Therapy – The right fit


I started to write a response to a post by Dr. Kathleen Young on What Makes a Good Fit in therapy and realized I was gonna get pretty wordy.  I don’t usually do this kind of thing and actually I think I kind of wrote about it on my “Into the Darkness” blog on LiveJournal a while back (link in sidebar) but, what the heck.  I have updates on my perspective since then so … here goes.

Trying to feel safe in a therapeutic relationship when relationships in general feel unsafe is really difficult for me.  I had a really hard time getting up the motivation to look for/ask for help finding a therapist.  I’m not really sure how I got through that part of it.  I guess things just got bad enough that I had to do it, for me my worst nightmare is ending up in a hospital.  That is just not an option for me, so that was kind of my push.

I’ve been in and out of therapy since I was around 12 years old or so up until I was out on my own my mom always was the one to get the recommendations and set me up with therapists.  The last long term therapist I saw was a psychiatrist and in the end that went very badly.  I think some of my getting back into the search and trying to feel comfortable was hearing from people who raved about having a fantastic therapist.  If it was out there for them could it be out there for me? I went to see a therapist at the university I was at and for awhile it worked and I liked her a lot, I think that helped too.  While it didn’t work out I was able to take away from it better knowledge of what I did and didn’t want.  I was so close to finding “it”, “the one” if you will haha! Still, it took things getting really bad before I set up that first appointment with her.

When I started my first search on my own this past summer I did start to evaluate before meeting the therapists.  I definitely noticed I was analyzing voice mail messages, one woman had a cold message voice and with a German last name (my mom of German descent too) my head was going all kinds of places about what would she really be like.  In the end that one didn’t work out because I ended up feeling like she was trying to slap a ton of labels on me and wasn’t really seeing me as a person.  Another person I was having mixed feelings about because he was, well, male.  Got what seemed like a very short, pointed email response from him and started to think, no. Later on he followed up and the tone felt a little warmer.  Another voice mail message from a female therapist had me really anxious to meet her because her voice mail messages seemed warm and upbeat.  My current therapist sometimes seems a little, I don’t know not cold, down? or I’m not sure how I would characterize her voice mail really just that it usually doesn’t fit how she is in person.  I did go through therapists websites, found myself evaluating photos if they put one up.

What made me feel safe enough to go into meet with my current therapist I think was that she was part of the ISSTD, Sidran, and EMDRIA.  She mentioned on her site that she kept current with the information put out by those organizations and other organizations, as well as attending education lectures she teaches as well.  My therapist at the university didn’t seem to know anything but acted like she was an expert in trauma which in the end scared me and is why I left that one.  I think mainly though I felt safe going to her because she was recommended to me by someone I already trusted.  I not only trusted that person but liked her quite a lot and she mentioned she thought they were somewhat a like.  I think I kind of thought “Wow! If I could have you as a therapist that would be perfect, this could be the next best thing!” I also noticed on my therapists site that she was holding groups for art therapy and that the practice she was a part of often had groups.  I thought that was really cool because sometimes therapy can feel so isolating and to maybe have opportunities to talk to others (no matter what they were dealing with) would be really nice.

Contact wise I don’t really mind phone tag.  I really hate to talk on the phone!  I have yet to really do the email back and forth thing aside from contacting potential therapists about setting up a meeting.  I’m still not sure how I feel about trying that.  Sometimes I want to but it doesn’t seem ‘right’ to me somehow.  I like to write I think sometimes I express myself better in writing because I can really take the time to think but sometimes I worry about misunderstandings.

Location wise I’m confined to a small area because I either walk or take public transportation so that was big for me.  I knew too that I was very resistant to having a therapist in the same building as my old psychiatrist.  I think I do need the in person meetings, while I sometimes think it might be nice to do anonline thing I again worry about miscommunication and things

Scheduling wise my therapist seems pretty flexible.  I like that she does offer me names and numbers of colleagues who have the same training and experience she does for when she is out of town.  I haven’t used them but it’s nice to know there is someone.

My preference for training was to avoid the psychoanalytical types.  I really have it in for Freudians haha! I felt kind of unsure of social workers only because I hadn’t had any experience.  In the end though that’s what I went with.  I was really looking for someone who kind of ‘dabbled’ in everything (maybe dabbled is the wrong word but you know).  Ok, minus heavy on the Freud ha! That’s what I had found I really liked about my therapist at the university she kind of was always coming from new angles, art therapy, assigning me homework, light role play, etc.

Demographically I don’t think I cared too much about age as long as the person wasn’t ‘stuck in their ways’.  I’ve had regular doctors like that and it sucks big time.  They don’t care what the latest research is, they don’t care what you think.  I was done with people like that.  Gender was a little sticky for me.  I went back and forth on it, my psychiatrist was male and I guess that left an imprint on me.  On the other hand I was worried a woman might be to easy on me and I have a history of bullshitting (not lying but avoiding) instead of talking about what’s really going on with me.  Luckily I was able to tell my current therapist that and she thanked me for letting her know so she could recognize when I might be doing that.  I’m slightly more aware of it in myself but I do need help with it.  I kept thinking it would be awesome if the character Judd Hirsch played in “Ordinary People” could be a real therapist! haha! I think I’d be ok with him being a guy. I think another reason I was considering a male therapist is I tend to be more open with my male relationships (even in talking about abuse – minus the experience with my  Pdoc), I think that goes back to my posts of feeling more wary around females.  In the end of course I went with the female.  Sexual orientation was not a factor for me.  Religion how ever is, I categorize myself as spiritual but not religious and am very opposed to organized religion.  I just talk about spiritual things in general sometimes with therapists but don’t want it to be majorly or overly present in our work.  The second someone goes into God, Jesus, what not, I have a tendency to tune out. (For anyone feeling the urge to jump on me about this, this is neither the time nor the place. Thanks.)  Race and ethnicity came to play in a different sort of away in that I was hoping for someone who understood issues regarding international/racial adoption.  I got really lucky that my current therapist is knowledgeable (even taught in the local schools) about the area I’m from.  So it’s nice when I can save a lengthy explanation and get straight to the issues.  Same with disability (not mentioned but I’m throw it in 😀 ) I was looking for someone who understood/was knowledgable about both learning disabilities and chronic pain (specifically Fibromyalgia and Chronic Fatigue).  The latter was really important to me because I’ve already been through, well, pretty much all of my life not being believed around that issue.  I didn’t want that to be treated as a psychological issue (“You’re just depressed that’s why” “It’s all in your head, I can fix it”).

It was funny because when I walked into my therapists office I knew.  Everyone else I had ever seen had really boring offices, I know that might sound kind of dumb but hear me out for a bit.  The worst one was the above mentioned “German” therapist, the office was nearly empty.  It was not a new practice or anything either.  I think I can still tell you every single thing that was in that room haha!  It was ‘cold’ which is how I kind of ended up feeling about that one.  My psychiatrists  office was usually dim, ugly furniture, huge desk, Freudian couch, textbooks (not like interesting ones but the ones that look like a law library) galore and his chair was way on the other side of the room with the lamp next to him.  Images of speaking to God come to mind haha!  In the end that’s how I felt about that one too, he was off on a power trip to say the least.  There were others but then there was my therapist at university.  I liked her office, not a lot but it was different from what I was used to.  She had pictures of her family and not just her degrees.  She had clocks galore!  Plants of various sorts, hmm she takes care of her plants ok haha!  She had interesting books of all kinds, feminism, workbooks of various sorts, ethnic issues, etc.  She invited me to sit anywhere even on the floor, pull my feet up on the couch (REALLY?! Couldn’t believe it, I never did though. Wanted to but couldn’t quite do it), grab a few pillows, wrap myself up in the blanket (never did that either) if I wanted, whatever it was fine with her.  That was big too me, the other big thing… there were a few stuffed animals on her book shelf.  So when I found my current therapist and walked into her room…  Books of all sorts this time including DID and trauma, she had her EMDR equipment, art work of all sorts, plants, chairs of all sorts, pillows, and…toys and art supplies galore!  She’s a put your feet up kind of person too (and as of yet still haven’t taken the opportunity).  The thing about the office is this for me, it feels safe.  It’s inviting, she’s invited me to try to be at home.  I think there is still a shyness about me and the parts of me but knowing she’s said it’s ok is big.  Seeing toys and art supplies might seem silly to someone else but to me it says it’s safe for me to acknowledge those parts of me and that she’s probably ok with those parts of me too.  It says she must care about kids and have a genuine liking for them, it’s kind of hard to fake.  I think I’d spot it if a therapist just threw toys, etc out and didn’t really care.  Probably like most people with DID there are a good number of parts that are fiercely protective of the younger ones and therapy will go nowhere if the therapist/office/process doesn’t seem safe.  I mean that pretty much goes for any part of my system but the adult ones sometimes will stick things out longer, doesn’t fly with the younger ones.

We talk about safety almost all the time and while sometimes I find myself annoyed with it because I want her to believe that I think she’s safe and that I’m safe in her office, I do greatly appreciate the acknowledgement of the issue.  I do think I need to keep evaluating that for myself, sometimes I’m not aware when I feel unsafe.  I might feel something is off or some other feeling so it helps that it’s always being evaluated.  I’m still in someways working out what safety means to me so I’m glad we can talk about it or I can go home and think on it.

I like that my current therapist comes off as very human.  One of my first therapists was too paly (is that a word? lol) with me, I felt like I was talking to my babysitter or something.  She wasn’t professional enough, I ‘got away’ with a lot (meaning my bullshitting).  Most of my other therapist were too …clinical shall we say.  It was like going to the doctors or something and it was all business.  They knew their stuff, this is how this is gonna go, I’m the doctor and you know nothing.  The sit there and do nothing types I’ve run into too.  That was pretty much my psychiatrist.  Or as one chick I knew called it “Stareapy” (look her up on YouTube haha!).  My new therapist admits she’ll make mistakes if she hasn’t already (I know, I think to myself, but it’s nice to hear haha!).  She doesn’t get bent out of shape when I’m late once in a blue moon, when she’s late she’s kind of funny about it sort of scolding herself, to me it’s funny anyway because every other therapist I’ve been to acts like “No, big deal. This is my time not your time or our time, soley my time”.  If we do something with art she’ll draw with me and sometimes quickly share what she did.  I like the company when doing those otherwise I feel like I did with my mom and other therapists, like a specimen.  I like that she shares because well, it just seems like the human thing to do and I get to see she’s not afraid of creativity/art so that makes me feel a little freer and safer.  She can laugh when I make a good natured joke about myself and not go looking to analyze something that’s not there in the joke.  She can offer up appropriate examples from her own life either in relation to or as contrast to my own at appropriate moments.  That’s really important to me because I wonder about how other people grow up and families but at the same time my mother threw way too much information about her life on me and my dad is walled off.  I need to know where that balance is between closed off and too much.  She doesn’t push me when I’m trying to talk about difficult things, she knows when to offer me other options of communicating.  Heck! Being able to offer me other options of communicating. (ok, I went off topic there) I guess what I was trying to say there is she doesn’t shy away or try to normalize, trivialize things.  She alerts me to my body language, facial expressions, asks me if I MIGHT be having this or that feeling or ask if I am aware of what I’m feeling and If I can name it, not telling me I AM feeling this or that feeling (Seen to many therapist who will say “You’re angry/sad” Something my dad would do was to tell me how I felt or how I should feel).  Which to me makes her seem very human, empathetic.  She’s just able to be professional with out being a high and mighty expert.

Over the last few months I’ve been thinking maybe I should just stay here (originally I had planned to move out of the state. Economy killed that idea for awhile) because I can’t really imagine finding someone else this is working so well.  As much as I hate being in my hometown, I’m really getting somewhere in therapy.  I know it probably is possible to find someone new but…ugh it really is a process to find a fit! I do now know a lot more from ‘shopping around though and have a pretty good idea what I want.

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