I also discuss these concepts in the July episode of my podcast: The Shrink in Beverly Hills
A number of people have asked me how to choose a therapist. So this article will contain some tips based on my experience as both a therapist and a patient.
Goodness of fit
The main indicator of whether you should stick with a therapist is how you feel with that person. After meeting with them for two or three sessions you generally have a sense of whether you like the way they work with you. Do you feel comfortable opening up to them? Obviously it can be challenging to open up to a stranger. But does this feel like a person with whom you could build a trusting relationship and share intimate feelings and thoughts? I like the analogy of dating. When people go out on 1 to 3 dates with a person they usually get a sense of whether they click with them. This chemistry is hard to define and put on paper. Some people have had the experience of being set up with somebody or meeting somebody through the internet and just not “feeling it“ when they actually meet them in person. Similarly, the therapist may look great on paper with the right degrees and training but if you just don’t feel it when you meet with them, it’s important to really consider that.
Another fairly common question is “should I see a male or female therapist?” Again generally it’s more important that you feel that the two of you clicked. Although I will on occasion recommend a different gender than the person has had in the past for therapy. So if for example someone told me they had two or three previous therapists who were female, I might recommend a male therapist. Not only can a therapist of a different gender offer a new perspective on certain issues, but a useful type of transference can emerge. The transference is the feelings the patient projects on to the therapist from past relationships. An example is a patient who had a disrespectful, belittling mother. The patient may feel that the therapist (and perhaps more so a female therapist) is belittling them. This is usually not the case and so the patient and the therapist can then sort out their interactions. Ideally, the therapist is attuned and supportive of the patient’s feelings which can be very healing. This is called the corrective emotional experience. It is often said that the relationship itself between the therapist and the patient offers the most healing.
This is not a social relationship so of course if you sense anything in the way of the therapist asking to see you outside of therapy or attempting to seduce you, I would strongly recommend never returning. Again you should feel safe.
If the therapist opens up too much too soon and you feel as though they are using you as their therapist, this is highly problematic. Occasionally, it is useful for the therapist to self-disclose as it helps the patient feel understood and can normalize the problem. But that’s different then the patient feeling used by the therapist who goes on at length about their own struggles with regularity.
Typically sessions are 45 to 50 minutes although there are some therapists who do longer sessions of 55 to 60 minutes. I Ideally the therapist manages the time frame carefully. This means they generally begin and end on time. If they go over the time limit by 10 or 15 minutes I would be concerned about their ability to hold the frame consistently. So if your sessions are 45 minutes in length sometimes and 60 minutes at other, that’s a real problem. This can be very confusing to the patient. The therapy space feels safer if it’s predictable and consistent. Of course if the therapist goes over a couple minutes here and there, it’s not that big of an issue. The therapist should also generally start the sessions on time as well.
Beware of overpromising
I would be leery of the therapist who either explicitly states or implies that they can make you a happy person in a relatively short amount of time. The goal of therapy should not be to eliminate negative emotions because that is not possible. You will still have moments/times of anger, sadness, pain, hurt etc. These are an integral part of the human condition. Through therapy over a period of time you can increase your self-awareness. You can manage your feelings better and act in ways that are less destructive to yourself and others. Throughout the course of therapy I have witnessed many patients experience more fulfilling relationships and greater career success/satisfaction. I’ve also seen therapy help diminish their symptoms such as depression and anxiety. But I would be hesitant to trust the therapist who guarantees these improvements especially in a short amount of time.
I hope these tips are useful to you. I believe at some point in almost everybody’s life they should be in psychotherapy. It is very complex to be human in these rapidly changing times and psychotherapy is a great way to increase self awareness, self actualization, and suffer less.