You go back to the psychologist who doesn’t believe your diagnosis, figuring he’s your only real option. He diagnoses you as having a major depressive disorder. But even though you work with him for months, you don’t seem to be getting better. You start to think that’s your fault—that you’re beyond help. You’re just too broken to be fixed. When you eventually drop out, you feel like a failure.
Or let’s say you receive a magical inheritance of a few thousand dollars and you can find whatever therapist you want. Even then, the process is not necessarily easy. You might find yourself rejecting a perfectly fine, competent therapist because he has a face that stresses you out. Or because he seems overly judgmental. Or because she accidentally cc’d you and all of her other clients instead of using bcc, exposing everyone’s email addresses, and now you don’t know if you can trust her again. These aren’t bad reasons to leave a therapist. You want to find someone you can trust, someone you truly vibe with. Just like with dating (except without any of the booze, sex, or fun), finding your match can take time. And just like dating, even if finding the perfect person might be life-affirming, the process itself can be so demoralizing that you wonder whether it’s even worth it.
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I had a couple of bad therapists when I was in college. A man with a bow tie who tried to hit on me. A woman who sighed at every turn of my childhood as if it were a Dickensian tragedy. There was a psychiatrist who tried to put me on Prozac. I quoted Brave New World. “I want to know what passion is! I want to feel something strongly!” The psychiatrist responded, “I think that passion might be a chemical imbalance.”
And then, luckily, I found Samantha. Now, I needed someone new.
I felt equally equipped to find a good therapist at thirty as I did at nineteen. I googled “Complex PTSD therapist NYC” and went to the first person listed, a man who promised he could cure anyone within three months. He charged $200 an hour, but over the course of only twelve sessions, that seemed like a deal. I got through only one session with him. In that one hour, he barely listened to a word I said. He talked twice as much as I did and kept interrupting me every time I said some key trauma word, pathologizing me with all the enthusiasm of a golden retriever playing with a Frisbee: “Oh, I see! You rely on your boyfriend for stability: That means you are codependent! Overly needy! Ah, but he was in a bad place when you met him, and you helped him, too? That means you are only attracted to chaos and broken birds!” I didn’t care if it was supposed to last only three months, I didn’t want each of my therapy sessions to feel like an episode of Jeopardy! where he raced to answer all of my questions before even hearing what they were. I paid him his exorbitant sum and spent the next two months trying to recover from being lambasted by his pathologies, shouting to myself in quiet moments, CODEPENDENT! NEEDY! YOU ONLY LOVE BROKENNESS!
With another therapist, I only went to one session because she was the opposite: too quiet. She barely responded to anything I said in our sessions, just kept asking, “So how does that make you feel?” Ugh. How boring. I could do that myself, at home, for free.
Another woman seemed competent during a consultation, but she butt-dialed me later that afternoon and left me a long voicemail. It was a drawn-out negotiation between her and her child: “No, Mommy won’t give you anything unless you clean your room. No, you need to go poop without Mommy.” The child was winning. I never called her back, which admittedly was unfair, but I didn’t think I could walk into her office and pretend I hadn’t listened to her laboriously debating her child’s poop.
At the same time, in my reading, I discovered some evidence that traditional talk therapy might not actually be particularly effective for C-PTSD. In The Body Keeps the Score, Bessel van der Kolk writes about how talk therapy can be useless for those for whom “traumatic events are almost impossible to put into words.” Some people are too dissociated and distanced from these traumatic experiences for talk therapy to work well. They might not be able to access their feelings, let alone convey them. For others, they’re in such an activated state that they have a hard time reaching into difficult memories, and the very act of recalling them could be retraumatizing. One study showed that about 10 percent of people might experience worsening symptoms after being forced to talk about their trauma.
Between 40 percent and 60 percent of people drop out of therapy at some point. Most drop out within the first two sessions. And plenty of statistics show that even pointed, skills-based talk therapy is ineffective for PTSD. Cognitive behavioral therapy (CBT), a form of talk therapy where patients unlearn negative patterns of behavior and try to practice strategically positive patterns, is widely accepted as a treatment for PTSD. But it has abysmal statistics. In one study of seventy-four patients, eight got better with CBT, compared with four who received no therapy at all.[6]
Still, my friend with C-PTSD, Lacey, mentioned that her therapist had helped her significantly. She said her therapist helped her restructure her life, creating boundaries and allowing her to take good care of herself.
Which again reminded me of dating. It seems like the worst thing in the world, an absolute waste of time, until you find your person. And then all that effort, all that complaining and crying—it all becomes worth it, right?
I really hoped it would all be worth it.
CHAPTER 16