Thoughts on Therapy and Therapists

I’ve started shopping around for a therapist. I am still doing much better than I was a week ago, but considering how low I was a week ago, it seems like a worthwhile thing to try. Time will tell if I managed to find an option that both works for me and is something I can afford. In light of the search, though, I thought I would write a few words about my thoughts on therapy and therapists.

Over the course of my life, I’ve seen a few different therapists. The first time I ever went to one, I only went for one visit. Not because the experience was bad, but because it was a one visit issue. I had a girlfriend who was going through some really rough shit at the time, and needed to process some things with a professional. The second one worked in the health center of my school at the time. I don’t really remember what I was dealing with then, but I saw him for a few visits, and generally liked him, but didn’t get a whole lot out of it.

The third one I went to, I went to for a couple of months in the middle of college. I didn’t like her. I didn’t dislike her, but I didn’t find that she helped me with the things I was going through very much. After a couple of months of seeing her, I realized that I looked on upcoming visits with frustration — it felt like all I was doing each time was reliving the shitty things that were going on in my life without managing to feel any better or do anything about them. After that, I searched around for someone else. I eventually got a recommendation that I followed up on for a therapist I was told was very good and very smart. The recommendation was spot on, and if I still lived near her, there’s a good chance she’s the one I’d be going to right now. Technically, she specialized in cognitive behavioral therapy, but as I remember it a lot of my visits focused more around just talking through things than anything else.

At the time, that was exactly what I needed. I needed someone to help me work through the things I was experiencing in the ways that I was thinking, and I needed that someone to be a good listener, and as good a thinker as I was. I needed someone who could follow my thought processes and add to them, and point out where they were inconsistent or needed to be worked on.

I’m pretty sure there was a time when I felt self-conscious about the fact that I was going to therapy. It’s hard to remember now, because I’ve gotten so used to the idea of thinking of a therapist as an important tool in my toolbox for dealing with depression that I can’t even conceptualize that self-consciousness very well anymore. Therapists can be good at what they do or bad at what they do, or they can be a good match for you in particular or a bad match for you in particular, but I don’t really get thinking of them as something to be ashamed of. I don’t get thinking of them as a tool that, if you use it, means you’re weak or broken. It seems much weirder not to go to one if it’s something you need – like if you needed to nail something down, and decided that using a hammer was a sign of weakness.

These days, when I think about looking for a therapist, the stigma doesn’t even cross my mind — I’m just thinking about what qualities I’m looking for. I know to look for someone who’s intelligent, who seems like they keep up with the latest research on therapies, who isn’t going to encourage me to try any of the dubious New Agey bullshit that’s out there, and who I generally get a good vibe from. These days, when I think about what I need from a therapist, it essentially boils down to a smart friend. I need a smart friend who knows about fixing brains the same way some of my other friends know about fixing cars. If I go to see a therapist, and that isn’t roughly the type of interaction I feel like I’m getting from seeing them, it’s probably a bad fit.

It’s struck me recently that every time I see therapy sessions portrayed in media, they don’t look at all like what I’m used to. In particular, recently I’ve been into watching the West Wing and Sherlock, both of which have episodes with therapy sessions that come off, to me, as astonishingly adversarial compared to what I’m used to. The sessions come off like the therapist’s job is to berate or verbally corner the person they’re “helping” into revealing or dealing with their emotions. In my experience, I’ve never had a session with anyone that even remotely seemed adversarial, and I think I would’ve immediately stopped going if I had.

Therapy helps me when it feels collaborative — when it feels like me and my therapist are working together toward a common goal. Generally, the goal is improving my mental health and habits. This collaboration works best if I get along well with my therapist as a person, just like I would want to get along well with anyone else I was working on a collaborative project with. There are good team members and bad team members, and there are team members who work well with you and team members who don’t work well with you. Judging a therapist by the same type of criteria I would use to judge anyone I wanted to work on a long-term collaborative project with has generally been a good perspective for me. The therapist is just a person you’re doing a very specific, personal type of collaboration with.

I feel like I should be tying this together somehow. I guess the message I’m going for is that therapy doesn’t make you weak, it doesn’t look like it looks on TV, it’s a useful tool, and that you shouldn’t give up on the idea if you have unhelpful experiences a couple of times any more than you should give up on cooking with friends just because the first couple of times you tried cooking with friends it didn’t go very well. Definitely give up on individual therapists if they don’t work for you (in fact, I cannot be emphatic enough about how important it is that you do give up on therapists who aren’t working for you), just don’t give up on the idea of therapy altogether because of them. The trick is to find one it reliably does go well with.

Those are my thoughts today.