Some folks think you book a mental health professional and they’re all doing the same thing. Some folks think that once you start therapy with one provider, you have to stay with that person. I want to share a ittle about what I’ve learned about those two assumptions, as I’ve recently been talking to friends about finding a therapist. I’ve been in and out of shrinks’ offices for all of my adult life and I wanted to put something somwehere in writing about things I’ve learned for myself about how to connect with a therapist.
HUGE DISCLAIMER: This is a personal account of my own layperson’s experience in thinking about therapy. THIS IS NOT PROFESSIONAL MENTAL HEALTH ADVICE. (To that end, I can’t respond to messages or notes that ask me for opinions or advice. I think you should speak to a mental health professional.)
First of all, I understand why people hold a deep skepticism about mental health practices in the U.S.—critiques of everything from colonialist to racist to patriarchal etc. etc. views. It might not be for everybody, and some people come to accepting therapeutic approaches to mental health at very different times in life. Some never do it. There certainly are other ways to do what therapy does (community, ritual, and a whole slew of traditions). Furthermore, I don’t think of therapy as a way to fix anything. I think of therapy as pretty similar to my processes in writing and artmaking. I’m there to try to articulate and ask questions in a fairly open form. And sometimes—many times—I fail at trying to articulate and ask rhose questions. Therapy, for me, is a process (like poetry) of memory, observation, and imagination, and an opportunity to slow down, immerse myself into or emerge from some feeling that I can’t quite describe… yet.
I should say that this particular idea of therapy — a way to ask questions — has sjown me that I simply respond to psychodynamic approaches better than, say, cognitive behavioral (CBT) approaches. CBT is great for folks who want concrete strategies they can apply to their lives. Psychodynamic has always struck me as closer to my writing life. My first therapist was super traditional in his psychodynamic practice, in that he hardly said anything at all during our sessions. That’s kind of the point, that one addresses another person, speaking and speaking and speaking—hopefully with less and less inhibition—until some insight enters through the speech. Maybe some connection gets made or a particular word comes up spomtaneously that is charged with memory. And I gotta tell you, that phenomenon is very close to the pheneomenon of writing a poem in my experience. So it’s important to know 1) that there are different theoretical orientations to be aware of (another that I seem to respond well to is Family Systems, by the way) 2) it might take a while to figure out which theoretical orientation you respond best to.
That leads me to another thing that I’ve learned over the years having worked with a number of therapists. Your first therapist might not be the one you end up working with. That might have to do with the fact that you don’t click with their theoretical orientation, but it also might be because you don’t click with that particular therapist. You’re working on some really deep memory and the core makeup of your psyche. Not every professional is a fit. Sometimes (oftentimes) chemistry is a huge factor in whether or not the sessions work. Sometimes you know right away whether or not this person is going to work out. You gotta be patient in this regard. Sometimes you have to meet with a single therapist a few times before you really get a feel for their approach. And sometimes you have to meet a few different therapists before you match with one whose approach and vibe work for you.
That’s all to say, it can take some time to find the right therapist. That can feel impossibly challenging if you’re in crisis mode. It seems to me there are few quick fixes. My best experiences have been therapeutic relationships that have lasted at least a year. And sometimes insights don’t happen for months or years after a therapeutic relationship ends. It feels really important not to rush the process of either finding a therapist or the process of therapy itself.
This leads me to one more guideline for myself that I learned somewhat later in life. This one is very practical: I always, always ask in the very first session with a new therapist: What is the protocol for terminating our sessions? I think it’s very easy to feel obligated to stay with a therapist when it’s just not working out. I do think you should discuss with your therapist if you have questions, concerns, or feel discomfort about what you are or aren’t getting from your sessions. Sometiems you just know right away that it’s not a good fit. Sometimes it takes a while to know that. In either case, you have every right to step away from a therapeutic relationship, and you should ask how that’s done right from the beginning. In part that’s good, practical information, but also it’s a way to remind and empower yourself in case you do want to find someone who is a better guide for the inner work you want to do.
This is an era when it’s easy to feel disconnected from the world, your neighborhood, your family, your social circles. I think people are turning to all kinds of things—some useful, some absolute trash—to help them get a hold. Therapy has been one way for me to tell myself a new story about my fear, anxiety, joy, excitement. For me, it really does accomplish things that my writing alone cannot. But both my writing and my work in therapy have felt like corresponding spaces—two places for me to bring my confusions and maybe even make meaning.