how to find a good therapist

is there some trick to this?

I have no patience & the cost precludes sifting through randoms by giving them a go. no one I know has any recommendations

does anyone have any tips for finding someone intelligent and creative/flexible i.e. would do well with an antagonistic client/patient? looking online there are literally hundreds of nearby options with nothing to distinguish them

aiui doctors sometimes have a list of recommended therapists for people who don't qualify for NHS treatment.

scrolling through the faces of strangers trying to work out if they could conceivably bring me emotional catharsis

I would go with a 'find a therapist'-type site with some sanctioning by a prominent psychotherapeutic board.

When I was looking for a therapist I sent out about ten 'feeler' emails with a couple of questions that concerned me (what style of treatment they employed, cost etc) and based on the responses I got, gauged who I felt would be best able to handle me based on tone. Then I researched these people thoroughly to check whose training most aligned with things that I like, and managed to find someone suitable. Good therapists will not charge the Earth for treatment, and usually they offer a means-based sliding scale, so if someone is asking for more than about £65 per hour, I would be seriously suspicious.

that sounds like good advice. idk about training; i find all the jargon alienating so am mostly looking for someone who will be adaptable, but I'd go to an imam if they got it

does manchester not have one of these yet http://www.angerroom.com

Yeah, I'm afraid I can't help and am going to be in a similar situation of looking for a long-term therapist soon. The people in the MH teams that have worked best with me haven't always been the ones that specialise in the sort of thing I think I need, so I would say connection is more important than training. That said, it's worth taking training into consideration, particularly if there's an approach you know you *don't* want. I hadn't even thought about sending out multiple feeler emails, though, that's a really really good idea.

scrolling through the faces of strangers trying to work out if they could conceivably bring me emotional catharsis

lol i did a comedy bit about this exact feeling. it's so weird, it's so weird generally how so many of life's interactions are becoming fusing together, shopping, dating, finding a psychiatrist, all sort of weaved together as words plus images you must judge.

i found myself shunning someone for a turn of phrase, or maybe just due to their face. or because they appeared to be schilling for business too hard.

the other thing i found almost impossible was understanding the way they worked. like i can google gestalt or whatever and read it, but when you say "i work with a combination of xyz in a holistic approach that focuses on you as a patient" - i don't have enough experience going to see therapists to know what that will mean practically. feels like the industry generally needs to be redesigned to suit the people that need it.

i saw a therapist for a year up until about march or so this year, i don't know if it did any good, i don't know if i feel any worse since stopping, i actually think i might feel better. i recently had a recurrence of a lot of the same problems, and i decided to get a personal trainer instead of a therapist. i'm not trying to say "a good stint of running will fix you up" or whatever, but versus like average therapy, or whatever therapy i was seemingly able to find, i honestly think i've felt better just for having a slimmer waistline and the endorphins of regular exercise. tho my mental probs are connected to chronic physical illness, so that probably is not a big surprise. in the end, with my therapist, we'd just cover the same things over and over, or he'd sit and wait to answer something i said for endless minutes, i mean so fucking long, these awful silences, so horribly long that i'd eventually start laughing out of awkwardness and then he'd use this as the basis for his comment. like "what is amusing right now".

i don't think the therapists are good at including their own personality or actual direct info about how a session with them feels. i mean, is it strange to want to hear things like "i'll ask you questions" or "i'll let you do the talking", "i'll push you about things you say", "i'll take everything you say as valid", "i'll ask you about things you don't mention", "i'll only ever ask you about what you talk about", etc etc.

all of that said, i did get some benefit from it, i would agree with others advising you use one of those "find a therapist" sites - there are a few officially sanctioned ones in the uk, it's at least a good way to see what people are like. i find a lot of them don't bother replying, but i guess they get a lot of emails.

there was a time when people in my life suggested i see a therapist. so, i went to one woman, who was recommended to me and found it awkward and overly supportive like she was just nodding at everything i said and murmuring, "how did that make you feel?" at least that's how i recall it. and also, the long awkward silences after i said something. but she was very well respected, i guess, and came highly recommended by multiple people i trusted. but she sucked, for me.

so, i found a guy who seemed chill based on his website and made an appointment but never went. for about a year after that, i kept up the fiction that i was regularly seeing him and made up an entire character for him, how he talked to me, what we were working on, and despite never meeting him, he became like a fully formed person in my head, who i would make believe conversations with about, you know, my childhood or whatever, and imagining his responses based on my imagination of a chill older brother figure/kinda like a cleanshaven calm talking nicholson baker grounded guy with strong leftist political beliefs/unbelievably patient/always dropping jewels and like picturing him or imagining him as this incredibly clean man in ll bean shirts, cleanshaven bald head, always smelling only like aftershave and talking about how he was in a band when he was at the university of manitoba and how he had started a mental health emergency group for remote first nations communities. it's been a year since that year and i still have trouble separating in my head--i mean, i can separate it, i'm not crazy--the person i made up from the fact that i never really met anyone like that. i spent the money for the fake appointments on dinners out with my girl, a new battery for my car, a trip to vancouver, and the times i had appointments, i'd usually go to the bookstore down the street from where his actual office was and browse and buy a magazine.

when i decided a few weeks ago to see a therapist, my girl's suggestion was partly based on how much that made up dude had helped me become a better person and helped me with a specific problem. so anyways i was in the same situation, where i had no idea if any of these people would be any good, and i can just see their dumb websites and ask what they charge and i thought to myself... i doubt it, i doubt this is going to work, faking going to a therapist has to be better than actually going to one of these people. i have no idea how i'd find someone i liked or was helpful.

i've been in a funny relationship with a guy i know recently whereby he sees his therapist and then i discuss it with him in the pub a few days after. (discuss isn't really the right word, not sure what is - guess i'm an engaged non-judgemental listener, but more so than the therapist who is as pointless impassive as garda describes of his). it seems to work quite well. he is fairly success-defined and a performative neurotic so he gets the processual satisfaction and achievement vindication of shelling out for a premium audience member that isn't himself (he automatically went for the most expensive therapist he could afford) (i say none of this of course), i get the therapy of some sort of emotional plurality and a restorative holiday outside my personal sinkhole. we both benefit from the meta shielding and besides enjoy the rare male interaction that isn't impotent football grunting or workchat. idk how this information is of help to anyone tbh, perhaps i am advocating a two stage uberpool type therapeutic strategy

anyway my fee is £89.99 per hour, use coupon code ILXOR at checkout to get 10% off your first visit

i tried but you're on surge pricing.

very bespoke algorithm, very dynamic

Having seen a bunch of different ones over the years, I would say that anecdotally I find a strong correlation between professionalism and being a good therapist, just simple stuff like making sure to be ready for the session on time and a certain way of carrying onesself.

decided the best way to do this on a budget is to book driving lessons and then share your innermost worries with the instructor

My insurance changed over the spring and I've been paying full price to see both my therapist and my prescribing doc and I can't afford to float that anymore and wait to get reimbursed. I'm going through some heavy shit and really need to find a new therapist and it's so hard to find one that even has free time for a consultation outside of working hours. Sucks.

That really sucks, E. I've not had finances get in the way of receiving counseling, and can't imagine how frustrating that must be.

I'm lucky that I am done with seeing therapists for quite some time now, but the struggle is real: it's really hit and miss. I've seen four during a span of eight years. And despite extensive research, writing to ppl in advance, asking my md etc, there's no guarantees I suppose. Which is as unhelpful an answer as it can get for OP. Try and go with your intuition, and especially don't hesitate to break it off when you feel it's not going anywhere, or if there's no 'click'. Because there's nothing worse than wanting help but staying in a situation where you know in the back of your mind this person isn't compatible with you. Feel no shame to say this when you do find yourself in that situation. Best of luck.

Yep. I'm currently scanning in receipts for over $1000 in out of pocket expenses over the last couple months. I've called over 7 doctors in the last week and none have had any times that work with my schedule. The whole process is very discouraging.

I've been lucky with this sort of thing but it truly is the worst.. just roll the dice and pray? My current therapist was a referral from a friend in the same field so maybe try that if you're lucky enough to know one.

appreciate all these thoughts - particularly enjoyed the tale of dylannn's imaginary therapist - & wish all ilxors well. I've gone through the sorts of conversations I think I'd have in a session lots of times, but now feel ashamed that rather an enlightening encounter with some wonderful mellow nicholson baker type all I've imagined is disastrous antagonistic sessions with platitudinous idiots in which I act like a tyrant and they are forced to admit I am beyond saving. have always considered myself a good listener & am much comfortable playing therapist for friends than I am at trying to talk about any of my own ish

I would be open to the methods of any sort of sage who could make me constructively sort out my time and thoughts, and have always had the suspiscion/naive hope that the right sort of ~practice~ would unlock my very being, but the sense I get from a lot of ppl is that it is often more of a comforting ritual, a gentle servicing halfway between a trip to the chiropractors and a performance review. anyway "why i don't need therapy" surely good material for a first session

i guess it depends on what you're looking for.. in general, trial and error.

my most "effective" therapist excelled in three areas specifically:

1) identifying my irrational thoughts and annihilating them in a thoughtful and empowering way (vague, i know)
2) crafting "action plans" and holding me accountable for them
3) just being nice and empathetic. this sounds glib but i've had a few who've rolled their eyes at me or made me feel bad for feeling bad.

xp my exact feelings also. so exact i'm choking up a bit

been dredging these depths again lately

it is totally broken as a system - like all of these therapists writing badly about their approach, in therapist's jargon, and expecting members of the public to have a clue what they're talking about. the main trend seems to be such a melange of approaches and techniques as to conceal any sense of how it might feel to talk to this person once a week, the things they might ask, the actual feel of a session with them, their personality, their beliefs in plain english about therapy and what it can do and what it can't.

and then yeah, the photos, and the blurbs. these cold blurbs about "sometimes starting is the hardest part" or whatever. maybe it's a thing to talk to a therapist about but as i scan all the therapists and read the way they write i just discount them based on their not seeming smart enough to actually connect with.

then when you mail them it's so business, like they are desperate to make the sale.

it is really frustrating. ultimately i'm left with the feeling that there are many, many therapists, it doesn't feel like there's a core competency there or that much standardisation. i don't fear irresponsibility but it is incredibly hard to ascertain skill.

Damn, that really sucks LG. I feel your pain, I was the same when in need of one. Especially the blurbs and photos. And I got burned with my first choice, which made me feel even more helpless and picky. Second time I got lucky, found a good one I stayed with for several years. I told her what you are saying now too, and that that made me suspicious. She said she understood but also stressed that stuff like 'starting is the hardest part' and cliches like that - for her and no doubt for others - are to be as accessible to people as possible. It didn't say anything about her capacities, it was to lower the threshold, to appeal to people who might be scared off by more abstract, in-depth texts. I get that, too. Last saw her nearly ten years ago so I don't know if 'the business', or how it presents itself, has changed much due to it being 2016, more internet etc.

Just to say that I am positive there are good therapists, even if they have a crap website and writing for what seems like 15 year olds. And I'm saying that because I truly hope you find someone who 'fits' you and can help you.

I prob should be asking them a lot of this shit or discussing it before beginning, I guess. I feel almost corralled into it by the first one that responds.

Great thread - wishing all ilxors luck in finding and well-being. Reading the thoughts around here and wondering out loud now if my yoga ~practice~ functions as a form of therapy. It was a friend's recommendation of a yoga teacher that just gave me what I needed at that time, and when I went to her classes -- pretty much from day one -- I just knew that 'sort of sage' had been found. She has moved to another country but that period of a year/18 months was all I needed and I got so much more. Yoga is not at all physical (it has those benefits but its a by-product). I look for that quality in other teachers which I have to say I haven't quite found though the practice, and very good classes with other teachers, continue..

Friend of mine felt they had to see a therapist because it was impossible to continue they way they were.

They picked out five therapists and had one paid appointment with them each. Three weren't good enough to want to see again, one was terrible. Generally in the original process to pick out five there was no way to correlate cost, qualifications, style and their descriptions were poorly written, were like "tinder profiles", would have failed basic CV proofing in my friend's opinion. Many also tended to state or imply expertise across all areas and specialities.

One of the therapists has proved to be superb, with effective week on week analysis and support that has, well, not transformed my friend's life, but in their words "I'm much better than I was six months ago". The sessions are intelligent (this feels too rare) and illuminating.

It was the only place which did a pre-assessment set of questions, and there was apparently some sort matching of responses to that with therapists in the group.

But given the hit rate it feels lucky. I've been tempted to go through the process myself but it seems almost as demoralising and expensive as looking for a place to live.

that ended on a stupidly negative note. my friend has found it incredibly worthwhile, and there *are* good people to find, but it's not as easy as it should be.

LG have you tried http://wpf.org.uk/ or somewhere similar (if there is anywhere similar)? Maybe it was just the relief at having the decision taken out of my hands but I felt much more comfortable going there than I would have navigating the murky waters of private practitioners. Basically you go and have a consultation, you chat about what you're after and then they assign you to someone. I guess it's still pot luck whether or not you get on with the person, the guy I got was pretty good but favoured the long silences, but I was pretty confident that I would get someone professional and competent.

My therapist hates banks and wants to move to Finland because he thinks people are probably happier there and he is also allergic to trees and grass. We get along fine.

i had an incredible therapist when i lived in boston and developed a very profound relationship w/ him over the course of almost seven years. i've thought about finding someone else here but most of the time i just want to call him. the thought of finding someone who could match up to him is very overwhelming

Really sorry to hear that, LocalGarda. The quest can feel futile, but to echo everyone's sentiments - good ones are out there. Unfortunately there is almost no standardisation of therapy in the UK right now and there are dozens of different places providing wildly different training. I'm sort of tempted to pass on the details of my therapist, but I'm not sure if that kind of thing is really 'done' or whether he is accepting new clients right now (falling into horrible business protocol again) or whether you would be interested at all. But if so, I can definitely check with him when I next have a session (Monday). He's very qualified and intelligent though, which is proof that such a thing exists.

I used the RSCPP find a therapist service, which employs a less cheesy interface than some and is also at pains to provide a breakdown of any jargon used. I think there is a kind of protection involved in a businesslike approach in the establishing of necessary boundaries, but I agree that no one should be making you feel like a transaction.

would be cool to see if it's possible to refer someone, though location etc could be an issue, but still, i'd appreciate that. i'm not in a sort of emergency situation, i just want to see someone to improve my life a bit rather than to cling on or whatever, i'm aware that makes me luckier than many.

it all sort of interests me because I work all day turning government speak into plain English - I've become really interested in I dunno, unifying providers or power with the people they serve. i guess the private sector has no duty to help people as such but i still find it strange and a bit sad that these people whose job is about empathy lack the language skills to deliver it. i totally see that they can't be all "hey pal what's your beef" but i think their formal language mostly just suggests fear and a need to control - fear of actually stating their method in plain language lest someone might see how basic it is or should be.

i honestly felt like writing a medium post about the whole process last night - i feel like a good viral shellacking of the current system might have some impact.

LG have you tried http://wpf.org.uk/ or somewhere similar (if there is anywhere similar)? Maybe it was just the relief at having the decision taken out of my hands but I felt much more comfortable going there than I would have navigating the murky waters of private practitioners. Basically you go and have a consultation, you chat about what you're after and then they assign you to someone. I guess it's still pot luck whether or not you get on with the person, the guy I got was pretty good but favoured the long silences, but I was pretty confident that I would get someone professional and competent.

this sounds good, thanks - i will give it a try.

my health probs have stopped me seeing a personal trainer but if i could be sure of physical health i honestly reckon seeing a trainer once a week would prob do more for me than therapy.

Okay, I'll definitely mention it next week, and if he's fully booked then I'll see if he has any other suggestions. He's been useful before in providing help for friends, so hopefully he'll at least have some advice I can relay.

I've not yet met a therapist who espouses jargon within sessions (unless you raise it), so I think it's a case of it being weirdly foregrounded to bolster someone's online profile to make them look more reputable or something, which as you've mentioned is likely to be more offputting than anything. The medium post sounds like a great idea - the entire impregnable world of therapy needs some serious rethinking. Two year waiting lists to maybe get some short NHS therapy tailored to your needs if you're in the right borough...it's a total farce.

Worth also mentioning that before overdoing it and fracturing my ankle recently, running was doing me endless good. I always scorned the purported therapeutic effects of exercise as something more than superficial benefit, but I was flying! Running at night and with loud music cancelled out most of the anxiety I originally felt about it too. Almost healed now, thank god.

yeah it's frustrating, i have chronic health probs and it means i can't always rely on being able to exercise. i probably could be better at doing *some* exercise rather than high intensity or nothing though. i mean i walk loads, and i know that's really good for you, but it doesn't give the endorphin so much. it's annoying as i'm really determined and have great willpower when i've even got a little bit of health.

appreciate the help.

Finding a good therapist is a total crap shoot. I still haven't been able to find the mythical "good therapist".

I don't think it's just the lack of standardization and strict regulations and enforcement. I think there's a cultural component, too, why there are so many weird and crappy therapists out there. Good therapy requires genuine altruism and personal sacrifice from the therapist since it's an inherently sacrificial role. Not only that but it also requires significant time and discipline to study and practice the methods that are proven to actually help people. And these aren't qualities that are valued or rewarded in our culture so much.

So a therapist not only has to go against the grain of their own culture, but is also willing to make personal sacrifices that aren't particularly valued or rewarded, either. Not to mention how uncommon it seems that people even have these qualities to begin with and then chooses to use them as a psychotherapist.

Nearly all the therapists I've called and interviewed were misleading about their expertise and qualifications. I've been looking for therapists experienced in trauma, and I've read pretty much all the professional materials I could find on it, books, studies, guidelines, treatment methods, etc. One organization in NYC branded itself as experts in trauma, and after talking to one of the therapists it was clear they had absolutely no idea what they were talking about. It's as if they hadn't bothered to read even the most basic materials on the subject. Not only that but the therapist played a bait and switch on me where she tried to upsell me on their services and used hard sell tactics to get me through the door. Which I was pretty pissed off at, especially since they're dealing with people who are looking for support, and are in a sort-of "inferior" bargaining position, which I thought was shady and potentially exploitative.

Another organization, run out of a major US hospital, branded itself as an altruistic non-profit dedicated to helping people, blah blah blah. So I do the intake and these people seemed legit. Then I meet with the therapist they assigned me with and he apparently is a New Age Reiki master wannabe who acted hadn't even bothered to read any of my intake materials. I had asked about their treatment methods, and they totally hid the ball about their weird New Age stance on treatment, so I didn't even give informed consent for that shit. So I decide not to go back and Reiki man calls me up three times and leaves these weird voicemails on my phone trying to pressure me to go back for this crap I didn't even have a chance to agree to. WTF is that? And it's run by a major US hospital.

The state of psychotherapy seems pretty shit right now, and even downright dangerous for clients to some extent. Which I think reflects the current state of our culture to a large degree. So I don't see how good therapists can even come out of this environment, except for a few rebels and saints that I have yet to encounter.

Wow, I'm sorry to hear you've had such disturbing experiences. It's unforgivable for people positioning themselves as 'professionals' to exploit those in need. What you said reminded me of an R.D. Laing quote - "such [therapeutic] techniques in the hands of a man who has not unremitting concern and respect for the patient could be disastrous". And like you mentioned, the average therapist doesn't possess this almost inexhaustible patience and care required, so patients can find themselves cycling through therapist after therapist becoming ever more cynical and paranoid, behaviours which the therapist will likely ascribe to a diagnosis rather than the cultivated mistrust which is endemic in mental healthcare.

I visited a crisis treatment team in A&E a couple of years ago and the guy who met with me (arriving six hours later) was clearly so pissed off at having been called out that he told me off for not being in my seat when he arrived. He proceeded to ask me a bunch of grossly insensitive questions from a clipboard ('any cuts?' etc), got me to move around some furniture and told me he would leave if I kept crying. This is close to being the last recourse for a lot of people and it's amazing that someone so grossly lacking in compassion can manage to slip through the cracks. I felt justified in filing a complaint and thankfully the rest of the staff that dealt with me in the months afterwards were kind (if largely unqualified).

This generalisation might be pretty unfounded, but I tend to have more trust in older therapists, especially if they started their career in psych wards. I get the impression that if you've managed to stay in the job for so many years (and if you don't charge crazy rates), then you probably have a genuine love of the work, and of people. Not an exact science I know...

Slightly tangentially (haaa), I love this Sandor Ferenczi lecture and especially the parts where he is discussing what he calls 'professional hypocrisy' - about the exaggerated divide between patient and therapist and the traumas that can arise in the enforcement of this. If anyone's interested: https://manhattanpsychoanalysis.com/wp-content/uploads/readings/HYMAN_OYP_r/Confusion_of_Tongues,Ferenczi.pdf

anecdotally, i have had way more good experiences with therapists than bad. out of the *counts* eight therapists i've seen in my life, only three sucked and i stopped seeing them after the first or second visit. not discounting anyone else's experience, just want to provide some hope/balance!!

I hope there are good therapists out there. My own search might be a little unique, caveat. I lived through kidnappings, literal skin-melting torture, attempted murder (or mock execution, no idea if it even matters), and my family were more like sadistic hostage takers than anything, and were as clever as they were cruel. So a lot of therapists probably aren't even qualified to treat that right off the bat. I still have no idea how I made it out of childhood (somewhat) in one piece, and maybe my situation is an anomaly. By all rights I should be dead or locked up, but I was smart and driven enough to raise myself in secret, and lucked out on picking the right things to focus on in doing that, so I avoided the worst psychological effects of that stuff.

I feel like I sort-of cheated my fate using wits and technique, so I've inhabited a weird no-man's land most of my life. Like I've had to custom-build my own treatment out of all different components I discovered from my research. And I thank the gods I was clever enough to discover the principles of exposure therapy when I was a kid, and it's stuff like that which saved my ass. No idea what therapist deals in things like this, but maybe I've made enough progress on my own that a regular, empathetic therapist could help, if I can find one. It's fucking freaky stuff, though, I'll tell ya that.

My main fear is I'll never find a therapist who can relate to any of this shit, because I feel like I really shouldn't have even made it this far. One nice thing is that after I graduated from law school my family went absolutely fucking berserk, and dear ol' mom groused that they all thought I should be dead or in prison. Which was funny to me because they knew nothing about my secret laboratory I was using to raise myself out of their view, and all the cool people I met who helped me along the way. So that was a nice final middle finger to those fucks.

Anyway, I clearly need to talk to someone about this stuff, so I hope there's at least one cool therapist out there who's down with stuff like this. I've made jaws drop and eyes pop out of their skulls just mentioning minor details from my upbringing, so it makes me feel a little guilty hoisting a poor empathetic therapist with the weird, dark shit I lived through.

Wow larry.

A friend of mine is a prison therapist and she hears stories that are comparable from a trauma point of view.

Yeah, I wouldn't have done very well in prison. Like, my family were proper, well educated, upper middle class people going back a few generations, they're just a bunch of sick fucks. I was the smartest of my brothers, in Kindergarten they said i was one of those "gifted" kids, and my family did everything they could to make sure I failed as a human being. Because they seem to like killing/destroying people for the sheer fun of it, and are smart enough to get away with their insane bullshit. They started this stuff before I was even in school, and my mom bragged about being involved in a (failed?) thrill killing in high school, so I'm not the only victim here.

So I was shot out into the world into blue collar working class life as an adult, basically crippled as a person, and it was some real life Cabin Boy shit. And I worked myself up from there to a pretty decent position. Which maybe makes my story even more unrelatable ... therapists I've told have either had no clue what to do with me, or they wanted to slap me in the face. So that's another issue with finding a good one, I feel like I have to hide myself and my life from people, because it's either ?!? or it just pisses them off.

I think there's a cultural component, too, why there are so many weird and crappy therapists out there. Good therapy requires genuine altruism and personal sacrifice from the therapist since it's an inherently sacrificial role. Not only that but it also requires significant time and discipline to study and practice the methods that are proven to actually help people. And these aren't qualities that are valued or rewarded in our culture so much.

Reminds me of this incredible piece in The New Yorker. There is discipline and training (of a monk but still) but there are many up-and-downs to then becoming that person, you can see the sacrifice you talk about.

^ Saved this to read tomorrow.

So I spoke to my therapist today and apparently protocol dictates that direct referrals are unfortunately not really allowed. He did say he would have a think about people he knows and if they are available though. He recommended (along the same lines as the service ledge mentioned) the British Psychoanalytic Council or the British Psychotherapy Foundation as being reputable organisations to try. The second one looks pretty useful actually, and if I was entering into this I would be inclined the follow the clinical referral application process.

Hope this helps and I'll let you know if I receive any more advice.

Thank you!

i am lucky to have a friend who found a good therapist. it's a tricky thing!

my therapist brought up maslow's hierarchy of needs this morning! man, i hadn't thought of that in ages. felt nostalgic. also, he thinks hippies fucked up their kids. i tend to agree.

haha - i learned about it in "business studies" when i was like 13 years old - i've always thought about it since, it seems pretty sound to me.

this guy needed (needs?) one or three. yeesh.

http://jalopnik.com/the-bmw-addiction-that-completely-destroyed-this-man-s-1794882542

I think even just two years ago it may never have occurred to me reading that story that there were tools and resources to help somebody like that guy, or me for that matter

I just glanced through the comments, did anyone attempt a diagnosis? Definitely some sort of compulsion that he channeled into the cars (and then, possibly, into church).

I had a really stressful home life for a few years and I can completely relate to the whole public persona thing. I don't think I ever outright lied to anyone other than myself, unless you count "I'm doing fine." But you really can cultivate this public face, even to family, that masks all kinds of shit going on.

someone recommended me a therapist in the end btw, seems good so far, it's odd how easy it is to talk there in a way which it isn't elsewhere. idk how long i can afford it though

almost crushed this guy's spirit, a few more sessions should cement the deal

How deliberate are the choices of books to have on yr shelves as a therapist, I wonder.

My one appointment with a dude who had Bill Clinton and David Cameron biographies was certainly a total disaster while seeing Joan Didion and Ali Smith made me feel a lot more comfortable w/ my current one.

my friend’s therapist apparently moved here and has a small practice as part of her late career, her earlier career included a lot of high profile criminal psych cases. apparently she was one of the people who did interviews of Ted Bundy pre-trial

o_O

for various reason i've decided to do this. i'm following a local authority services path initially, as I had gone to my GP, but will in parallel look at the private options.

even talking to my GP felt weird - it both made the whole set of things that were existing in a certain place in my mind more real, but also they felt silly, almost trivial, though I'm quite clear they're not. I left the surgery with paradoxical feelings of 'well, i'm glad i got that out of the way' (absurd) and feeling slightly unwell at having had to articulate these things.

first part is an automated process - online forms/text responses - which also asks for some description of the issues. And again, slight feeling of unease, that I'm hypostasizing (is that right, it looks wrong) things that both start putting me into an external social/medical category, and making them more real to myself in a way that doesn't feel immediately helpful. Then I got a phone call to check my wellbeing etc. Being part of this administrative *process* doesn't isn't especially welcome, and I can see the appeal of private therapy, and also the reluctance to put yourself in the hands of local authorities (it's what it feels like, and I can imagine people who are much more vulnerable than me feeling very very wary of doing that).

The people I've spoken to have all been good though.

good luck fizzles. I hated speaking to my GP, had rehearsed it so many times and then just felt overwhelmed. she gave me some leaflets about cheapish private options (I wonder what she thought the chances were I'd follow that up) and pills bc otherwise it would be 6 months on a waiting list.

I enjoyed the first few sessions. my moods were up and down but I offloaded a lot of stuff as honestly and self-critically as I could and enjoyed engaging with him. he's been good at spotting patterns in my behaviour and thinking, which has helped to better identify some of the problems, but after 3 months I just seem to have got him as stuck as I am. he's given me the option of drawing the sessions to a close, or doing another 6 for cheaper, which struck me as slightly strange and has been playing on my mind, and pretty much all of the last session was about whether we should continue or not and it's just left me feeling frustrated and stuck. there are the two small consolations at seeing someone else stumbling around failing to solve the problems that keep beating me too, and of having my initial scepticism about therapy validated - this step now is exactly where I suspected/feared it would end. but mostly I just feel irritated and resentful especially of the pomp and prestige which is attached to therapy, the idea that it only doesn't work when the client's attitude is wrong and so on. maybe despite a superficial openness I am deep down too hostile for therapy, but if that's the case then what do you do?

it sounds like you are willing to and have engaged though. an acquaintance of mine put up the shutters in any sort of therapy and told his therapist they were wrong. i think i see that as real stubbornness.

of course i am only just starting out on this exciting journey, after having been traditionally resistant and still wary, but other people seem to have had good long therapy, which has helped them deal with deep-seated issues and identify patterns and lead as far as i can tell a happier life. i must admit i'm slightly astonished at this (tho it's obv good) but i don't know whether it's ultimately any more than the things you've already identified from that initial period. how much can anyone do? (plus there's all the stuff gone into upthread about just how hard it is to find a really good therapist - how do you know even?)

I think I'm already too good at questioning myself, entertaining alternative perspectives, doubting my motives and so on, which seems to be a lot of what therapy offers people. I'm trying to build up positive things rather than just removing problems. but yes, it's a lot of not knowing, & I'll stay in limbo while I consider my options

I expect this varies by health authority etc but I assume there's normally a waiting list for NHS therapists? I was told (erroneously it turns out) that I could self-refer to a mental health team in the same building as my GP surgery, but they told me I have to go through my GP which will depend on being able to get an appointment (the next available online one is in a month, but I can sometimes get one on the day if I call at 8:30).

I suppose what I'm getting at is am I better off just not bothering trying the NHS and pay up for a private one? I'm kinda skeptical about NHS therapists in the first place given someone I know's experience with them, which was as soon as they found a reason (smoking weed in this case) to discharge them they did. "Oh you smoke weed? Well I can't help you then, bye! Go and see a drugs counsellor". Of course in that person's case, there was no drugs counsellor for weed in that health authority, so brilliant work there by the NHS once again. I did manage to get CBT via the NHS around the same time, but while it wasn't quite that bad, it was similar in that once they'd talked through the basics of CBT and mindfulness they pretty much said that was it, see ya later, you're all sorted now.

I think I've been quite lucky in that my GP is also a mental health specialist, and Lambeth - in my case anyway - was fairly quick and effective at setting up CBT (I had my first appointment within a week and a half of seeing my GP). During the course of the CBT, the counsellor suggested that I might benefit from further NHS therapy separate to CBT, that looked more at other areas. I think at some point I will want to go private, but I'm going through this process first before doing that. If you've already been through this process though, then I guess maybe going straight to a private one might be the right answer here.

Are you still on the south coast? I've got a friend who's had a very good experience with a therapist in Brighton if you want a recommendation (it's a centre and they evaluate you for the best therapist).

I am still on the south coast, but not in Brighton any more. A recommendation might help. Tbh I don't really know what the fuck is going on in my life at the moment.

i’ll DM you some stuff CP. i was in a bit of a pinch recently and decided i’d kick off the nhs process while exploring private options just so i felt i was doing something, which kind of helped in itself alone with anti-depressants (and i was lucky that the cbt has been positive so i postponed the private option for the moment).

as i said upthread, my brighton friend interviewed several therapists (who ranged from the fucking awful to the really good) before selecting someone. not sure if you’ve got the time or energy for that but it did mean she ended up with someone she’s found really good.

take care mate.

I wouldn't be sceptical about NHS therapists per se, as they're quite likely to work privately too - there isn't a clear line.

My NHS therapist specifically warned me not to mention drugs in our first session questionnaire as she'd be legally obliged to pass me on - she thought it was a stupid rule and wanted to warn me. I think the inference was that it would be fine to talk about drugs, just not in the first session.

So - from a small amount of experience - I'd be confident with an NHS therapist but it depends on urgency - it could take a while for the referral - and cashflow - if you're going private make sure you can afford at least six weeks. Whatever therapist you use it's fine to set a deadline (e.g. "I can only afford four sessions so let's do our best in that time"). I'd be cautious of any therapist who disagreed with that.

i had an nhs therapist before and they were excellent. it took a long time to get a slot tho, like a year. i dunno if this is different to your experience but my nhs gp centre was referring people to counselling run by mind, the charity.

you got 12 weeks if referred, for free. this is some years back so not sure how it works today.

From my experience the most important thing is finding rapport w/ your therapist - they could be great for someone else with different problems, but if they're not working for you then they're not any good. This is the issue w/ NHS stuff, it takes so long to get any sessions at all that if you find yourself with someone who you can't talk to then you're basically screwed. Also, yes, over-reliance on short courses sucks.

I'm now with the Br1ght0n Th3rapy C3ntr3 and my therapist is excellent, would definitely recommend. I'd suspect that it's too far for you to make weekly trips, though?

^ think that's the one my friend goes to emil.y - also says she has an excellent therapist.

I've been going to see a private therapist for the past few weeks. It's mainly been going OK, I think part of my "problem" as such is allowing myself to have a problem. A lot of my cyclical ruminations involve hating myself for even having a problem, because most of my family have some kind of problem either with each other or being mistreated in some way, and I suppose I look at that and think I got off easy really. So I judge myself for feeling bad because at least nothing like that ever happened to me, so why am I so fucked up inside? The reason I'm posting this, and I kind of don't want to post this because this thread is public and while I trust everyone who posts on this thread anyone can read this and use this against me, is because at my last therapy session my therapist said I need to work out what I want to achieve from going to see him, and then he said "I'm not trying to get rid of you" but that made me think actually he is trying to get rid of me, because I'm doing therapy wrong or something. I know this is probably part of the issue in the first place, I think everything I do is wrong so of course I think I'm fucking this up somehow. But I don't really understand what he said. Maybe he thinks he can't help me. Maybe I'm annoying him. I thought the whole point is I don't know how to help myself, that's why I'm going to see him in the first place. WTF am I supposed to say to him. He's the professional here. That's why I went to him, I'm trying to make an effort here. If I knew what I needed I wouldn't need therapy!! I had a bit of a mental block in that session where I shut down completely and couldn't really speak, and he said I looked distressed, and I said well that's something that happens sometimes, and he said it looked like a coping method from some childhood trauma, and I said well, my childhood was fairly shit but not really traumatic. Then he said I was probably blaming myself for my parents' divorce because kids do, and I said well not really, I was 4, I was too young to blame myself or understand relationships and all my memories of my dad when he was at home were bad, so I only remember being happy he was gone. I never thought it was my fault. I dunno, I'm not sure but maybe I annoyed him by disagreeing with him, because I was very sure that I never thought it was my fault they split up and we kind of argued about it. Argh.

I suppose now I'm thinking he's a shit therapist and just going for the easy option. Oh, your parents are divorced? That must be it then. It sucks because I thought he was alright and I've just spend £200 for fuck all. What's the fucking point.

Wait. He argued with you when you told him you never thought it was your fault your parents divorced and that you mainly remembered being glad when your dad left? God, I hate lazy incompetent therapists. They are the worst. Is there some professional accreditation bureau you can complain to about him?

Counterpoint: the therapist might be doing a fine, if clumsy, job. The argument came *after* a mental block where ... you say you shut down completely and couldn't really speak. And that is very challenging to figure out, even for a therapist. The therapist was likely trying to understand what was going on inside your head during your pause, and went into his drawer of tools, some of which involve asking irritating questions, taking stabs in the dark, and considering the possibility of transference/distortions. You responded (as truthfully as you could) that the therapist's theory about your childhood was incorrect, and he probed a bit more to make sure you weren't just reflexively minimizing or denying an uncomfortable truth. It must've been really frustrating for both of you.

Hours or days later you're still thinking about whatever happened. Even if you've lost some trust in the practitioner, you've used the process effectively to rule out (by exclusion) some common causes of the distress that brought you into his office in the first place. I think your best bet is to go for another session and explain – exactly as you did here – that you are annoyed at the extent to which he fixated on the divorce as a root cause of your issue.

Good luck, btw. My second from last therapist tried to pin all of my issues on my adoption. (I was an infant adoption).

That sounds shit CP. It feels to me from your description that he's not really engaging with your difficulties there. I restarted therapy privately with a therapist I'd seen before Christmas last year on the NHS.

That therapy had ended with three or four perhaps contradictory things:

• The therapy had made me more anxious and worried about stuff, but in a way that made me feel i had to carry on, because i now felt i needed to lay those anxieties to rest. And that response in itself worried me. As if it hooked you in.
• I'd never done therapy before and didn't know whether this therapist was good or what good looked and felt like.
• I felt, especially with the curt way it ended, that maybe she didn't really like me as an analysand (is that the correct term?). I knew that she was a professional, but i still felt some basic sympathy (in the 'sympatico' sense) would probably result in better therapy.
• I didn't really know whether i needed to be in therapy. As you say CP, how do you know what are fears, whether your pains and anxieties are commensurate with others' etc. Unanswerables and doubts like that all get bundled up for me into the question 'Should I be here?'
• With the prospect of going private with the same therapist there was the question 'do i really want to be paying £60 a week for this?' That's a large sum, and i'm trying to be more careful about the how the value of my skills and expertise as it is represented in my pay packet at the end of the month gets converted into value for me.
• linked to that, how do you know when you're done? Obv taking Larry David as a real world example, the comedy of constant therapy doesn't appeal to me at all (not least from a f'ing cost pov).

On the 'sympathy' (for shorthand), she said, after a lot of careful structuring her answer away from whether she liked me or not, without actually saying that (which is fine - i don't need her to *like* me as such), she said she was happy to take me as a patient, and that furthermore i shouldn't feel worried to broach these i guess metatopics. She said that many therapists try to retain a sort of blank face in response to questions about the relationship between therapist and patient, but that she felt these needed to explored if they were there because one way or the other this was a relationship and it wasn't helpful for either person to withhold themselves.

On how you know whether you're done she said that one problem with therapy is that your patients are also a source of income. It is perfectly possible for the patient to feel, sometimes maybe often rightly, that they are hooked on the therapy for reasons that aren't beneficial to them. My therapist said she looked to decrease the frequency of the sessions when she felt it was useful, to avoid co-dependency, and would sometimes introduce breaks to see how patients coped, and would also tell them when she felt the therapy was no longer necessary or useful.

Both these answers really helped answer another question - they gave me confidence in her and made me feel that this was a good therapist for me to be with.

On whether I needed to be there, i described how i'd made some efforts at the beginning of this year to tackle some of the issues we'd covered last year. I used the analogy of learning something, where when you achieve the first thing or level, it's easy to think 'yes! i've done it' when you've only just begun, while a whole mountain still lies ahead of you, and that it can be hard to reproblematise something when you've got it sorted, or in the learning analogy, hard to go back to a position where you feel very inept again.

After that word and analogy salad, I said 'So, is there a mountain? Do I need to be here?' And she said she felt yes, I did, at least in part because i'd said i was focused on trying to resolve things. I got the impression that indifference to the process would be a problem for her (while anger, resentment, fear, etc would be fine obv).

I find it difficult know fully the grounds she has to say that, and even she said in her experience both patient and therapist just know.

I've gone into such detail, because a lot of this came back to me when i read your post. A lot of his questions sounded challenging, which i would have found very unhelpful and clearly and understandably made you go into your shell. For me, the answer to 'you need to work out what you want to achieve from coming to see me' is 'i don't know, that's why i'm here, and i want to understand what's wrong with me and help make it better' (or whatever the therapy equivalent of 'make it better' is - awareness, coping etc). 'cos i can't at the moment, and that's fucking me up, and i need your help here please'.

I think if you have to say that then there's something a bit wrong, but i'm not in your situation and obviously wasn't there. I also don't see how telling someone that something looks like 'a coping method from childhood trauma' is going to help at all. If they feel that's the case, I'd expect them (solely from my own experience) to say something annoying like 'it's interesting that you've done this. can i ask you about x period of your life' and then perhaps later say why they wanted to explore that and allow you to answer as you did.

aiui it would be unusual to say the least to suggest that you are to blame for anything (tho of course that doesn't mean we don't feel guilt for things for which we're not to blame).

it does sound like he's clumsy. would you be able to bring up the things you've said here with him? that might help clarify the relationship?

Fuck these therapists. What clout or backdrop does he have to judge you. So ducking out of touch.

I find it hard to trust any therapist who hasn't Been down in the dumps. Or tried drugs.

Thanks everyone, you've given me some things to think about.

I'd like to strike the 2nd post I made saying my therapist was shit from the record as drunken ranting, the main post though I think is fairly accurate.

I think you're probably right, soref that I put him in a difficult position by clamming up. The thing is I can't even remember what he asked me that caused me to do that. I think it was something fairly innocuous, running through what I do remember I think I said I'd been a bit stressed by work and wasn't very focused that day and he asked where I felt stressed. Looking back I think maybe he was looking for signs of anxiety like feeling it in my stomach? I have no idea why I just went blank, I think after a while I'd forgotten what he asked me and I just sat there going "er, I dunno" for a bit.

I think your answer to what do I want to achieve Fizzles is spot on. It seems so obvious to me, that's probably why I was confused by him asking me it.

He's probably not wrong that I was affected by my parents but I think he was fixating on the wrong aspect of it with the blame thing. It is difficult to determine what is a real childhood memory vs adult rationalisation of it, so I can see where he was coming from but I'm pretty sure I'm not making it up. I'm much more cloudy on some other stuff because I was so young at the time - my mum has told me my dad locked me in a cabinet and pushed it over when I was 3-4, and that he did other stuff (unspecified) to "toughen me up". I did tell my dad about that when I was about 20 and he denied it all saying she was trying to turn me against him. I do remember him shouting a lot. I don't really remember the cabinet thing but I do remember that there was a cabinet in the shed and being creeped out by it, but that could have been because my mum told me about it, not actually remembering it. I think it's more likely my mum is telling the truth than my dad though. Once when he was drunk he started play-wrestling with me when I was about 8 and it turned nasty and my step-mother had to get him off me. That definitely happened, so it's not unreasonable to think the other stuff did too. Thing is I told the therapist about that so that's why it annoyed me that he went for the divorce blame theory, when that seems less traumatic than the other stuff.

He has been quite good about other things. He said I have an avoidant personality. I looked up Avoidant Personality Disorder and I'm not comfortable with self-diagnosing that I have it but I certainly have a lot of aspects of it, if like most mental disorders it's a spectrum then I could be high-functioning version of it. Might just be general social anxiety though.

Anyway I'm not paying ILX so I should probably stop waffling. I'm going to give him the benefit of the doubt and keep going, at least for now. I might've lost a bit of trust but not all trust. I'm second-guessing myself now of course thinking I'm making a big fuss about nothing. But it obviously bothered me a lot.

today after ten sessions my therapist said 'so, we have ascertained that you *do* have feelings'. tearing up trees here. soon be time to take the stabilisers off. (i've been lucky – she's excellent).

just reading your last para CP – definitely waffle here. analysand's support group/how to be an analysand feels a perfectly reasonable thing to build – we have resources too!

too honest in my feeler emails; no takers

think I'll need some therapy before I'm fit to see a therapist

I had a therapist for 6-7 years and then he died 6 years ago and I never looked for another one. I need one now.

A few comments:

1. I am somewhat resistant to therapy. This shit is so hard and I seem to have limited capacity to take the intellectual insights I recognize from therapy and actually internalize them so that I can apply them to my emotional state (mostly anger issues). Therapy helped, but mostly on the margins. Regardless, I would take even that right now.

2. Previous therapist was a straight-up Freudian psychotherapist (and quite old). I might want someone a little more practical this time. I don't want someone to merely prescribe me a drug, but would want that to at least be on the table if the professional thought that would help.

3. US-based.

Any recommendations for limiting my search beyond who is in-network for my insurance?

Any help or advice is very appreciated.

go for an integrated facility with multiple providers and standards/accountability rather than just some bloke in an office, just my 2p

Trust your instincts, be prepared to kiss a lot of frogs.

For myself, one of the most important qualities in a therapist (besides compassion etc) is an ability to set structure and not just let every session be “brimstead whines for an hour”... I need goals

The way I found my current (amazing) therapist is I went to friends-who-themselves-work-as-therapists and asked them who was the best therapist they would recommend.

Thanks all for the suggestions; they are helpful.

This resonates with me:

For myself, one of the most important qualities in a therapist (besides compassion etc) is an ability to set structure and not just let every session be “brimstead whines for an hour”... I need goals

Especially since most of my issues are self-inflicted.

I tend to favor psychologists over social workers as therapists, but of course there are awesome social worker therapists and shitty psychologist therapists. But I think training in a good psychology program is better suited to individual psychotherapy practice than social work training.

You can also use Psychology Today to double check any in-network lists; some may have cringe-worthy profiles that will help you weed out the obvious NO NO NO folks.