I've had a fairly wide range of experiences with therapists--a few did seem
to fit the "crazy" bill. The therapists who are really competent and up on the
latest research about trauma are worth every penny imho.
Having experienced extreme trauma in childhood and gotten into severely
abusive relationships as an adult, I was in desperate need for help when
I first started seeking help. I've had some terrible experiences with a number
of therapists, and I've always wondered if my vulnerability was a factor.
When someone knows you're vulnerable, they tend to let their true colors shine forth.
Here's what I found for what's it's worth--therapists can be:
1. "crazy"-basically demonstrate behaviors that should put them firmly on the
couch so to speak instead of the patient/client. can be very traumatizing
2. incompetent--angry? punch a pillow! abused by your Dad? write an unsent
letter- emotionally eating? drink more water! While these suggestions can be
sound, if you do them and come back wanting more and are just given more
of the same, they've already run out of tricks in what is a fairly shallow, formulaic bag
3. indifferent--barely stifled yawns, tossed off suggestions, no memory of your
situation one week to the next, disbelief about details of your trauma, one size fits all diagnosis (everything looks like ADHD) listens to your
description of trauma stony faced. Basic lack of empathy, which can be cause trauma in an of itself.
4. elitist--responds differently to those with favored background whether from
elite university, glbt community, age range, same philosophical bent. Feels good when your'e in, but not so great when it's not a fit, but either way not healthy.
5. unprofessional --shows up late or not at all, erratic billing, blaming you for
mixed up appt times or dates, talks about themselves excessively
or other clients histories and progress. Can also be traumatic. Imagine being in crisis and waiting anxiously for appt and therapist never shows, then being
accused of making mistake and implied that maybe you're a bit crazy to be
upset. Having a business card with the appt written down in their writing helps.
6. competent and professional and empathic--my experience has been these
are fairly rare, but worth the searching process and definitely worth the expense.
For myself, trauma/abuse has been the cause of many physical problems. I
would much rather pay a good therapist than run around to a bunch of doctors
chasing symptoms.
7. machiavellian-- the scariest of all. Unfortunately not as rare as you might
think. Those who "get off" on the power differential, like to emphasize your
problems and difficulties and their competence. Can be dangerous if
you're really vulnerable. Often combines "love bombing" type behavior in
beginning with callous or indifferent behavior later to foster anxiety and
dependency. For example, I had one therapist who was great in the
beginning, but then started to ask me to start thinking of her as a sort of savior
"I'm the only person who's there for you" (not true!)and withhold therapy until I
started to praise her "being the one" for me. Discouraged steps I was taking
in personal growth (ie attending classes) When I balked she started
talking about how she might need to change my diagnosis from PTSD
to something more serious. Creepy and threatening. I pretended everything
was fine for a few sessions and then claimed unavoidable scheduling
conflicts to get the hell out. Totally traumatizing experience.
So while I haven't had the most are "crazy" experience, I've had some pretty
terrible and traumatizing experiences with therapists. Who have either slowed
or set back my recovery considerably. So it's definitely buyer beware, just like
looking for a good lawyer or real estate agent.
That said, obviously the good therapists have been tremendously beneficial
to me, so it's worth the search and expense. The best way to "shop", that I've
found is to have your history ready to tell in fairly unemotional format. And
have your goals and obstacles in mind. If you're not sure pick one and work on
it. You'll know pretty quick whether or not they can help you. Also, if you're in
crisis and just need a soft landing spot, please be cautious. It was precisely
in these situations that I ran up against the worst of therapists behaviors.
The most important quality is experience with your particular situation
(ie whether it be domestic violence, rape, etc) and empathy. Experience is
vitally necessary to help steer you in the right direction (ie leaving a domestic violence situation can be dangerous can require some planning) and empathy is the essential ingredient to provide emotional safety.
I think $100 hour is actually a very reasonable charge for a competent therapist
given all the hidden costs. Actually most of the good people I've worked with
don't even accept insurance anymore, so they can preserve their livelihoods.
Sure a so-so, incompetent, etc therapist shouldn't be making a good living, but
what about all those incompetent or unscrupulous lawyers who are living large?
Frankly, a lot of therapists are women who rely on their partner's income. Those
who are supporting their families or are on their own charge much more.
And they are often better about staying on top of the latest developments in the
field of trauma recovery, as they see the need to distinguish themselves from the
rest in the field.