Hi folks,
I wanted to share some thoughts on an evergreen matter I’ve been meaning to discuss: therapists and how to find them. This is because, not infrequently, people ask me how to find a therapist. People also ask if I’ll refer them to my therapist. (Answer to that is no, for a few reasons.)
I get why people ask me this and I do want to try to offer my thoughts on this matter, generally. Here I speak both as a journalist who’s studied mental health care for well over a decade now, but also as a person who has long sought such care, myself. In short: I’m some guy who spends way too much time thinking about all this…
I’ll use the word “therapists” here as a catch-all but what I’m going to mean by that are: any of the healing-type professionals we may engage to work with us when it comes to our souls, our psycho-social-emotional wellbeing, what have you. This is an intentionally huge category I’ve just described, one that includes mental health care professionals of all sorts but also folks who call themselves counselors or coaches or even various spiritual healers and much else. I don’t judge any of these professions as being inherently better or worse than any other; more, I think the thing to keep in mind is the quality of the individual in question, given your needs right now.
As you may already know but I’ll explain in case: Different mental health care practitioners do really different stuff, depending on the sort they are. Some will be primarily seeking to diagnose and treat with interventions like pills. Some will be relying on talk therapy, perhaps some specific sort of talk therapy, one influenced by a dead white dude perhaps. In effect this might mean a more silent or more inquisitive practitioner, or one who is more or less prescriptive in terms of what they want you to do. Some will employ methods that try to harness neuroscience to ‘reprogram’ the brain. Some will be more focused on the body’s influence upon the mind. Others still may offer other perspectives, for example guidance of a more spiritual sort. Again I don’t want to argue whether any of these approaches is inherently better than any other; what’s important is you find somebody who offers something that truly appeals to and suits you. I say this in part because your own belief matters a lot, when it comes to whether any approach might be effective.
I don’t think going to therapy makes one inherently better than anyone else. However, I do think being willing to submit oneself to a therapy-type environment, i.e. opening the deepest darkest scariest-seeming shut doors inside oneself, that is probably inherently better than not. Some of us have obvious deep dark doors and therefore, sooner than later perhaps, we may need to do this work. Others live their lives avoiding such spaces. Still others may go to therapy but are nonetheless good at avoiding actually open up. So again, mere attendance in therapy isn’t necessarily what matters, but rather the spirit in which one goes. As does the actual therapist you engage.
Something tricky I wish to bring up: Some therapists suck. Like truly fucking suck. Maybe because they suck as people but probably just because they suck as therapists. Therapy is after all not some abstract concept but just a bunch of individuals who’ve elected to go into this work. Many probably need healing themselves more than they need to become therapists.
I mean this not as a critique of all therapists, especially not the actually helpful ones. Being a therapist is an unbelievably hard sort of job to have, generally speaking; I say this, again, having studied this space a long time and knowing many mental health care professionals personally. Such professionals are often under-paid and over-worked and taking on unquantifiable volumes of other peoples’ pain and often lacking in adequate mental health care support themselves. Unsurprisingly, turnover and burnout amongst such healing professions is high.
Just to state this, because it’s really the problem: we’re suffering, all of us, because of our for-profit (mental) health care system (and, more generally, under capitalism). As has long been the focus of my journalistic work, much of our mental health care infrastructure is probably damaging people more than it’s helping them. Therapy is ostensibly one of the least on-its-face terrible pieces of this pretty toxic overall situation, but the institution itself is nonetheless overdue for reexamination.
That all being said, some therapists are amazing — even life-saving. I know that, speaking for myself, there are a few such professionals to whom I probably owe my life. I know I’m hardly alone in feeling this sort of way. Having a trusted healing professional in your corner, it can make all the difference in this world.
Because of this tangle of seemingly contradictory facts, I do often wind up contemplating how do we help people find therapists who can really help them, as opposed to the opposite? Therefore I want to introduce the analogy of buying jeans.
This analogy’s sorta intentionally silly, but hopefully it will at least give us all something to contemplate. My point here is you cannot just tell someone how to buy jeans. They tend to have to figure out for themselves what sort of jeans they want to buy. Because where would one go to buy jeans? A thrift store? A big box store? Some high-end boutique? But, above all else, the first consideration is going to be access. Can you even afford to buy jeans? If so, what sort of constraints do budget put upon you? The shitty reality is therapy is expensive and many therapists who engage in talk therapy for example don’t take insurance (so supposing one is fortunate enough to be insured, this often doesn’t matter when accessing such).
That being said, resources do exist for people when it comes to therapy and therapy-like options — by which I mean, spaces where one may safely share and explore one’s actual internal state. Depending on what communities you are already involved with, there may be more resources available to you than you realize (I’m thinking for example of therapy programs through LGBTQ centers). Or one option I tend to plug: non-clinical peer support meetings like the Hearing Voices Network are a free option, online for those who prefer. These are meetings where people who’ve heard voices or seen visions or had other “unusual or extreme experiences” may discuss whatever’s actually going on inside their head. In my opinion, such groups of this sort aren’t a replacement for therapy or other individual counseling necessarily, especially those with severe trauma histories or extreme challenges at present, but such groups can provide some support. I’d offer some support tends to be better, especially if the alternative is somebody feels all alone. Especially if their mind is a treacherous place to reside.
I have selected jeans shopping as my analogy in part because jeans shopping is pretty fucking tough for some people and extremely fucking tough for others, and so forth. Nothing about finding a therapist will necessarily be easy. (Likewise, therapy itself will not be easy.) In general, though, it is much easier to find a therapist if things are going well in your life, not when things are already really hard. So if you aren’t actually struggling much today, that may be a great reason to try to find a therapist, for that eventual future when your life is harder.
Supposing one can afford therapy, and one can theoretically handle searching for one, how to begin? This is where I like to again think about appropriateness for you. Jeans aren’t just jeans. There are various washes, various cuts, so many styles. So to our actual point, I encourage you to contemplate: Supposing you are going to talk deeply with somebody, in a very unguarded way, what are the things that are important to you, for that other person to be like or values or other identities for them to possess? I suggest you consider what factors are actual dealbreakers for you or which would probably expedite your potential to connect intimately with a stranger.
Once you’ve figured out your own needs or preferences (or at least guessed), your search begins. As for how to search, I wish I could offer some quick answer but I can’t. You can ask your friends if they know anyone they’d recommend (for example if their own recommended therapist makes referrals). You can of course search online, specific to whatever factors are important to you. You can search locally or you can explore remote options, depending on your comfort and again, access. I for example vastly prefer remote (mental) health care both because I live rurally and because I am an anxious trans person who mostly avoids leaving my property.
I strongly encourage you to try out various options. I don’t think one can tell how a pair of jeans will feel on just looking at them; ditto, you’re really not going to know what it feels like to work with somebody until you try out a session. Most therapists offer a free consultation of fifteen minutes or so, during which the two of you can meet and get a sense of mutual compatibility. So, if you are searching, I encourage you to try to schedule such a session with one person or a few, just to see how you respond. In the session, I encourage you to pay attention to yourself, to how you actually feel about this person. I encourage you to notice your body’s actual responses. Noticing all this isn’t necessarily easy, especially if you are perhaps conditioned or used to ignoring your body’s discomfort or you are usually bathing in negative thoughts (however unconsciously).
So, as you do a session with a new therapist, or after, perhaps think of the buying jeans analogy. Imagine you’re in a dressing room. For the sake of this exercise let’s imagine your goal is to find jeans you actually like, ones that actually make you feel good. So rather than stuffing yourself into something uncomfortable, keep in mind that your own ease is actually the number one most important thing here. Perhaps afterwards you can think about the version of yourself this person seemed to elicit. Did you feel comfortable? Did you feel like you were being defensive? Did the session feel natural and pass quickly? Or was it awkward and go by slowly?
Through the years, I have done many one-off sessions with therapists I didn’t ultimately stick with; these days I try to view that as part of the process. I try to not blame myself if someone made me uncomfortable or just didn’t seem like the best I could find. I’ve also given up my search at times in the past, frustrated about my options, or confused about what I wanted, or feeling I couldn’t afford therapy at the time. As you’re meeting new therapists, it may be hard to discern immediately whether someone’s right for you; therefore I do think it wise sometimes to attend a few sessions before you decide, if you can afford to do so. Especially because introductory sessions can be sort of inherently awkward, like first dates. Not enough time to cover anything well and the fact of a new person itself a distraction.
Another point I like to say because sometimes I think people need to hear it: You are allowed to change therapists; in fact, sometimes, it’s probably good to do so. Just like the jeans you bought five years ago may not be your style anymore or fit your body (as a trans person a few years into second puberty LMAO do I feel this!!! 🙃), I tend to think it wise to stay honest with yourself about whether your therapist is still an adequate match for you. Maybe somebody was awesome for you at one time but meanwhile you have changed or they have or the world has or all of the above. In which case, I do encourage you to do the possibly hard thing and find someone new. If you’ve got a therapist who doesn’t seem to help you or who makes you feel worse, absolutely feel empowered to stop seeing them and continue your own search. Maybe you want to reflect on what if anything you’ve learned from that experience. (You can even employ a new therapist to discuss how another therapist made you feel; I’ve done it.)
Ultimately do you need jeans? No. Do you need a therapist? Again no*. Or at least, nobody’s going to go to therapy because I or anybody else told them they should go. Put another way, those who are going to benefit by virtue of such healing relationships, I’d offer, are those who are genuinely seeking, inside themselves, to feel better. To work on those hardest things. To more gracefully handle the endlessly stressful nonsense that is human life on earth.
*My one caveat is I do think all therapists need therapists, probably; I’d say this is true for anybody whose job involves the handling of other peoples’ pain. As a writer covering mental health, I consider myself part of this broad category and suffice to say I take my own mental health care very seriously these days.
Tangent but I was looking through my photos to find a shot of myself wearing jeans and truth is, I seldom wear jeans anymore. I consider jeans clothes for being-in-the-world and again I tend to avoid going to there.
This was the only sorta recent one I found:
This is partially a problem of being a few years this new gender presentation and having few clothes that fit me now, let alone feel right. Let alone knowing what clothes I’d want to wear now? Like, how do I dress, as a guy?
If I must go somewhere, one strategy is I dress kinda like The Edge…
But, like I said, I’m mostly home, or in the garden, or walking. So I wear a lot of sweats, or other such loose-fitting garb.
As for my own mental health care these days, what form that takes... that’s a whole discussion, one I’ll be having in this next book.
Just to say, ultimately, my point is: You do you.
I wish you luck, if you are looking for a therapist or other such healing professional. Or if you’re considering doing so. I hope you find someone worthwhile. I bet, with some patience and commitment to the search, you will.
ttyl,
Sandy
p.s. As a quick reminder, I’m starting an advice column! You can send in questions to whatshelpingtoday@gmail.com. If I respond to your question, I won’t print your name. Questions can relate to mental health or gender or really anything. Looking forward to sharing this new project with you all.
p.p.s. What’s Helping Today: This new episode of You’re Wrong About! Especially the end! Happy Pride.
p.p.p.s. For a bit more on the Hearing Voices Network and such, see my piece about the movement for psych patient civil rights for The Cut. Also my website’s Resources page.