[SarahSweden]

So today I ended it with my counselor after seeing her for more than two years. I left her office without saying anything at the end of the session. I cried some during session and because of what she said and what happened I also stayed quiet for most of the time.


I cancelled our next session by writing to her secretary (all cancellations go through the secretary) and told my counselor I don´t want to see her anymore as I feel she deeply let me down. I also told her I don´t feel she´s on my side but thinks myself is to blame for being in the situation I´m in.

I´m now without treatment, no counselor nor doctor and noone to sign my sick leave when I need a new one.

[amandalouise]

Originally Posted by SarahSweden

So today I ended it with my counselor after seeing her for more than two years. I left her office without saying anything at the end of the session. I cried some during session and because of what she said and what happened I also stayed quiet for most of the time.


I cancelled our next session by writing to her secretary (all cancellations go through the secretary) and told my counselor I don´t want to see her anymore as I feel she deeply let me down. I also told her I don´t feel she´s on my side but thinks myself is to blame for being in the situation I´m in.

I´m now without treatment, no counselor nor doctor and noone to sign my sick leave when I need a new one.

was this the counselor you were telling us was not a therapist doing therapy but doing supportive chats that you have been posting mega problems with..

if so my own opinion is that its a good thing. you posted you were not comfortable with her, nor got anything out of it, and felt she was not responding to you in the way that you wanted her to.

now you have the option of deciding if you want to be in actual therapy instead of "supportive chats" and what kind of therapy you want to do. then look for a real therapist not an untrained in therapy counselor. look for the therapists that actually do the kind of therapy that you think you will be able to work with and benefit from.

or you can not be in therapy and use your own tools to manage your life the way you want your life to be outside of therapy.

as for someone to sign your sick leave. maybe you can contact your medical doctor and they will set you an appointment where you can go in and get a general medical check up and talk with your doctor about why you need sick leave time.

most people here in the US dont get sick leave specifically for mental problems. the way the work force works here is you start out with a certainnumber of sick leave days to use as you see fit, and the same with vacation time. and how much you work you accumulate more sick leave and more vacation time to use any time you want. if we go beyond our accumulated sick leave then we need a medical doctor to fill in the papers.

I know your systems where you are, are different but maybe just maybe you can talk with your medical doctor who treats you for medical things like colds, flu's and such things and maybe they can be the ones to sign your sick leave papers when you cant work.

[Lostislost]

Oh no it sounds like a horrible day you had yesterday. From your other posts I know the counsellor didn’t seem to be helping you much at all. I’m not sure how it all works where you are, but you can still see a normal doctor right? Maybe they can help with the sick note? Or maybe there’s some kind of job you would like to try that would be ok for you to do right now? There must be someone or some way of getting the support you need, it can’t depend all on that one counsellor surely?

[SarahSweden]

Thanks. No, after how she acted yesterday I felt there wasn´t anything to go back to. The thing is that there is no other doctor and it´s very difficult to find a new one as I´m within psychiatry and doctors at health centers and similar doesn´t sign sick leave for many months in a row. Also, here you can´t see a doctor just for getting sick leave, it goes together with some kind of treatment. I can´t get psychotherapy, which I need, at health centers as they don´t offer such treatment.

I now also risk being cut off from this facility and I´ll then be on my own as they don´t offer referrals and they´re not obligated to offer anyone else for counseling or therapy.

Originally Posted by Lostislost

Oh no it sounds like a horrible day you had yesterday. From your other posts I know the counsellor didn’t seem to be helping you much at all. I’m not sure how it all works where you are, but you can still see a normal doctor right? Maybe they can help with the sick note? Or maybe there’s some kind of job you would like to try that would be ok for you to do right now? There must be someone or some way of getting the support you need, it can’t depend all on that one counsellor surely?

[Shotokan]

I'm so sorry Sarah that all of that happened. Sarah, would you be able to see someone virtually or would it be way too expensive for you? I'm just trying to help you figure out how you can still get help.

[Amandae8787]

I’m so sorry that this has happened to you! I’m very familiar with the Swedish healthcare system and I know that there’s a lot of rules and hard to get sick leave. But I’m curious - can you not still see a doctor at the clinic? I mean, if they only offered supportive chats, then thats not really treatment... so why can’t they offer you anything else?

I know that they normally only offer short time treatment like CBT, but can’t you try that? It might get you well enough so that you’ll be able to work a little bit, and then you can chose to see a private therapist who can treat you more?

I’m from Sweden and I only got to see a therapist that didn’t fit me at all. She could offer me like 5-10 sessions and that’s it. I stopped seeing her and after a while I had to start working again. I have panic attacks, a lot of anxiety and probably PTSD, but I didnt know then. Anyway, I managed to work full time for about 6 months until I crashed again. This time my father offered to pay for therapy. I’ve been in therapy since, it was two years ago, with two different terapists. Now I get therapy paid from my workplace (företagshälsovården). So I know how hard it is and I understand if you need something else than CBT or supportive chats.

[Brown Owl 2]

You sound like you are in a tough situation. Would it help to talk here about what you intend to do - what options you have?

[divine1966]

If you are completely unable to work and it’s been an issue for years, I’d speak to a doctor about going on disability. Is that an option?

[SarahSweden]

Thanks. Yes, it was that counselor I´ve been posting about lately. Even if I think she couldn´t help me, it´s hard to end it with her on such a negative note. I don´t regret writing to her (through her secretary) how I feel and that I want to end our contact but I miss part of what we had. I guess I miss her as a person even if she wasn´t good for me in her role as a counselor.

There´s no option for me as I can´t pay for therapy and we don´t have access to longer therapies within our public health system, if we had I hadn't stayed for so long as I did with my counselor.

Also, I don´t have a medical doctor but only my psychiatrist and as I´ve told her I need therapy she´s at the moment looking into my records to see if there will be any other options for me. It´s though very likely that she´ll cut me off from the facility as they´ve already stated they don´t offer therapy and as I´ve now also ended it with my counselor.

Originally Posted by amandalouise

was this the counselor you were telling us was not a therapist doing therapy but doing supportive chats that you have been posting mega problems with..

if so my own opinion is that its a good thing. you posted you were not comfortable with her, nor got anything out of it, and felt she was not responding to you in the way that you wanted her to.

now you have the option of deciding if you want to be in actual therapy instead of "supportive chats" and what kind of therapy you want to do. then look for a real therapist not an untrained in therapy counselor. look for the therapists that actually do the kind of therapy that you think you will be able to work with and benefit from.

or you can not be in therapy and use your own tools to manage your life the way you want your life to be outside of therapy.

as for someone to sign your sick leave. maybe you can contact your medical doctor and they will set you an appointment where you can go in and get a general medical check up and talk with your doctor about why you need sick leave time.

most people here in the US dont get sick leave specifically for mental problems. the way the work force works here is you start out with a certainnumber of sick leave days to use as you see fit, and the same with vacation time. and how much you work you accumulate more sick leave and more vacation time to use any time you want. if we go beyond our accumulated sick leave then we need a medical doctor to fill in the papers.

I know your systems where you are, are different but maybe just maybe you can talk with your medical doctor who treats you for medical things like colds, flu's and such things and maybe they can be the ones to sign your sick leave papers when you cant work.

[SarahSweden]

Thanks. Nice to see somone else from Sweden on this forum. :-)

I do see a psychiatrist but as I´m not on meds I don´t see her regularly and she can´t do anything for me, I see her only to get my sick leave. They simply don´t offer longer therapies which is what I need. I´ve been within psychiatry for several years and short term CBT therapies are very far from what I need.

As you describe they most often offer 5-10 sessions only and then you´re left on your own regardless of how you feel. I´ve been evaluated and those psychologists recommend a longer period of therapy for me, it´s just that that don´t fit into our mental health care programs.

You should really have gotten better care within our public health care when you say you suffer from PTSD, that´s not something you manage on your own. I understand you now see a psychologist but it´s very bad our mental health care system is so badly equipped.

Originally Posted by Amandae8787

I’m so sorry that this has happened to you! I’m very familiar with the Swedish healthcare system and I know that there’s a lot of rules and hard to get sick leave. But I’m curious - can you not still see a doctor at the clinic? I mean, if they only offered supportive chats, then thats not really treatment... so why can’t they offer you anything else?

I know that they normally only offer short time treatment like CBT, but can’t you try that? It might get you well enough so that you’ll be able to work a little bit, and then you can chose to see a private therapist who can treat you more?

I’m from Sweden and I only got to see a therapist that didn’t fit me at all. She could offer me like 5-10 sessions and that’s it. I stopped seeing her and after a while I had to start working again. I have panic attacks, a lot of anxiety and probably PTSD, but I didnt know then. Anyway, I managed to work full time for about 6 months until I crashed again. This time my father offered to pay for therapy. I’ve been in therapy since, it was two years ago, with two different terapists. Now I get therapy paid from my workplace (företagshälsovården). So I know how hard it is and I understand if you need something else than CBT or supportive chats.

[SarahSweden]

Thanks. I don´t expect much from healthcare after this. I intend just to wait and see how my counselor reacts to me telling her I don´t want to see her anymore. As I asked for someone else to talk to, just temporarely, I guess she´ll just close my file and perhaps give it to someone else. Or, they´ll just cut me off from the facility.

It´s kind of an unspoken "rule" that you can´t end it with the counselor or therapist you have been allocated, if you do you´ll risk being cut off from the facility as they then see it as the patient "said no to treatment".

Originally Posted by Brown Owl 2

You sound like you are in a tough situation. Would it help to talk here about what you intend to do - what options you have?

[SarahSweden]

Thanks. No, that´s not an option as I´m not disabled in that sense that I´ll never be able to work. I´m within an unemployment program at the moment, parttime, and they are trying to find me a trainee job. To be part of that program I need to update and show them my sick leave or else they see it as I´m able to work full time. That is, I can´t just tell them I can´t work full time. But there´s no cooperation between the unemployment agency, health care and so on, it´s up to the patient to verify and sync everything.

Originally Posted by divine1966

If you are completely unable to work and it’s been an issue for years, I’d speak to a doctor about going on disability. Is that an option?

[divine1966]

Originally Posted by SarahSweden

Thanks. No, that´s not an option as I´m not disabled in that sense that I´ll never be able to work. I´m within an unemployment program at the moment, parttime, and they are trying to find me a trainee job. To be part of that program I need to update and show them my sick leave or else they see it as I´m able to work full time. That is, I can´t just tell them I can´t work full time. But there´s no cooperation between the unemployment agency, health care and so on, it´s up to the patient to verify and sync everything.

If you are able to work, even part time, could you just try to get employed? I don’t know how long unemployment pay lasts in Sweden, but here you need to get a job relatively soon if you are able to work. How long does this sick leave last?

I find it curious that you don’t have a doctor. I think it’s crucial to have a doctor, where do you go if you are sick?

Yeah it’s up to the patient pretty much everywhere.

[elisewin]

Have you tried meds? If you have depression and are unable to work, where I am they would try meds for depression and anxiety to get you back to the society.

Obviously you were very unhappy with the counselor as well. But I remember you rejected at least 2 different real therapists you were given earlier. Perhaps therapy is not your thing.

[divine1966]

I agree with a previous poster that it might be worth to try meds. I am surprised that doctors haven’t considered it. Many people have to take meds in order to function and definitely in order to work

[SarahSweden]

I´ve been on sick leave for more than four years. I haven´t had the need to see a doctor for any physical conditions and by that I don´t have a doctor besides my psychiatrist.

Originally Posted by divine1966

If you are able to work, even part time, could you just try to get employed? I don’t know how long unemployment pay lasts in Sweden, but here you need to get a job relatively soon if you are able to work. How long does this sick leave last?

I find it curious that you don’t have a doctor. I think it’s crucial to have a doctor, where do you go if you are sick?

Yeah it’s up to the patient pretty much everywhere.

[SarahSweden]

Yes, I´ve already tried meds.

Originally Posted by elisewin

Have you tried meds? If you have depression and are unable to work, where I am they would try meds for depression and anxiety to get you back to the society.

Obviously you were very unhappy with the counselor as well. But I remember you rejected at least 2 different real therapists you were given earlier. Perhaps therapy is not your thing.

[SarahSweden]

I have already tried meds.

Originally Posted by divine1966

I agree with a previous poster that it might be worth to try meds. I am surprised that doctors haven’t considered it. Many people have to take meds in order to function and definitely in order to work

[Salmon77]

Sarah, I don't know if this is possible, but if there is a psychoanalysis training institute in your area, sometimes it is possible to work with someone who is training to be an analyst for low or no cost. It seems like that kind of frequent contact and deep work might help you.

I wonder what other kind of mental health practices you have? I know a lot of studies show regular exercise, spending time in nature, things like that can improve mental health.

I know from your posts you have struggled for a long time, and it sounded like this last counselor was not helping you. I hope you can find something or someone that does help.

[divine1966]

Originally Posted by SarahSweden

I have already tried meds.

So meds didn’t help? Sometimes you need to try a couple of different ones.

What was the follow up on evaluation for ASD? You mentioned it awhile back. Or any other evaluations? I feel you need specialized support and treatment. You have been out of work and unable to work or even apply for a job for many years yet you aren’t on disability and aren’t getting vocational support/treatment/mental health help. Nothing except financial assistance.

What’s the goal? Game plan?

Where is your doctor in all this? You are eligible for having a doctor in Sweden.

[here today]

Originally Posted by SarahSweden

. . .I asked for someone else to talk to, just temporarely. . .

It´s kind of an unspoken "rule" that you can´t end it with the counselor or therapist you have been allocated, if you do you´ll risk being cut off from the facility as they then see it as the patient "said no to treatment".

From what you have written here, you have been having difficulties with this counselor for some time. If it were therapy, people could say you were "stuck". It also seem like this counselor hasn't had anything much to offer to help you -- or the two of you -- through these difficulties. Perhaps that is more than she is trained to do?

Nevertheless. . .I don't see you as saying "no" to treatment. You have asked for someone else to talk to, at least temporarily.

An "unspoken rule" is. . .confusing to people, to say the least. Since it is a public health facility, it seems to me like it is only fair that you have some explicit rules, from someone, if they are going to terminate you.

If you don't hear from them early next week, I would encourage you to follow up with your request to see somebody else temporarily. Or, if they terminate you, I would encourage you to ask to speak to your psychiatrist again or perhaps the director of the facility, to get an explicit reason why they are letting you go. It may be difficult to read or to hear, but especially if any of their reasons are NOT sound and if they did not make their rules explicit to you FROM THE BEGINNING (as it sounds like may be the case) then perhaps there may be some kind of recourse, somewhere, if you want it. Perhaps a government ombudsman somewhere in the system. Or maybe somewhere outside it.

Wishing you the best!! I hope, of course, that they do allocate you somebody else to talk to and that, eventually, they offer you some treatment that will actually help!

[Gettingitsoon]

Were you not able to find any meds that helped?
Its common to have to try a few or several before finding one that is effective.
I went through possibly 6 over about 18 months. Some were just ineffective. Some were majorly awful.
Ive been pretty stable now on one for about 4 years.
My functionality would be much less without meds.

I hope you can find some relief.

[Shotokan]

This is an extremely tough and frustrating situation for you to be in Sarah. Divine has a good point about having a doctor. If you get a doctor, is it possible to get referred to a clinic/day program/therapist? You know a few pastors/priests/ministers also have training in therapy. Someone on this sight was seeing someone like this. Is this possible for the time being?

[SarahSweden]

No, meds didn´t help and I´m not looking for just reducing symptoms but to get help with underlying causes.

The evaluation for ASD (and ADHD which was evaluated at the same time) showed I don´t suffer from any neuropsychiatric conditions.

I do attend an unemployment program but due to the pandemic the agency has a very hard time finding trainee jobs for their clients.

There are no proper goals as there are no resources to reach those. The only doctor I have is the psychiatrist at the same facility and she´s going through my records together with their head doctor to see if they can offer me something else.

It´s though highly likely that they´ll just cut me off from the facility.

Originally Posted by divine1966

So meds didn’t help? Sometimes you need to try a couple of different ones.

What was the follow up on evaluation for ASD? You mentioned it awhile back. Or any other evaluations? I feel you need specialized support and treatment. You have been out of work and unable to work or even apply for a job for many years yet you aren’t on disability and aren’t getting vocational support/treatment/mental health help. Nothing except financial assistance.

What’s the goal? Game plan?

Where is your doctor in all this? You are eligible for having a doctor in Sweden.

[SarahSweden]

Thanks for understanding, here today.

No, as you say my counselor couldn´t deal with me being disappointed and she didn´t want to talk about anything that concerned her and her actions. I think she perhaps was told to keep a distance to me so I wouldn´t get attached and she thought she perhaps could just cancel appointments, shift appointment times and so on without me reacting to that.

Yes, the unspoken "rule" about not being allowed to say no to treatment isn´t something they tell clients straight out. But a lot of people have experienced this and the facilities use this against you, as a way of cutting patients off from care.

I don´t know if my psychiatrist and her colleague have actually begun to look through my records so I´ll wait for some time to see what happens. Perhaps my counselor will call me to tell me what they have decided but I´m not sure I'll answer to her call.

There´s an ombudsman to whom you can file complaints but they can´t decide what treatment you get. They only help patients in writing complaints and getting an answer from the facility about what they think happened in the actual case.

Thanks, I appreciate you hoping this for me!

Originally Posted by here today

From what you have written here, you have been having difficulties with this counselor for some time. If it were therapy, people could say you were "stuck". It also seem like this counselor hasn't had anything much to offer to help you -- or the two of you -- through these difficulties. Perhaps that is more than she is trained to do?

Nevertheless. . .I don't see you as saying "no" to treatment. You have asked for someone else to talk to, at least temporarily.

An "unspoken rule" is. . .confusing to people, to say the least. Since it is a public health facility, it seems to me like it is only fair that you have some explicit rules, from someone, if they are going to terminate you.

If you don't hear from them early next week, I would encourage you to follow up with your request to see somebody else temporarily. Or, if they terminate you, I would encourage you to ask to speak to your psychiatrist again or perhaps the director of the facility, to get an explicit reason why they are letting you go. It may be difficult to read or to hear, but especially if any of their reasons are NOT sound and if they did not make their rules explicit to you FROM THE BEGINNING (as it sounds like may be the case) then perhaps there may be some kind of recourse, somewhere, if you want it. Perhaps a government ombudsman somewhere in the system. Or maybe somewhere outside it.

Wishing you the best!! I hope, of course, that they do allocate you somebody else to talk to and that, eventually, they offer you some treatment that will actually help!