Posted by fallsfall on February 20, 2004, at 20:34:50
In reply to Re: therapists's reactions to termination » fallsfall, posted by mair on February 20, 2004, at 16:55:23
Hi Mair,
Many of the decisions were easy. The last one, however was hard. This is probably more information that you wanted to know, but I guess my fingers feel chatty tonight.
A couple of months before I started looking for a new therapist my old therapist and I had a crisis. I was incredibly upset, afraid she was going to kick me out, trying to work things out with her and not feeling like I was getting anywhere - it was so awful. At that time I went to see a therapist, who used to run a group I was in, for a consultation. I didn't tell my old therapist I was going. I didn't like the group that this woman ran, but I had seen her for a handful of individual sessions - before I started in the group, and when my regular therapist was on vacation. I liked her a lot on an individual basis. So when I went to see her, I was going back to see someone I knew. I was quite desperate during that session. We had already established trust (5 years before) and I knew that I didn't have any extra time. To explain the situation to her was going to take at least 35 minutes, so I honestly didn't have time to be shy. She was wonderful. She gave me the feedback I was looking for, she calmed me down, she gave me hope. I think that session helped make my search a lot easier, because in that session she proved to me that someone other than my regular therapist could really help me. I knew that if, during my search I didn't find anyone who I liked better than her, that I would be safe and taken care of by her. So I went into the search feeling like I had an excellent choice to start with.
I got names for my list of possibilities from a number of sources - my GP, my pdoc, my therapist, and 2 friends I have who are therapists themselves. So I had a lot of confidence in my list to begin with. Everyone on the list was highly recommended, and had lots of experience.
I started with the people who had been named by more than one of my sources - I figured these would be good bets. I augmented that list with people who had gotten comments from my sources that made them sound particularly attractive to me. Then I started calling around. I got better at doing phone screens. I started with the group therapist I had seen a couple of months before - I was so terrified, but it got easier after that. I had a list of questions that I got off the internet, plus some of my own. Some people were crossed off the list as a result of the phone screen (one had no room, another did only CBT, etc.)
I interviewed 4 new therapists on the list.
The first one was awful. The chairs were arranged at a 45 degree angle so we weren't looking at each other. He seemed really uncomfortable - he didn't know what questions to ask and had to sit there and think about it. I was bored. I asked him some questions and he seemed put out to have to answer them. Plus, it turned out that he lied to me on the phone - I told him I was looking for something other than CBT. He said that was no problem. But when I asked him what other methods he used, he said something vague about EMDR. It was clear that he was a CBT therapist. Then he just assumed that I would be continuing (I was amazed that he didn't think it was a terrible session). I told him I needed to see some other people before making a decision and that I would call him. I could have told him right then that he had flunked, but he was my first interview and I was a little nervous.
During the previous 8 1/2 years I had been exposed to a number of therapists - my regular one, 4 group therapists, the therapist who covered for my regular one, 2 psychiatrists in the hospital, plus a bunch of counselors in the hospital. Through all of this, I had learned that being shy and scared wasn't going to help me. I guess I had enough experience to tell me that, in general, therapists would treat me well, so I may as well tell them as much as I could. Also, if I decided not to see them who were they going to tell my secrets to? They didn't know me at all. So in all of the interviews I was very candid, and tried to give them a sense of who I was as a patient - and hoped that this would let them be who they were as a therapist.
There was one who I didn't do a good phone screen on. I had been told she did Psychodynamic therapy. I told her I was looking for something other than CBT and she tried to pass me on to one of her collegues. But I had been given *her* name, not the name of her collegues and I wasn't going to be passed off. Well, she used to do Psychodynamic therapy, but these days she only does CBT. Too bad, because I really did like her - the communication was easy, she asked reasonable questions to make sure she was understanding me and to get some details that I left out, she was kind and concerned (I cried in all of these interviews because my relationship with my therapist had fallen apart). Early on we knew it wasn't a match (because I didn't want CBT), so we agreed to keep talking and I picked her brain for ideas on what I should do about my therapist. She would have been a candidate if she was still doing Psychodynamic therapy.
Another therapist was an Art therapist. I had learned an enormous amount about myself through the art program at the hospital. I think art therapy is really cool. I could only find one art therapist in the area. I didn't really know what to expect, but there wasn't really any place to do "art". We talked about how she organized the sessions (usually it ended up with about 3 just sitting and talking sessions for each "art" session - she "knew" when it was time for an "art" one). She didn't ask me anything about any art that I had done already - I found that strange. She listened carefully to my lament about my therapist, and then was very adamant that I should go back to my therapist and work this out. Essentially, she was telling me that she didn't want to work with me because she thought I needed to work it out with my current therapist - even though my current therapist knew I was looking (and in fact had given me her name). The conversation wasn't as smooth as some - she asked questions in an unusual order (from my perspective), she wanted more detail on things that didn't seem important to me, and didn't seem interested in things that I thought were important. It just didn't "feel right". I did get some interesting insights from her - I'm glad that I spent the time with her. But there were lots and lots of things that said that she wasn't who I was looking for.
My current therapist gave an interesting interview. He knew I was looking around and the first thing he wanted to know was what I was looking for in a therapist. I told him I wanted to be understood. Then we talked. He was much stiffer than my current therapist, but he was clearly interested in what I was saying, and he told me a little about another patient he had who had similar issues and how they had worked on those issues. He seemed to understand quickly what I was saying - he didn't ask extra questions - everything was very efficient. There was plenty of time for me to talk about my situation and also to ask him questions. At the end he asked me how he had done (he showed just a bit of ego...). I told him that he had "pretty much understood my problem" (I was almost in tears again, because he really was understanding me, and it had been a while since I felt that way with my current therapist). T: "Just 'pretty much'?" Me: "... No ..." T: "More?" I nodded. He knew EXACTLY where I was, and he wasn't going let me weasel out of it - but he was really sweet and gentle during that exchange. I also asked him if I should see a man or a woman (my transference with my current therapist was "Mommy" based - at least that's what I thought at the time...). He said that it didn't matter if I saw a man or a woman, that the transference would happen with either - that it was important for me to choose a good therapist. This seemed like a really good answer.
So then I had to choose between him and my group therapist. She was a known quantity (I knew that she could understand me and calm me down etc.), but I had some hard feelings left from the group, and she almost made me feel too comfortable. I have dependency problems, and the more I thought about it, the more I was afraid that she would swallow me up - it would be much too tempting to be dependent on her. The guy's stiffness gave me more confidence that I could avoid ending up in the dependency hell that I was in with my current therapist. So the therapist I knew better had some minuses, and the one I knew less seemed to have some plusses.
This was the hard decision - to go with someone I knew who wasn't exactly right, or someone I didn't know who seemed to have (slightly) more potential. I sent summaries of each interview to my 5 closest friends and got reactions. I ended up asking my current therapist for her recommendation between the two (she had suggested both of them - so she knew them both). She recommended the guy, and that is who I chose.
In my next session with him he asked why I had chosen him over the others. I told him that he was efficient. I'm really happy with my choice.
I think the most important thing was that I was able to be really honest with them and not hold stuff back. That gave me the best chance to see how they would deal with me.
poster:fallsfall
thread:315969
URL: http://www.dr-bob.org/babble/psycho/20040218/msgs/316235.html