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Finding Therapist/counselor Who Gets It?


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I know a lot of us have had this experience with doctors, but I’ve been having trouble finding a good counselor/therapist. The counselor I was seeing seemed WAY too quick to assume I was anxious and that anxiety was the cause of symptoms I mentioned in passing, and she seemed way too confident she was right. It was so frustrating, because I went out of my way to let her know I’d be honest about the times I WAS anxious, and that I expected to be believed if I said I didn’t think a given symptom had to do with anxiety.

I know there must be good counselors out there. I had one, about a year ago now, who was just wonderful (she even researched POTS on her own time, just so she could understand what was going on, and she seemed to almost immediately get how POTS is different from anxiety). I want to find another counselor like that, who doesn’t get hung up on the idea that anxiety causes everything and who can hopefully understand some of the challenges of living with a chronic, unpredictable condition.

Have any of you found techniques to screen out not-so-helpful counselors from the ones who ARE good about the POTS? Maybe counselors/therapists with a certain type of experience or approach, or who work at certain kinds of places? I don’t know. I’d just really like to avoid having yet another negative experience, if possible, and I’m not really sure right now how to make that happen…

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I am so sorry that your last counselor didn't seem to get it. Not every counselor is for everyone. (I'm in school to become one! LOL) Just like everyone has different personalities, every counselor has different styles in how they work with people. One of the things that really helped me to find a great counselor was to figure out what I wanted from therapy and find a counselor who aligned with that. Do you want a counselor to be a sounding board? Do you want someone to give you homework? Are you looking for talk therapy, or experiential therapy etc? Are you open to group therapy or do you prefer private? (these are just suggestions, you don't need to answer them here!) Then I made a list of my goals and what works for me to achieve them. I found counseling to be much more beneficial to me when I had that kind of direction. It also helped me move through stuff since I knew when we had completed a topic. (or I could move to a deeper level with some of the harder stuff...)

My advice to you would be to research counselors through psychology today's website or even yelp or online reviews. See if you can search their topics of interest or their specialties. Then I would ask the counselor about their experience with dealing with people who have chronic illness in therapy, and share with them what you are looking for. The counselor, if they are being true to their profession will let you know if what you want and need they can help you with. If that particular counselor you interview doesn't think they can help, they may know a colleague who can. I treat it like a first date or an interview. Just because you meet with someone once or twice does not mean it's a good fit. You need to be able to trust that this person can help you and it's OK to be honest about that expectation up front.

On a side note, people who have chronic illnesses often have anxiety and depression along with the illness just from the stress of it. However, not everyone does. I'm wondering if your old counselor just hasn't had much experience with chronic illness and is just addressing it from one viewpoint. Obviously that's not helpful for you! It certainly doesn't help the remove the idea that "it's all in our heads." I would encourage you though, to not throw the baby out with the bathwater, so to speak. I've found that a lot of anxiety techniques really work for me with POTS symptoms- especially adrenaline surges, and staying mindful really really helps. Positive self talk etc. I love progressive relaxation and I'm starting biofeedback this month for sleeping issues. Again, what works for me may not work for you, the joys of being individuals.

Good luck and I really hope that you are able to find someone who is a great fit and will help you deal with your struggles.

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My therapist is wonderful, I have been seeing her since before my diagnosis with POTS and when I got my diagnosis she took time to research it and figure out how that plays into my mental health. I actually was diagnosed with panic disorder with OCD, but now we're fairly certain I just have OCD and the "panic" is pretty much all POTS.

One thing that I think might help is to ask the doctor that is treating you if they refer patients to a particular therapist. Even though I started seeing my therapist before my POTS diagnosis, I was refered to her my my primary care doctor who was already suspecting something was wrong with my health. I think generally if other patients with chronic illness have recommended the therapist to your doctor it might be a better bet. Also my therapist works with a nutritionist, which is not only very convenient but I also think that its a sign that she is more experienced with physical health going along with mental health. And definitely be open to relaxation techniques, my therapist says mindfulness meditation helps loads of people who chronic illness. Good luck!

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Thank you both so much for the thoughts and advice. Azmusiclover, do you mind my asking what level of school you’re at right now? I actually majored in psychology in college, and have been going back and forth about going to grad school someday and becoming a counselor too, so I’d be interested to hear if you’re in grad school right now, and how that’s going and such, if you’d be willing to talk about it :)

I think what’s frustrated me is that I tried to be so careful in my last search (the one that landed me with the counselor I just left). I knew which approach I was interested in and what goals I specifically wanted to work on, which she and I talked about in the first sessions. I found her through psychology today’s website, and was specifically drawn to her office BECAUSE all the counselors there had a fair amount of experience with chronic illness, and it seemed to be a particular area of focus in the office as a whole.

I guess she and I just didn’t click, which I know happens sometimes. The biggest irony was that she’d had clients with POTS before, but that prior experience just seemed to create problems, because as you say azmusiclover, we’re all individuals. She said her experience was that she’d helped these clients with POTS be less anxious, and they got loads better. The problem was, I’d already done a lot of work to bring down the anxiety I’ve felt. (Speaking of which, it’s interesting that you both suggested relaxation and mindfulness…so far, I’ve found that relaxation exercises haven’t helped me so much, but mindfulness definitely has. Again, interesting how we all find different things, and some of the same things, that help :) )

She just seemed unable to get past the idea that I must be really anxious all the time. She’d ask me repeatedly if I was worried that this symptom or that could mean something life threatening or whether it could be coming from something more than POTS. Now, if she’d asked me those questions a few months earlier, I would probably have said yes, but those worries have faded quite a bit over time. No matter how many times I answered I wasn’t especially worried, though, the idea I was anxious just seemed to pop up again and again, in small ways. When I was having a bad POTS spell and wasn’t walking one time, she speculated I was trying to avoid uncomfortable sensations and thus fueling anxiety…never mind the fact that I deliberately push myself through uncomfortable symptoms pretty much every day, sometimes just so I don’t become afraid of them again. When I mentioned I was somewhat concerned about the future, because I knew some of the more troublesome symptoms (vertigo!) might not be easy to treat or fast in going away, she turned that back on me and suggested I was making myself anxious. I just came to feel that no matter what I said, she interpreted it as anxiety, and no matter how I tried to convey what I wanted and needed, she couldn’t seem to easily adapt or understand. We had a couple discussions where I tried to let her know what would help me, and each time seemed to bring changes for the better (which is why I stayed as long as I did), but then the whole anxiety assumption would sneak back in again.

I just felt like she couldn’t see past her own ideas to what was actually going on with me, and that progress was slow on the problems I came in to work on because she’d get distracted by her own ideas of what was “wrong”. I know she was trying to listen and understand, but she never seemed quite able to hear what I had to say about myself, my situation, and the problems I came in to address.

Anyway, I’m hoping she was just not the counselor for me and that I’ll have better luck next time. I think I’ll definitely take your advice, margiebee, and talk to my PC to see if she can recommend someone, and maybe do a bit more research this time before I choose one to try.

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Wow! It sounds like you really did your research. It may have been that the counselor just went with what worked for her other patients and couldn't break out of the box for you. I am sorry that even with all that preparation and communication it didn't end up being a good fit. I like asking your PCP if they have any recommendations.

I got sick with mono my first time through college, I kept going even though I wanted to take time off and shortly after the POTS symptoms started. I kept trying for 2 years and it was killing me so I quit. I have about a year left and I am doing school online. I like it so much better! I'm quite introverted so it works well for that as well as for my days that are hard. (and kids stuff and dr appts, and and and) After I graduate my plan is to continue online with a graduate degree. I am thinking of getting my PsyD, and I'd like to end up counseling families and clients that struggle with substance abuse and addiction. If I find I don't like that as I get more into the program I would probably want to work with families who have kids with special needs. It's very hard to find someone who understands that in the counseling world.

I wish you all the best in finding someone to work with. Hang in there! The right person will come along. And I don't believe in accidents, so I think your last counselor was right for you, in teaching you whatever there was to learn. Maybe it was to be a better advocate for yourself or fine tune what you need etc.? ;)

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