What Kind of Therapist Do I Need?

Emilie Slechta Thomas, MA, LMFT 

First, the good news: with every passing year, as times become more challenging and people feel increasingly isolated from supportive communities, the stigma in caring for one’s mental health decreases accordingly. Athletes, celebrities, and professionals have all attested publicly to having sought mental health treatment. The bad news? With so many people looking, it can be quite difficult to find help, especially since finding the right fit with a therapist is so crucial to healing. However, there are a few guidelines to consider when beginning your search for your partner in this journey, and following them can shorten the time it takes to get started. 

First of all, keep in mind that the relationship to the therapist, along with your commitment to the process, is the most important factor in ensuring a positive outcome to therapy. Theoretical approaches differ, and we will discuss only two of them very broadly in this article, but the “click” you feel with your therapist is at least half the battle. A strong alliance with someone you feel attached to heals wounds in and of itself, and the resulting trust allows the interventions that the therapist uses to sink in more effectively. If you make an initial appointment with a therapist and do not feel that you like this person or feel comfortable with them, find another therapist. 

Getting it right in the first place with someone you look forward to working with and with whom you feel safe saves a lot of time and money in the end. 

Secondly, consider your needs and goals. While many therapists favor an eclectic approach and can mold their treatment to fit your needs, they also tend to lean one way or another. A psychodynamic psychotherapist may work with you on uncovering past wounds from your childhood whose lack of resolution contributes to the struggles you may be facing today. These issues reveal themselves through chronic depression and numbness, low self esteem, trouble in relationships, and having reactions to people and situations that are not commensurate with what is actually at hand. Finding and healing those wounds in a trusting atmosphere can uncover buried emotions such as shame and unworthiness. While working with these wounds and emotions, the therapist should validate your experience and help you find more compassion for yourself and the child you once were. While that by itself is healing, the various psychodynamically oriented therapies don’t rely only on insight. As you progress, your increased awareness of the patterns you have learned because of past traumas allows you more control over your behavior and responses to life events. You will find that your emotions become more vibrant and alive, and that life seems to be lived in more color. This is a good approach to begin with if you are having trouble in your relationships or are struggling with chronic depression or anger. 

However, what if you find that you are having obsessive thoughts or compulsions? What if your mind races constantly with worries that keep you from sleeping or you are prone to anxiety or panic attacks? Do you find that you sabotage yourself just when life is going well? Do your emotions seem to run out of control? While it’s true that these issues can also arise from childhood wounds, recent research suggests that much of the anxiety and emotional lability many people suffer has a genetic component. Often, a therapist who practices with a cognitive 

behavioral approach is the right match in these cases. This kind of therapy focuses not so much on the past but on habitual ways of thinking that reflect unconscious and non productive beliefs. An example might be assuming that something bad will happen if we enjoy ourselves too much. This false root belief can create thinking patterns that then trigger irrational feelings of anxiety, resulting in acts of self sabotage that actually might make perfect sense if only the belief were true. By examining and then challenging these beliefs and thoughts, you can ultimately affect your emotional patterns, allowing for more successful outcomes in your resultant behavior. Emotions can become more regulated, and practical tools and coping skills can be used to diffuse anxiety before it gains a foothold. 

While the above paragraphs can only scratch the surface of the many modalities- and their derivatives- of psychotherapy, hopefully they can serve as a starting point for a discussion with your therapist. Knowing some of the language used in the field and having a sense of your own goals in therapy can streamline what can be a daunting process. Never be afraid to come to any therapy session with a list of questions about techniques, theoretical orientation, or where or how the therapist was educated. It is your healing at stake, and it is our job to win your trust and confidence as your guide.