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Things i wish i'd known about my therapist...

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zombycat

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Hey guys,

If you don't want to read the long post, no biggie. You're welcome to skip down to the questions at the end. Thanks in advance for any advice!

I'm pretty new here. I've got a traumatic past that I thought I was dealing with pretty well, moving on coping healthily and all that, but my mom was recently diagnosed with a disease that is going to kill her with in the next few years. It shook me to the core, and I've been watching all the progress I thought I'd made unravel over the last few months.

I saw a quote online somewhere that said something to the effect that anxiety is like being in a video game, hearing boss battle music and being stuck in fight mode whether an enemy ever appears or not. The quote had this cute, snappy way of saying it, but I think you get the idea. That has been me for months now, and it's freaking exhausting. I'm snappish, tired all the time and easily overwhelmed. I can't stand to be touched, even by people I like, and I have no motivation to do even the simplest things I usually enjoy. I had hoped that once the shock of my mom's illness wore off things would level off, but it's not. It's getting worse.

My boyfriend and I went out to dinner last night at a popular pizzeria in town. In hindsight, hitting the place up at 8pm the Friday night before St. Patrick's Day was probably not a good idea, but it's always those little things I don't think to think about that get me. The place was packed and beyond noisy,. Nothing bad happened, but we still ended up having to cut our dinner short and come home because I was so overwhelmed. I came home and bawled like a baby. Ugh. I always feel so embarrassed about it, even though I know that bottling it up doesn't help me in the long run.

Anyway, It's become increasingly obvious to me that I need to find myself a good therapist. It's been a long time since I was in therapy, and I can't say that I ever had a therapist that I really felt understood the whole picture of me. There was always a part of me fighting the help because I felt I needed to push back against incorrect assumptions about myself.

I find the thought of going back intimidating. I'm not afraid to do the work. Okay, who am I kidding? I'm terrified of it. It's hard and it hurts, but wellness is more important to me than my fear. I just don't want to bare myself to someone who doesn't have the skill or emotional IQ to handle the complex issues I need to explore to find the path back up out of this hole I've found myself in.

Sooo, my question to you guys are these:
How did you go about selecting your therapist?
What are questions you wish you'd asked your therapist before you started seeing them?
Do you have and tips or tricks you use to see if a therapist is a good fit for you?
What are things you've learned to recognize as a sign your therapist is not the right one for you?
Any other nuggets of wisdom for me?​
 
How did you go about selecting your therapist?
What are questions you wish you'd asked your therapist before you started seeing them?
Do you have and tips or tricks you use to see if a therapist is a good fit for you?
What are things you've learned to recognize as a sign your therapist is not the right one for you?
Any other nuggets of wisdom for me?

It's a little different in Canada, but I lucked out with mine. I called the office, and requested to see a therapist. Since I somewhat work in the field, and we live in a smaller town, the first person they suggested I declined because I went to high school with her. The second name they gave me was someone who happened to be able to get me in that night, so I agreed. Obviously it takes a little bit to get to know a person (therapist or not), but I enjoyed meeting with mine instantly. I am someone who questions everything, so perhaps that's helped me throughout this 'journey', but I thoroughly love how my therapist is very confident and assertive, yet down-to-earth and genuine. She doesn't feel me bullshit, and she doesn't try to play games with me. The best 'nugget of wisdom' I can offer for you is to not look for 'tips and tricks' to know if it's a good fit for you. Ask your questions, get your own vibe from them and evaluate how you feel. In a sense, it's much like dating. What qualities do you like in a person? Which ones do you dislike? As well, it's important to ask/ choose someone who happens to have a speciality in the area your require. The best is when you find a wonderful mixture of personality and brains. Personally, my therapist could be the smartest person in the world (I actually do highly regard mine for this), but unless you can also show you are a real human being too, it means nothing.
 
The last time I found a new therapist I was able to find someone I really liked and we are working well together. Decide what's important to you first... who are you most comfortable talking to? For me, that would be a female within 10 or 15 years of my age. I'm in complete agreement with @Justmehere in that just because they list trauma as a specialty, most therapists don't actually work with a ton of patients who have been through big T trauma and/or have ptsd. That's been a real game changer for me. Yes, they're all trained in how to handle trauma but not a ton of them choose to stay truly trauma informed with the latest research, continuing ed, etc.

It's usually a lot easier to tell if it's a bad fit simply based on their communication and intake questions. One therapist I interviewed asked me extensively about my religious beliefs. While to many people that may not be bothersome, to me it was. She was otherwise great but that made me uncomfortable. Maybe she would've been the greatest fit in the world for me but I don't have the time and money to see someone for 4 or 5 sessions before I figure out if that one sticking point is going to be an issue. Conversely, I had a therapist that I worked with for about 6 months that I really liked a lot, but in that situation it wasn't a good fit therapeutically.

For me it's also really helpful to know that they're someone who has a similar background (to a point) or personality. I'm gay, so finding a therapist that specifically listed lgbt issues as a specialty was a big deal. Most therapists are completely fine working with lgbt clients, but it's the fact that they went out of their way to make it clear that I would be accepted (even though I don't really have any issues related to my sexual orientation).

I'm terrible at talking about my past, but it's important in your intake interview to be honest. You don't owe them any answer that you really don't want to give, but you're only prolonging the suffering and making it harder to find the right person if you're skirting the issue. "yep. I have depression, anxiety, adhd, and ptsd. have had panic attacks x amount of time. diagnosed with the others when i was xyz ages. the ptsd stems from x event. i have a history of xyz." If they can't handle your answers then they will likely refer you to a colleague who can better suit your needs. Don't get discouraged if that happens- think of it as them doing the leg work for you to find the best care.

Good luck!!!
 
I think the responses above cover the things that i considered when i chose my T.
I did look for someone who specialised in trauma and i wanted someone who was emdr trained. I did meet one t who i just couldnt gel with and i felt like i actually knew more than her!
The t i ended up working with was a consultant pyschologist in the NHS so i knew she had the credentials , was a trauma specialist, also experienced in numerous therapies inc emdr and experienced in dealing with csa. I had to be careful who i was trusting my brain with ! we just clicked and i quickly trusted her implicitly. Turned out i chose the right T.
 
I think much depends on where you are tbh. In the U.K. I’d say really look at their training, whether they’re registered with a regulatory body, how much experience they have generally (not how long they’ve been practicing - someone could technically have been in practice for 5 years seeing 2 clients a week or have been in practice for 2 years seeing 20 clients per week - I’d be heading towards the latter).

The kind of work they do is also important ie are they used to doing longer term work or has most of their experience been in short term, time limited work, eg providing student or workplace counselling. I don’t want to get into things and find out they don’t know what happens after session 12.

I want them to have a good mix of stuff that they work with so yes, the trauma part is very important in terms of experience but I also don’t want someone whose whole caseload is trauma work because I need to know they can look after themselves and balancing their case load is part of that. I also want them to have regular supervision and to have been in therapy themselves at some point in a long term basis - these two are an absolute dealbreaker for me.

For me, their core training was important, I wanted someone who’s initial training was in Client Centred Therapy and who had gone on from there to do trauma specific training. The client centred part means they should be able to offer a very safe relationship without getting caught in transference and counter-transference - but I want them to have a wide knowledge base so I’d be looking for training and academic work beyond their core training. Unlike a previous poster, I wouldn’t want a clinical psychologist because many don’t offer therapy as such and I don’t like the medical model of working with mental health issues.

On a personal level I need to “click” with them, they need to be wholly accepting of me, clear with boundaries but flexible enough when I need them to be. I need them to really get why something is an issue for me and be very prepared to sit with me in some very dark places without feeling the need to rescue me or move me along. They also need to set their fee at a reasonable level - the profession in the U.K. isn’t like the States, folk mostly pay out of pocket here and while I firmly believe people should be paid for their work, I’m not prepared to pay more than my car payment every month in therapy fees.
 
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I know I posted this a while ago. I kind of wandered off to deal with some things. I just wanted to say thank you for all your feedback. I appreciate it.
 
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