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  1. #1

    How to find the best therapist for you

    How Do I Choose the Right Doctor?
    By: Nando Pelusi Ph.D.
    Psychology Today Online, 4 December 2007

    How to find the best therapist for you. And the difference between a psychiatrist and a psychologist.

    I've been fighting depression for years and I'm now thinking about seeing a professional. How do you choose the right doctor? What's the difference between a psychiatrist and a psychologist?

    The first thing to know is that there is help for depression, and a standardized protocol has been shown to be most effective. That protocol consists of getting a combination of cognitively oriented behavior therapy with medication as needed. Therapy and medication together are more effective than either approach individually. Psychiatrists are medical doctors who are trained to dispense medication and evaluate patients; psychologists are trained to conduct psychotherapy (as well as to research treatment methods that are tailored to various illnesses and personality types).

    However, as with any skill, both psychology and psychiatry are conducted with varying degrees of expertise and results depend on the clinician—so it is critical that you find a professional with whom you click. Look for a psychologist and, or, psychiatrist who "gets you." Also, many other counselors could be just as helpful—such as practitioners who hold degrees such as a Psy.D. or a master's in counseling, for example. This person won't necessarily strike you as a potential soul mate, but you should get a sense of genuine empathy on their part. People fit better with some clinicians than with others—and every practitioner is good for someone, but maybe not for you.

    Here's a brief checklist of qualities to look for when seeking a counseling professional:

    • Do you feel that you have a good fit? Do you feel understood? This is known as a good therapeutic alliance, and studies indicate it may be the single most important factor in successful therapy.
    • Does the professional listen and genuinely understand your statements?
    • Does she help you find your irrational beliefs, and do you agree that they are indeed irrational for you?
    • Does he help you in giving up these beliefs? Does he help you genuinely dispute, in various and creative ways, the beliefs that hold you back? Most irrational beliefs are not immediately apparent to us—they stem from demands that we hold. We place some demands on ourselves, some on others, and some relate to the larger world. People who evaluate the world with these demands are prone to depression, even when they are on medication.

    Psychiatrists and psychologists often work in tandem, and they work for you: If you find that their work does not significantly help within 10 sessions, then move on. However, if you find someone who helps you in the ways mentioned above, see her for a minimum of 30 sessions. Research has found that changing the way you think can change your chemistry—just as changing your chemistry can change the way you think. You can enjoy a more fulfilling and passionate existence, as well as better relationships, when you feel a purposeful mastery of yourself and acceptance of your circumstances.

  2. #2

    Re: How to find the best therapist for you

    Ive a question David because I was concerned about the statement about not feeling an improvement after ten sessions. I have been seeing a therapist since December (significantly more than ten) I find its actually made me very inward looking, like I am constantly wallowing around in my own thoughts which doesnt feel very healthy, Im more distressed and unhappy, although coping mostly. i cannot say that I feel better and sometimes much worse. What I can say though is I do feel that he hears me and that as a "good fit" goes, that he is okay.

    I have a lot of past stuff that we have been resurrecting which I didnt expect to be easy but I have wondered when then turns a corner and starts to feel better.

    This is attachment based therapy and I have attachment disorder .. I am now not certain that I am doing the right thing .. especially as they state "its a minimum of two years in order to build a secure base" ... which I really need but I am also afraid becuase it seems to make me regress quite a lot and again .. Im not sure its healthy.

    anyway would be interested to hear your thoughts

  3. #3
    Join Date
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    Re: How to find the best therapist for you

    I'm not David Molly but I had a thought around this myself.

    In December I started seeing a trauma based therpist which I see once a week. Since I have started seeing her the obsessive "neediness" is gone, in more ways I am fully in the present and in many ways I feel more peaceful.

    But I am more tired, focussing is difficult (reading material) and my memory has changed. I wonder if at times things need to get a bit more difficult because we are talking about difficult stuff, that its ok.

    My for what it's worth.

  4. #4

    Re: How to find the best therapist for you

    I have had 15 sessions there now and a really bad one this evening, I just found myself in some disproportionate rage (I am not an angry or rude person) but I absoluted hated him so much I wanted to hit him .. and why? because he (the therapist) couldnt give me the love that I need. I appreciate that this is what they call "transference" but what scares me is that its not going to help me in the long run .. right now its making me feel pretty screwed up. I dont know where this rage came from that I experienced tonight but something to do with him just not giving me what I need .. all sounds a bit crazy and extreme. I am a perfectly rational person which makes this all the more scary for me

    I dont know .. I just dont know if this is the right therapy (or therapist) for me and I dont want to pull out in case its necessary for me to go through this

  5. #5

    Re: How to find the best therapist for you

    I too am not David but I thought that I would share my thoughts and experiences with you in hopes that you will be able to relate.

    I know that this is going to sound like some bad cliche but I am going to go ahead and say it anyway..... Sometimes you will get worse before you get better. Now before you dismiss it altogether think about it for a minute. You have had 15 sessions with this therapist with whom you are beginning to build a relationship with, starting to talk about your past with, starting to reveal yourself and become vulnerable with. In my opinion, who wouldn't feel worse at the beginning. I know I did and still do at times especially when dealing with difficult topics.

    What specifically caught my attention in your post was this part:

    I have a lot of past stuff that we have been resurrecting which I didnt expect to be easy but I have wondered when then turns a corner and starts to feel better
    I know for myself that digging up anything from my past is difficult and always brings up a wide range of emotions. I normally don't feel any better while doing the work in therapy but what I have to keep in mind is the end result which although it may be a long time down the road, it is going to be a much happier and healthier life. The road will get easier and less bumpy but probably not while I am still trying to bring up and deal with a lot of issues and feelings from my past.

    As for your anger in today's session, you said that you felt angry at your therapist because he could not give you the love you need. Did you talk about that feeling with him? If you can, I think that it would be a really good think to address next session and possibly explore who you are really angry at and really want the love from.

    Anyway, I hope you stick it out with this therapy and the therapist as you really are just beginning a journey of discovery.

    Take care

  6. #6
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    May 2005
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    Re: How to find the best therapist for you

    My short answer - I could write a book, but I won't! - is in the words from the Bear Hunt poem "You can't go over it, you can't go under it, you've got to go through it". In other words - the only way out is through.
    If you're looking at years of attachment distress, 15 hours isn't very much when it comes to recovery. Normally you'd build a secure base over several years as a small child, and in my view, going into that level of feeling is important for the repair to take place.
    Sometimes what appears as 'regression' is actually being with what's already there, but has just been covered with all kinds of defence and coping mechanisms. It can feel painful and raw - try and hold onto the fact that through therapy, you'll be able to build some protection and support around that.

  7. #7
    Join Date
    Jul 2007
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    British Columbia
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    Re: How to find the best therapist for you

    Quote Originally Posted by braveheart View Post
    My short answer - I could write a book, but I won't! - is in the words from the Bear Hunt poem "You can't go over it, you can't go under it, you've got to go through it". In other words - the only way out is through.
    If you're looking at years of attachment distress, 15 hours isn't very much when it comes to recovery. Normally you'd build a secure base over several years as a small child, and in my view, going into that level of feeling is important for the repair to take place.
    Sometimes what appears as 'regression' is actually being with what's already there, but has just been covered with all kinds of defence and coping mechanisms. It can feel painful and raw - try and hold onto the fact that through therapy, you'll be able to build some protection and support around that.
    Well said Braveheart

  8. #8

    Re: How to find the best therapist for you

    thank you!

  9. #9

    Re: How to find the best therapist for you

    I have 2 people I see for counseling. I had 3 but the 3rd was a shrink who spent about 15 minutes to get to know me and on my 2nd visit she gave me a prescription to take which I didn't want but I took it anyway and on my 3rd visit with her she wanted to increase the medication because of the anger issues she said I had. I don't have anger problems.
    I am having frustration due to real issues. The psychoanalysis I see agrees with me 100% he is the one that told me how to approach the shrink on the fact I didn't want to take the new medication but increase the one I was already on for 2 months. My other counselor I see also agrees I don't have anger issues. The shrink wasn't to happy when I stood my ground about not wanting to take the new pill even the increase she wanted me to take (I am not good at standing up for myself so that showed the improvements I had from the other pills I take.) So I called her office this week to cancel the follow up appointment I had in May. I thought shrink spent about 45 minutes with a patient not 15 minutes. How can they get to know a person in 15 minutes?
    It up to my family DR to give me my pills but I feel that he is uncomfortable in prescribing ADHD medication and Depression pills so I thought with a shrink(hard time spelling the real name) I would get counseling and have her prescribe all of my medication. But she wanted my family DR to keep prescribing my usual medication.
    I had other shrinks in the past. One didn't believe in the typical ADHD medication that is helping me some right now and she suspected I might have ADHD for 4 1/2 years but never said anything to me until I asked her to be assessed for it. She thought my anxiety was more important to deal with then ADHD. Well since being on ADHD medication my anxiety has dropped by roughly 75%. I knew they were linked but some Drs think they know a person better then the person themselves.
    I had another shrink after that but he only believed that I could only go so high of a dosage of my Concerta. I knew I needed more but he was firm in his belief and I got my family DR to increase my Concerta medication.

    So now I don't have a shrink and my psychoanalyst doesn't give out medication since he switch from being a family Dr. to a psychoanalyst
    Since it is hard to get a DR period to get a shrink that believes in me and trusts and believes what I tell them is hard enough. In the past I had a counselor who didn't believe in me and made me lose more confidence in myself instead of gaining some and she question the nice compliments I received in the past and one about a year ago. She said are you sure they said that? Were you alone with them at the time. I said no there were other people in the room at the time. I saw her last summer for a bit and I am glad I don't see her anymore I tried to get drunk twice after visiting her last summer and I hate alcohol so I couldn't get drunk. Give me a Pepsi any day over alcohol. Last summer I was at my worse because my health was deteriorating fast and I was my being harassed at work everyday by co-workers and management and I had to deal with her not believing in me and making me feel like crap.

    So how do you find the best shrink for you?

    Sue

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