My Journey Through Therapy

For some, finding the right therapy can be difficult. It’s not just as simple as going to your GP, requesting a Mental Health referral and waiting for CBT. It can take a lot of trial and error before we find what works best for us. But what happens when you’re constantly being put through the incorrect treatment due to a misdiagnosis?

The first guest post this month is from Ruth over at That Autistic Fit Chick. She discusses her journey through various therapy types and finally getting an accurate diagnosis at the age of 28.

“Therapy and me.”

In the ’90s and the early 2000s, nobody was looking for Autism in girls. I wasn’t diagnosed until 2018 at the age of 28. However, I was noticeably struggling by the time I was 7. My mental health continued to decline, and my therapy journey began with school counseling when I was around 11.

Since then I’ve done a lot of therapy, so I’m going to give you a quick overview of some of the therapies I’ve tried and why I did (or didn’t) find them helpful.


Counseling;

I’ve had counseling on six different occasions in my life. Some counselors I found useful, others not so much.

I was brought up in a home where expressing any struggles, or any emotion other than “happy” was seen to be disobedient and punished. I’d never felt safe to talk to anyone about the things that bothered me until I started seeing my school counselor.

Being with an adult who allowed me to express dissatisfaction and unhappiness, and who encouraged me to talk openly about my social struggles and home life, was the first time I’d ever felt listened to. The power of being heard and not being punished for expressing myself was groundbreaking.

All the counselors that I found helpful focused on really listening to me and encouraging me to express what was happening in both my world and my head. They even listened when I couldn’t put names to all the emotions.

Counselors that I didn’t find helpful were the ones who would ask me lots of questions that I didn’t have answers for. They’d get frustrated when I couldn’t give them the answer they wanted and I’d become distressed. I’d feel like they were thinking I was holding something back, when I wasn’t consciously doing so, and every session I’d leave feeling like a failure.

Overall I think counseling was one of the most helpful therapies I experienced. It was certainly one of the ones I ‘clicked with‘.

“The healing power of having someone to just listen is hugely underestimated.”

While I didn’t really process any of my trauma or learn any specific skills, the times I was in counseling weren’t really the right times for me to be doing that.


CBT

I did a single cycle of CBT in early 2005 during a psychiatric admission. We were taught that there was a triangle of thoughts, feelings, and behaviors that were fueling our mental illnesses. This triangle worked in the same way as the fire triangle in that if one side of the triangle was taken away then it would collapse and we would be “cured” of our mental illness.

The focus was purely on eliminating behaviors, in particular, self-injury.

“It sounded so simple. If we stopped hurting ourselves, we’d stop wanting to hurt ourselves more. The thoughts and feelings surrounding us when we self-harmed would just disappear, they would become extinct along with the behavior.”

14 year old me still trusted adults implicitly and was so excited that this was going to make me better. It was a shocker to find that stopping what had become my only coping mechanism actually led to a sharp decline in my mental health.

Whenever I brought this up in therapy I was told that it must be my fault and that I must be doing it wrong. They tried to convince me that I wasn’t “fully engaged with the process” and to stop talking about it because it was discouraging the other patients and inhibiting their progress.

Having discussed CBT with other people as an adult, it sounds as though the therapy has either moved on and improved a lot since then, or that our group was run by some pretty rubbish therapists.


DBT

With the failure of CBT I was moved to a new ward in the hospital that was dubbed “self-harm rehab”. On this ward, we did intensive DBT. I spent a year there and completed the entire program 4 times.

Every time we did the program I found more inconsistencies within it and would challenge the therapists.

We were told that DBT was like CBT with some extras. It was split into 4 modules; Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance.

If we were to master the skills from each of these modules then we would be able to communicate our distress, manage conflict, and cope with our overwhelming emotions without resorting to self-injury. Sounds fantastic!

Mindfulness;

The reality was that the only type of “mindfulness” we were taught was meditation. These sessions were usually guided meditation, and on a bi-daily basis, we were made to sit and meditate. That, or lose any privileges we had.

I later learned that we were being taught “Transcendental Meditation”. We were taught to be emptying our minds of thoughts so we could reach a higher plane.

I personally found every session distressing because I’d be told that I’d failed constantly. At that point, nobody had picked up on my sensory sensitivities and the fact that I literally could not block out the sounds around me. I was just told to try harder.  

Interpersonal effectiveness;

The interpersonal effectiveness module was a waste of time. I’d already learned how to hold a scripted conversation, I’d learned the skill of appearing interested in what other people say, and how to hold eye contact even though it was painful for me to do so.

The most dangerous part of this module for me was the introduction of never being allowed to say “you made me feel” because nobody else could make you feel anything. Apparently, you were solely responsible for your own emotions. With my literalism, this left me so vulnerable to toxic and abusive relationships as I reached adulthood because if nobody can make me feel anything then it’s my fault.

They were inconsistent with their approach to the way I communicated. On one cycle I was told to swear for emphasis because I have a flat tone of voice and fairly blank expressions. Then the next cycle I was told that I shouldn’t swear at all because people didn’t listen when you swore. No matter what I did or how closely I followed their instructions I was told that I was doing it wrong.

Emotional regulation and distress tolerance;

Emotion Regulation and Distress Tolerance modules were no better for me. While they included new skills and acronyms such as PLEASE MASTER, the skills didn’t help me to regulate myself at all.

The final nail in the coffin for DBT was when the lead therapist told the group that if self-harm worked then we would only ever have to do it once and we’d be happy. When I challenged that logic with the response that DBT skills must therefore only need to be practiced once and we’d all be better, let’s just say that wasn’t appreciated!


Transactional Analysis;

I came into this one at the end of a cycle but for some reason, it was stopped. This meant that I only got one or two sessions, which is a real shame because I’ve always felt that it had the potential to be really helpful for me. Whenever I’ve requested it as an outpatient I’ve been met with blank looks. I’m not sure if it’s an outdated therapy that has been mostly replaced with CBT and DBT or if it was an outlier even when I tried it and it never became mainstream.

We were taught that we had different internal voices.

  • Parent voices which can be both nurturing and abusive.
  • Adult voices which can be rational and reassuring.
  • Child voices which are usually emotion-driven. In my case, this is mostly afraid and confused.

When we had intrusive and distressing thoughts it was helpful to try to identify which voice the thought belonged to. We then had to respond to it with another voice. For example, if the voice is that of an abusive parent talking to a child, then we respond with the rational Adult. That way we would be protecting the child while challenging the parent.

The one issue with this therapy for me is that I tend towards dissociative states and I hear voices anyway. That being said, it was the best way for me to look at my own self-talk.


Art Therapy;

I’ve had mixed experiences with Art Therapy. As an inpatient, we would take part in art therapy every Monday afternoon. They were the oasis of my week as it was completely focused on creation. Although it was run as a group and we could discuss our projects, if we didn’t want to then that was okay too.

As an outpatient and an adult, art therapy has always been about being able to explain what the picture is communicating and how you feel about it. The mediums have been prescribed, rather than dictated by the user. Trying to find images in a Country Life magazine to make a collage about your week when you’re 19 is challenging.

Overall art therapy has been great when I’ve had the opportunity to just express myself without having to find the correct words to go with it.


Mentalisation Based Therapy;

MBT was my last group therapy, and to be honest, it was a bit of a Hail Mary.

I went into the group angry. 7 years previously I’d been told that the only therapies that worked for my diagnosis were CBT and DBT which I’d already done. So, to find out that MBT was actually the gold standard, and not only had it not been offered to me, but it hadn’t even been mentioned as a treatment that existed. Yet it was available in my area the whole time.

I was also excited because I so desperately wanted a therapy that would teach me how to function better in the world. Having accepted that Borderline Personality Disorder was for life, not just for Christmas, I just wanted to regain enough control and understanding to function.

From the offset, this therapy was wrong for me. I had no difficulty in imagining what other people might be thinking and feeling. It was a skill that I had spent a lifetime perfecting. But I couldn’t read facial expressions. I was worse interpreting the photos than anyone else in the group.

“What do you think this woman might be feeling?”

“That her eyebrow itches?”

When it came to written scenarios though, my main issue was a lack of relevant information so that I was unable to narrow down the possibilities. If Sandra has been texting Jack and he’s late home from work, I need to know if there’s been a history of car accidents in Sandra’s life or if Jack has cheated on her before. Without more insight into their lives it’s difficult to say why Sandra might be feeling concerned, or if she might also be feeling angry.

The other patients in the group picked up that I was very different from them in the way that I view the world and the people in it. They were also able to pick up on the fact that the lead therapist treated me very differently from anyone else.

I used to go home crying and I’d always assumed that it was because therapy was supposed to be difficult. When the other patients pointed out that he was picking on me in a way he didn’t on them, I initially assumed they must be misreading the interaction. That was until one of them challenged his behavior towards me in a session and I watched him turn on her.

The subsequent complaint is what led me to the reassessment of my mental health diagnoses, and the admission that I had been misdiagnosed with BPD at 16. It was also when I flagged up as autistic in an autism screen and was sent for diagnosis.

This was the first time in my life that I was told by a psychologist that it wasn’t my fault that the therapies I’d done had been ineffective.

They simply weren’t designed for my neurotype.


Currently, I’m still waiting for the therapies I was promised would be offered after my Autism assessment. I’ve been told that there’s CBT which has been Autism adjusted. If I were to go ahead with it, I’d try to go in with an open mind despite my previous experience.

After learning about more therapy options from Nyxie’s Nook, I’d like to try others like ACT, EMDR, and EFT.

“If a therapist tells you that it’s your fault that their therapy isn’t working; They’re wrong. If one therapy doesn’t work for you, it’s not your fault, it’s probably not even the therapist’s fault, it’s just not a therapy suited to your brain type and way of thinking. Don’t allow therapists to blame you for not responding in the way they expect.”


Ruth is the author of the blog That Autistic Fit Chick. It’s packed full of healthy recipes, mental health and autism awareness, wellness, and information about various workouts. 

Ruth is a Yoga enthusiast and works along side a personal training to keep her at her fittest! She’s an inspiration, and has been a big supporter of Nyxie’s Nook since day one.   

40 thoughts on “My Journey Through Therapy

  1. CBT and mindfulness didn’t work for me, and I’ve had a few counsellors who really forced it into me, as if it was the only approach they actually knew, but my current therapist thinks I’m actually just beyond those methods. Simple talk therapy helps me, when I say something made me feel bad, I don’t like how CBT therapists basically tell me I can’t think of feel that.

    1. I have no clue what works for me personally. I’ve done CBT that often that I think it mustn’t be working. But it’s the only thing offered to me right now, and I can’t afford anything alternative. Ruth has been very brave in sharing her experience with us and I can’t thank her enough. Also, thank you for reading as well lovely!

    2. I think because CBT became really mainstream and popular, it’s taking time for counsellors to move on from it.
      I honestly believe that simple talk therapy is the most effective for a lot of the population, because being heard and validated is so powerful a healer.
      I’m glad that your current therapist is giving you a break from those methods and I wish you all the best in your healing journey <3

      1. I personally find that talking therapy helps me so much. I’ve been through CBT a lot myself because nothing else is offered for ED’s, even though there are better alternatives. So, sometimes it’s a relief just to talk without all the BS. Thank you for responding Ruth 😀

  2. As always thanks for sharing your experiences. I cannot imagine what it was like to have someone belittle you or tell you your mental illness was your fault.

    1. Thank you for reading. I’ve experienced this myself, and have often been told by outsiders that it’s my fault, but I have never been told it by a therapist. Ruth has been very brave in sharing this with us.

  3. Thank you so much for sharing your experiences – especially with the CBT and MBCT (which it looks like you know under another name). I struggle to see how they would do CBT in a group setting, because my experience with CBT is that it is very individualised and specific to each person… but, as you say, perhaps that was the therapist…
    I am so sorry for all the harm done to you by those who didn’t understand your particular challenges!

    1. Mentalisation Based Therapy/MBT was what we were told, it probably does go by other names as well!
      I find that the therapy offered locally on the NHS is almost exclusively group therapy; and if you don’t go into the group therapy then you get removed from the mental health services because you aren’t in any treatment. It’s a bizarre situation, I’ve had times in my life that I’ve been put into groups even as the therapists are saying that groups aren’t a good setting for me!

      I did push for individual CBT with an autism adjusted practitioner while I was waiting for assessment (which took 3 years) but unfortunately the lady who referred me retired immediately afterwards and got replaced by the therapist I had made a complaint against… I’m paranoid enough to suspect he blocked/cancelled the referral but who knows.

      Thank you for stopping by and reading my story.

      1. Thank you for responding to these Ruth. It’s lovely to see a guest poster popping over and reading their comments. You did an excellent job on this pet!

    2. Thank you so much for stopping in and reading Beth. Ruth did an excellent job on this post and I couldn’t be more grateful to her for sharing her story.

  4. What an incredibly thoughtful and thorough post! Very insightful because I have a son with a mental health disorder and friends who have autism so this is enlightening! I think the fact that with mental health there are so many different processes of elimination that it can be so hard to center in on effective treatment. It’s too bad that they can’t narrow this process down more quickly to get the patient to treatment and back to living a full life! Great share!

    1. Thank you! Ruth did a great job on this post! It’s great to not only cover mental health but also Autism as the two can often go hand in hand. Thank you very much for stopping by and reading.

    2. I think a part of the problem in the UK is that mental health keeps on getting it’s budgets slashed, so the therapies that are even offered in each area can vary and are the ones that are cheap to deliver, rather than the ones that are the most effective/tailored for each client.

      I hope in the future we might get to a point where clients (especially the long term ones like me) are asked what therapies we’d like to try and offered them – regardless of whether NICE guidelines recommend them for our label.

      Thank you so much for stopping by and reading 🙂

  5. Such an interesting article, it’s great to read your personal experiences with each therapy. I was always lead to believe the CBT was the magic cure in a lot of cases but obviously not so. Thank you for sharing x

      1. The process of creating for Art Therapy is wonderful for me, because it helps me to express all the things that I don’t have words for!
        I’m very critical of my (non existent) art skills, but I still draw a lot, especially when I’m finding things really difficult to cope with.

        I’m so glad that your friend has found these therapies helpful 🙂

    1. Honestly, it does help a lot of people. But they don’t like to advertise the people who don’t find it helpful so there is a huge confirmation bias of “CBT is the best therapy since sliced bread” out there.
      There’s a similar trend with Mindfulness – a few years ago there was a newspaper article about “The Dark Side of Mindfulness” because it’s not always useful for people with a lot of trauma; but if it isn’t helpful people tend to either not go back or be told to hush up.

      Please don’t let my experiences put you off trying any therapies….but do remember that if they aren’t helpful to you that it is NOT your fault!

  6. Amazing guest post from one of my faves. I’ve had 2 types of therapy: CBT and Talking Therapy and I didn’t find CBT useful at the time. I was so anxious, ALL of the time that CBT was useless to me. But I was so lucky to find such an incredibly private counsellor. I’m not sure where I’d be without her. It’s really sad to hear how much Ruth was told she’d failed during things like meditation. Meditation doesn’t HAVE to be about blocking out all the noise. It’s allowing yourself to accept the noise and continue anyway x

    1. Thank you for reading Jenny. Ruth did an excellent job on this and I can’t wait to have her on here again. CBT has been the therapy I’ve had for the majority of my life, and like you, I find that I’m much to anxious to let it work. My head works at 100 miles an hour, and it’s only recently when the therapist agreed to give me something to calm me down that it’s even slowed down remotely. CBD helps me, but not as much lately. Anyway, sorry for going on a bit.

    2. Awwww you two are amazing!
      The more I’m hearing about other people’s experiences the more I’m drawing conclusions that CBT works for people that are mostly mentally healthy (whether they’ve got there through meds, or just over time) and they are in a position to be able to rewire the brain and thought patterns.

      I think I do my own kinda meditation now Jenny where I just sit and listen to the birds outside the window, and the crackling of a candle as it burns. It’s taken me a long time (over another decade) to get to the stage where I don’t feel guilty for it, and because I’m not entering a state where I see golden dragons.

  7. I like the thorough breakdown of each type of therapy and your personal response to it. It shows that, just like regular medicine, it’s often a trial-and-error approach to get the right diagnosis, treatment, and dosage right, and it’s such a personalized process that it makes it difficult to treat each individual the way in the way that works best for them. Really informative and interesting.

    1. Thank you for stopping in and reading. It means so much that so many people are finding this post informative, especially as it touches on the less talked about side of mental health i.e misdiagnoses.

  8. Thanks for sharing. I feel for you. A lot of people gets thrown around in the system not getting the right help that they need for many years. Personally I’ve worked with ACT (for depression) and I still use it. Obviously I don’t know if it will work for you but I suppose it’s worth a shot.

    1. Pernille I don’t know either as I have a huge difficulty when it comes to identifying and naming emotions, but I think anything that I’ve not tried before could be worth exploring.
      Someday something will make sense with my brain pathways!

  9. Thank you, Ruth, for opening up and sharing in such a vulnerable way. As someone who has also had to work through my own years of therapy, there is such power in seeing that you aren’t alone. Reading this can make such an incredible difference for someone currently living in the middle of it.

    1. Thanks Britt <3
      I really wanted people to know that they aren't alone if a therapy isn't bringing the results it's "supposed" to, and also to let people know that it's really not their fault! Some therapies, even the popular ones, just don't fit with everyone's brain patterns and ways of thinking.

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