There seems to be a common misconception floating around that you are somehow limited to the first therapist you either choose or are assigned to. A great many people seem to be under the impression that receiving successful therapy that offers a solution to their existential crisis is as simple as walking into a pharmacy and purchasing a remedy for the common cold.
The truth is that there is no one-size-fits-all approach to therapy where you can pair up two strangers and they’ll automatically connect and understand one another. Humans are far from straightforward beings even at the most emotionally stable of times, never-mind when you add factors such as depression and anxiety into the mix!
In fact, engaging in effective therapy sessions and actually taking something useful way from the experience is something that is as desirable as it is infinitely complex. It not only requires you to accept your own vulnerability but to express your darkest thoughts to somebody you barely know.
I remember nodding politely whenever my therapist, with her forced smile and air of nonchalance came up with what seemed to be the most manufactured and generic of ‘solutions’ to my depressive episodes. Despite having previously turned to coping mechanisms such as meditation, regular exercise and maintaining a healthy diet, I couldn’t hold back the tide of depressive and suicidal thoughts that threatened to submerge me.
And so I sought out help in a move that I believed would help me better myself and for a better future.
Sadly it did not quite work out that well!
I recall being told to ‘keep smiling’ and to ‘be happy as I had a good life studying for a degree in something I loved’ every time I voiced a concern and this did little to help me in my time of mental distress.
It’s disheartening enough to hear these maxims from an uninformed, if well intentioned friend or family member; it is absolutely soul-wrenching to hear it coming from a supposed mental health professional.
After a while, I failed to see the purpose in even attempting to explain my issues to this therapist. It even got to the point where I’d make up things on the spot, reasoning that I needed something to fill the time left as opposed to sitting in stony silence with someone who did not seem to care to know or even want to understand the nature of mental illness and how it was actually impacting me and my life!
I sometimes even caught her eyes darting eagerly towards the clock situated on the wall adjacent to where we were seated, as if she were counting down the seconds until our session would come to a welcome end.
‘You don’t buy the first pair of shoes you try on […] and this is a lot more important — and expensive’
I could and should have done things differently, and it is with the benefit of hindsight that I now know what to do should such a situation ever arise again.
While my power to alter my choice in therapist was limited by the fact that I was seeking out help from the National Health Service (more on the drawbacks of this here), I could and should have stood my ground.
According to a survey conducted on nearly 2,300 psychologists in the United States, only 69 percent of them actually used C.B.T. part time or in combination with other therapies to treat depression and anxiety. This has been attributed to some therapist’s biases and training taking precedence over the latest research findings.
As much as therapy does need to address and delicately handle those who are being rued by their emotions, without an underlying foundation of empirical evidence to fall back on any effort to help such an individual will surely collapse under its own lack of scientific evidence?
There is nothing wrong with art in the conventional sense of the word, but there is something questionable about it when it is being applied to real people with real and potentially life threatening mental health issues.
Furthermore, on the authority of a recent report carried out by mental health charity MIND, nearly three in five people aren’t offered a choice in the type of therapy they receive after they sought out help for their issues in the first place.
This would correlate with the statistics attained by NICE, in which Cognitive Behavioural Therapy (CBT) accounted for 38% of the total appointments (approximately three billion appointments) in 2013-2014 alone, thus making it the most common form of therapy in the IAPT programme. This lack of transparency is arguably going to have a detrimental effect on the mental health of those seeking out support!
While as mere recipients of such a health system and not its organisers, there is not much we can do about its flaws. We can however take affirmative action to ensure that the treatment we receive is the right one for our very specific problems. According to Dr Jacqueline Hetherton, a clinical psychologist in London, ‘a good first place to start is by seeing a clinical psychologist who can direct you to where you need to go’ as you will need ‘to be assessed and advised on what sort of therapy you need.’
In addition, assuming you have the financial resources (more on that here) and means to see a therapist of your own choosing, it turns out much of the preliminary work is relatively simple; it does however require a lot of research and self determination, and I will go into the some of the details of things to look out for below.
‘A good therapist is nonjudgmental, accepting, and patient. Otherwise, our patients are just getting what they grew up with’
A private practice psychiatrist
Starting with the basics, think about the gender, age, cultural background and ethnicity you’d prefer your therapist to be. While for some people such details are irrelevant, for others communicating with someone who looks and sounds like them can make a world of difference and actually increase the likelihood of them being willing to open up to said therapist about their problems.
As a general guideline, it is said that a good therapist:
- listens to what you say
- values what you say
- shows empathy and understanding
- doesn’t talk down to you
- checks you’re getting what you want from therapy
- deals with any worries you may have about the therapy, such as how you’ll manage when it comes to an end
In regards as to how you can come to a judgement as to whether the therapist you’ve been assigned to is the best fit for you and your issues, here are just some questions you can ask:
1. What kind of specialized training have you received related to my particular problem?
2. Why did you choose this career path?
3. What is your training and certification?
4. How long have you practised as a therapist?
5. Have you worked with others with a similar issue/background to me?
6. Are you a member of a reputable professional body such as The British Association for Counselling and Psychotherapy, The United Kingdom Council for Psychotherapy, The British Psychoanalytical Council or The British Psychological Society?
Keep in mind that while it is important an ideal therapist isn’t someone who talks down to you, it is equally as important that they do challenge what you say and that they do question your line of thinking in emotionally troubling situations. This essentially means that if you find them blindly agreeing with everything you say and perhaps even making light out of every dire circumstance you find yourself in, it is time to reconsider your options.
‘If you fundamentally don’t believe it is possible to completely reprogramme the way you think, you might not feel convinced that cognitive behavioural therapy is the way to go’
Professor Stephen Joseph
Author of Theories Of Counselling And Psychotherapy: An Introduction To The Different Approaches
If any of the above resonates with your experience with therapy at all, the therapist is not doing the job they are being paid for, and you are not getting anything but a false sense of complacency out of those sessions!
Perhaps when all is said and done, there is the option to call time on sessions with therapists who show no sign of connecting with you. Of course, it may be easier for this to be done via email or by phone as opposed to a potentially awkward face to face conversation.
‘Seeing a therapist who doesn’t do her own therapy is like going to a priest who has no relationship with God’
Writer and a licensed marriage and family therapist
Of course, always be wary of the possibility that your desire to discontinue with therapy may not always be due to the therapist themselves, but due to your own reluctance or inability to disclose your mental health problems in a productive way!
‘The idea of therapy as an art is a very powerful one […] Many psychologists believe they have skills that allow them to tailor a treatment to a client that’s better than any scientist can come up with with all their data’
After you’ve exhausted yourself out with excessive drinking, explosive arguments with loved ones and various episodes of mental breakdowns, you tend to reach a point when you suddenly realise that its time to leave the battlefield and go and get properly stitched up.
Be forgiving, but don’t be shortsighted; at the end of the day you are the one who is suffering and you need to put yourself first! It is important to remember that the optimal outcome of therapy, regardless of whatever variant of it, is to give you the inner resources to effectively manage your mental issues, as opposed to ‘curing’ such problems!
Self care is often undervalued in our increasingly fast-moving society and the stigma that comes with accepting help in times of need can be an obstacle to accepting outside help as well. This however does not mean that you need or have to settle for second best!
There is surprisingly, always hope.
Did you know?
In the UK at least, the profession is completely unregulated. Meaning that hypothetically, somebody with no training nor qualifications can call themselves a therapist . Even more reason to be thorough with your research!
Remember that there are a vast array of different kinds of therapy on offer:
– In the case of you believing that there may be an unconscious motivation for your behavior, you might want to go to a psychodynamic therapist.
– If you don’t ever want to talk about mom and dad and you only want the here and now then maybe narrative, behavioral, or solution-oriented therapies are something to consider
– If you want to change your thoughts and you think doing that will change your life, and you don’t believe in an unconscious, then you might want a cognitive therapist.
– If you want to work on your family and not just on you, then try a family-oriented systems therapist.
- The British Association for Counselling and Psychotherapy (BACP) recommends a minimum of 400-450 hours college-based therapy training for their something, so it is worth inquiring with your therapist as to the depth of their experience and qualifications and what that this could subsequently mean for you and your treatment.
The latest figures from the British Association of Counsellors and Psychotherapists show 94% of us now believe it’s acceptable to turn to talking cures for conditions such as anxiety, compared to just 67% in 2004. So regardless of whatever your specific issue is, there may be some comfort in knowing that it is considered the norm by the vast majority of society!
It is also worth stating that even if you are in a position where you cannot afford a conventional psychologist, consider a university clinic, church group, or supportive subreddit – there are always options!
A registered charity whose comprehensive list of information is a very useful resource!
A list of warning signs to look out for in any case of a bad counselling and/or therapy!
A website that is designed to explore many different aspects of therapy such as the kind of therapeutic approach that might work best for you and the duration of therapy, personal traits of the therapist such as age, language, culture, sex and race.
What are your thoughts on what an ideal therapy session should look like? Have you or a loved one struggled to find a therapist who ‘gets’ you? Let me know in the comment section below!
Emotional support helplines:
Samaritans :116 123
Rethink Mental Illness advice line 0300 5000 927 (Monday to Friday 09:30-16:00; local rate)
Sane Line:0845 767 8000
Mind also has a useful guide of support and services, which can be found by clicking the link right here