Finding your first therapist. What you need to know.

Going to therapy for the first time or going to a new therapist is a bold step. Thus, it might elicit some strong feelings. For example, will I make progress? Is this person a good fit for me? What if I feel worse? These apprehensions are expected, and they accompany the process of entering therapy. It is totally okay to ask yourself these questions, as most people do. In addition, going to therapy might bring to the surface strong emotions and feelings - fear, anger, shame and so on. It is normal to feel them as you have already unconsciously started your therapy the moment you made the decision to go. Your feelings are waiting to be addressed, so they start to make themselves obvious. This is also normal at this stage, and you don’t need to feel alarmed by their presence.

Here are some things to consider when starting therapy.

-Chemistry with your therapist is vitally important . As psychiatrist and psychoanalyst Dr. Glen Gabbard wrote, therapeutic alliance is the main predictor of success in therapy; your therapist’s approach is less important. If you have working contact and are building trust, and as a bonus are able to see and appreciate the small successes that you are making as therapy progresses, then you are going in the right direction.
-Working with two therapists at the same time might not be the best idea, as it contributes to the defense mechanism called splitting. The client unconsciously splits two therapists into the good one and the bad one, and the good one gets all the good news, while the bad one gets only the bad news. This splitting prevents unification of good and bad within oneself and being able to deal with them at the same time and integrate them. It is recommended to find one therapist and deal with negative and positive things together.

-Determine your objective. Different needs influence your therapy — are you coming to therapy to learn how to be happy, or are you in acute onset of PTSR? Do you want to improve relationships in your life, or are you coming to grieve? These are different goals that will influence your choice of therapist. Someone working well with acute stress does not necessarily work well in long-term open-ended therapy dedicated to treating separational depression, for instance.

-While you may decide which therapeutic method you prefer, you won’t know which will suit you until you try it. Some people respond to cognitive-behavioral exercises, some to emotionally focused therapy, some to bodily therapy, some find solace in psychoanalytic approach, Here, you really don’t know until you try, as you might think that you’ll respond to one system when in reality you respond well to another thing.

-Some need to be in therapy longer, and some will find short-term therapy to be sufficient to reach their goals. It is, however, better to be ready for long-term therapy at the outset, because it will take off the pressure of expectations from yourself to “do well” at the very initial stages and for your therapist to do equally well. This initial expectation of fast results, combined with the fear of the therapy being ineffective might increase anxiety and hinder your success. If you are prepared for lengthy work, you will be more at ease. Another alternative is to decide on a pre-set number of sessions. This way, therapy will give you predictability and you will be able to draw conclusions regarding your progress in a set timeframe, and to continue as needed The way I work, for instance, is I set an unlimited number of sessions for a client, giving them the opportunity to decide when to terminate therapy, while at the same time talking about our work and client’s progress around the fifth session.

-If you feel no progress, it is beneficial to talk about it with your therapist. Lack of apparent progress in therapy is a good subject to raise, because you might be making some important progress that you are unaware of while being conclusively focused on other progress that you have been craving (but its time has not yet come).

There are some common misconceptions about therapy — and therapists — that may come up in your therapeutic journey.

-You might develop strong negative feelings toward your therapist early on — does that mean they are unprofessional? Not necessarily. Freud described the notion of “transference” that occurs in therapy sooner or later. It is a way of communication by which we tell the therapist about our condition. In this case, the hate or strong anger might not be evoked by the therapist themself, but is directed to some other significant figure in your life and manifests in the presence of your therapist. The occurrence of transference of any strong feelings toward the therapist is actually welcomed in therapy, because it’s a sign that the client feels confident and safe enough to bring them into the therapeutic environment. Sometimes it is hard to talk about these feelings, but it really helps when they are discussed as they provide deep insight into your condition.

If you are NOT feeling somewhat uncomfortable in therapy, something is not right. Therapy is not only about listening — it is about changing things and overcoming challenges. Sometimes, the therapist and the client establish an unconscious pact — the therapist doesn’t challenge them or go to places that feel uncomfortable to the client, and the client just does the “required” part: attends, pays, and talks. In this case, therapy may appear as happening on the surface, but the deeper work is actually sabotaged by two sides. At the same time, if therapy is devoid of happiness, something is wrong. As a client, you definitely need to be able to experience satisfaction from yourself and find resources, sources of joy, and so on, while not denying the importance of facing difficulties that brought you to therapy in the first place.

-Some people believe that therapists are only there for money. There are definitely unscrupulous people in any profession, however, the therapist profession usually draws people who care about other people. Otherwise, they wouldn’t be able to deal with all the suffering that people bring to them. Imagine consulting 15-30 clients with different issues, ranging from emotional suppression to trauma and addictions to suicidal conditions. One needs to have a high inner motivation to continuously deal with these difficulties, and money by itself is not a sufficient factor

-Clients often worry that a therapist can’t help them, and in fact nobody can. Granted, therapists are people and have their limitations, both personal and professional. Sometimes therapist is indeed not being able to help. This is often perceived by new clients as rejection, and they might abandon further attempts to seek a new therapist. The pain of rejection in this case can be too high, especially when what initially brings many people to therapy is trauma from rejection. I would like to encourage you to not give up. Perhaps your therapist can recommend someone who they think will be right for you. Perhaps their supervisor can advise them on who can help you or how they themselves can better help you. Perhaps you found a great therapist, but they are overbooked — you can still reach out and ask for recommendations.

I encourage you to seek and ask questions, as finding the right therapist for you is like finding a trusted dentist, insurance agent, mechanic, or accountant — they will be with you for the rest of your life.

I hope this has been helpful and will lower your anxiety in the search of a therapist that is right for you. You are starting a very exciting journey of changing your life for the better, doing things differently, and discovering the new you, which you’ve always known to be there.

Bibliography:

Yalom, I. (2017). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients (Paperback).

Gabbard, G. O. (2017). Long-term psychodynamic psychotherapy: A basic text (3rd rev. ed.). American Psychiatric Publishing.

Full version of this article published by author on Complicated.life: https://complicated.life/blog/finding-your-first-therapist-starting-strong-and-overcoming-challenges/