How To Find The Right Therapist?

[WillowMarie]

I have been in therapy since March, but I don't believe she is the right fit for me. I try to explain how my emotions work and she just doesn't understand. I interpret her responses as that I shouldn't have problems expressing myself, or letting my emotions come up. I need someone that can explain why things are happening and why I may feel the way I do, and reassuring me what I am feeling is "normal". I also want someone who can read body language and help me when I feel numb or disssociative , someone who can help push me, or at least encourage me, but also know when it might be too much for me. My therapist now has mentioned she knows I dissociate when I start playing with my hands, but doesn't do anything or say anything to help me in the moment. This has lead me to feel unsafe around her and I go into my mental tapes that nobody understands me or can help me.

There are some comments she has made that make me irritated and hurt. I was explaining I had found this website (myptsd) and I finally felt for the first time that people understood my emotions and my reactions to things. I also mentioned that I know that I haven't been diagnosed with it yet, but I could relate to most of the things people were talking about. (For the record, I did just complete a 30 day residential treatment program for self-injury and they diagnosed me with PTSD, so it is a diagnosis/label or whatnot that I have now. I forgot to mention this when I saw her yesterday, which was my first appointment back.) My therapist responded, sounding frustrated, that I can't be diagnose with PTSD until my memories come back.... so apparently my response around angry people where I start shaking and feeling like I am going to cry doesn't matter. And the ten or so memories I do have, that I have already told her about, don't count as being traumatic. At least that is how I took her comment. I don't think she realizes the effect my past had on me, even though I don't remember a lot.

I want to think that there is something better out there. That someone is more able to help me. I have been to a lot of therapists and either ended up being told that they couldn't help me anymore or I ended up not going because I would just sit there and not know what to talk about because I was so shut down. I know that shutting down and not knowing what to say or express things is more on me than the therapist. But I wish that I would have had a therapist that would understand what I was doing and explain it to me. Help me work through it and feel comfortable. I mean, maybe there isn't one like that out there, but I have read other people having therapists that validate them by being able to explain what they are going through feelings wise.

I guess my question is, how do I find one that fits my needs? The one I am going to now does have trauma experience and that is why I picked her. I even asked her once how she does trauma work. She said she has the person go over and over the situation until it doesn't affect them as much anymore. And that if they start crying hysterically or stuff like that, she will stop and help them calm down. I don't think she realizes my problem is that I can't get in touch with a lot of those overwhelming emotions, or allow myself to feel them easily. And when I do let them in, start to dissociate. Even though I told her on my first session I want to work on not dissociating and feeling more emotions.

Is there hope that I can find a therapist that understands me better? I feel so hopeless thinking of all the ones I have tried. I think it is all up to me to let everything out, but I also want to hope that I don't have to feel so alone in trying to push myself and that no one else can help.

Any advice is super appreciated, thanks everyone!

 

[gnirolockoob]

I don't know how to find the right therapist because my second one was already the right one. Since I can't verbally express my feelings sometimes I have to write them down or if I don't want to talk about a specific topic (i.e. my past) he finds another topic for me. I guess it's because I haven't been officially diagnosed with PTSD because I want to keep the past buried and am still trying to find courage to talk about it...

 

[Abstract]

I relate to a lot of what you describe here.

I had a lot of wasted therapy as a result of therapists not being trauma therapists and me blocking off and not mentioning or discussing trauma or trauma symptoms. My dissociation was misunderstood as lack of cooperation and when I did eventually venture to say how I felt I was not believed. Why? I think because apparently I seemed so fine. The reason I seemed so fine was because I was so shutdown and instinctively did all I could to put a veneer of normality on to hide my vulnerability. One of the less than ideal signs for me is when I am absolutely still and not speaking or in a freeze.

One thing I will mention is that I think someone having some trauma experience and them actually specialising in trauma are two different things entirely.

These are things I am considering and are something to think about:

• Are they specialising and specifically trained in trauma.
• What psychological approach or combination of approaches do I want. CBT, Body therapy, person centred etc?
• Am I telling the therapist when the way something is approached is not helpful to me? Am I saying what I would find helpful?
• If I find that hard then what can I do to help change that or get someone to help me change that.
• Is the therapist experienced and properly qualified in general.
• What qualities in a therapist would be helpful for me so that I can find someone with a good fit.
• What qualities and indications of those qualities do I want to avoid and how do I identify them.
• Do they show awareness of keeping me safe and how will they do that.

It might be worthwhile thinking of all of these, filtering out as many as possible and then interviewing a few therapist by having a session to pick out one with a better fit. You can both see if you think you can work well with each other.

 

[Hope4future]

Finding the right therapist can be incredibly hard for so many reasons. Abstract lists out good things to keep in mind. I'd also add to trust your instincts. I knew my therapist was a good fit when my usual avoidance techniques didn't work. I couldn't fool him into thinking I was ok and that was a terrifying relief.

It's a relationship and that takes time to build, but once you've screened for qualifications and specialties, there should be an honest connection. I know for me I don't always trust myself, but the truth is that I believe because of trauma we can be especially sensitive to how we connect or don't connect to people.

Also, I would set my own expectation of not planning to talk about any 'hot' trauma topics until a baseline of safety and trust is established. That can take some of the pressure and fear out of the situation and also allows you to see if the therapist respects where you're at and can meet you there.

Keep looking until you find the right person. You deserve to find someone who will help and support you in this difficult work.

 

[Deleted member 1860]

Just as a therapist isn't qualified to diagnose you, a therapist isn't qualified to UN- diagnose you! You're right to move on.

 

[TeaLeaf]

Willowmarie-I see lots of red flags from what you described in how your therapist responds.

I would personally be really bothered by some of therapists behavior had I been on the receiving end. She knows when you dissociate but doesn't do anything to help you get out of it. You are right to have an expectation that she would have some type of intervention relating to your dissociation- helping your with grounding, expressing how the dissociation feels like, something. She argued with you about whether you were diagnosed with PTSD when you found relief on the PTSD forum and felt like people finally understood you. I would think a therapist would have some sort of validating response to you finding relief through connecting with others. I find it very sad that in her eyes you have 10 memories from childhood that don't count as traumatic when it sounds like you have blocked out most of the rest of your childhood. Even if she wants to be careful with putting labels on people, it sounds like the way it was handled wasn't very positive or therapeutic especially since you just came out of a residential treatment facility which says a lot about how hard things must have been for you

I have been to a lot of therapists and either ended up being told that they couldn't help me anymore or I ended up not going because I would just sit there and not know what to talk about because I was so shut down. I know that shutting down and not knowing what to say or express things is more on me than the therapist. But I wish that I would have had a therapist that would understand what I was doing and explain it to me. Help me work through it and feel comfortable.

It sounds like you put a lot of pressure on yourself to be able to spill your guts and get stuff processed but it is your therapists job to help you feel comfortable enough to be able to talk about feelings. I had severe trauma as a child, physical, emotional, sexual abuse and poverty along with a mentally ill parent and an addict parent. In my early 20's, my whole first year with one therapist was playing a card game while we talked, a lot of it was superficial at first. Because of my history, I couldn't trust people but slowly as she was patient with me, supportive of me and gave me lots of control over what I was going to talk about, I was able to build trust and talk about things that were going on in my life and it started to get more into my trauma. I would not be where I am today without a skilled therapist like her.

Even if she says she is a trauma therapist, it doesn't guarantee that she is the right fit for you or even that she is good at her job. Therapists are human and not every trauma therapist can help everyone and some of them do suck. I have had some bad therapists, one of them was so bad (a trauma therapist!) that my current therapist apologized for her behavior "on behalf of therapy". I also think there is a big difference between a trauma therapist that is effective at helping people recover from a single trauma versus one that has had multiple traumas in childhood. I like what hope for future said, as trauma survivors, we can be especially sensitive to how we connect or don't connect to people.

You deserve to have a therapist that you connect with and feel can help you. Is there any way you can tell your therapist some of what you are feeling about her not being a good fit? There is a possibility that maybe she doesn't know she could be doing things differently to better help you. You can always look for a different therapist too, many therapists have a free meet and greet for 10 minutes or 30 minutes where you can ask questions and determine if it would be a good fit. Sometimes it is hard to tell if they are a good fit just by their qualifications. You should also feel comfortable with them to some degree.

I wish you the best on finding a good therapist!
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[Tinyflame]

It sounds like you put a lot of pressure on yourself to be able to spill your guts and get stuff processed but it is your therapists job to help you feel comfortable enough to be able to talk about feelings.

In my early 20's, my whole first year with one therapist was playing a card game while we talked, a lot of it was superficial at first. Because of my history, I couldn't trust people but slowly as she was patient with me, supportive of me and gave me lots of control over what I was going to talk about, I was able to build trust and talk about things that were going on in my life and it started to get more into my trauma. I would not be where I am today without a skilled therapist like her.

I think that was an absolutely brilliant idea of that T, wow. She sure understood. :tup: (((((((TeaLeaf)))))))

Best wishes WillowMarie, I hope you find such a good one. (((((((((WillowMarie)))))).

 

[WillowMarie]

Oh, and another thing I remembered from my last session. My therapist commented on seeing a huge difference (it was my first session back from the month of residential) because I talked so much and never shut down. Little does she know, I was a bit shut down, and wasn't feeling as much as I could have been. Because I could feel emotions bubbling up, but detached from them. I will be mentioning this to her next session because I felt frustrated that she commented I was fine, when I was clearly not.

I had a lot of wasted therapy as a result of therapists not being trauma therapists and me blocking off and not mentioning or discussing trauma or trauma symptoms. My dissociation was misunderstood as lack of cooperation and when I did eventually venture to say how I felt I was not believed. Why? I think because apparently I seemed so fine. The reason I seemed so fine was because I was so shutdown and instinctively did all I could to put a veneer of normality on to hide my vulnerability. One of the less than ideal signs for me is when I am absolutely still and not speaking or in a freeze.

I can relate to being still and not speaking. It is like I am afraid to move or make words come out of my mouth. As well as seeming fine to others, especially because I acted happy for so long since I was a child/teen without realizing it. Thank you for all of the tips, I really appreciate it!

She argued with you about whether you were diagnosed with PTSD when you found relief on the PTSD forum and felt like people finally understood you. I would think a therapist would have some sort of validating response to you finding relief through connecting with others. I find it very sad that in her eyes you have 10 memories from childhood that don't count as traumatic when it sounds like you have blocked out most of the rest of your childhood. Even if she wants to be careful with putting labels on people, it sounds like the way it was handled wasn't very positive or therapeutic especially since you just came out of a residential treatment facility which says a lot about how hard things must have been for you.

I was hoping for a validating response. And thank you for validating my feelings of being upset with her response. And about the memories, especially since I have two of them are about my dad being physical with my younger brother, either slapping him across the face, or kicking him in the leg hard underneath the table when we had dinner one time. Those were when I was a bit older, like middle school/junior high. And I don't know why, but I remember feeling very protective over my younger brother when I was younger and one time I was holding him while he was crying, but don't know why he was. I also have a memory of my dad grabbing my wrist when a friend was over when I was young (before middle school, I think), and my friend spread rumors around the neighborhood kids that my dad almost broke my wrist.

I have also told her about my body's response when I am in the presence of someone expressing anger, even if it isn't directed towards me. Of how my body starts to tremble and I feel like I am going to start crying, even if I don't feel any emotions at the time.

Is there any way you can tell your therapist some of what you are feeling about her not being a good fit? There is a possibility that maybe she doesn't know she could be doing things differently to better help you.

I will do this some next session. I know I want to mention that I did shut down some emotionally even though she had commented that I didn't shut down at all. I did learn during the residential treatment I do different things at different times. Sometimes I play with my hands or move my body a lot, and that is more like a distraction from feeling. I had actually tried a whole bunch of grounding techniques before I even had a chance to start dissociating, but that made it really hard to connect with any feeling because I felt distracted by the grounding techniques. Sometimes I stare at something and feel like I don't want to move or say anything. Sometimes I let myself start to feel, and all of a sudden I notice I feel floaty or like I am in a fog. My mind pretty much shuts down and goes blank with almost all of these.

I know you mentioned she might not know how to help me, and that's my main reason I want to find another therapist. I shouldn't have to train her on how to do her job. It is another thing to say that a technique doesn't help that she may be trying, or if I already know something does help and to tell her. I don't really know what all helps me yet, so I need someone who knows various techniques and can help me in the moment with them. Thank you again for all your advice and support! :)

 

[Hashi]

I need someone who knows various techniques and can help me in the moment with them.

I see an integrative trauma therapist, for this reason. I don't know if integrative is what they're called everywhere but it means someone who's trained in several different therapy approaches. They use different techniques depending on the client and how the client is at a particular time.

The mixture of techniques can vary depending on the therapist, so you do need to think about what might be good for you as an individual. My current therapist includes art therapy, body psychotherapy and gestalt (which suit me personally - not saying they'd necessarily be right for you) but my first integrative therapist didn't do any of those.

I shouldn't have to train her on how to do her job.

I agree with this. I think it's important to establish first whether you feel you've given her enough information about how you're feeling and she's had a chance to explore alternative techniques with you. Especially when we find it hard to open up and we're good at putting on appearances, it can take time - and explaining - for a therapist to understand what might be really going on.

Having said that, if you're seeing red flags, or you talk to her and are convinced that she's not right for you, I wouldn't wait around. In that case, unless you need support until you find someone else (and if she can be supportive in that way) I wouldn't continue with a therapist who's not right, apart from one or two finishing sessions,

 

[WillowMarie]

I agree with this. I think it's important to establish first whether you feel you've given her enough information about how you're feeling and she's had a chance to explore alternative techniques with you. Especially when we find it hard to open up and we're good at putting on appearances, it can take time - and explaining - for a therapist to understand what might be really going on.

This reminds me of the time I went in and told her that, if I am paying attention and listening to my body and emotions, I can really tell what point I dissociate at. I told her about when I was at work and a boss said I wasn't doing something right and that is a trigger for me. I felt my emotions coming up and tried to just let myself feel them, but they spiked high real fast and I felt myself panic and feel scared. Then all of a sudden this calm washed over my body and my head was quiet and it was hard to think. The whole process was only about 5 seconds long. I also felt like I was slightly in a fog, so I realized I had dissociated, but just had never had tried to pay attention to how my body feels like before, so I never realized how instant and different it felt. So I told my therapist this, and she said that was very insightful of me and that is about it. Nothing about what to do next time, ways to help me out.

I guess we will see what happens in the next session because I did also tell her that I learned grounding techniques distract me from feeling emotions if I haven't started feeling them yet. So I have been trying not to move or anything while starting to feel.



That's kool you are doing art therapy :) When I was looking up therapists, I saw one that did that, but she did not take my insurance. The rest of her profile page didn't catch my eye though, so I kept moving on.

 

[Hashi]

Nothing about what to do next time, ways to help me out.

Have you discussed this with her, as a general point? That you would like her, as your therapist, to explain to you what's going on when you experience things like this, and help you work through it, and make suggestions for what to do?

From what you've said it seems to me that this is a general point for you, that it comes into all your interactions with your therapist. If she's just not that kind of therapist then I can't see you ever being compatible. My query would be whether she understands that in general, you're looking for a lot more input from her - her insight and suggestions, not just her commenting on yours. And then whether she can/will do that.

It seems like this is the crunch point for you, and if she can't meet that need then that's probably one of the most important questions when you look for someone else.

 

[WillowMarie]

Have you discussed this with her, as a general point? That you would like her, as your therapist, to explain to you what's going on when you experience things like this, and help you work through it, and make suggestions for what to do?

I have not. It has been more that I tell her and explain to her what goes on. That I understand that my emotions can be so intense in situations because i may be feeling them to the extent of when I was experiencing trauma when I was younger. She never agrees with me, saying, you are absolutely right, that makes a lot of sense. Just kind of stares at me. I am still convinced she thinks I am crazy and need to be on medication.

I did tell her last appointment that I didn't like one of her responses and she said she didn't mean for me to take it that way. But I did not mention about still dissociating/checking out a lot still. I need to do this next session. Especially since she sees me talking more, I think she assumes I am better, but I still feel so disconnected from the feelings.



I did a roleplay with her last appointment because I am worried about going back to work. One of my triggers/sensitivities is if someone tells me I am not doing something good enough, uses a stern voice, and if I respond and the person disagrees with me. So basically how I remember communicating with my dad. He yelled a lot and was very critical, and if I yelled back or told him I was right about something and that he was wrong (which was a reality sometimes), he yelled back saying he didn't care or to shut up. He yelled at me when he didn't like something I was doing, even if it was something small, so I can only imagine that is one of the reasons I want to be perfect at work. It is just at this job, it is so hard to be good enough... I had a revelation that I avoided this trigger by being able to do everything that was expected of me and being so perfect no one had to ever tell me that I needed to improve. But this new job... I just can't be perfect and am terrified of making mistakes. I have already stepped down to a less demanding position and hope that helps.

Back to the roleplay, so we decided to try a situation where a boss is saying I am not doing good enough. She said her lines and I was already kind of shut down because I was nervous, but I managed to take a minute or two and responded, I just got back, it might take me a day or two to get back into the swing of things, and that I am going to do my best. I was not expecting her to talk back, and she did, and with a raised voice. I felt my eyes start to water and curled up into my chair pulling my knee against my chest. I tried to remember my skills like taking a deep breath. I tried to tell myself that I need to take a deep breath and tried to breath in. I remember muttering that she was being really mean. I didn't really know how else to respond. She stopped the exercise and was asking me if it was what she was saying or her tone that affected me (I didn't know, I just know it affected me), what I felt (I have a hard time with this, but I think I was scared), what age I felt (didn't know), and what I thought (didn't know). I was pretty shut down, so I don't really know and my brain was pretty blank, so I couldn't really give her information.

I think if I wasn't so out of it and could think, I would have told her I needed help getting grounded/getting through the emotion. I know afterward she applauded me on responding the first time and that was a good response, and also for starting to cry because that is the first time she has seen me do that and feeling the emotions (although I have cried one other time in a session with her while talking about memories). I think she assumes that since I cried I was fully connected to the emotions and never dissociated/detached from them, which wasn't true.

Unfortunately, I feel even worse about going back to work now... but as soon as my full work schedule is up (by Monday, I think), I can start making appointments with other therapists I want to try to see if I can find someone that can read me better.