I wish psychologists and therapists didn’t give me the “we will work together to find options but you will have to work to have to implement them” speech. It wasn’t so bad before I had horrific therapeutic experiences, but now, when I struggle to trust medical professionals generally and have little reason to do so, I feel unseen right from the beginning.
That speech has always been the basis of why therapists pushed me towards traumatising-to-me things, like mindfulness meditation. (I will admit that most people won’t have my trauma around mindfulness, but explaining this often didn’t stop psychologists from making me try it for the umpteenth time.) When something wasn’t working for me, I wasn’t working hard enough to implement it. If I couldn’t do something, I wasn’t giving it a fair try. My not trying became the reason describing the failure for all the standard tricks pulled from the therapeutic grab-bag, and that’s now all I hear in that speech. A ready-made excuse that the therapist won’t look past.
I want help with making and sticking to routines, and I’m saying this as someone who has alarms on my iPad, who writes lists, who has tried all the conventional ways to make one work. Like many autistics, I do well with externally-imposed routines, like school, while severely floundering without its supporting structures. (No, the answer isn’t pretend I go to school, because I’ve been trying to do that for over a year!) I don’t know how to make myself not distracted; I don’t know how to stop writing and go to bed like I should. Obnoxiously-loud, jarring thrash metal alarms do not work. Getting up to turn off the iPad several feet away from my desk does not work. Now I’m afraid, because of that cursed speech one session in, that my failure to get a routine going will be my fault. Again. Or that, when I’ve dismissed every single pain-management strategy suggested because they do not work for me, I’ll be branded as difficult. Again.
When I’m constantly trying my hardest against a brain that isn’t and never will be made for an allistic universe, to encourage me to work without recognising my efforts now only makes me feel already a failure. After so many frustrating, bad, terrible and downright traumatic experiences with therapists, such a speech takes my suspicious tendencies and lets them run riot with distrust. After all her reassurances, I already feel like I’m too difficult for her.
If you work in mental health, especially if you’re handling people with more complex diagnoses and disabilities, cut the “you need to work hard to get better” line from your spiel. Start looking instead at the ways we’re already working hard. Because we are. And sometimes it takes all our strength and courage just to get out of bed, and we need the world to see it.