Finding "the one," part 2 of 2

First of all, I feel the need to apologize for this post coming a lot later than it should have. I became seriously ill last week and that inhibited me from getting it done. I'm working to build up a backlog for future incidents of that sort, but haven't gotten there yet. Thanks for your patience. :)

When the practical issues of finding a therapist have been resolved, it's time to narrow your options down based on who you want to work with. Remember that whoever you choose will be an important figure in your life, even if only for a while, so don't close your eyes and point at a random name on a list. Following are some areas to pay attention to.

The first thing you'll probably notice is personality. Now, everyone deserves a fair chance, but not everyone is going to be your confidant. If there is a trait or quality that truly interferes with your ability to fully engage in the sessions, it's worth some consideration. On the other hand, for a while I saw a therapist that seemed – no, was – excessively eccentric. It turns out that he was also extremely empathetic (and entertaining). A complaint about personality should not always be an automatic elimination, but if it keeps being an issue and it's not
                                                                                                                   something that can be addressed and solved, it                                                                                                                            might be worth looking elsewhere.

While therapists purport to be specialists in certain issues or conditions, experience can be worth much more than certification. If you are an adult male with an eating disorder, you might be better off with a clinician who has dealt with a handful of clients in the same situation than with a specialist that has only worked with teen girls. During an initial consultation, ask what the concerns and conditions the therapist typically sees in her practice. Find out if she has experience with similar issues or populations. A child therapist might not be so great with end-of-life issues. Everything's case-by-case, but use good judgment.

Similarly, talk about what techniques are used. While hypnotherapy, thought modification and biofeedback can all successfully treat anxiety, you might have a preference for one. "Theoretical orientation," or the specific theory of personality and behavior a clinician subscribes to, might come up during this discussion. This deserves (and will get) its own post, but in short, be comfortable with how the therapist conceptualizes his field. A behaviorist believes that we become the way we are through our environment, punishment and reward, etc. while an existential therapist focuses more on the larger questions in human existence and how they impact the individual.

When it comes to choosing a therapist, however, the quality that trumps all others is trust. Treatment is more or less useless – maybe even harmful – if you don't trust your therapist. You might think you're coming in for something small and relatively unimportant ("I'm having a hard time sleeping"), but keep in mind that other unexpected issues might come up ("My spouse was killed in a car accident this weekend"). Would you feel comfortable with your therapist in more extreme circumstances? Alternately, are you confident that your therapist will take you seriously when you bring up something that might seem insignificant?

You are choosing someone that you can share every single aspect of your life with, as needed. Yes, trust does need to be earned, but if you just know it's not going to happen, trust that feeling. If not, you will be more likely to withhold important information or be less willing to follow any guidance you may receive.

Closely related to trust is rapport. You are entering a relationship of sorts and if you have a hard time communicating, it's the therapeutic equivalent of a highly inquisitive person dating someone that gives one-word answers. It's just not going to work. This doesn't mean that there has to be a constant conversation. Silence definitely has its place. I was told by one psychologist that he once had a client come in, cry on his couch for an hour without saying anything, then leave. He found out the next week that it actually helped. Find someone you feel comfortable around whether you're at your best or your worst. Trying to tailor yourself to your therapist (or trying to get him to be something he's not) defeats the whole purpose of why you are there.

It is essential that you feel comfortable with whatever practitioner you choose to work with. If you aren't, find someone else. You aren't getting married! It's okay to try someone else after one session or even ten years. If a therapeutic relationship fails and you still need help, don't be afraid to move on. If you are switching therapists on a monthly basis, however, the problem might be you. Be reasonable, but also go for what you need. You deserve respect as well as treatment that works for you, specifically.


Have you ever worked with a therapist where any of these issues were relevant? Share your story – good, bad or hilarious.