It seems like last week’s post Is Therapy Pointless for the Unmedicated Bipolar Patient? caused a bit of a stir. In the last week I’ve received quite a lot of responses with many different opinions on the matter, which have led me to the following conclusion:
people’s expectations of what having a relationship with a therapist means varies WIDELY, and there is no single answer when it comes to what folks expect their therapists to do for them.
On top of that, I would say at least 50% of the people I’ve talked to are unhappy with their relationship with their therapist and weren’t sure what to do about it.
Most responses I heard were very clear that the effectiveness relies, in large part, to having a patient/therapist relationship that works for you. Is therapy pointless? That depends on what you are trying to get out of it, and what your therapist is able to provide.
So I thought I would spend a little time today on finding the right therapist.
I definitely agree that getting what you want out of therapy can not only be tricky, but finding a therapist who is on the same page can be a grueling process as well. Should you pick one and just give them a go? Try out a few and then decide who you feel most comfortable with? There are a lot of different ways to go about this process.
Never had a therapist before? That’s ok. Here’s a quick rundown of how this process normally works.
If you are going to a clinic, there is usually someone who does an intake appointment, and the person usually is not going to be your therapist. You may or may not be charged for this initial evaluation, where you will be asked about your history and current situation. After a brief evaluation period you may get a call letting you know whether you have been accepted or denied into the clinic, at which point you will be scheduled with a therapist.
Clinics can be great because if you don’t mesh with your initial therapist, there are often many more in the same office you can switch to. On the downside, you don’t always have as much of a say in who you will be seeing specifically (at least initially), and having an intake appointment with someone who wont be your final therapist can mean telling the same story twice.
If you are seeking someone in private practice, you can often read people’s bios on the internet or get information through your psychiatrist or general physician. This can be nice if you already know that you are looking for something specific, like art therapy, for example. Generally I’ve found that private therapists will give you one free session to get a feel for how things fit between you, and do not require a next appointment right away.
Private therapists can be great if you are looking for something specific, and having a free session means you could potentially try out several before making a final decision about who you like best. On the downside, some will ask for a specific commitment period (which would mean agreeing to something like weekly sessions for a 6 month period), and they tend to be a little more expensive overall.
If you are short on funds there are a few options. Sometimes local schools have programs for those getting advanced degrees to become therapists which can offer free or low-cost therapy if you are willing to see a student. Sometimes this can mean being recorded or videotaped in your sessions so their instructor can review how they’re working, but this is something that can be helpful in a pinch if you can’t afford any other options.
On the plus side, potentially free! On the downside, these folks are much more inexperienced so it is possible that having a diagnosis such as bipolar disorder may not qualify you for therapy at their level.
In addition to where the person is practicing and what the cost is, there is more you’ll want to consider. I know, shocker right? Some people don’t take the time to read any further into what they’ll be getting out of this relationship though, and those tend to be the ones that are frustrated or disappointed with what they get. It is ok to be picky. Granted, some people have limitations based on the population of the area they live in, which is something I’ve had to deal with in the past, but there is a big difference between compromising and just saying yes to the first person you meet.
Here are the three things I would consider, to get a better understanding of what I’m looking for:
1. What kind of values are you looking for in your therapist?
At the same time you can ask yourself, what kind of values do you have? Is natural or alternative medicine something that appeals to you? Are you interested in an artistic or spiritual approach to whatever you’re dealing with? Should the person be LGBT friendly?
My own therapist is really big on reinforcing that she doesn’t look at anyone as a label or specific disorder, she considers everyone she sees to just be people, all on a level playing field. That is a value that is important to our relationship.
Some people aren’t particular about the values of their therapist, which leads me to the second consideration,
2. What kind of perspective are you hoping to gain?
Do you want a therapist with the same values as you, or are you hoping to gain an “outside” perspective? Some people chose their therapist based on what perspective they hope to gain. Personally, I feel more comfortable with a woman therapist, and it isn’t that a man’s perspective isn’t valuable to me, it just isn’t as helpful with my own personal situation. Are you potentially interested in a therapist who is much older than you, or one around the same age? It all depends on what kind of perspective you’re interested in and who you feel comfortable with.
3. What do you expect your therapist to do for you?
When you enter into the initially awkward, yet sacred bond between patient and therapist, what are you hoping to get out of it?
I’ve seen a lot of therapists, and they almost exclusively start the relationship by asking what goals I wish to achieve by participating in therapy. My mind always goes blank and I never feel like I have a good answer, or at least the right answer, as if there is one. The word goals is what usually puts me into a stupor, I’m quickly sent back to school in my mind trying to figure out what my goal is, in regard to how quickly I want to be able to run a mile in class. Since this word makes me like a deer in the headlights, I’ve tried to go about this a different way. What is at the core of the very reason I’ve agreed to see a complete stranger in the first place, what services am I expecting this therapist to provide?
I think this is the part where debate about whether therapy for unmedicated patients is pointless or not becomes murky. Most responses I heard were very clear that the effectiveness relies, in large part, to having a patient/therapist relationship that works for you. Is therapy pointless? That depends on what you are trying to get out of it, and if you’re therapist can realistically give it to you.
If the point is to cure one of bipolar disorder, it’s pretty easy to argue therapy will fail, and is therefore pointless.
There are a ton of other, more realistic reasons for seeing a therapist though, some of which may have gone unconsidered. Here are a few of the big reasons people seek out therapy:
- A Mentor
Many perfectly “mentally healthy” people see a therapist as a mentor-type figure. Someone who can help weigh the pros and cons of potential big decisions, or give advice on how to conduct onseself in particular situations.
- Career Therapy
Some people, especially those unemployed, can seek out therapy to help figure out their career goals. If you’re switching industries or want to make a change to another career path, there are therapists who can help with that specifically.
- A Spiritual Guide
Some people seek out therapy with the intention of finding someone with similar spiritual beliefs that can help guide them. When folks don’t exactly agree with the modern forms of treatment, this is a common alternative, and I’ve seen that there are therapists available in a number of religious and spiritual concentrations.
- Releasing Steam
Some people have friends or relatives that they talk to on a regular basis about their lives to release steam and let off some pressure, but some people don’t -or don’t feel comfortable talking about specific topics with the people they know. Therapy can be a great way to release steam and decompress when something particularly aggravating is going on.
- A Support Person
Sometimes we just need a supportive force in our lives, right? For anyone who has been around a lot of negativity, having time around someone who is supportive and can praise our accomplishments can be a big mood-booster. Having that extra support can also mean the difference between succeeding in overcoming a problem, and not.
- Friend With an Outside Perspective
Many of us surround ourselves with friends with similar values to our own, so some people really find it helpful to have another “friend” who can look at situations from another point of view. Maybe you’re not religious, but your therapist is -can you work together to find common ground to feel good about each other? This is great for people looking to get a more “well-rounded” perspective on things.
- Learning Coping Skills
This is a common theme among many therapists, they usually want to teach “tools” on how to cope with various situations. This can be helpful for things like anxiety and stress, as well as bipolar disorder, PTSD, & more.
- Gain an Understanding of Mental Health
For many people, therapists act as a sort of “mental health 101” in regard to informing people about the ins and outs. If you’ve just been diagnosed for the first time, chances are that a therapist might be able to give a little more insight into the world of mental health.
- Heal From Trauma or Loss
It is common for people to grieve the loss of their “easy” life after being diagnosed with bipolar disorder. This process can take years and a form of acceptance can be difficult to reach, but therapy could potentially help. It could also be helpful in grieving any kind of loss, or grieving and healing from past trauma. This is something that can be very uncomfortable, so building a stable foundation with your therapist before starting on this process is considerably helpful.
- Build Stronger Relationships
It is said that our relationships are based on the ones we grew up around, so therapy is important to a lot of people for either building a new, healthy relationship or learning ways to make a current relationship stronger. These could be relationships with anyone from co-workers, friends, family, or partners.
- Change Thought Patterns
Low self-esteem from negative thoughts about your self, or negative/unruly thoughts in general? Some people find therapy helpful in alleviating these, as well as obsessive or other harmful thought patterns. Keep in mind, this is not something that will change overnight, but with time changing thought patterns can be exceptionally helpful for changing one’s life for the better.
- Change Behaviors
Some people want to change certain behaviors but don’t know where to start. Things like addiction can be particularly daunting, so having someone who can guide you through the process can be very helpful.
- Relating to Others (group therapy)
Many folks facing big issues in their lives feel isolated, group therapy is awesome for getting a chance to relate to others facing similar issues. This can add a lot of perspective and give some the inspiration to persevere in situations where they may not have otherwise.
- Understanding the Self
Sometimes I ask myself, “why do I do what I do?” and nothing has been more helpful in answering those questions than therapy. We are all such complicated beings that there is usually more going on than meets the eye, and my general thought is that I might as well get to know myself as best I can -we’re going to be stuck together for a while!
- Improve Communication Skills
Is there a topic in your life that you have trouble talking about with others? Or are there situations where you feel your ability to communicate is hampered? Maybe to your boss, or to strangers, or your family? Therapy can be a great way to learn new methods of communication and improve what you’ve already got!
There are certainly plenty more reasons to see a therapist, but I’ll stop there. I really just wanted to give you some idea of the scope of what is available, and what some people find helpful.
Once you figure out what you’re looking for, it is important to discuss what you’re looking for in the relationship and what you’re trying to achieve with your [potential] therapist. It is possible that they may not be able to provide something you are looking for, and if that is the case, that’s ok. You can keep looking, or make a compromise, but the point is that the choice is up to you.
The idea is that by figuring out what we want out of therapy and what we’re looking for in a therapist, we can avoid having those “pointless” therapy/patient relationships. After all, why keep paying for/doing something that isn’t helpful?