Does paying for therapy change therapist's attitude?

[Iwantoutrightnow]

I paid for an online therapy session this morning, not because of hopes for recovery but because i wanted to know why I coped so much better as a child when life when very difficult than I am coping now as an adult when life theoretically should be better.

I have always found mental health services in the UK to be somewhat belittling. They talk to you like you are stupid and confirm any thoughts of not being worthy. But this guy I spoke to wasn't like that at all and I can't help but wonder if the difference was because I was paying him. Obviously the people I spoke to in the past were paid but I don't imagine for a second that NHS hourly wages are anywhere near what I paid this guy. Or have I just been really unlucky over the years and I've stumbled across a good one and the money has nothing to do with it?

 

[nerve]

There was a study done that showed when someone is paying for therapy out-of-pocket, they're more likely to report positive outcomes. There are obviously a lot of nuances to that ("well if they're paying for it of course they'll want to say it works") but I think it's overall true that paying for therapy will make some subconscious part of the brain "work harder" if that makes sense. I say this just to give you some credit for your decisions & role here.

A therapist working under the NHS is also under so many different conditions than someone online is. I'm in the US so I can't speak to the NHS specifically, but the publicly-funded agencies I've been to here employ mostly inexperienced people susceptible to burnout and then overwork them until they're useless. The government can't afford people with better qualifications or the people with better qualifications just don't want to work under their broken system because they actually want to help. There are good and bad therapists everywhere, but the NHS makes it so difficult for any good therapist to actually be good.

Trying again is a really underappreciated part of living with mental health issues. It's so easy to fall into the "I already tried this, what'll be different this time" mindset and not look into other options, let alone explore them like you are.

I hope your luck keeps turning around I've got no clever insights into your situation, but I'm here and I see that you're trying your best

 

[BlackPoppet]

I pay for my therapy now, after the NHS let me down. I think my private therapist is very good. The NHS therapy I had was ok. But I had a bad experience with a psychiatrist and a psychologist so planned to never have any form of counselling with the NHS ever again.
Im not sure whether private counsellors work harder because they are being payed. But they seem very professional and my counsellor has clients up til 9 pm at night. So she has a lot of clients. She still gives 100% of her expertise to me though. So I'm glad I pay for my counselling. I think it's worth it. I'm happier to be away from NHS MHS. Which in my opinion, are inferior.

 

[Iwantoutrightnow]

Trying again is a really underappreciated part of living with mental health issues. It's so easy to fall into the "I already tried this, what'll be different this time" mindset and not look into other options, let alone explore them like you are.

I'm not really trying again, I just really wanted my question answered. I can't afford it really, I only had some spare cash because I haven't done any shopping for about 6 weeks.

He answered my question though, he said that I never learnt how to live as everything was about how to survive. As a child I used schoolwork to survive and managed to show my friends and the school that I was ok because that's what I needed to do to survive. Now I do the same, I just do what seems like the best chance of surviving or staying safe. I'm not coping worse because I wasn't coping then, I'm still just surviving but surviving now requires something different to when I was younger. This explanation made me feel a little less pathetic but it hasn't given me hope.

 

[GoodPersonEffed]

From what I understand, NHS mental health is like community mental health centers in the US. They're very regulated, they're limited in the types of services they can offer, therapists can't really think outside the box. Private practitioners have a lot more freedom to pursue learning about and using more modalities than just evidence-based practices, which I've found don't do enough. Because they're less stressed by the system, I think they're a lot more relaxed as well as more focused on the client rather than on the client within the framework of the NHS system. I've worked in community mental health as well as been a client, and it's a totally different experience from private practice, where I was respected and in charge of my treatment. I was the boss. I was an individual and not just another needy, hopeless person in the crowd. In community mental health, they had guidelines that didn't serve me or my best interests, and when I worked there, it was the same. Clinicians were so stressed out by paperwork and regulations and having to do each session in a certain way, rather than organically and focused on the client.

I'm glad you felt validated and understood by this therapist.

 

[Iwantoutrightnow]

I just had another session with the therapist. He's a nice guy, very validating, nothing like what I've experienced before. We mainly talked about my mum, it's her birthday on Sunday and I'm dreading it and really don't want to be here to see it.

I'm utterly conflicted now. I don't think I have hope and yet I can't help but think what if this guy can actually help me. For the first time I've been allowed to talk. All other therapists have said that I have to focus on the now, not talk about the past, focus on finding helpful coping strategies rather than relying on unhelpful ones. I used to leave sessions feeling worthless and wanting desperately to self-harm. After both sessions with this guy I have felt drained but not the pathetic waste of space that I used to feel and my instinct isn't to hurt myself but to comfort myself. It's a very strange feeling for me.

He offered me a session next week but I said I can't afford it. He said he's happy to discount the next session but I said no. He said he's going to text me on Monday to check on me and offer another session again. I don't know what I'm feeling, it's completely alien to me.

I'm scared because every time I have seen a glimmer of hope and told myself to give life a chance I always fall again and fall deeper. Even if I have found someone who can help me I can't afford to keep going with it. Life is cruel

 

[TowerUpright]

One thing I've noticed when I pay for therapy (co-pays, I'm based in US), is that if I find I don't like my therapist and/or psychiatrist, I can find a new one very easily. I'm thinking specifically is the therapist is clueless or if there is not a good connection between us.

If I had to use free services, I'd be limiting my options a lot.

 

[Iwantoutrightnow]

Maybe if I could afford to continue I'd be less confused and go for it. If that is the case then maybe I'm not as ready as I thought I was but I can't afford it so it's a moot point really.

He said that my guilt about my mum is misplaced. He said I've never grieved for my mum and I need to grieve and then I can learn to forgive myself. Even though the guilt is misplaced I feel it so have to forgive myself. I don't feel that I can ever forgive myself but if I could what would that mean? The last 10 years of my life have been a train wreck and even if I can move on mentally I think that socially/economically the damage is irreparable. So even if I can mend me, my life is still over.

If anyone is up for a chat it would be most appreciated