Wednesday, April 15, 2009

Finding a therapist

(this is an excerpt from a book I am writing on living with ADHD)

Therapy is a relationship with someone who is a few steps ahead of you. It is important to shop around until you find someone you are comfortable with. I will share with you some of my own preferences when I was looking for a therapist. I wanted someone who would share her own life with me when it was instructive to the therapy we were doing together. I preferred a woman because I wanted someone I felt understood women's issues and who communicated the way that I did. I also did not want the hassle of falling in love with my therapist in a sexual way. I felt safer working with a woman. Since I was working on addictive issues I wanted someone who had been to meetings and preferably was recovering. If they were not recovering I wanted them to be familiar with the 12 steps and who had been trained in addictions and codependency. Lots of therapists don't even believe that codependency exists. In my opinion, they just don't get it. I also wanted someone who understood the whole medication thing and who was comfortable working with MD's who prescribe medications. I found out later while working with my favorite therapist, Sally, that I needed someone who knew about sexual abuse and wacky family dysfunction as well.

I got lucky. At the time I did not have any idea what I needed. I just needed to feel comfortable to share my secrets and to know that my therapist was not perfect or holier than thou. Now I know and that is why I am attempting to pass this along to you.

I think it is very important for a therapist to admit mistakes when they happen. I happen to have a very shoot from the hip, blunt, forthright style. Because of this I occasionally will hurt a clients feelings. If they feel safe enough with me they know that they can confront me and that I will make amends for my error. This builds relationship.

As you can tell I am not much for the detached professional demeanor style of therapy. Some people need this to feel safe. They don't want to feel that their therapist even has a life. They want the therapist to just be there for them. This is fine too. It just important to know what you need before you go in to interview a therapist. That first session should be an interview. Do not feel obligated to return if it does not work for you. Your therapist works for you. You can hire or fire her or him at will. Just be sure that you are not avoiding the truth by quitting a particular therapist because she said something that was upsetting. First confront them with the upset and then see how they handle it. If it goes well and you feel that you were heard and acknowledged, then you will feel safer to expose yourself and to be in her care.

Again, it is important to be able to have a functional relationship with your therapist. If you are being diagnosed, it is your right to know what your diagnosis is and to be able to process your reactions to that diagnosis. If your therapist wants to recommend you to be evaluated for medication, she needs to be able to tell you why and to have a basic knowledge of brain chemistry and how medications work.

If you are into spirituality in your life it is a good idea to find a therapist who is open and well versed in her own spirituality. I am a Buddhist practitioner. I tell my clients that up front. I also let them know that I know a lot about Christianity and metaphysics too. I am able to convert many of the principles in Buddhism to similar Christian principles. If you are not at all into spirituality, your therapist should shut up about the subject and respect your point of view. It is a very bad idea for a therapist to impose their own world view on a client. I always ask permission to share about what I know about Buddhist principles. If they say no, which actually is rare, I don't mention it again.

Most of all you need to feel safe and comfortable while having respect for your therapists knowledge. I look at the therapeutic relationship as being sacred. It has the potential of being much more intimate that regular relationships. For this reason it is important to have a therapist who will not mix up the relationship with friendship. You may love each other very much but only in this very sacred professional way. I go to meetings and often see clients there. I will do fellowship after the meetings in the form of lunch or coffee and I don't hesitate to share these moments with my clients as long as it is in the context of the meeting. This is very difficult in a small town and I recommend talking freely about it with your therapist. This relationship is so sacred that often clients want to be friends too. I explain in the most loving way possible that I would not want to violate or taint the amazing thing that we have called the therapeutic relationship. It is difficult for many clients when they hear this and they may feel rejected. I try to be as compassionate and loving as possible as I explain the sacred nature of the relationship.

I hope this is helpful to any of you who feel that you might need therapy. It is a great and very bumpy ride full of surprises, thrills, and disappointments. Good fortune on your journey!

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