless you want drugs not treatment. A trauma therapist can and will diagnose you.

I have to disagree a little. I was diagnosed by a psychotherapist (she was a trauma specialist). It isn't essential to see a psychologist. Psychologists have a particular approach which may or may not be helpful, so I think it's important to be aware of that.

You want to be looking at psychologists/counsellors rather than psychiatrists I would have thought if you're wanting therapy?

Um... or psychotherapists. It doesn't have to be a psychologist, and in fact they tend to be much more expensive. I suspect the therapists that have been suggested to Liana might be psychologists - the fees seem to be much more psychology than psychotherapy type fees. I've only ever had psychotherapy with trauma specialists and that has been great for me.

Edited to add - sorry, I realise what I just said wasn't accurate. I tried seeing a psychologist after I had to stop going to the RASASC. The fee was too much, and worried and bothered me, but I felt it was important. However, the whole psychology approach didn't suit me at all and I left after a few weeks then found my great psychotherapist.

 

[Echo]

@Hashi - you are right, in my case that was a typo. My trauma therapist is a psychotherapist.

 

[digger]

Um... or psychotherapists. It doesn't have to be a psychologist, and in fact they tend to be much more expensive. I suspect the therapists that have been suggested to Liana might be psychologists - the fees seem to be much more psychology than psychotherapy type fees. I've only ever had psychotherapy with trauma specialists and that has been great for me.

Yes, sorry, couldn't think of the proper words earlier, just didn't think psychiatrist sounded right for someone looking for therapy.

 

[Deleted member 20280]

My diagnosis was again by a psychotherapist. I was told one of the top five in the UK. His fee was £150 a session. I had 8 sessions with him last year and I am still in contact via emil and text message. I was extremely luckt that my then Employers (Police) paid the bill. My experience of the NHS was tainted by a so called 'Head of Psychiatry' He signed me off local NHS help almost on a whim!

I will be looking at the charity sidevof things myself to see if there is anything I can get to get back into therapy myself.

 

[Liana]

So to clear a couple things up. I'm not officially diagnosed with PTSD. My doctor thinks I have PTSD, as do I and so does my boyfriend. So I want to find a psychiatrist who can first of all, find out if I do actually have PTSD and prescribe medication if I do. I am not a bit therapy person, everyone I have had to talk to in the last 2 years have been rude and inconsiderate. I am willing to, if I do have PTSD and I find that medication isn't working well purely on it's own, find a therapist/psychotherapist/psychologist who can help me talk out my problems. In fact it's most likely I will need to talk it out, I guess, but I don't want to find someone and just go 'I think I have PTSD and I want to do a trauma based therapy thing'.

 

[Bedbug]

@Liana, you've worried me a little bit with that last post. Medication won't "[work] well purely on it's own". It may help to alleviate some of your symptoms, but it won't help the underlying cause. By all means, seek medication if you need it, but don't expect it to "fix" PTSD. Have you looked into coping techniques for your symptoms?

Similarly, just "talking it out" probably won't help much either. You need to learn ways of working with your trauma. A therapist may be a helpful guide, but if you are really resistant to working with one (or, as in my case, don't have one available to you), you can still learn to help yourself. At the end of the day, you have to do this work yourself anyway. No therapist can do it for you.

This thread might be a good read:

profile

I think it's really important to get a diagnosis from a suitably qualified person so that you know exactly what you are dealing with. If it is PTSD (and this seems likely) we will help to support you as much as possible on here.

I wish you well!

 

[Echo]

@Liana - you are right to want a diagnosis first. Whichever way you chose to go about it. What you might find though is that you are not offered drugs at all. I certainly have not been. Neither by the NHS nor has my trauma therapist suggested that I ask for them. If you read the NICE guidelines here: [DLMURL]http://guidance.nice.org.uk/CG26[/DLMURL] you will see what you are likely to experience. Bear in mind though that these are just guidelines, and as you will see from the various accounts people have given here, provision on the NHS varies depending on which county you are in, whether you are in England, Scotland, Wales or Northern Ireland.

You would not be able to go to a trauma therapist or any other kind of therapist with a self-diagnosis and say you "want to do a trauma-based therapy thing". They will want to diagnose you first and find the right treatment for you.

Some trauma therapy is talk therapy, like cognitive behavioural therapy, for instance. Some, like the sensorimotor therapy I am doing, is primarily body work, so-called somatic therapy, akin to somatic experiencing. You might find it helpful, if you want to know more about the latter approach, to read Peter Levine's book 'Waking the Tiger'. Another good book is Babette Rothschild's 'The Body Remembers'. Someone else here might be able to recommend books on CBT and other options. I felt very strongly that talk therapy wasn't the way for me, right from the start. Luckily all the therapists I encountered, whether in the NHS or not, agreed with me.

You do have choices. But just bear in mind that you can't insist on medication, but you probably know that. That is not to say that you won't get it, you may. But it is usually given in conjunction with some kind of other therapy. The NICE guidelines specifically say that medication may only be given to suffers of PTSD if they refuse talk therapy. The best thing is to inform yourself, so you can make the choices you do have. Stick up for yourself and go with your gut. And if you are not sure whether you have PTSD, have a look around at other anxiety disorders or depression, whatever seems likely, and see how you can expect them to be treated. There should be NICE guidelines for those conditions, too.

Best of luck

Echo

 

[Liana]

I'm not expecting to get medication, or just have medication purely on it's own. I know that it would be needed in conjugation with other treatment - i.e. getting to the root of my problems. All I want is to get a proper diagnosis and get help. I've scared myself and my boyfriend over the last couple weeks, as I've been deteriorating a lot so I'm a bit desperate to get help..