Finding The Right Therapist Isn’t About Having A Preformed Idea Of The Therapeutic Process
In her recent New York Times article “How To Find The Right Therapist,” writer Marissa Miller documented her three-year search for, as she calls, “The One”–the right therapist. Reading her advice to fellow therapy seekers, it seemed to me, as an NYC therapist, that Miller made some presumptions about good therapy in a manner that I doubt would be made about, say, good cardiology.
As a cardiology patient, you have a right and a need to know why your cardiologist is taking a given path in your diagnosis and treatment, but it’s arrogant to assume that because something isn’t intuitive that it isn’t the right move. Credentials or a strong referral shouldn’t be sufficient. You need to use a set of skills as a cardiology patient to gauge competence and establish a reason to trust. So too with therapy.
Your therapist should be an expert at helping people. Unlike cardiology, however, which most people understandably know very little about, therapy seekers know some things about emotional help, what might work for them and what may not. While, as a therapy seeker, you have some expertise, it’s also naïve to go into therapy with a preformed picture of how the help will help. It’s important to see finding treatment, and therapy itself, as a co-creative process between you and a therapist.
“Trust Me, I’m A Therapist” Isn’t Enough
This doesn’t mean therapists should get a free pass. I believe that therapy patients–consumers of therapy–have been poorly treated. There’s a tradition in therapy that is borrowed from medicine (as are most traditions of therapy), which is the idea that the process of therapy is so complicated–the therapist so specially trained–patients couldn’t possibly understand what’s happening. Therefore, patients should select a therapist based on recommendations and credentials rather than trying to decipher a style or methodology in determining what’s right for him or her.
Part of this relates to a sort of old-school aversion to marketing that runs rampant among psychotherapists. It’s considered base or even unscrupulous to advertise. Even leaving that aside, there is something of a “Trust me–I’m a therapist” attitude out there.
A Therapist’s Job Is To Explain What Is Offered And How They Work
Therapists have a responsibility to help patients understand, just as a cardiologist does. Therapy is complicated–it’s hard to understand and while people who seek therapy are fully capable of making informed decisions, it’s the job of the therapist to help them with that. I’ve written about this previously in the context of marketing–I, in fact, feel it is unethical not to market, inasmuch as marketing is a way of communicating to prospective patients what it is you offer, who you are and how you work. Knowledge is power and communicating well how one works is a part of the job. It’s likely a good indicator of how the experience of therapy will be.
Part of the process of collaborative therapy–creating therapy together–is getting an understanding from the therapist as to why he or she is making particular choices. Don’t be afraid to ask: “What makes you think this will help me? How have you seen this approach help other patients you work with?”
When Searching For The Right Therapist, Communicate
Once in awhile, I’ll read something on the Internet about a particularly bad experience someone had in therapy and yet, it lasted for a long time. My immediate critique is, “Why’d you stay around so long?” but that’s not entirely fair. Therapists need to convey, from the start, that they welcome (I’d say even, need) their patients to communicate with them about what works and what doesn’t, what feels off and what feels good.
I like swiping left with bad therapy–it’s the same advice I give my patients around dating. There are a lot of duds and if you want to find a winner, move on quickly from the duds. “Trust me” or “My friend loves this guy” should only be enough to get you in the door. At the same time, you have to be curious about how the process works in order to make an informed decision about what’s right for you.
Just because therapy works in a way that doesn’t make immediate sense doesn’t mean you should altogether trust your judgment to dismiss it. You need to ask questions like, “It seems like you’d be doing X, but you’re not. How come?” As a therapist, I love those kinds of questions. Don’t take my competence for granted. Don’t just trust me. But at the same time, don’t dismiss a direction I’m giving just because it doesn’t match your expectations.
You Have To Own Your Own Therapy
It’s important to not relate to therapy as a process that you simply give yourself over to as in “I trust you, Doc, whatever you say.” You have to own your own therapy, meaning create the therapy together with your therapist. Not only does that include asking questions, but you also may need to think of the process of getting a great experience in therapy as including getting some training in the practice of therapy too. You may need to train as a therapist, in a sense.
I think of this process as similar to the “bespoke” cocktail bar that has been in fashion in NYC for some time–the sort that’s known for inventive cocktails and yet, doesn’t have a menu. Ordering is tricky. The mixologist is an expert and likely has ingredients the customer has never heard of. At the same time, both the mixologist and customer have an interest in arriving at a choice of cocktail that the customer will enjoy. Similarly, both the therapist and the patient have an interest in finding the right mix of therapeutic approaches that will best support the patient.