[annielovesbacon]

I have been seeing my T for over a year now and love her dearly. But I have been seeing her for depression and anxiety, but it turns out I have bipolar disorder, as well as substance abuse and an eating disorder.
I see my T through my university's clinic, so the therapists here are all trained mainly in depression and anxiety. I'm not sure my T is equipped to treat me anymore.
But I love her and I don't want to leave her. I also can't afford to seek therapy outside the clinic. Is continuing to see her, even if she may not be able to give me the full help I need, better than nothing? I think so, yes?

[TrailRunner14]

My counselor has helped me in so many ways.

When I first started meeting with him I don't think he really understood where I was or what I was working through.

I educated myself and shared what I found that relates to how I felt and what I was dealing with.

He thanked me.

Maybe you could share with her, openly, how you feel and ask her to work through it with you because you know her and trust her.

[annielovesbacon]

Originally Posted by TrailRunner14

My counselor has helped me in so many ways.

When I first started meeting with him I don't think he really understood where I was or what I was working through.

I educated myself and shared what I found that relates to how I felt and what I was dealing with.

He thanked me.

Maybe you could share with her, openly, how you feel and ask her to work through it with you because you know her and trust her.

That's good advice, thank you. I will be out of the country from January-May so I will not be able to see my T (that's another scary story, lol) and I have been considering seeing someone else when I get back, just because I worry that I am too much for her. But maybe I will talk it through with her.

[ElectricManatee]

Definitely talk it through with her. She should be able to tell you about her training and level of comfort with your concerns. I know that my university counseling center had several people with expertise in addictions and eating disorders. I think many therapists get fairly broad training, even if depression and anxiety are most commonly encountered in practice. Your T should be able to reassure you and/or talk about options for you to get extra support and help. I kind of doubt that you're "too much" for her, but you should definitely share that concern with her because I think that's a very common fear.

I have been with my T ffor 7 years and I had to wait while he did training in different modalities and at last it looks like we have hit a winner with Internal Family Systems but it took ages to find what work and to get him trained.

I think that depression and anxiety are fairly common and most therapists will have the skills to treat this but the bipolar, eating disorder and substance abuse may need a therapist with specialist training, something like addiction training with is completely different and most ts won't have addiction training.
All of your issues are related though and they are all creative adjustments to trying to manage emotions. I think a t who is trained in trauma or sensorimotor psychotherapy could be very helpful to you.
What makes you think your t is not equipped to help you? She may very well not be but perhaps this is a way of pushing her away?

[annielovesbacon]

Originally Posted by monalisasmile

I think that depression and anxiety are fairly common and most therapists will have the skills to treat this but the bipolar, eating disorder and substance abuse may need a therapist with specialist training, something like addiction training with is completely different and most ts won't have addiction training.
All of your issues are related though and they are all creative adjustments to trying to manage emotions. I think a t who is trained in trauma or sensorimotor psychotherapy could be very helpful to you.
What makes you think your t is not equipped to help you? She may very well not be but perhaps this is a way of pushing her away?

Maybe this is a way of pushing her away, as I'm sad to know I'll be leaving her in January. But I do also feel like perhaps she is not experienced enough? It took me months to work up the courage to tell her that I drink too much, and she told me it was "normal coping mechanism" and we haven't talked about it since. I wonder if she is just not experienced enough with addiction to know that me drinking every single day is a serious problem?

[Miswimmy1]

The first thing I will say is that her calling your daily drinking a "normal coping mechanism" raises a red flag for me. While I do know people who drink on a daily basis, none of them are university students. And the fact that you are coping with some other diagnoses makes me question the reason behind the need to drink that often. I'm also concerned because often, people who are struggling with addiction could benefit the most from seeing someone who has specialty training in treating substance abuse disorders. The same goes for eating disorders.

Secondly, I had a therapist whom I loved more than anything. And I could tell that she cared about me as well. She was also trained in anxiety and depression. I was dealing with severe OCD. In hindsight, it was very clear that she was in over her head. But she kept me as a client for over a year. Perhaps it was because OCD is technically an anxiety disorder that she felt she had the training to help me. Or maybe she was too attached in her own way. Or maybe she was just in denial about her lack of skills in this particular area. Regardless, her keeping me as a client instead of referring me to someone who had specialty training in ERP therapy (which is used to treat OCD) ended up hurting me in the long run. I ended up in residential treatment because it got so out of control and if I had found someone who had the proper skillset earlier on, maybe it wouldn't have gotten to the point of needing to be hospitalized. This therapist was actually accused by the hospital of being unethical because of her failure to refer me once she knew that I was struggling with something for which she had no real skills to treat and in fact made worse.

Therapists are obligated to refer you if they feel that someone else would be better equipped to help you. However, that doesn't always happen. Therapists are human and they feel connected to their clients too. It sounds like you have bonded with her and there is nothing wrong with that, until your connection gets in the way of you getting the treatment that you need and deserve. I think that it's very insightful of you to notice that perhaps your T isn't the right one to help you with these new diagnoses. I say go with your gut.

As a T at a university, she should have connections and be able to refer you to someone that specializes in more of the specific areas in which you require treatment. I don't know how your university health system works but for mine, they would only refer you to people who accepted your insurance plan or the school health insurance. Typically, universities have partnerships with local providers who agree to take the school insurance or match the fee of what it would cost to see someone on campus. I would ask her therapist about a referral. I think that she will understand your concerns and at the very least, either confirm them and refer you out or reassure you that she does have the proper training by giving you specific certifications, etc. that she has. Just because someone "has experience" treating people who has a specific disorder doesn't mean that they actually have had professional training in treating that disorder. Every therapist could say they "have experience with eating disorders" if their definition of treating someone was if they had a client who came through their doors who suffered from an eating disorder.

Don't be afraid to advocate for yourself. When I got out of the residential treatment center, I saw someone else for about a year. And then I went back to my old T. We just agreed that I would see her for other issues and not anything OCD-related. But just because she wasn't my therapist in that area didn't mean that our relationship just ended forever.

[annielovesbacon]

Originally Posted by Miswimmy1

The first thing I will say is that her calling your daily drinking a "normal coping mechanism" raises a red flag for me. While I do know people who drink on a daily basis, none of them are university students. And the fact that you are coping with some other diagnoses makes me question the reason behind the need to drink that often. I'm also concerned because often, people who are struggling with addiction could benefit the most from seeing someone who has specialty training in treating substance abuse disorders. The same goes for eating disorders.

Secondly, I had a therapist whom I loved more than anything. And I could tell that she cared about me as well. She was also trained in anxiety and depression. I was dealing with severe OCD. In hindsight, it was very clear that she was in over her head. But she kept me as a client for over a year. Perhaps it was because OCD is technically an anxiety disorder that she felt she had the training to help me. Or maybe she was too attached in her own way. Or maybe she was just in denial about her lack of skills in this particular area. Regardless, her keeping me as a client instead of referring me to someone who had specialty training in ERP therapy (which is used to treat OCD) ended up hurting me in the long run. I ended up in residential treatment because it got so out of control and if I had found someone who had the proper skillset earlier on, maybe it wouldn't have gotten to the point of needing to be hospitalized. This therapist was actually accused by the hospital of being unethical because of her failure to refer me once she knew that I was struggling with something for which she had no real skills to treat and in fact made worse.

Therapists are obligated to refer you if they feel that someone else would be better equipped to help you. However, that doesn't always happen. Therapists are human and they feel connected to their clients too. It sounds like you have bonded with her and there is nothing wrong with that, until your connection gets in the way of you getting the treatment that you need and deserve. I think that it's very insightful of you to notice that perhaps your T isn't the right one to help you with these new diagnoses. I say go with your gut.

As a T at a university, she should have connections and be able to refer you to someone that specializes in more of the specific areas in which you require treatment. I don't know how your university health system works but for mine, they would only refer you to people who accepted your insurance plan or the school health insurance. Typically, universities have partnerships with local providers who agree to take the school insurance or match the fee of what it would cost to see someone on campus. I would ask her therapist about a referral. I think that she will understand your concerns and at the very least, either confirm them and refer you out or reassure you that she does have the proper training by giving you specific certifications, etc. that she has. Just because someone "has experience" treating people who has a specific disorder doesn't mean that they actually have had professional training in treating that disorder. Every therapist could say they "have experience with eating disorders" if their definition of treating someone was if they had a client who came through their doors who suffered from an eating disorder.

Don't be afraid to advocate for yourself. When I got out of the residential treatment center, I saw someone else for about a year. And then I went back to my old T. We just agreed that I would see her for other issues and not anything OCD-related. But just because she wasn't my therapist in that area didn't mean that our relationship just ended forever.

Thank you for such a thoughtful reply. My biggest problem when it comes to referrals is that I cannot afford to see any therapist outside of my university (I am an out of state student, so no private practice therapist accepts my insurance). So if she referred me it would have to be to someone else within the clinic. I have no idea how many people work in the clinic (I know it's not many) or if any of them have any specialties. Information about the therapists at the clinic is not made known publicly, you only know a therapist if you have seen them before.

I am going to bring up drinking with her again when I see her next week. It's been a while since I have talked about it, and I'm not sure I made clear how much I drank (I was/am pretty ashamed of it), so some of her blase response might be on me. I'll try to be honest and straight forward this time. Hopefully her response to that will give me a clearer picture of if it is right for me to see someone else or not.