*Photo taken by Sabina Sarin
Like most people, you saw the words “The One”, and your mind immediately leaped to romantic notions of finding your soulmate... Well, fortunately or unfortunately, “the one” that I’ll be referring to here is not your “happily ever after”, but the therapist that might help you get there... (should that be your quest, of course).
Finding the “right” therapist is not easy, and ironically involves a process a bit like finding your life partner. In all likelihood, you wouldn’t marry the first person you met or developed a crush on, nor should you expect to mesh perfectly with the first therapist you meet.
Therapists, like all people, come in all shapes and sizes, have their own biases and feelings, strengths and weaknesses, skills and limitations, and one person’s “fire them” might be another person’s “hire them”.
My intention in this piece is to provide you with some tips to help you navigate the process of dating and ultimately choosing the therapist you want to settle down with. Keep in mind here that while some people might only need to date one or two before they find “their one”, others may need to “play the field” awhile longer before they find someone they feel good with, and that can meet their needs. There is no “one size fits all” ; we all have something different to offer. in recognition of this, one might even choose to be “polytherapized”- hiring and working with more than one therapist, each of which has different skills and approaches and caters to different needs or problem sets.... This isn’t a bad idea, as long as it’s been done ethically, and all therapists are aware of each other, so they can work together instead of against one another!
With that said, imagine you’re looking for a life partner. What’s the first criterion you would look for? If you’re like most people, you may have (sheepishly) thought, attraction. I need to be attracted to them…
Well, you may be surprised to hear that it’s no different here. However, the form of attraction I’m talking about is not physical or sexual. In fact, if you are physically attracted to your therapist (which is actually a fairly common occurrence), this will add a whole other dimension you might want to explore and work through in your sessions.
What I’m talking about though, is what draws you to them in the first place? Is it the way they describe themselves, or have been described? Is it their approach? Is it their voice or mannerisms? Were they recommended to you? If so, why? What is the pull or nature of your attraction to them?
Next, what are you looking for in a therapist? Now this might be a hard question to answer. You might not know, or you may even be relying on faulty or insufficient criteria.
Let’s start with some of the more seemingly superficial features. Are you looking to work with someone of the same sex or the opposite sex? This may not matter to you, in which case, you can cast a wider net. On the other hand, you may feel more comfortable speaking with someone of a particular sex, and you should honour that. While for the most part, I would suggest doing what makes you feel more at ease, there is one exception to this: let’s say you are struggling with anxiety in interacting with the opposite sex – in this case, you may want to expose yourself to the feature that makes you anxious in order to work through it within the confines of a safe, boundaried and regulated relationship.
To elaborate on this a little more, assuming you have trouble speaking with women… what better way to help yourself overcome this difficulty than to speak with a female therapist? You will simultaneously be confronting the physical stimulus that makes you feel a little uncomfortable, while also having the opportunity to address your concerns with someone with lived experience with the quality that makes you uncomfortable. Discomfort is the pathway to growth.
The next aspect you may want to consider is the race/ ethnicity/ cultural background of the therapist you choose to work with. Again, you may feel that this feature doesn’t matter for you, in which case, move to the next step.
However, if you are someone that is struggling with issues related to culture/ ethnicity, this may matter a LOT and you may want to find someone of the same background who will better understand your concerns (without guilt/ defensiveness/ fragility). For example, if you are a native French speaker, you may want to find a francophone therapist for ease of communication and for a sense of comfort in knowing that certain nuances in humour or self-expression may be understood. Alternatively, you may be BIPOC, and wanting to address past racialized experiences and the ways in which they might hobble you in the present. Perhaps you are navigating the difficulties that come with being raised within and influenced by a cultural tradition that is not mirrored by those around you. In these cases, working with someone with an appreciation of the ways in which these embodied experiences can influence daily living may be a necessity. You do not want to have to “school” your therapist or “defend yourself”, nor should you have to sidestep, tread gently or cater to your therapist’s fragility, guilt, or discomfort. While some of these sensitivities might be worth addressing in session, it should not form the focus of work in this area. It can be hard enough to have these discussions without having to worry about the impact it will have on your therapist, or without worrying about making yourself more “palatable”. That said, while cultural similarity can be helpful, it does not mean that someone of a different background will not understand, appreciate or be open to the kinds of racialized/ cultural discussions you need to have (or that someone of the same background will necessarily share your feelings/ experiences!). Do your research and find out… If your therapist is not open to, or is skittish about having these kinds of discussions, move on.
The next factor is also tricky: Sexual Orientation. You may not want to inquire about your therapist’s sexual orientation directly, though some therapists that are on the LGBTQIA2S+ spectrum, or allies to people on it, may self advertise that way.
If you are struggling with anxieties about “coming out” or have had oppressive or discriminatory experiences as a result of your sexual orientation, you may feel more comfortable working with someone that is also on the spectrum, or who specializes in working with LGBTQIA2S+ issues. This is not a concern to minimize. If you meet with a therapist, and your sexual orientation is something that suddenly feels like the “elephant in the room” (and you know it’s not coming from you), or you find yourself becoming defensive, you may want to inquire about your therapist’s experience, skill, or comfort level in working with LGBTQIA2S+. If they are unable to answer this, or become “touchy”, you have your answer. If however, this is a part of your identity that you have already come to embrace, and your therapist’s orientation and expertise in this area is irrelevant to you, then you can check this off your therapist “wishlist”.
Finally, with respect to demographic or identity factors, there’s age. While you most certainly don’t want to come right out and ask your therapist how old they are, their physical appearance, and most importantly, their years of experience are going to give you some indication of this.
Now why would their chronological age matter? Well, imagine you’re going into the hospital for a treatment – would you prefer to work with a trainee or someone that has decades of experience performing the treatment of question? Contrary to what you knee jerk reaction might be, this is actually not a simple answer.
Trainees tend to be “fresher”, more “up to date” with knowledge in the field and they often feel they have “more to prove” so they work harder. They may however also display more ego fragility and defensiveness as a result of these same features, and you certainly cannot underestimate the skill and wisdom that comes with years of experience working at something... If you choose to work with someone that is young and early in their career (less than 5 years), you may want to ensure that they have their own clinical supervisor, whose wisdom and experience you can also benefit from.
On the other hand, “seasoned experts” in the field, while often a “blessing” to work with, also get “lazy”. They’ve typically been seeing the same types of clients for so long they no longer feel challenged. They tend to think “they’ve seen it all”, so they start working with one eye (or ear) closed, their minds already predicting what you’ll say, a diagnosis formed within 5 minutes of meeting you. These kinds of experts might also be more defensive to being questioned or challenged. In which case, run! This is not the basis for a safe therapeutic relationship.
In addition to therapist age, your own age may also come into play here: if you are a teenager coping with some of the really hard changes that occur in the body and mind during this time in your life, you may want to see someone that is younger, more “connected” to “youth” culture, and with experience working with adolescents; someone that will likely empathize with your struggles without being minimizing or patronizing. On the flip side, if you are moving into the retirement stage of your life, struggling with “empty nest” syndrome or otherwise dealing with the challenges that come with aging, you may find yourself better held by someone who has been down “that road”, or at least closer to it, than someone fresh out of school.
But regardless of age, do ensure that whoever you choose to work with is licensed with the regulating body in their province (e.g., the College of Psychologists in Ontario), and has a minimum of a Master’s degree in their area of expertise. If you do choose to work with someone with a Master’s level of training, remember that it is only people with a PhD, or MD, that are licensed to make psychological diagnoses and that is only after having done a thorough psychological assessment (a few questionnaires are not enough!). Anyone that jumps to diagnosing you without proper training, licensing, or a thorough assessment should set off warning bells. Also, note that some insurance companies will only cover payments for therapeutic work with doctoral level psychologists, which may be an important factor to consider for many.
So that’s the “surface” level stuff… Sort of like the “preliminaries” on a dating app., like Bumble. But now let’s get into the proverbial meat and potatoes, the “stuff” that is actually within your therapist’s “control”.
The therapeutic relationship is a sacred one and should be treated as such… by you, and by your therapist. Therapy is not a business - its a service - and it is ripe with pitfalls, vulnerability, error and repair. It is an opportunity to delve deeper into your psyche and into uncomfortable territory to make quantum changes in your body/mind, to learn to create and sustain the kinds of human relationships you desire, and the list goes on. Which means that this territory needs to feel safe, but too safe. In therapy sessions, we need to be mildly activated (triggered) in order to be able to have corrective experiences, and in order for change to happen. So if you are coasting through your sessions, leaving feeling great and never really feeling the ripples, it isn’t therapy, its a supportive space, and meaningful change cannot occur. But you don’t want to be consistently dreading your sessions either – feeling as though you’re entering shark ridden waters and leaving with chunks taken out of you. The space needs to feel “safe enough” to do the work of leaving the shallow end to swim a bit, before returning to even ground.
But what actually makes a space safe? This is an important question. Please don’t feel you need to believe anyone that tells you “this is a safe space”, especially from the onset. An appropriate response to this might be, “Really? In what ways?” A space certainly isn’t safe simply because someone says it is. And simply because it’s safe for your therapist (or another client) doesn’t mean that it’s going to feel safe for you. Safe spaces are co-created; they don’t just exist as preset features. You don’t enter a safe space, you build and shape a safe space. And one of the most important aspects of being able to do this, is trust.
Trust is a little like safety. I don’t expect my clients to trust me right off the bat. Why would you? You don’t know me, I don’t know you. In fact, it’s a little foolish to trust someone (fully) just because they’re in the role of therapist. And anyone that tells you that you need to trust them, I would want to know why? What is it about them that should engender trust? You don’t need to trust someone just because they tell you to. In fact, the people you can trust probably never need to convince you to. Trust is earned, shaped, corrected, strengthened. It is built on a bed of honesty, reliability, consistency, credibility. So if you’re seeing an expert in a particular field, you might have more trust going into the relationship than if you were seeing someone with a sprinkling of knowledge. But even then, that degree is no guarantee. You may trust an expert to provide sound knowledge, to know the techniques, but do you trust them enough to be vulnerable, to demonstrate your insecurities, to delve into the hard and sometimes “yucky” stuff? Do you trust them to stay boundaried, to put their egos and self interest away (as much as is humanly possible), to see you/ hear you/ believe you, and to steer you accordingly? Do you trust them enough to let go and dive every once in awhile? It’s important to have a therapist that you can question, and talk to about the “uncomfortable stuff” and while you’re doing so, you are justified in wanting to feel safely held and accepted, not secluded and judged.
You may feel like you’ll never trust someone to this extent, and you know what? That’s also okay. In fact, some might say you should never trust someone 100% . Trust is not an “all or nothing” experience. Some level of reservation and critical thought is always required. You may be glad to know that the mere fact that you have even decided to see a therapist, perhaps already booked an appointment and had your first session signals the presence of a base level of trust. Trust is demonstrated simply in choosing to enter a therapist’s office and in disclosing some of the more intimate details of your life. There is trust in entering a nonreciprocal relationship that involves a power structure. And the more trust there is in the therapeutic relationship, the more effective the therapy will likely be. But again, that that trust will be built and shaped over time. Rather than “I need you to trust me”, look for a therapist that says “what would help you trust me, or what makes it hard to trust?” “what is about this relationship/ space that feels scary?” “what do you need more/ less of in order to trust me? And if you choose to address this lack of trust with them, notice whether your hesitations are held and explored, or if you walk away feeling guilty and doubtful.
Presuming you have found someone that earns this base level of trust, what would augment it? Someone once told me, “if you ask your therapist, what do you not do well? What are your shortcomings as a therapist?” and they can’t or won’t answer that question, RUN. Therapists are humans, and as mentioned earlier, we all have our limitations, biases, shortcomings, and weaknesses. And you have a right to know what these are (and to ensure these aren’t being projected or enacted with you!).
You also may want to know what your therapist does really well - their strengths, skills, approach, and the kind of clients they excel with (as no one works well with everyone and everything). Can you live with your therapist’s shortcomings and are you drawn to their strengths? (Ironically, this is also a question you might ask yourself when finding a life partner!) If you choose to give your therapist feedback in your sessions about what you like, or just as importantly, what you don’t like, how do they respond? Do they take it in, and explore it with you? Are they gracious, curious and responsive.... or do you suddenly feel as if you’ve done something wrong? Or even worse, do they become defensive, turn your comments around and make it about you? (Some of which might be, of course, but certainly not all of it). If they do become defensive (it happens to all of us at times), do they later own it, and engage in repair with you? There are many therapists that have been trained in a traditional school of thought that is “expert-centered”, and they consequently neglect to see their own role (e.g., flaws, biases, mannerisms, relational dynamics etc) in the therapeutic outcome. They may be more inclined to see everything as a reflection of “you”, your interpretations and your biases… While there is certainly validity to this line of thinking, therapy is a relationship, and you want to see someone that is going to acknowledge their part in the relationship, and that includes making mistakes. Therapists may have expertise, but they are not experts on you. You are your own best expert and you need a therapist that can help you tap into that wisdom and self knowledge.
On the other hand, some therapists take the “personal” element a little too far, and stretch the boundaries of what is actually a non reciprocal relationship into one that feels a little “too intimate”. If your therapist thinks about you a lot out of session, discloses frequently about their own life and leaves you feeling as if you need to take care of their feelings, plant a red flag. While it is important to be kind to your therapist, and to recognize when you are projecting onto them, you are not there to take care of them. And if you feel you need to, that is a pattern worthy of exploration (is it your pattern, or theirs?). If you find yourself wondering about your therapist, and asking them personal questions about their life, (which is normal to some extent) why is it important for you to know this information? If your therapist answers these questions without hesitation or curiousity, how does that feel for you? Disclosure on your therapist’s part is okay, but it should ideally be meeting a therapeutic need of yours. If your therapist shares something that makes you feel uncomfortable (and you’re left thinking, “oh I really don’t know if I wanted to know that”) tell them. You should not feel left carrying the burden of their disclosures..
In session, your therapist may be “friendly” or “caring” with you, but they are not your friend or primary caregiver; you can “depend” on them (to provide the established and agreed upon features of a safe therapeutic relationship), but without developing dependency on them... Therapists have their own personal opinions, belief systems, and practices (e.g., religious beliefs) but these should be owned, and not imposed upon you. I once had a body worker that during a session, spoke to me about my past lives… When I told him I wasn’t sure if I believed in past lives, he became quite upset and defensive. A pattern developed of him projecting beliefs, stories and opinions onto me, without sufficient explanation, and often to the neglect of my own wisdom and wishes. Expressed upset or disagreement on my part was met with the critique that my interpretation that was the problem, rather than his boundary violation. Needless to say, this therapeutic relationship didn’t work out…
What we’re talking about here, is boundaries. Boundaries come in three forms – physical (distance / space), emotional (disclosure), and spiritual/ psychic (energetic). In any relationship, but particularly a therapeutic one, boundaries are necessary, not optional; it is for you and your therapist to navigate these murky waters together to establish ones that feel safe for both of you.
So far we have been talking about what are known as non-specific factors, factors that highly influence the therapeutic process and its effectiveness, but are not specific to the therapeutic modality itself. But this guide wouldn’t be complete without addressing the factor most people think is most important, and that insurance companies can be sticklers about: the therapeutic approach.
If you’re like most people, you’ve heard certain the name of various therapy approaches thrown around - they often follow bandwagons or zeitgeists. Once upon a time, CBT or cognitive behavioural therapy was “all the rage” - at a later point “mindfulness or MBSR” - and now “somatic therapy”. Most of the time these bandwagons have little to do with the effectiveness of a therapy itself. There is no hierarchy with some therapies being intrinsically better than others. There are numerous approaches out there that are excellent and highly effective. What is most important in choosing a therapist is that they use a form of therapy that has been empirically (scientifically) tested and supported for the problem you’re struggling with, keeping in mind that some of the most influential parts of a therapy can’t always be operationalized or tested (e.g., therapist warmth or positive regard). Moreover, some therapies (e.g., CBT) are more amenable to scientific testing because they are easily manualized and thus, replicated; these therapies are usually the ones that are most suitable for very simple and uncomplicated issues (e.g., simple phobias)… This is generally why insurance companies like them - they’re short term, uncomplicated, and “well tested”... except for where they’re not (e.g., complex trauma)! In general, the more complex the case or issue, the less likely it is to be effectively treated by a readily manualized treatment.
So the work here for you is in knowing what approach works for what you’re struggling with. CBT is excellent for uncomplicated depression and some forms of anxiety. EMDR is highly effective for single episodic PTSD (e.g., car accidents), but much less less effective for complex PTSD and developmental traumas (which are more chronic and less “event based”). In the case of the latter, EMDR should not even be used until a significant amount of time has been spent building rapport and trust, and developing one’s repertoire of positive coping resources. Mindfulness-based therapies are wonderful for working with anxiety and general wellbeing, but should not be used for people with psychosis, or high levels of limbic system instability. Finally, some therapies are more effective for certain people at certain times (e.g., some respond better to somatic approaches like sensorimotor psychotherapy, while others respond better to more emotion focused methods such as DBT). And of course, there are adjunctive therapies such as yoga, that have been scientifically tested and established as effective as treatment for a number of illnesses, though it typically should not be used as a stand-alone treatment. In addition, where certain forms of yoga are effective for some problems, they may be less effective for other illnesses. For example, while hatha and restorative yoga are excellent for generalized anxiety, they may not be particularly helpful for depression, for which a more activating, vinyasa-style practice is indicated.
You may be wisely asking yourself at this point “How am I supposed to know what therapy works best for what?” A quick online search can usually point you in the right direction for the best approaches to treat your concern, with the caveat that the credibility of the online source is important. Much of what is “out there” is politicized and often sponsored, and so sticking to medical and scholarly sources is advised.
Now, presuming you have found someone who specializes in the type of approach that has been found to be effective for your problem area, your next concern might be how well the practitioner actually applies their tool. Therapy is an art and a science; you can give every therapist the same type of paint but some artists simply work better with oils than others do. In fact, one of the single strongest predictors of the effectiveness of a therapy (outside of its own merit and suitability) is how much the practitioner “believes in it”, which will usually determine how well they apply it.
The next factor determining a therapy’s effectiveness is how well you take to that approach. Even an exceptional artist may not paint equally well on all canvases (e.g., some work better with large canvases, others with small). In other words, a highly skilled CBT practitioner may find this method less effective with a highly intellectualized and rational client, as their client may already be prone to using “rationalization” as a defence or coping strategy (thereby bypassing the experiential). So while you may like the kinds of paintings the therapist creates, and they may feel like “your style”, it may simply not suit your gallery. As the old adage goes, sometimes what we want isn’t always what we need.
Finally- and this pertains specifically to the area of trauma therapy, or to those of you looking for someone to work through past traumas with - trauma is not like a lot of other psychological issues. Unlike other mental health issues, trauma is stored in the body, not the mind. This means that in order to work with your trauma, you need a therapist that is trained in somatics (body therapies), especially when working with early stage or unresolved trauma. Trauma therapy involves its own distinct toolbox of skills and subscribes to unique principles such as clarity, transparency, non hierarchy, empowerment, choice and control. Unlike other talk therapies, it works “bottom up”, not “top down”, where talking about the content of trauma is secondary to working with the bodily effects of the trauma. So if your therapist allows you, from the onset, to launch into the details of your story (as people are often eager to do), to emote without exploration of the facets of your emotion, and analyzes or rationalizes your thoughts about the events, WITHOUT exploring what is happening in your body (including your tone of voice and mannerisms), then you are not in the right hands.
When it comes to trauma informed sessions, you should feel like you have “choice” and the ability to say “no” to any intervention your therapist suggests. Your therapist should be transparent about what they are doing and why, leaving room for collaboration and boundary setting. And while it may sound strange, it may also be important that you like the sound and cadence of their voice. In no other area is vocal prosody so important (vocal tone, speed, pauses, timbre, frequency). Your therapist’s voice and demeanor should help you stay regulated and calm, so if they themselves sound like they are running to the finish line, ask them to slow down. And they should be doing the same with you, if for no other reason than to promote the regulation of your nervous system. It is important to gather information but it should be done in a way that is calm and well paced.
Some final questions you may want to ask yourself to help you decide whether a therapist feels like the right fit for you:
1) Do I feel seen? Heard? Believed? Understood?
2) Do I feel like my therapist is really present and engaged/ invested? Or do they seem distracted, divested, and/or unable to remember the things we speak about?
3) Do I feel like my needs are being attuned to? If not, when I signal this, does my therapist respond in a way that feels good? Sometimes misattunement is necessary, but repair and transparency is paramount.
4) Do I feel like my therapist is talking at me, or to me? Does it feel mechanistic or humanistic? In other words, do I feel like I am being treated as “a textbook case” or do I feel like I am being seen as a unique human being, and authentically engaged with as such?
Now chances are, you are not going to find someone that meets ALL of these criteria, but you also don’t want to “settle”. That said, even a therapist that meets many of these criteria will fall short sometimes (we all have “off days”) but they should be able to engage in a process of repair with you. As a general rule, you should feel good in your therapist’s presence, despite what you might be carrying and despite the distress/ turmoil that comes with exploring it in session. Therapy is not supposed to be “easy” or “comfortable” and the amount that you get out of it will depend on the work you put into it, not on how “well your therapist does”. Your therapist is your guide, not your mechanic, and they are there to make navigating the unknown a little more tolerable. They are there to help you find your answers, not supply you with theirs (education aside).
At the end of the day, the person you really need to trust on all of this is yourself. Deep down, you know what you need and your instincts and intuitions are invaluable. This includes the instinct on whether a particular therapist feels like a good therapist for you…. Or at least a good enough therapist for “right now”.
Best of Luck!
