So you’re thinking about going to a therapist. And then, if we’re being honest, you’re also thinking of not going to a therapist. Because not only is seeing someone whose main goal is to help you with your mental health a challenging proposition — What if you discover things you don’t like about yourself? Worse, what if you have to change them? — but there’s a certain stigma that goes along with considering therapy, let alone actually calling someone up, sitting down in their office, and then trying to dig through the years and years of “stuff” you’ve accumulated throughout your life.
Before I was a writer, I was working towards my own licensure as a Marriage and Family Therapist (I had the degrees, I worked in a crisis clinic, and I was pretty close to finishing my one-on-one client hours) and I can tell you that a therapeutic relationship is very strange (at least at the beginning) from both sides of the couch. “No other profession,” a woman I went to grad school with said once, “is predicated upon going into a room with a total stranger, locking the door, and unloading all your secrets.” It’s something that’s stayed with me for years, and it’s also something that may be keeping you or someone you know out of therapy.
But actually, therapy’s not so bad. In fact, for many people, it’s a vital form of self care that outranks retail therapy, warm baths, and those open letters on Medium people like writing so much. It’s a way to talk through your own issues, to yourself, with another person facilitating. And in the long run, it can make you feel peaceful, content, and maybe, if you work really hard, even happy.
In order to answer all the questions you may have about seeing a mental health professional, what it’s like to actually sit in the chair, and what you can and can’t expect from your 50 minutes a week, I talked to Danni Biondini, a therapist and college instructor in San Francisco. There are lots of rewarding things about being a therapist, Biondini says, but none more than the time one of her teen clients — she provides therapy to high school students — told her she was the only person on campus who “wasn’t a police.”
That sounds funny on the surface, but as Biondini points out, it’s also an important message; after all, how many of us have even one person in our lives — including ourselves — whose sole job is not policing our thoughts and actions? In order to demystify the mental health field further, Biondini shared some advice she wishes she could tell everyone who enters her waiting room.
Going To Therapy Doesn’t Mean You’re Crazy
You’ve heard this one before, and it’s still true, but it bears some reminding. That’s because most of the people you see visiting a therapist in popular culture are portrayed as “crazy,” so how could you not believe that a little bit? Even if its usually untrue.
“Some people wait until things are really really bad in their lives to go to a therapist but you certainly don’t have to wait until then,” Biondini says. “You can go to a therapist just because you want to talk or because you are curious about understanding your own mind or because you are aware that there are patterns in your life that were laid down by your early relationships or by your family or by your parents and you want to do things differently even if the way you’re doing them now isn’t so terrible.”
Even people not struggling with depression and anxiety might benefit from sitting down with someone to discuss what they want in life, whether they’re getting it, and how they can go about making the changes they need to live, as Oprah would say, their best lives. “Therapy is a place where you can go to find these answers for yourself,” Biondini says, “to find the answer to the question of ‘what do I want?’”
And, of course, hope plays a large part in why some people choose to pick up the phone and make an appointment with a local counselor — because when you’re going through a difficult time, it may seem impossible to foster the feeling that things will one day be okay by yourself, and that’s not something to be ashamed of.
“Your place of hope might be very, very small,” Biondini says.”Hope might be 1% and the other 99% is a place of despair, but that 1% is important. That’s the reason you pick up the phone or come into the office and I always think about that with my clients. How do I speak to that small part of you?”
Your Therapist Isn’t Your Friend
“What I get a lot from clients that I work with,” Biondini says,”is they really don’t know what a therapist is going to be like. A lot of them come in thinking that a therapist is like a friend, that I’m going to listen to their problems, give them advice and respond with what I think they should do. But that’s not how it works.”
Before you immediately start racking your brain to decide whether your therapist — past or present — talks too much or gives more advice than they should, Biondini also points out that the personal relationship between client and clinician is incredibly important, so finding a therapist who talks back a bit more than the ones you see on TV — not all of them make you lay on couches, either — isn’t a problem per se, but you don’t want to go in assuming that what you’re going to get is someone who will tell you how to fix your life and do better. Instead a therapist, unlike a friend, will work with you to figure out what’s going on and what you can do to improve your circumstances or get to know yourself better.
Not All Therapist Practice The Same Way
Here’s something really tricky: If you’ve ever watched a therapist on TV, then you’re already familiar with what it looks like: You come in, you sit down, you talk about what’s concerning you, and then the therapist — in their most calm and soothing voice — turns to you and asks “how does that make you feel?” It’s a good representation for popular culture, but it isn’t completely accurate, because therapists practice in many different ways.
“There are a lot of different therapeutic orientations out there,” Biondini says. “That means there are many different beliefs that therapists have about what the therapeutic relationship is. That’s an important thing to understand when you’re looking for a therapist. Think about whether you want somebody who is going to show up in the room as a relatable person or not. Some therapists will reveal more of their personality, and others will be more opaque.”
“I practice from a psychodynamic perspective which comes from Freud,” she continues. “What that means is the therapist tends not to reveal their own thoughts,interests, personality, or beliefs. The idea is that the the therapist tries tob a ‘blank slate’ that the client will project what they need to work through onto the therapist.”
If that approach sounds good to you — and Biondini admits she’s biased towards it — then that’s the kind of therapist you should seek out. But there are many other types of ways that people practice. Cognitive Behavioral Therapy (often cited as the most scientifically validated orientation), humanistic therapy, and somatic therapy are just a few of the different therapeutic orientations that therapists use.
“Personally, I want a space where I can hear my own words and my own thoughts,”Biondini says, “but in my experience working with many different clients, I’ve found that there’s no one right fit.”
Sometimes You’re Not The Right Fit For The Therapist, And They’re Not The Right Fit For You
While many people find a therapist they like and stick with them for years, it’s important to remember that psychotherapy, like any other relationship, is a relationship. And that means both people need to be on board and — after some time — comfortable with each other. If you’re walking into an office every week where the counselor you’re speaking to doesn’t seem to understand you, there’s just not going to be any progress.
“Certainly there are clients who come in and aren’t the best fit for me because they really want somebody who is going to give them suggestions,” Biondini says. Those clients, she points out, are the ones that may not end up staying. But that’s not a knock against the client, nor is it a condemnation of the therapist in question. It’s just a matter of fit.
So how do you make sure that you find the therapist that fits you?
“It’s good to do some research and some thinking before you see your first therapist,” Biondini says. “Once you have a sense of what the possibilities are, you’ll know there are some therapists that are more directive, some therapists that are non-directive. Cognitive behavioral therapists, for instance, are going to be much more directive in therapy. They’re going to be guiding you or telling you what to do, giving you really clear solutions to problem which is a more directive style of therapy.”
That kind of research could have been a struggle even ten years ago. Because becoming a therapist requires years of schooling and practice, unless you really knew what each orientation entailed, you were going to flounder until you found someone who fit you or, worse, see one therapist, realize they weren’t the right match for you and decide that this whole psychotherapy thing wasn’t what you were looking for in the first place. Now, however, you can get breakdowns of each approach (although each clinician will practice a little differently) with just a few keystrokes. And there’s no shortage of directories which will provide you with therapists in your local area.
Biondini says that researching what a specific practice looks like is one of the most important steps of getting the help you want or need. “Most therapists will offer a consultation over the phone before you meet,” she says. “It’s a good idea to do your research, and then take them up on that 20 minute phone call before you ever step foot in their office.”
“Not all therapists will consult with you, though,” she cautions. “That’s when you have to decide whether you want to pay for a first session with them to see what it’s like.”
You Can And Should Ask Your Potential Therapist Any Questions You Might Have About Their Practice
Okay, so you’ve done your research, but there’s only so much that can be expected of you. After all, you’re not the one that went to grad school for this, you’re just trying to figure out your life and find someone to help you do that. The problem, unfortunately, is that therapists are often seen as almost mystical creatures who have special mind-reading powers that can’t be questioned. But you know what? That’s bullshit. Therapists are people just like you and me — albeit with a highly specialized skill-set — and asking them about their work, their style, and their credentials isn’t against any law. In fact, you should absolutely ask every question you have that will make you more comfortable and the therapist, if they’re doing their job, should be able to give you some clear answers.
“Talking about orientation may be too clinical in language,” Biondini explains, “so the first question you might want to ask is ‘what is your style?’ Therapist ethics dictate that your therapist should be able to explain to you what the process of therapy is like.” After that, you may even go more specific. “Are you going to use empathy to try and make me feel understood? Or are you going to be more of a blank slate and keep your personal feelings to yourself?”After that, you may even go more specific. “Are you warm and relational and are you going to do things to try and make me feel understood by you? Are you going to use a lot of empathy and maybe even bring in examples from your own life so that I know that you really get me or are you going to be more of a blank slate? Are you going to keep your opinions to yourself?” These are valid questions that you can and should be asking. After all, you’re investing a great deal of yourself into this endeavor; why should you be left in the dark or feeling like you don’t understand what’s going on?
Biondini suggests you ask yourself, “Do you want a therapist who’s going to give you homework, or educate you about your symptoms, or help you come up with coping skills? These are more directive interventions that some people find helpful, and others don’t. It’s good to know what you want so you can find the right match.”
Don’t Quit A Therapist After The First Session
Remember that thing about therapy being the only experience that requires you to share all your deepest thoughts with a relative stranger? Well, that requires a great deal of trust. Trust you can’t just build in one 50 minute hour. And, let’s be honest here, even if you want to be in therapy, you don’t really want to be in therapy because the cultural stigma of taking care of your mental health is still so strong that many people hide the fact that they have a therapist. Put all that together and you’ve got a recipe for feeling uncomfortable and wanting to get the hell out of dodge as soon as your first session is over.
But wait! It doesn’t have to be like that. If you’ve done your research, asked your questions, and really want to make this work, you can do your best to sit with those uncomfortable feelings and see if they’re truly real or just anxiety. And doing that will help you decide whether your therapist isn’t the right fit or whether you’re not really giving either them or yourself a fair shake.
How many sessions should you test out a new therapist? Biondini says three or four is a good amount of time. And if you notice problems during that time, you shouldn’t be afraid to tell the therapist what’s not working.
Don’t Feel Bad About Sharing Your Concerns
“The most important thing to remember about therapy,” Biondini says, “is that it’s your time to talk about everything that’s on your mind, including the therapeutic relationship itself. That’s one big thing that people don’t know about therapy. You can tell your therapist ‘I like this’ or ‘I don’t like this’ and your therapist will listen to that.” And that in itself can be therapeutic. How often do we get to be honest about what’s not going right in a relationship?
Being honest with your therapist about how the therapy’s going — and conflict is 100 percent normal — won’t just make the therapy better, it may actually help you speak up outside of the therapy room. And that’s a win-win. Of course, if you don’t feel safe criticizing your therapist for fear that they’ll be shattered or retaliate against you in some way, then that person may not be the right fit. Much of a therapist’s job is being there for the client in the way that the client needs them to be, so if someone you’re seeing consistently bucks criticism or turns it right back around, then it’s probably time for a different therapeutic relationship. But give both yourself and the therapist some time to get adjusted.
“The interesting thing about therapy,” Biondini says, “is that none of us really knows what we’re getting into. Not really. Even if we think we have an idea, the actual process of therapy is often different than we expected and what you uncover about yourself is often times very surprising. My advice is to be open to being surprised.”
Then, if it really doesn’t feel right…it may be time to move on.
“If you get the impression that your therapist isn’t listening to you,” Biondini says, “that’s a problem. That’s their main job. Their one and only job is to listen to you and there are definitely are therapists who are not good listeners. I don’t know how they made it that far in their careers, but they’re out there.”
“You can and you should talk to your therapist,” she continues. “One of the most difficult things for me is when I’ve been working with a client and then suddenly they stop coming in and I have no idea why. I have no idea what went wrong for them. I’ve also had clients who will tell me that my approach doesn’t work for them or that they wish I would give them more feedback. That’s the most important thing they can do because then we get to talk about it. We can talk about the ways that I have let them down or how I’m letting them down, how I’m not what they are wanting.”
“It doesn’t hurt my feelings if you tell me that you don’t like me because I’m there for you. I’m there for the client and I set my own ego aside as much as possible. That’s the ongoing work of a therapist — to set our own egos aside in order for the client to really fully say everything they need to say.”
Don’t Worry, You Don’t Have To Tell Your Therapist Everything Right Away
Here’s something awesome about going into therapy: You don’t have to talk about the things you don’t want to until you’re ready. It doesn’t matter why you’re there or what you put on your intake sheet — the form most therapists have you fill out with your history — until you’re ready to talk about it, most therapists won’t force you. In fact, some people go months — it can take up to six for trust to truly build up — before they really delve into the most difficult issues.
“I’m always surprised when people come in and feel comfortable revealing their deepest, darkest thoughts immediately,” Biondini says. That’s not because there’s anything wrong with that, but because that’s not just how most of us are wired. Even when we know that spilling everything out will make us feel better, it’s hard to do that with a stranger, no matter how many times they’ve stressed that confidentiality is the cornerstone of a successful relationship. And that’s totally fine! It’s normal! You’ll get to the important stuff, but you need to build that trust first.
What can help you get there is understanding that your therapist is not a cop, legal, moral, or otherwise. While there are limits to confidentiality — child abuse, elder abuse, imminent harm to self and/or others must be reported — one of the things Biondini says is great about therapy is that your therapist isn’t a judge or jury. They’re really just there to be your support and to hear and see you as you really are.
“On one hand it’s funny,” Biondini says, speaking of the student who crowned her with the title ‘not a police’ during a session, “and on the other hand, it’s what therapy is really about. You’re the only person in somebody’s life who’s really really far away from being the police.”
Your Therapist Isn’t Talking Behind Your Back And They’re Not Judging You, Either
Being afraid that your therapist is laughing about you to everyone they know is a common fear. The good news, however, is that such breaches of confidentiality are both completely unethical and very, very rare. Does your therapist have feelings about you? Absolutely, because therapists are humans just like the rest of us. Are they out there airing your secrets to their friends? Nope.
“I don’t spend much time with therapists who would gossip about their clients,” Biondini says. “I think that therapy is a really amazing and beautiful process and so I hold it with a lot of respect. I can’t imagine gossiping about my clients. I think that if a therapist does feel that urge, what they need to do is go into their own therapy to work out what their issues are with this client [ed note: therapists going to therapy is quite common] because that’s a sign of some very severe and intense feelings that in order to do their job, they need to work through.
“I don’t approach my clients with judgement. I approach my work with curiosity and a true desire to hear the person. We’re not in this field to determine whether you’re right or wrong, to determine whether you’re good or bad, or to condemn your actions. We’re here to be as open minded as possible, to really just listen.”