To T or Not to T... that is the question

So I get my mental health care from the VA. I have PTSD & MDD. I denied a need for mental health care for 20 years, was in a very firm state of denial, and only a few years ago reached out for help because I had a sort of 'omgcan'tcopeImfreakingout' episode of several months duration. Since then, I've seen several therapists, each of whom passed me off to another therapist for a different kind of therapy after a few months. Last therapist before this one announced that the VA had tried everything, and as far as she was concerned, I was done with therapy, I had all the tools I needed, and other veterans need help too, so tah-dah no more therapy for me. I cried, and begged, (embarrassing!!) and said - I can't imagine living the rest of my life like this, I need help to figure this stuff out.
She said I'd be fine, the end.
After chewing on it a few weeks, I called a different branch of the VA and they put me on a 6+ month waiting list for EMDR, and in the meantime, passed me off to another therapist. Well, I've seen that therapist 8 times, and he told me today that I have a 'good foundation' and the VA doesn't like people to be in therapy more than 12 weeks. During the conversation, I told him that when I blank my mind and emotions that's the only way I can stop crying. He told me maybe I should stop thinking about myself so much, then. I told him I feel that I have no value outside of what I can do for people. He said that's 'shame', and everyone feels that same way.

So, fellow people in need of support - is that true? is the way I feel the way EVERYONE feels, but they just handle it better? If so, that is the most tragic thing I've ever heard in my entire life.

If that's true, I just need to firm up my backbone and stop being a wuss and asking for more therapy isn't going to help anything. But I really need to know if it's true. I hate continually having to ask for help. I hated asking for help the first time, but going back with my stupid hand out asking for "More, Please" only to get told I'm being selfish and greedy is not something I can handle much longer.
If I do need therapy, I need to find a way to express that need so that they don't keep brushing me off.

If everyone really feels the exact same crushing weight of despair and emptiness and black-hole-soul I do, then God Help us all.

I'm sorry the T told you that. I don't think everyone goes around with such a heavy load of shame. If you are experiencing despair and emptiness that means the MDD and PTSD isn't better. Are you on any medications? That might help. Some people don't like meds. For me, they are a lifesaver. Literally. What about getting help outside of the VA? I saw former T for 10 years. I have seen current T 2.5 years. I have to pay for their services of course but I don't feel like I am being selfish or greedy. I have a crap ton of stuff to sort out and I need help. I hypothesize that you do too. And you deserve that help. HUGS Kit

I can only speak for myself and tell you to not give up. I have had therapists tell me the same thing and I have had a very horrible childhood and tons of suffering all to be told that short term therapy was all they could do for me. I did not give up and finally I got a therapist 2 years ago who im still with and im making progress finally after 18 years in the system. Maybe try a different therapy clinic that might not be with VA but offer help for you with trained therapist. I am very sorry you are not getting the help you truly deserve. I can also tell you that it's not selfish in getting help it's brave of you. Please know we are here for you. Hugs

I am a veteran too and using the VA system. In the past had no difficulty getting therapy. However I thought it was my clinic that had the therapy problems for going to short term therapy styles and pushing groups instead of individual therapy the past few years. Now I am wondering if it's the whole VA system that's screwed up. Not everyone does well with short term therapy. Once again, are they trying to make a "one size fits everybody" mentality???? I have been really angry at my clinic over this therapy limitation stuff.

Now I may be very angry at the VA system. Other than this, and for the past approximately 4 years I have had excellent care from the VA.

I don't know what to advise you. Maybe push for VA paid therapy outside of the VA? I forget what program that is called.

@SlumberKitty (I hope I did that right)
Thank you, I am on medication, and it has helped, as I am not as depressed as I was. I was pretty bad before. Like really really bad. lol.
I'm willing to go outside the VA if I need to - I just don't know if I really need to. I mean - I feel like I need help, but I also don't want to be one of those people who wants everyone to do everything for them. I read and try to figure things out on my own, but I get sort of sucked into the whirlwind if I don't have someone outside myself to ask about things. I also feel like I have a crap ton of stuff, lol. From childhood mess through mess in the military, and then all the mess from trying to stuff all that for my whole life. My coping mechanisms are 'run away' and 'deny everything' I've spent the last few years forcing myself to face this mess to try and fix it, but bouncing around from T to T isn't helping.
Thank you for your response, I really appreciate it.

I just remembered, if you are a combat veteran or military sexualvtrauma victim and there is a Vet Center near you; you can oftentimes get better therapy there. Plus their therapy notes don't go into the regular VA computer system.

@Cheryl27 Me too with the childhood & suffering. I'm glad you have a good T and are making progress! I appreciate your comments, it helps to hear that you don't think I'm being selfish. I was raised that I'm nothing and deserve nothing, so this whole thing is really hard for me. Asking for something when I'm fighting the idea that I'm nothing, I mean.

@neverending I think the short term therapy thing is new. Stupid if you ask me. But apparently they did a study and found that most veterans benefited most from 8-12 weeks of therapy, and veterans who don't benefit from 12 weeks are out in the cold. of course all veterans have different levels of PTSD, and all veterans are PEOPLE aka human beings and different, not cookie cutter models of GI-Joe/Jane, but hey, that's the VA. I get a lot of my medical treatment through the community care program, but the VA will only pay for what they agree with. "approved therapy" is 12 weeks regardless of which dr sees you.
I think I'll just have to go with outside therapy. Thank you for your response, I'm sorry to see other veterans are dealing with this as well -but also kind of not sorry because now I see that I'm not the only one dealing with this, if that makes any sense. I mentioned it to my senator's office after the last T dropped me at the 12 week mark, and they said they have nothing to do with mental health policies. I'd think that they'd be more worried about it, but no.

I felt depressed on and off for twenty years. I didn't have a good childhood, but it wasn't horrible either. I have seen my current therapist for literally hundreds of sessions. I was well over a year into seeing her before I started to see small amounts of actual change in my way of dealing with the world and in how I feel about myself. Now I still have down days and small bouts of depression, but it's nothing like it used to be. I sometimes feel self conscious about how much therapy I've had, but I clearly benefit from it. My T says that it took thirty years to get to where I am, so it's not all going to change overnight. I think the stability of my relationship with her is a big part of the healing, so in some ways, maybe you've barely even gotten started since you haven't been able to stay with one therapist. I don't think you're asking for too much, and I absolutely think you should try somebody outside the VA who does longer-term work, if that's an option for you. Not everyone feels the crushing weight of despair all the time, and I suspect you won't feel it either if you can get access to more comprehensive, compassionate treatment.

If you need more therapy, there's absolutely no shame in that. The shame is on the VA for trying to one-size-fits-all mental health. Twelve sessions wouldn't even be enough for me to even trust the therapist or scratch the surface let alone be done with therapy. If you have a way to access therapy outside the VA, that's probably the way to go although not ideal. I'm sorry you're having to deal with this. You deserve all the help that you need to heal, not breadcrumbs.

No, everyone doesn't feel the same way nor are you a wuss who needs to just get on with it.

Those therapists are pretty uninformed if all one needed to do was to grow a backbone and get on with it. Their conclusions are rather laughable. This is not how life... or therapy works.

It just seems that those therapists available through the VA don't want to do long-term therapy. They're just like MDs or car mechanics: as long as the body/vehicle is on the road, who cares how well the engine runs. Very simplistic and uncaring attitude, to say the least.

Rive, I don't necessarily believe that the therapists all actually believe that short term therapy is what is needed but that the people in charge of the mental health guidelines for the VA are heavily requiring it and the therapists are required to follow and promote those guidelines.

@neverending the closest Vet Center is pretty far from me. I have physical disabilities as well, and it's too far to drive. I tried to get in touch with them to ask for virtual assistance but no one got back with me, twice, and so I just left it.

@ElectricManatee thank you SO much for that response. I'd be grateful for even a small improvement, but the constant rejection I feel like it's making things worse. And it does feel like rejection and a sort of 'you don't deserve any better than what you have' which is the exact message I've been trying to fight my whole life. I'll look for a long-term therapist, I think. Time to give up on the VA...

Thank you for your response, @NP_Complete. I have trust issues anyway, lol, so it's challenging. The VA therapists start by saying, OK tell me your traumas. Then I have to blurt out all my worst stuff to them, complete stranger that they are. Then they say, yeah, you're going to need some therapy to deal with that! Then, after 10 sessons or so, they say, OK we're getting to the end, you're good now! Then I have to say, no, I don't think I'm Good, I feel terrible, and then they say no, you're fine, this is Good enough to go on with. And then I give up and after a few weeks I talk myself out of giving up and so I have to force myself to push and push until they send me to another therapist, and then it starts again. I hate asking for things, I hate the whole process, so it's just ugly start to finish.

@rive Thank you, I appreciate your comments. I don't think they're uninformed, I think they're just following rules. Like VA doctors aren't allowed to prescribe certain medications bc they're expensive or whatever. I think it's unethical, honestly, to tell someone they're fine bc the rules won't allow more sessions. I think they should say, 'hey, the VA doesn't allow more sessions but you would benefit from maybe group therapy, or maybe take a few months off and then restart the clock, or whatever,' lol. Anyway, I agree that it's uncaring for sure. It feels like I'm drowning and they throw me a life preserver, then take it back because they've got other stuff to do than to pull me in.

@neverending I agree.

I am so sorry that you were treated that way. You might want to try TMS (Transcranial Magnetic Stimulation) for MDD. You know I would want to report that therapist for being so crass. Wow! He should not be working with patients.

If you are able to travel, there is a clinic in Hawaii and a VA center there that does TMS. They have even advanced the TMS method too.

Thank you, @Shotokan I have heard about it, but I do have issues with travel unfortunately.
I've reported mental health doctors at the clinic before, but nothing happens. (One laughed at me when I was crying and made fun of me to a trainee as I was walking by because I kept crying.) I think he's just trying to convince me I'm good enough to get on with, and get me out the door. I've changed my mind about 50 times now about my next appointment with him at the end of the month. I want to cancel. Part of me says, no, you shouldn't cancel, you should tell him how you feel about what he said. Problem with that is, there's nothing he could say that would resolve this situation, so it'd just be stressful for nothing. I have tried the 'confront people who are hurting you' thing and it just doesn't seem to make me feel any better, or solve anything. It makes more sense to me to just let them be who they are, and stay away from them.

One doctor laughed at you and made fun of you?? Despicable.

Some people need to be called out on their callous behaviours. This is no way to treat a human being.

I actually told her a few weeks later how I felt that it was unprofessional, and that I didn't feel comfortable seeing her again, and asked her to clear me to see a different doctor instead. She said I was being too sensitive, and cleared me to see another doctor.

Good lord, you are too sensitive? How about she gets some lessons in good manners or etiquette?!

Glad you spoke up and that you are seeing another, hopefully, more respectful doctor.

Yes, my new Psych doc is really really really really nice. Funny, the VA doesn't mind people being on medication for their mental health issues for the rest of their lives, but therapy is 12 sessions and that's it. LOL.

So I'm going to cancel my next appointment with my current therapist who is dumping me because the VA limits the # of sessions. Because - if he said to me, "Look, you've got issues you need help with but the VA will only approve 12 sessions. When we're done here, I advise you to XYZ, but don't just give up, whatever you do." then I could respect that. I can't respect the "What you have now is just going to have to be good enough for you because the VA won't approve any more" - how can a doctor say that with a straight face? Every other civilian doctor I've seen who has gotten a run-around by the VA on medications or tests or treatments has said "This is BS, you need this treatment/test/medicine, and we're going to fight for it" which is a reasonable stance, I think. I actually did have one doctor who got so frustrated with VA refusal to approve tests/medicines that he stopped seeing veteran patients altogether which kind of stunk. But a doctor who looks at a patient who cries during every session, reports severe depression, has a lifetime of trauma, and says, "Good enough." - I just don't think I could look him in the face again.
I've signed up with an online therapist but I'm getting frustrated there too, because all I get are what look like canned answers. I feel like I'm talking with a bot. All the reviews for this person are sooooo glowing but my experience is just not good so far. I'm trying to decide whether to ask for another one, or tough it out for a while and see if it gets better. Seems like nothing is ever easy, lol.

@Toughcooki,

First of all, thank you very much for your service.

I am so sorry for what you are having to go through. You know it SUCKS the way the VA treats their soldiers. It really does. They are so disrespectful.

That's good that you cancelled him. Save your money.

Now that you are going outside the VA, I should tell you that many psychologists do EMDR. There is good research that supports this treatment. I have been having EMDR treatments for years for the trauma that I have experienced. He has also worked used this technique with military veterans.

My psychologist told me that the more traumatic the experience, the faster you are able to access the negative feelings. When this happens, the faster the technique works.

Just make sure that the psychologist is following the Francie Shapiro, Ph.d method. Dr. Shapiro is the one who developed this technique.

I hope you can find someone outside the VA. Please let us know how it goes.

Again, thank you again for your service. I am sorry for what you are going through.