Changing therapists

[LoveTea]

So a few weeks ago my main therapist told me she is leaving the practice, meaning I have to stop seeing her. The question is what to do next. I have a DBT therapist and an EMDR therapist as well. My DBT therapist has not wanted me in group since I dissociate so often, so she said she will not put me in group until I do an intensive 6-8 week hospital stay. So, my therapist found another DBT therapist for me to meet with. This therapist would be my main therapist along with DBT and I would have to give up EMDR. She said she would take me on, but she says she wants me to do inpatient based on my current DBT therapist’s asessment. However the program they are suggesting is just not feasable at this time in my life (both financially and logistically).

I don’t know how to make a decisions. Normally what has happened is I wait so long that a decision is made for me. I feel like I am floundering though. I don’t like feeling that my current DBT therapist is giving me an ultimatum (especially since I am paying for individual sessions out of pocket and they are twice as expensive as group). But at the same time, I am really freaked out about talking to her about leaving her program for another one. An additional problem is that new people are very scary for me and it takes a long time for me to warm up. I don’t want to stay or leave out of fear or avoidance. I know that isn’t healthy. I just don’t know how to make a decision about my own therapy. Do I stay with the people I have and find a new main therapist? Or do I switch to entirely new people? I am not looking for an answer, I guess I am just wondering how to make a decision? What is important to consider and what is unnecessarily weighing me down? How should I approach a conversation with each of these therapists?

 

[Justmehere]

What does the therapist that you are working with now think is the best path forward? Does she have recommendations on level of care? Is she able to talk to these other providers and help come up with a solid transition plan that is actually doable? Do these therapists understand you can not afford the 6-8 week treatment and do they have an alternative suggestion?

I think you should be upfront and very clear about what you financially can and can not do, and ask for recommendations on next steps within what you can afford to do. If it still doesn't work out, then you can seek out other options, see what others say, and evaluate your choices. You don't have to end with these possible new therapists in order to get second (or even third) opinions.

 

[LoveTea]

My current therapist wants me to switch people entirely, but at the same time says it is my decision, which is very confusing for me. I understand that she thinks it is more comprehensive than the piecemeal situation I have now. But I feel like if I make that switch, I can’t change my mind and go back. The additional problem is that my current DBT therapist dosn’t agree with that and thinks I should stay in her practice and seems offended that I even mentioned another practice.

There have been so many different iterations of a treatment plan that it has taken a while to even narrow it down this much and I only have one session left with my main therapist to figure it out. I am so overwhelmed and consumed with the different directions in which I feel like I am being pulled.

I have mentioned that I can’t do the hospitalization, and the response I have gotten is confusing. In my current DBT practice it means that I won’t be allowed to start DBT in a group and I will have to keep doing it individually. I don’t know what it would mean in the potentially new DBT group. But no one has given me any alternatives to hospitalization or been trying to work on skills to prep me for group and I am confused as to why that is not a priority if they think these issues are problematic enough to require a hospital stay.

I just feel like thereis a weird power dynamic between my main therapist and my DBT therapist about what to do, and I don’t know how to handle that. My indecisiveness only seems to be making the problem worse because people are inserting their opinion then saying it is my decision and with each session with each person I am becomming more confused, stressed, and anxious.

 

[grit]

on one hand you sound extremely intelligent and articulate to voice your opinion, on the other hand you sound really young like almost teenager and afraid to stand alone and voice a need or an opinion.

I feel the confusion is with you at least from reading your posts. You are a paying client who want certain services. but yet you are adamant to make the decision and you are also not trusting others' decision for you. Maybe take a risk and make the best decision you can live with today.

I hope this is OK to say. I want to respect your autonomy.

 

[Justmehere]

I’d suggest gathering more information about other therapists and treatment options outside of this group of therapists. You don't have to quit the therapists with this group to gather more info on other options.

My current therapist wants me to switch people entirely, but at the same time says it is my decision, which is very confusing for me.

It is your decision. Advice from others is just advice. You can choose to follow it or not. At the end of the day, it’s really important, especially when recovering from trauma, to know that you do get to choose.

But I feel like if I make that switch, I can’t change my mind and go back.

You don’t even have to make the switch. You can also simply not return to sessions for now, let these therapists know you are going to take some time to review all options and get back to them in a few weeks, and then go consult with other therapists. Then the door isn’t closed with them, and you can gather info and consult with other possible therapist and treatment options.

The additional problem is that my current DBT therapist dosn’t agree with that and thinks I should stay in her practice and seems offended that I even mentioned another practice.

It would be pretty unprofessional to be offended someone is looking into all options.

But no one has given me any alternatives to hospitalization or been trying to work on skills to prep me for group and I am confused as to why that is not a priority if they think these issues are problematic enough to require a hospital stay.

It should be a priority, but they may feel like it’s one they can’t address, so they are not even going there. They should be working on DBT skills and ways to stabilize - especially to be able to be grounded in the group sessions.

Have you looked into partial hospitalization or intensive outpatient options for treatment? That might be a more doable middle of the road option. It's a higher level of care with less expense.

I just feel like thereis a weird power dynamic between my main therapist and my DBT therapist about what to do, and I don’t know how to handle that.

I wouldn’t worry about it. This is where you making choices that are right for you is very important. Nevermind their issues. You focus on you.

You hired them. You get to choose which you’d like to continue to hire to help you meet your goals in therapy and life.

 

[EveHarrington]

I think you’re taking things WAAAAY too fast with WAAAAY too many kinds of therapy.

You say you do t have basic coping skills....?

No wonder!

With three different kinds of therapy, how would you ever have time to practice them?

My advice?

Drop EMDR for now.

If your dissociation is so off the charts right now that you can’t even do group, you’re light years away from being able to do EMDR.

This is an unnecessary expense (of both time and money) right now.

Healing is a long process, and it seems like you’re trying to do everything at once. (Who in the world advised this kind of therapy schedule? IMHO they’re completely off the mark!)

Stick with two therapists AT MOST. Just one would probably be better, one who can focus on skill building so that you can stay grounded.

Because if you can’t stay grounded? Healing is going to be glacial at best.

 

[Nessa7]

What do your EMDR and main therapists think about hospitalization?

It also seems weird to me that you are capable of doing EMDR and not group DBT if the issue is dissociation. Do you dissociate more in group settings or behave in disturbing or disruptive ways when you dissociate? What does your other therapists think about your ability to do group therapy?

 

[LoveTea]

@Nessa7 My main therapist originally thought hospitalization was unnecessary and now seems more open to it. My EMDR therapist doesn’t really have an opinion and is deferring to my main therapist.

Basically all my therapists don’t think I am ready for group settings. However, I have been hospitalized 4 times now and I didn’t have a problem in those groups. When I dissociate, I pretty much freeze, there is nothing directly disruptive about it. I guess that they think I may not get as much out if it. I’m just kind of confused about that aspect because I thought that this DBT group was aimed at people with a trauma background.

 

[Nessa7]

I don't know if it would help to have someone say this, but this seems like a very difficult decision to me also. When I'm in your position, the thing that helps me is to keep talking about it until one option starts seeming better than the rest, so I'm going to keep asking questions.

How has EMDR been going for you? Is it more or less effective than what you've been doing with your DBT therapist?

Have you been progressing towards your other goals with your DBT therapist? It is concerning to me that none of your therapists are working towards your goal of group therapy and being more comfortable with people if that is something that might be happening soon.

Is the new therapist willing to see you for at least a trial period before wanting you to be hospitalized? Would you be going from seeing three people one-on-one to only getting group therapy? That would be a pretty drastic change.

How would you feel about looking for other therapists?

 

[rosey]

l you many EMDR therapist won't accept a client until they have done something such as DBT and have an established and working set of healthy coping skills.
I would not do EMDR until you are in a stable and coping mindset.
I agree with others that too many therapies at the same time is a bit much. Again most therapist won't see someone who is having another form of therapy here in the UK. Different therapies can contradict each other so could be very confusing.

 

[Justmehere]

When you have multiple therapists, you have to be careful to not get caught up in loops with therapists not in agreement with each other. It's best to have a primary therapist take the lead, and it seems like they have. The DBT person is just unwilling to have you in their group right now.

DBT is a good treatment for trauma. It can be helpful to do in a group. Outpatient groups assume a greater level of stability than inpatient, so they do a bit more work. I have generally found inpatient groups to be a lot more laid back than outpatient ones.

I’ve frozen up, and been around folks that freeze up. As much as freezing up isn’t outwardly disruptive, it is a sign that what is happening around you is more than you can engage. It also can be difficult for others in a group to know how to engage and support someone who is unresponsive and staring off into space.

If the DBT therapist is not reviewing DBT skills with you in the individual treatment with them, then what work are you doing with this therapist?