Finding a Therapist

Dear Dr. Darcy

I’m one of the few New Yorker’s who has never crossed the threshold into a therapist’s office. I’ve been told that I should try therapy but I’ve always avoided it because I feel like I should be able to fix my own problems. I also hesitate to go because I don’t know what to expect. Hoping you can educate me on what goes on behind that closed door so I can figure out how to find a therapist.

ANSWER:

I’ll be happy to tell you what goes on behind my closed door & the doors of therapists who I’ve personally been a client of, but I hesitate to generalize and declare that these experiences are universal of how all therapists practice.

Let me start from my own experiences of being a client, with the disclaimer that I’m condensing them for the purpose of not putting my readers to sleep:

Of the three individual therapists who I’ve seen, all have been analytically trained. With the exception of my last therapist who I discontinued working with a little over a year ago, analytically trained therapists don’t do it for me. I find them to be far too passive, bordering on silent, not goal-oriented, certainly not solution-focused, all of which left me feeling as though they were, well… sort of lazy. Analysts are trained to be quiet so that the client will be forced to do most of the work. To be completely frank, I find this to be horseshit.

When I go to my accountant, I expect him to guide me on whatever financial issues I’ve brought to him. When I go to my attorney, I expect him or her to direct me on legal matters. I cannot imagine another service industry where it’s acceptable for the provider to remain passive, expecting the client to set the agenda, stay on the agenda, and remain unilaterally responsible for meeting the goals of that agenda. Most therapy clients don’t even know what they are specifically working on in therapy.

What makes it worse is that because it is so highly confidential, there is this weird veil on the therapy process which keeps it relatively secretive, keeping the masses clueless about what to expect when they see a therapist. With virtually no one knowing what to expect, clients have nothing to compare their therapy experience to and they often don’t know whether or not it’s working. I don’t have enough time to express to you the extent to which I take offense to this.

There are, however, therapists who take some responsibility for what their clients achieve in therapy. My most recent couple’s therapist demonstrated this, so I know I’m not the only person who practices with a commitment to doing some heavy lifting. The bottom line is that a therapist's training is a good indicator of what to expect, so ask enough questions to ensure that you find a therapist who is right for you.

My personal approach to practicing, which is considered a little unorthodox, is to frame it almost as though it were an independent study course; my client being the subject. My clients and I take notes throughout the sessions – I point out particularly poignant moments which warrant note-taking. My clients are given homework during every session which we review in the following session; each session builds on the previous session, creating a thread of focus culminating in the achievement of the client’s goal, which my clients and I establish together. When we achieve a goal, we identify the next goal.

I see my role as facilitator, therapist, coach and mentor, and I switch hats as needed. I will say that the amount of energy that I expend during sessions is multiples of what many of my colleagues expend, and for that I charge a hefty fee. But my clients get better, they achieve their goals and I pride myself on giving them the best services I’m able to render. Finding a therapist is like buying a car: You can buy used or you can buy a luxury brand. And like with most things, I believe you get what you pay for.