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 finding a therapist,
psychotherapist, counselor, "shrink" finding a therapist Finding a therapist or counselor can be a pretty anxiety-provoking idea and a fairly confusing, stressful activity. A person can feel very conflicted about finding a professional that will be prying into angry feelings, sadness, hurts and anxieties. It's easy to bounce back and forth between thinking maybe someone can help you and maybe it would be a painful waste of time. You may feel like you would be going to a strange doctor for open-brain, open-heart surgery. You might tell yourself that you really have no idea what you would say. Most people who haven't ever been in counseling or therapy -- and most people who tried once but had a less-than-positive expereince in doing so -- think of going to a therapist just a little less fondly than they think of going to the dentist. Clarity of vision. In actuality, the best metaphor (in my opinion) is that of going to the optometrist. You go because you don't seem to be seeing clearly and you seem to be missing a lot of things and bumping into doorways and such more than you should. You have to go more times at first than you would the optometrist, but if all goes well you don't have to go back every year. If all goes well, your vision gets clearer and clearer as the years go by -- long after you stopped seeing the Doc. And -- you don't have to wear glasses or worry about contacts. Weak-mindedness? I hear a lot of people telling me that they feel it is weak to go to a therapist. Why don't I hear that it's weak to go get checked for glasses? The difference is there is a lot of negative stigma associated with "being mental." (There may be a joke there somewhere -- stigma? stigmatism?) A person needs to decide what is really the weaker -- being too afraid to get help when you need it, or getting help when you need it? insurance An important issue that you should understand is insurance. If you have health insurance now days, your insurance company will often have a list of health-care providers they recommend. They tell you that you must either go to someone on their list or you have to pay more in co-pay and/or deductible. Sometimes insurance companies tell you that they simply won't cover any services provided by anyone who is not on their list. These recommendations are not made solely on the basis of how good the health care providers are. These recommendations are made on the basis of 1) whether the health-care provider is willing to work with the insurance company's paperwork demands, 3) the providers' credentials, 2) how competent the health care provider is AND 3) how much of a discount the health care provider is willing to give the insurance company for the services rendered to you.
If you think it will cost you money to go to the therapist of your choice or if you don't even have insurance coverage for mental health issues, it is easy to use this as an excuse for avoiding dealing withn your problems. This can be a little like knowing you have cancer but telling yourself it might cost to much to treat it. It is, of course, your call. Maybe things will clear up by themselves. On the other hand, there is no way to put a dollar value on feeling safe, contented, happy and/or ridding yourself of intense anger, fear or sadness. You don't know what it will cost unless you ask about prices and terms. Most therapists will work out a reasonable payment plan -- professionals who are in the business of helping people solve their problems don't usually want to give them more problems. best ways to pick Possibly the best way to pick a therapist (or any kind of doctor) is to ask friends and colleagues that you trust for recommendations. Once you get a name or two of therapists who are considered very good, you then go to your insurance company and see if the therapist is on their list. If not, call the therapist and the insurance company and ask if they could work out a deal so you can see the particular therapist and be covered by your particular insurance. Most insurance companies that are worth a hoot will be willing to help you get to the health-care provider of your choice. It's simply good business. If your insurance company isn't willing to try, ask them why. Most therapists will be happy to work with a particular insurance company to take care of the needs of someone who wants to see them in particular. The therapist may find the insurance company's procedures to be too painful to be worth getting regular referrals from it, but most therapists like to work with people being referred by friends and colleagues and most will bend over backwards to get you in. It's simply good business for the therapist, too. It's easier for the therapist to be successful and it's poor community advertising and politics to refuse to work out an arrangement so someone can be seen. And if all else fails in trying to get an arrangement going so you can see a particular provider and be covered by your insurance, contact the provider and see if there is a payment plan that can be arranged. Strongly consider the relative potential value of seeing someone that you hear is really good -- but having to pay $25- $100 or so monthly over many months -- as compared to seeing someone that nobody recommends except your insurance company. "it didn't work" Finding a therapist is like finding a hair stylist or car mechanic -- if you find one that seems worthless, you don't just give up -- you find another. I hear people say, "I tried going to counseling but it didn't work," quite frequently. Somebody needs counseling -- psychotherapy -- and tries and hates it and quits. The fact is, finding a therapist you can work with is sometimes tough and can take a few trials and errors before you get it right. Finding a match with a therapist is very much like finding a match with a hair stylist or mechanic. Some do several kinds of thing really well and are very poor at others. If you go to a hair stylist and come home looking like a poodle, or come home feeling and looking like your hair didn't get cut at all, you don't give up having your hair cut ever again (well, anyway you don't have to). Clearly, you may decide it's wise not to keep going back to that stylist. If you complain to your hair stylist that you look like a poodle, you don't let the stylist tell you that it's your hair's fault unless you're pretty sure that's possible. You try another stylist. IF you have two or three or more hair stylists tell you it's your hair, THEN ask what can be done about it because maybe it is your hair that's causing the problem. The same goes for therapists. individual differences Therapists are all different and come in all shapes and sizes. Therapists/counselors are basically human critters like everybody else. Like other people, they sometimes make mistakes, give off attitude, have weird interpersonal mannerisms or can at times just seem full of crap. Like other people, some are smarter than others and some are smarter at one set of things than they are about another. Some basic things sort of set them apart from other people in general. One is that they're very intelligent when it comes to book reading and taking tests -- you can't get into graduate school to be a shrink unless you are very brainy about the tasks involved in going to school. They are also usually a little or a lot obsessive-compulsive and often don't have as much interest in a social life as other folks do. These are the qualities required to get through years and year and years of studying with no summers off, while you work two or three part time jobs teaching or doing some sort of research. (Think about it. Who but somebody a little bit obsessive-compulsive would say no to countless fun times with friends so they could study for several years for a piece of paper to hang on their wall? Psychologists, for example, go to regular college for 4-5 years and then go to grad school for 5-8 more. Then after a year or two of being closely supervised they can be a licensed shrink. That's 10-15 years.)
"nuts"So often shrinks seem sort of "nuts" themselves. Yes, and this can be the case for a few different reasons. First off, many people who devote their life to studying and fixing psychological and emotional problems either had some struggles themselves (and possible still have some) or they grew up around people with screws loose and it bothered them so much that they decided they wanted to study why screws come loose and what to do about it. That's why they wanted to be a healer rather than physicist, a baker, a marine biologist or steel worker. The graduate programs do try to weed out the really obviously nutty ones, but you can't get into grad school or get through grad school without being a little off (obsessively-compulsively at least) as described above. Most counselor-types have tightened up their screws pretty well by the time they open up business. They have a lot to offer in the way of both experience and expertise. Some are at the very least good technicians and can help many people with most problems. Some... well, you know, there's a bad apple in most barrels of apples. Another reason so many therapist types seem a little "nuts" is because they don't seem to conform to community standards of "normal behavior." This is because when you work day-in and day-out with people in agony because they're pounding their heads against brick walls made up of impractical "shoulds" and impossible "coulds," it gives you a distaste for doing things just because society and community tell you to. Also, when you routinely work with people in or just out of pain and terror, and regularly hear life stories of torture and trauma, it gives you a very different perspective on what's important to worry about in life. Some of the finest psychological minds I've known were very "unencumbered" by worries about social proprieties. credentials Anybody can get some form of credentials (if they don't care what they mean). The issue is usually where the credentials come from and what the credentials really mean. I get emails every few months offering PhD's in almost anything by just applying and paying a fee. Generally speaking, credentials should be from a nationally recognized, respected organization or from a regionally accredited school of higher learning. The easiest credential to look for and check is a license. States license professionals and this assures you that you can count on at least a minimum level of education and training. These days you can also do internet searches about particular credentials and often find out just what those credentials mean. Be cautious of (but if you have to consider) anyone with skimpy credentials -- and stay away from anyone with flaky credentials. Sometimes, especially in rural areas, choices are few and far between. Sometimes someone with a "lesser degree" (e.g., MA rather than MD or PhD) can provide really excellent services. A higher degree usually means they jumped through more hoops, read more books, wrote more papers, got more supervised training, but there are many good practitioners that simply didn't feel like devoting the extra several years for the extra prestige of a higher degree. That attitude doesn't necessarily correlate with ability as a helper and healer. Frankly I can't think of any good reason for a competent person to obtain and convey that s/he has flaky, flimsy credentials. I'd be very cautious about anyone with only barely-legal, unethically proffered credentials.
"travel"Some times the resources you need are not near at hand When you live in a smallish town and there are no nearby resources, it may be important to travel. This is not the worst thing in the world. Many people get into their thoughts both on the way to counseling and on the way back, which may actually be very advantageous. It is not optimal to have life distracting you fully immediately before and immediately after a counseling session. There is a lot of psychological "disgeting" that can be missed when this happens. Travelling an hour and a half before and after a session might just be optimal. It is mostly important that you not be dwelling on deeply depressing things on the way home and it is a nightmare to be locked in a car, fighting with someone, for an hour and a half drive. Avoid those two situations and a long drive to and from counseling can be very therapeutic. Controversial Position #693: who's responsibility is it to make therapy effective?
If this seems to happen to you, be forgiving and explain to your therapist that you were hoping for more help than that. Explain that you are one of those lightbulbs who needs his or her therapist to take charge of making things work in the therapy session. Explain that you read an online article where it was explained that it is the therapist's job to make you comfortable enough to talk about what you need to talk about. Explain that you were hoping that your new therapist would be able to take responsibility for figuring out what and how you need to change. Be forgiving and patient and if you do not get the answers you need, perhaps you could consider checking out a different therapist. It is natural for the lightbulb to fear changing - to not be 100% behind the idea of change. (See the articles on this website about why many lightbulbs normally have fears and resistance to change, no matter how burned out they are.) Dear Dr J, I have been in the care of a wonderful psycologist for some time. Genuinely concerned without being judgemental and with an obvious desire to help (what more could you ask for in a psychologist?). On many levels I feel like I'm getting the help I'm seeking (I can tell because my life is getting better) however I find I'm unable to broach certain subjects, things that I sought out help for in the first place. I have a few issues I've never spoken with another human being about and I fear I may never be able to. Even in this anonymous format the idea of admitting to some of these issues is unbearable. Should I look for a different psychologist? Hypnosis? If a confession were drawn from my subconcious could I then be confronted with these issues in a concious state? I won"t talk with someone whose opinion dosn't matter to me and because my current Doctor's opinion matters to me, I just can't go there. Response (revised to actually be a better response that I gave, but such is life) - There are several perspectives to answer this from. First, I should say this: people go through terrible things in life -- some more than others -- but if you are able to rise above shame and guilt to talk about things you've gone through, you strike a blow for freedom for everyone. It is the subtle feeling in our society that going through tough things -- being molested or being witness to ugliness or etc. -- is shameful that makes it so hard to deal with these things. It is a twisted, sad part of our human/mammal/animal condition that being wounded or victimized is seen as shameful. Your therapist will not be one of those people who looks at you as shameful. You say your therapist is good with you. This will continue when you get to the tough stuff and the deeper the bad feelings you have, the better it will feel when you find out your therapist sees you as valiant and tough to have gone through and/or done such things in your past. Next, if this is you not wanting to be looked down on: It is a common problem to get attached to a counselor to the degree to which you have -- where you don't want to be candid because of concerns that frank, open honesty might cause the counselor to "look down" on you. If you really don't want to be open and candid, hypnosis will not force you to be. If your life is getting better but you cannot comfortably be open and candid, perhaps you should decide to look at your values. Do you want more to be unable to control your self or do you want more to have control? Do you want your happiness to be more important or do you want what any particular person might think of you to be more important? Do you want to be the kind of person who places a higher value on someone respecting you for who you pretend to be or the kind of person who would rather have someone respect you for who you are or not respect you at all? Do you want to treat the counselor like a dumb date that you lie to in order to keep things cool? The long and the short of it is that this is a natural feeling that can make your counseling relationship into garbage if you indulge it to the extent that it becomes a significant worry and issue. Your counselor doesn't need to know everything. It would take a thousand lifetimes to get one lifetime turned into words so you could tell about everything -- even if you're still in your teens. BUT if you think that your "secrets" need to be talked about, then they do. If your counselor would only like and respect you for who you pretend to be and not like you and respect you if he finds out about these "secrets," then your counselor isn't really as cool as you apparently think he is and your relationship isn't worth that much anyway. So, obviously, my advice is that you should decide it's no big deal or get talking -- and soon. Get straight with your responsibility to yourself and to the counseling relationship -- if you pretend to not be who you are, the benefits from counseling will be very limited. You will almost certainly find that -- unless your "secrets" involve plans for hurting someone else, plans for murder or etc. -- you will be very relieved when your counselor reassures you that your secrets can be talked about without the ceiling caving in on your life. You may catch hell for the thing, whatever it is, but that's not the same as being looked down on for doing it. (It needs to be okay for your counselor to "look down" on a very negative behavior or thinking if it is worthy of that -- but that can happen without looking down on you, you know. And even if this is about something you did, I'll bet you $5 that you will find your counselor is less negative about whatever it is than you are, your self.) As the Nike people say: Just Do It. Just blurt it out or print your part of this email and give it to him. Or, decide it isn't important and you don't need to talk about it at all. Either bag it or blurt it -- but get working on getting past this one way or another before it causes problems. It apparently already has you thinking quite silly. ("Should I fire him for being someone that helps and being someone that I like? Should I go find some idiot that I won't care what I say to?" Duh.) With regard to hypnosis: It is possible to be hypnotized and to tell about something that you don't like to think about. It is actually easier, though, to hypnotize someone and have him or her disclose something to the therapist that he or she has not been able to disclose to him or herself -- than it is to hypnotize someone to be candid about something he or she doesn't want to "confess." It is (obviously) my preference as a wise, old, grizzly shrink, to suggest to you that you be candid right quick with your counselor. Just do it. (Unless you are talking about talking about a plan to be hurting someone. In that case, talk to an attorney.) And my general bias is that if you can do it without help, just do it without help. However, if you are having a tough time "just doing it," hypnosis might help you find the strength and trust the wisdom of doing what you think right. If you'd like to give one of my tapes or CDs a shot, self to self partnering might help deal with yourself better and healing tree 2 might help with the idea of facing an anxiety-provoking challenge. My preference is also that you check with your counselor before using another counselor's intervention -- but if you need the second to do the first, then what is is what is. And in spite of wise cracks to the contrary, my bias is that people should be practical and get healthy in the safest, fastest ways available. If you'd like to try the hypnosis tactic, my recordings are money-back guaranteed and you would know within a listening or two to just one of them whether they are going to be helpful. Hope that helps. Good luck |
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