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The only therapist I liked talking to was this grad student a few years ago. I liked talking to him because he was insightful and gave me honest reactions to what he was seeing from me. Not sure how to find that again.
My wife is like that, she stumbled onto a super good therapist once, but it was a long commute and at the time she couldn't afford to pay for it anyway. She has never found anyone as satisfactory / simpatico since.
I think a therapist has to be someone you respect and trust, first and foremost. Not in a "tell me what to do / think / say" sort of way, but someone who challenges you to be your best self. it is devilishly hard to find, particularly if you're intelligent. Many therapists frankly aren't that talented and sort of "phone it in".
We've been through the wringer with my stepson on therapists, too. We ended up going 60 miles away before we found something that "clicks" for him. Fortunately Covid has been our friend here, it pushed them to remote therapy and we don't have to drive the 2.5 hour round trip twice a week.
My wife, ultimately, has figured out ways to think her own way out of her issues for the most part. Recently, she has decided to push back against a natural aversion to doctors and meds (partly based on past bad experiences with mismanaged meds) to take the edge off of her chronic anxiety, using a telemedicine service, and that has gone well. She's found however that she has had such a lifelong relationship with anxiety that tamping it down messes with her motivational structure. She hasn't had to develop her self-drive fully because her anxiety was always lighting a fire under her. So without the anxiety she feels strangely passive and empty. I was able to point out this mechanism to her and she's working on it.
So ... basically attack things from 2 or 3 angles and keep trying, is about the only general advice I know to give. Therapists, self-help, empathetic friends and family, whatever you can bring to bear. If you hit the jackpot again with a therapist, don't assume it will last forever, and don't burn any bridges. Pursue all paths, always.
It depends in part on what your issues are, OP. For example, if you're dealing with your relationship with your parents, say, or a confusing or tumultuous potentially abusive childhood, there are people who specialize in that. Or if you need a trauma therapist. You can google specific keywords that suit you.
Still, even if you narrow it down to your general category of issues, you'd have to do some trial and error in your search for a good fit. Let's say you find 3 listings that deal with your specific concerns. First off, you could talk to them over the phone to ask how they practice, and try to gauge by how they come across, and what methods they use. Next step (let's say you've narrowed the options to two), have a couple of sessions with each.
What you know so far, it sounds like, is you don't want the type that just sits there silently taking notes. You want someone who interacts with you, gives you feedback, educates you about what certain behaviors mean in a principal player in your life (for example) and helps you understand why they behave the way they do, or why YOU behave the way they do. Someone who engages with you and gives you insights or suggestions. You should be able to eliminate the the silent types from that initial phone call, when you ask how they practice.
You can get a lot of info from their website, too. You can see where they got their training. Some list "institutes" that teach some New Age-y methods (look up the institutions they got their degrees from), that are trendy and kind of flakey.
One thing you can't determine until you've had some sessions with someone, is whether they've resolved their own issues or not. If they haven't, that can get in the way of your healing process or therapy process. It's hit and miss.
But make good use of the internet. You can not only study the practitioners' websites, you can look up review sites, to read the reviews. These are resources that didn't exist until the internet really took off. People used to just go by word of mouth, and it didn't work out well, in too many cases.
Many different kinds of people with different backgrounds and education can hang out shingles and claim to be a therapist. It is a very poorly regulated field and there's no standardized training or testing in order to call yourself a "therapist". So it boils down to the person, their experiences, their degree and education, and their knowledge of basic modes of therapy.
Therapists are not mind readers. They usually start out taking a history and doing a mental status exam. Then they should ask you what your expectations are and what you're hoping to accomplish in therapy. If you're not sure, they should guide you in the next few sessions about what your issues are. Many times what you thought your issues are, evolve into other issues that were underneath, usually more difficult and painful to deal with. The patient/client must lead the therapist to the issues that they want to address. Therapists aren't mind readers, there is no formal recipe to follow and therapist is very individualized. But you have to be part of the equation. If you're just sitting there each session and not participating, you're not getting good therapy. If you leave therapy feeling like you just had a pep talk, you're not getting good therapy. Therapy is hard work, and not usually fun because you're unroofing issues that are usually problematic and painful. If you're getting good therapy, your relationship with your therapist will eventually mimic your relationships in the real world with all the same emotions (anger, frustration, sadness, intimidation, envy, jealousy, depression, anxiety, etc) and the goal is to identify those emotions, and work through the whys. Then you begin to practice methods in real life that help you modify your behavior to promote a higher quality of life. If you're having "chat" sessions, shooting the bull, etc., you're not getting good therapy and wasting your time and money.
Your therapist is not there to be your friend, your therapist should be a professional who is there to hopefully challenge you in a supportive, non-threatening, diplomatic fashion and help you work through issues that emerge during your relationship with your therapist. You need to be prepared to tell the therapist you're angry with him/her, feel judged, feel frustration, feel intruded upon, feeling attacked, etc etc etc. A good therapist will then use that as grist for the mill. Cognitive behavioral therapy is a very effective mode of therapy with a proven track record and requires you to do homework outside of therapy and practice techniques. Your therapist can't do that for you, they can only lead you. But the more you set the agenda, participate and reveal your true feelings during sessions, the more progress you will make.
It's your money and time, don't be afraid to jump right in and get to work right away, don't sit around talking niceties, and small talk, go right for the reasons you're there. Therapy can be very very helpful, it can also be a waste of time if you don't know how to proceed and what to expect, your therapist is there to lead you to learn about yourself, how you think, how you resolve conflicts, tolerate frustration, and many other maladaptive behaviors.
As far as what kind of therapist to work with, a PhD or PsyD is a doctorate level psychologist. Then there are social workers and you should look for a masters or doctorate level therapist if possible. Nurse practitioners have joined the therapy realm, people with education degrees do therapy as well. So I've listed various therapists in order of skill sets. But more importantly, you need to set the agenda, get to work right away, no BS, and express your feelings as you get to know your therapist, that gives the therapist something to work with. Good luck.
Many different kinds of people with different backgrounds and education can hang out shingles and claim to be a therapist. It is a very poorly regulated field and there's no standardized training or testing in order to call yourself a "therapist". So it boils down to the person, their experiences, their degree and education, and their knowledge of basic modes of therapy.
Therapists are not mind readers. They usually start out taking a history and doing a mental status exam. Then they should ask you what your expectations are and what you're hoping to accomplish in therapy. If you're not sure, they should guide you in the next few sessions about what your issues are. Many times what you thought your issues are, evolve into other issues that were underneath, usually more difficult and painful to deal with. The patient/client must lead the therapist to the issues that they want to address. Therapists aren't mind readers, there is no formal recipe to follow and therapist is very individualized. But you have to be part of the equation. If you're just sitting there each session and not participating, you're not getting good therapy. If you leave therapy feeling like you just had a pep talk, you're not getting good therapy. Therapy is hard work, and not usually fun because you're unroofing issues that are usually problematic and painful. If you're getting good therapy, your relationship with your therapist will eventually mimic your relationships in the real world with all the same emotions (anger, frustration, sadness, intimidation, envy, jealousy, depression, anxiety, etc) and the goal is to identify those emotions, and work through the whys. Then you begin to practice methods in real life that help you modify your behavior to promote a higher quality of life. If you're having "chat" sessions, shooting the bull, etc., you're not getting good therapy and wasting your time and money.
Your therapist is not there to be your friend, your therapist should be a professional who is there to hopefully challenge you in a supportive, non-threatening, diplomatic fashion and help you work through issues that emerge during your relationship with your therapist. You need to be prepared to tell the therapist you're angry with him/her, feel judged, feel frustration, feel intruded upon, feeling attacked, etc etc etc. A good therapist will then use that as grist for the mill. Cognitive behavioral therapy is a very effective mode of therapy with a proven track record and requires you to do homework outside of therapy and practice techniques. Your therapist can't do that for you, they can only lead you. But the more you set the agenda, participate and reveal your true feelings during sessions, the more progress you will make.
It's your money and time, don't be afraid to jump right in and get to work right away, don't sit around talking niceties, and small talk, go right for the reasons you're there. Therapy can be very very helpful, it can also be a waste of time if you don't know how to proceed and what to expect, your therapist is there to lead you to learn about yourself, how you think, how you resolve conflicts, tolerate frustration, and many other maladaptive behaviors.
As far as what kind of therapist to work with, a PhD or PsyD is a doctorate level psychologist. Then there are social workers and you should look for a masters or doctorate level therapist if possible. Nurse practitioners have joined the therapy realm, people with education degrees do therapy as well. So I've listed various therapists in order of skill sets. But more importantly, you need to set the agenda, get to work right away, no BS, and express your feelings as you get to know your therapist, that gives the therapist something to work with. Good luck.
Incorrect. "Therapist" is a regulated word. The closest I can think of where your opening paragraph is accurate is in religious therapists, who are covered under the idea of (wink wink, nudge, nudge) separation of church and state.
If you have a DEEP religious belief that your ability to counsel others is coming to you from the almighty, you get to claim that exemption. Everyone else has to attend classes, pass exams, go through apprenticeships, and pay into professional organizations to get licensure. That is NOT to say that 50% of people don't graduate in the bottom half of their classes.
Consider investigating the various modalities used, and what exactly you hope to accomplish. CBT has been mentioned, but there are many other depth therapies, and others that work outside of what many think of as "therapy." There is "Focusing" (E. Gendlin), which can be either professional or lay practitioners, "Sand Tray" an offshoot of Jungian therapy that allowed the subconscious to express directly in a safe environment, "Transactional Analysis" that is particularly effective with interrelationship patterns and issues, "Adlerian" that is less common now but a great help with kids and those with a need for simple interaction and results, therapists who specialize in trauma, childhood abuse, PTSD, drug rehab, and so on. Not having a clear goal or an idea of what to expect and what might work best for you, you could flounder around for years.
Once you have basic understanding of the technique being used, some of what might seem odd or mysterious begins to fall into place. This is not to say you should learn as much as a therapist, but if you know how to speak the language of a type of therapy your chances of success increase significantly.
The most accomplished therapists can be selective in who they choose to work with, costly, and are in high demand. Therapy is hard work for both client and therapist, and clients who don't seem to put in the effort get released by the best to others, so that their skills are not wasted.
The grad student was actually using CBT and had me doing worksheets from a CBT book. I liked it but I also wanted to talk about my upbringing. I'll look into the other types you mentioned to see which one I need right now.
Last edited by Gabriella Geramia; 12-31-2021 at 08:22 PM..
Incorrect. "Therapist" is a regulated word. The closest I can think of where your opening paragraph is accurate is in religious therapists, who are covered under the idea of (wink wink, nudge, nudge) separation of church and state.
In theory, yes, but in my experience and observation, there are a couple orders of magnitude between a better one and a poor one. As the poster you're responding to pointed out, there's a range of education and different training. There are also different modalities, ranging from Freudian or Jungian talk therapy to CBT.
Finally, it's not all about education; therapists are people and so some of them are asshats or idiots (or both), or crazy themselves and trying to work out their own issues. My stepson was trying out this guy who was practicing out of his house. It smelled like cat urine and there were other, er, red flags. I checked him out more closely and was astounded to find that he had been charged with murdering his wife in another city some years prior, and some questionable practices in treatment. He was trying to elude his reputation and start over in a new city. The next one was better, but had an odd fetish for putting all his patients on Lithium and had some pretty preconceived and dated ideas about autism.
The third time was the charm in that case. Organized, goal-oriented, methodical, smart, focused, and importantly in my stepson's case, bright enough to hold her own with the patient, and be respected by him.
It's always a chore, selecting for a good therapist. It doesn't help when you move and have to start over; now that I think of it, the very first therapist for my stepson where we used to live talked to him for 20 minutes and declared that he was suffering from "pre-schizophrenic prodome" and said it right in front of him -- he was 16 at the time. He was later diagnosed by a competent practiioner with HF autism, ADHD, OCD and some cognitive / memory issues (substantiated with appropriate testing). Some of these people have the diagnostic skills of an earthworm.
Then there are those who think everything is fixed with a pill. My wife was prescribed Xanax before I met her, and it made her so high she became alarmed and went off it cold turkey. Her father, a retired doctor, got wind of it and realized she had been immediately given the highest possible dose. Clearly the intent was to get her hooked and keep her coming in for the meds. So ... again, they are people, and like some people, are sociopathic hucksters. Practice due diligence. They are not gods. But when you find one that's got their act together and that you "click" with, it's magic.
The grad student was actually using CBT and had me doing worksheets from a CBT book. I liked it but I also wanted to talk about my upbringing. I'll look into the other types you mentioned to see which one I need right now.
I went to a CBT practitioner once myself. He'd written a general-audience book about CBT twenty years earlier and his "treatment" consisted of selling me his book and having me work through the questions. So yeah, this happens ... it spares them your sad story I guess. I consider this approach "phoning it in".
I'm not knocking CBT here, just the rote, untailored practice thereof.
1: entrustment
2: civil, respectful in practice
3: influences you to think for yourself. Neither judges or demands.
4: structured.
5: willing to address your irrational mindset.
6: sets in co ordination with you, a plan to get from a to b.
7: asserts and assists .
8: gives or suggests other resources for your conditions.
Have had four therapist. Enjoyed each technique they incorporated into the patient plan.
Not a single one of them EVER played doctor with ' ohh your mom must be a narcist, or your boss is gaslighting you!
When I hear a person say this in post, I shut down. A therapist doesn't engage in that pop culture labeling. Makes me just as Leary when someone says therapy didn't work. No. The therapy was most likely practice accredited. It's the patient that didn't work.
1: entrustment
2: civil, respectful in practice
3: influences you to think for yourself. Neither judges or demands.
4: structured.
5: willing to address your irrational mindset.
6: sets in co ordination with you, a plan to get from a to b.
7: asserts and assists .
8: gives or suggests other resources for your conditions.
Have had four therapist. Enjoyed each technique they incorporated into the patient plan.
Not a single one of them EVER played doctor with ' ohh your mom must be a narcist, or your boss is gaslighting you!
When I hear a person say this in post, I shut down. A therapist doesn't engage in that pop culture labeling. Makes me just as Leary when someone says therapy didn't work. No. The therapy was most likely practice accredited. It's the patient that didn't work.
The reality on the ground is very different from the ideal. It is not a given that just because someone got a sheepskin that they are as good as any other therapist with a sheepskin. This is not true of any profession. In some professions where a degree is not really a requirement, it would be a bad assumption that a non-degreed experienced pro is not as good as a degreed one. That would be my field ... software development. I have met people with a masters in computer science who can't program their way out of a paper bag. This is not to knock a college education, it is just not to worship it.
Knowledge and demonstration of mastering knowledge has nothing really to do with character beyond the ability to persist in a long-term goal -- nor does it have anything to do even with how suited one's personality is to the role. And after a decade or so a degree is old news anyway, especially in fields where the state of the art is fast-evolving.
Finally, you're ignoring that some therapists are going to tend to be way more effective with certain kinds of patients and conditions.
The only therapist I liked talking to was this grad student a few years ago. I liked talking to him because he was insightful and gave me honest reactions to what he was seeing from me. Not sure how to find that again.
I've done a lot of self-therapy. It would be nice to talk to someone outside myself.
This is how my lay counselor through my online church worked. It's a volunteer service so money is no motivator for them (her). She looked to be in her 30s so I thought how on earth can she relate to me in retirement? She gave me honest reactions too, remembered everything I said, and somehow, I was able to come up with some remarkable conclusions just from "working it out" with her.
I had maybe 8 sessions thru' Zoom and feel like I might not need anymore....we'll see. I've had therapists before and they were largely useless. These lay counselors get a lot of training through a program called "Renovation" and are just so caring. Unlike the detached professionals. Nor do they talk about God solving anything. No God talk at all, unless you want to bring it up.
Mental health is an amazing, much-needed service for a church to provide!
One huge insight I had was that I had to accept my surgeon's timeline of a whole year to fully recover and am dealing with the physical "work" that entails. Once I made the connection that I had to allow my mental state an equal amount of time to recover and not think it "should" happen overnight, that adjusted my thinking. I had really sunk into destructive thinking and glad I got out of that sucking whirlpool.
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