Finding a Therapist: Flexible, “Yes”, Compromise, “No”!

Choosing a therapist based upon insurance coverage or geographical location is akin to choosing a lifetime soulmate based upon physical attraction or wealth. Of course, the recommendation of a friend or colleague might increase the likelihood of a good match, but in more cases than we would wish, those choices are essentially founded on speculation, anticipation and probably little more than a leap of faith. The purpose of this article is to provide informaton that will assist the reader in pursuit of the right therapist for the right reasons.

Modern Therapy and Therapist Choice

I recently gave a talk to a Chamber of Commerce group in New Jersey. The subject was, “What to Expect from Therapy and the Therapist”. Midway through my talk a woman in the front of the audience raised the following question: “Doctor Les, are you a Freudian, and do your patients lie on the couch”? I replied, “I don’t get many requests for traditional psychoanalysis these days, but, just last week a garage mechanic just happened to requested Freudian analysis. I wanted him to be comfortable so I had him lie under the couch”. After that light-spirited moment I focused my presentation on the state-of-the-art in contemporary psychotherapy .

Among the more recognized of the current therapies are: cognitive/behavioral, humanistic/interpersonal, dialectical behavioral, psychodynamic, and a range of psychoanalytic orientations. Current research attests to the notion that the successful outcome of therapy is less dependent on the approach of the therapist and than upon the relationship between the therapist and the client. This research finding is “old news” to those of us who have been in the field for decades.

So, What’s “New” on-the-Scene?

Over 100 years ago when Freud founded psychoanalysis, the therapist was considered an authority figure immersed in technique. The “person” of the therapist was deemed a distraction, or, in a worse case scenario, a disruptive, anti-therapeutic agent. Eureka! In the late ’80s, for reasons that extend beyond the purpose of this article, an orientation was developed that began to amplify the research findings referenced above. This modality that mirrors the research is known as “Relational Analysis,” wherein the actual person of the analyst is the sine qua non of the healing process. Relationalists adhere to the principle that although what the therapist does (choice of technique, etc.) is relevant, of greater significance is who the therapist is as a person.

Attributes of the Therapist as a Person (Opinion)

The seasoned therapist, if you will, reflects the following character traits and intervention style:

(1) avoids an authoritative posture and reflects a horizontal (collaborative) approach to the treatment process.

(2) actively and relentlessly facilitates a learning atmosphere in order to neutralize the win-lose (blame) mentality.

(3) promotes the idea that most, if not all conflict scenarios are co-created, and that resolution is a shared responsibility.

(4) speaks in plain-talk, rather than using technical terms or fanciful language or ideas that are motivated to impress.

(5) serves as a role-model for clients with regard to humility, empathy, sensitive confrontation, authenticity and openness.

(6) avoids promoting false hope, such as the resurrection of the blissful Romantic Phase. Damage control and a return to harmony are more realistic and more attainable objectives.

(7) is not inhibited about addressing delicate matters including finances, in-law matters and potential break-ups when children are involved.

(8) demonstrates that authenticity, objectivity and humility, are more relevant to treatment outcome than projections of caring and kindness.

(9) is aware that time allocation and attention to both partners is balanced and is cognizant of not taking sides.

(10) affirms that the “darkest moments” between partners provide optimal opportunities for learning.

Can the quality of the relationship between therapist and client be assessed during an initial consultation? Similar to courting a potential intimate partner, the passage of time will reveal “the truth” about the therapist. At a minimum, if the therapist does not meet criteria 1, 4, 5, 7 and 8, it might be time to resume your search.

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