When I haven't felt heard, I say so directly in person and in email, and if it's something that is still not getting across, I keep bringing it up. Something in me doesn't let it go until she will talk about whatever the issue is, and we go at it like that around and around for weeks and sometimes months and into years.

Sometimes, maybe because of internal complications, it's that her replies are not comprehensible. But other times, it has just been a battle I wage while she waits until I finish or get tired. And then I forget and start it all over again, so a good amount of it is coming from my end. I guess it's a mixed bag for me, but on the whole, I feel most things get understood on both sides. I once made the mistake of looking at old emails and saw that I had been carrying on with the same issue and question dozens and dozens of times, as though it was new each time, and my therapist never said you have asked this many times and I've answered already, so she has shown a lot of patience. A few times, she's gotten irritated, but I get on such a roll that I plow right through that until I feel heard or can better understand her end of things.

But, all of that is possible because I've seen her long enough that there's a history there. I completely agree with you that it's hell to start over with a new therapist. So much is not known about how it will go.