Making the decision to see a therapist is an important step, but how do you find one that's right for you? I believe that the majority of people who become therapists do so out of a desire to help their fellow and female humans learn how to better deal with this often-scary enterprise called life. However, earning letters after one’s name (mine are LCSW, licensed clinical social worker) is not a guarantee that this diploma-ed professional is the best suited to steer you through the delicate minefield of your various emotional dysfunctions.
While conducting a book tour last year for my anthology How Does That Make You Feel? True Confessions from Both Sides of the Therapy Couch, my no-punches-pulled collection of essays from both therapists and clients, I was dismayed by some of the questions asked by audience members. For example, during an event at the Southampton library, a woman said she was regularly asked to pick up her therapist’s dry-cleaning on the way to a session, finishing her story with the question: “Is this normal?”
Some therapist behaviors are clearly egregious — such as coming onto patients sexually or asking them to run errands. Other negatives involve subtleties that can define whether or not someone is a good or bad fit for where you are right now. Alas, a person seeking mental health services is in an emotionally vulnerable place, thus not always able to deduce the best therapeutic match.
Here are a few guidelines to help you find a therapist who is a good fit. You’re with the right shrink when he or she:
A major part of a healthy therapeutic alliance is that you feel your therapist really wants to know who you are — the good, the bad, what you perceive to be "the ugly" — and will accept all of it.
Being able to admit a shameful secret and have someone smile at you and say, “That’s OK. You’re still a good person" is incredibly healing. If you hold back from your therapist because he or she will judge you rather than show compassion, you are not getting the help you need.
I am not the sort of therapist who sits in a chair and says little but “hmmm” and “tell me more” in the course of a session. My aim (and I believe therapy should have an aim) is to help the patient not just develop insight into a behavior that is negatively impacting his or her life, but to offer suggestions to help cement the insight.
For instance, during couples therapy, a patient I’ll call Beth flashed on a memory from childhood and said, “Wow, I never realized I purposely provoke Dan into being hurt and angry just like mom did with dad.” Her between-sessions "homework" was to begin to control the impulsive emotions that led to her outbursts. When she felt herself beginning to snap at her husband, she would take a three-second pause and ask herself, "What will happen if I yell and say mean things? I’ll just regret everything and apologize later.”
Change isn’t easy, and it is less likely to happen if efforts are made only 50 minutes a week.
Don’t worry about hurting your therapist’s feelings. This is about your needs, not those of the person you are paying to help you. Besides, asserting yourself in session is great practice toward asserting yourself in life. It’s your right to say things like, “I don’t feel this is going anywhere. All I do is rant. What can we do to make therapy more useful to me? Is there a plan?”
If your therapist is resistant to listening to your qualms and answering your questions, it says more about his or her shortcomings and psychological issues than yours.
It's also important to recognize if you're with the wrong shrink. Some ways to tell if that's the case is if he or she:
Before I was a therapist, I put in a yearslong stint as a dating columnist at a women’s website. There, I was able to fulfill my desire to tell people how to run their lives. Once I finished my schooling and put out my shingle, it quickly became clear there was a huge difference between proffering written "wisdom" to someone I’d likely never hear from again and preaching to a person sitting across from me who could nod his or her head in agreement to my point of view, then leave the office and continue hating his or her job and doing nothing to change the situation.
Your therapist’s job is to help you connect the dots, figure out your own route, not hand you a completed roadmap.
The polar opposite of a therapist who works to make a patient feel safe and taken care of is one who disregards or derides your emotions and/or goals.
A patient I’ll call Denise came to see me at the insistence of her boyfriend and mother. During our initial consultation, she said flatly, “I’m here to get them to stop worrying about me but the last time I was in therapy I wound up feeling worse about myself than ever.”
Denise’s former therapist dotted sessions with salvos like, “So I guess you couldn't bring yourself to ask for that raise this week” or “I know you think you’re happy being zaftig, but I printed out a great diet for you to follow.”
Understandably, it took months for Denise to trust me and participate in our work together in a meaningful way. I had to prove I valued who she was, not who I wanted her to be.
The best way to find a compatible therapist is via recommendations and/or checking the “Find a Therapist” tab on the Psychology Today website. You can narrow your search using parameters such as geographic location, accreditation, insurance, etc. University health centers staffed by students in training and local mental health offices can be more affordable options. You can check your potential healer’s reviews on websites such as Healthgrades and Zocdoc. Don’t commit until your gut says you’ve made the right choice.
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