Feeling seen & safe: Is your therapist the right fit for you?

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Psychotherapy can feel like a mysterious, alchemical process, especially for the uninitiated. When I started therapy, I chose a clinician based on her Psychology Today profile and a good hunch during our consultation. I crossed my fingers and hoped for the best.

But because I had nothing to compare it to, I sometimes wondered whether my therapist was the right “fit” for me. What did a good fit even look and feel like in this relationship that is so unlike any other?

A 44-year-old reader also wanted to know: “How do you know your therapist is right for you?”

For anyone in therapy or interested in starting therapy, it’s an important question to ask. Research on therapeutic effectiveness shows that a client’s relationship with their therapist matters at least as much as the treatment method.

Therapy can provide what’s called “corrective emotional experiences” that help heal wounds caused in important relationships, especially by parents and partners. But that can happen only if you feel safe with and understood by your therapist.

So what makes up the special sauce of a transformative therapeutic bond? I spoke with Katheryn Perez, a licensed marriage and family therapist in Burbank, and Kaytee Gillis, a licensed clinical social worker in New Orleans, about what a supportive, healthy alliance looks like with a therapist.

A good therapy fit

One of the most essential characteristics of good therapy is the ability to be vulnerable in sessions, Perez said. It can take a while — several months for some folks — before you trust your therapist enough to share the truth of your internal world.

“I’ve had new clients who tell me they’ve spent years in therapy, but were never able to get into the deep, core issues affecting their lives,” Perez told me.

Does this sound like you? Part of the problem that we face in those first few sessions relates to how we’ve been coping without any healthy coping mechanisms. When we deal with our struggles on our own for a long time, we build up defense mechanisms to protect ourselves from the pain of it, like a fortress around our most difficult emotions. It’s hard to break out of those patterns — like pretending everything is OK when it really isn’t, or rationalizing behaviors that aren’t working for us. It’s also common to start therapy with a lot of built-up shame around depression, anxiety, traumatic experiences and relationship problems.

But when you’re working with a therapist who’s a good fit, you’ll start wanting to open up, most likely because the therapist is patient and nonjudgmental, and respects and understands your cultural background and other identities. A therapist who “fits” will use your correct pronouns and won’t expect you to educate them on your ethnicity, faith, gender identity, sexual orientation or disabilities. If they don’t already have that information, they’ll be steadfast in educating themselves.

If this foundation is laid by the therapist, you’ll be far more likely in sessions to express the emotions you hide away from the rest of the world — the sadness, the rage, the shame. This unleashing of pent-up emotions is a critical part of your personal growth — and growth in the therapeutic relationship. It’s a sign that you trust your therapist.

“With safety comes knowing you’re not being judged. Whatever you’re going through, it’s valid. There’s nothing wrong with it,” Perez said.

Your therapist should also be willing to disclose when a topic or approach is outside of their skill set. “They’re able to say, that’s not something I’m really sure about, let me do some consultation,” Gillis said. For example, you could go into a therapist about your relationship and together realize you’d benefit from seeing a sex therapist for specific sexual health needs. And a good therapist regularly checks in with you to see how you’re feeling about the therapy process.

“I always ask, ‘How does this relationship feel for you? How are you feeling after last session? Did you have any questions?’” Perez demonstrated. “It gives clients the space to verbalize what’s really going on for them, what’s working and not working.”

You might need to change therapists if…

A therapist can be perfectly kind, thoughtful and knowledgeable, but you may not feel that “click,” sort of like when you’re on a date with someone cute who was great on paper, but there’s just no chemistry, Gillis said. That unspoken connection, and ability to be comfortable and feel like yourself in a therapist’s presence, is so key. I like to think about it as an easy warmth, an intangible glow. You’ll know it when you feel it — or don’t.

Here are some clear signs that a therapist might not be a good fit, according to experts:

????You don’t feel seen or heard: “In therapy there’s something called ‘active listening,’” Perez said. “We have to really truly be present and in tune with clients to know what they’re saying.”

If you see your therapist wandering off, not fully paying attention to you, or they look really distracted, that’s a problem. Therapists are people too, imperfect and fallible. They might not be fully attentive 100% of the time. But your therapist should be attuned to the conversation for the vast majority of the session.

????You feel judged: A good therapist will respectfully and gently challenge you as they help you explore patterns that may be holding you back. “If a therapist is making you feel bad about yourself, is shaming you for the way you think or past behaviors, it’s probably not a good fit,” Perez said.

The same goes for a therapist who dismisses your concerns or minimizes what you’re going through. Bad news bears.

????Too close for comfort: While it’s true that you want to connect with your therapist, the relationship shouldn’t feel like a friendship, at least in the traditional sense.

“There should be a boundary there. The therapist shouldn’t be texting or calling every day, or meeting you outside of scheduled therapy times,” Gillis said. “I specialize in working with people who have family and relationship trauma, and often have a history of people having poor boundaries with them. My responsibility as a clinician is to make sure I have good boundaries, to show them that someone can still care for you and hold those.”

???? At the end of the day, try to trust your gut. Anything that gives you an icky feeling in the therapy room is worth examining — either by thinking about it yourself, talking it over with a friend who has also been to therapy, or bringing it up with your therapist. Sometimes talking over uncomfortable moments with your therapist can deepen the relationship. Even in a trusting therapeutic relationship, you will have disagreements with your therapist.

Lastly, if you feel pressured by the therapist to share more than you’re ready to, or you feel like you’ve been reduced to a symptom or a diagnosis and don’t feel seen for the complex and worthy human that you are, it’s time to reassess whether this relationship is working for you.

Signs that therapy is working

Many of us go to therapy because we want to move through our relationships, through our everyday lives, with greater ease and fulfillment.

A big part of knowing whether a therapist is right for you is whether you’re making progress in these areas. This doesn’t mean your problems disappear, but that your level of insight and quality of life improve over time. A few areas of growth to consider:

????You start feeling better: If you came into therapy feeling numb, frustrated, angry or lonely, you should feel the immensity of those emotions begin to lessen. “You might have more energy to engage in things that make you feel good,” Perez said. “Maybe you want to be around people more. You see positive changes in your daily routines and interactions with others.”

Gillis recommends checking in with your body to gauge improvements. Maybe you suffer from stress-related back pain, insomnia or nightmares. Have those ailments gotten any better?

“Many of my clients can usually tell their progression in hindsight,” Gillis said. “It’s not easy to see in mid-March how much better you’re doing if you started therapy March 1. But at the end of April or at the end of June, you can look back and say, ‘I haven’t had any nightmares lately,’ or ‘I used to have panic attacks once a day, and now it’s once every four or five days.’” Progress looks different for everyone!

????You’re gaining awareness: Once you’ve been in therapy for a bit, you should feel more aware of your thoughts, feelings and behaviors. “You start reflecting on your actions, words, and the way you interact with other people,” Perez said.

For example, someone who struggles with people-pleasing might start catching themselves right before they offer to help someone, even when they don’t have the time or emotional capacity. “They’ll notice that this doesn’t feel right in their body, that this feels uncomfortable,” Perez said. What used to be an automatic thought or impulse becomes something to reconsider — and, with a lot of support from a good therapist and hard work, shifts over time.

***

I want to acknowledge that not everyone has the ability to shop around for a therapist who feels like the perfect match. Therapy is expensive, and you might be limited to working with someone who offers low-fee services (those therapists can be awesome, but you don’t often get to choose your clinician in community healthcare settings, and the pool of affordable therapists is a lot smaller in general). Or you might have an insurance company that pairs you with a therapist without first finding out your needs.

If you’re in any of these positions, as many of us are, it’s still important to advocate for your needs, Perez said. When it comes to insurance companies, you have the right to ask to work with someone else if whomever they initially matched you with isn’t a good fit. And if you’re open and able to use telehealth, there are more low-cost options for therapy than ever before (although there are some caveats to consider).

As I’ve previously lamented, the U.S. mental health system makes it entirely too hard to access affordable and consistent mental health care. Finding and affording a therapist is far more challenging than it should be. That said, I hope today’s issue has helped provide a bit of light on your path toward healing.

Wishing you all luck and patience in your search.

Until next week,

Laura

If what you learned today from these experts spoke to you or you’d like to tell us about your own experiences, please email us and let us know if it is OK to share your thoughts with the larger Group Therapy community. The email [email protected] gets right to our team. As always, find us on Instagram at @latimesforyourmind, where we’ll continue this conversation.

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More perspectives on today’s topic & other resources

Now that you know what a good therapist fit should look and feel like, how do you find one? My colleague Ada Tseng laid out simple steps for your search.

Therapist Lori Gottlieb asks some fundamental questions about what therapy is, and what it can and cannot do for us, in her book “Maybe You Should Talk to Someone.” In an interview with the New York Times, Gottlieb shares her perspective on what a therapist’s main job is and her definition of “successful therapy.”

Other interesting stuff

One Inglewood resident has built a supportive community of Black fathers who lean on one another as they evolve as Black men and parents, Times photographer Jason Armond writes in this beautiful feature about reclaiming Black masculinity. “It takes a village not just to raise our children,” Bobby Brown said. “It also takes a village to grow into ourselves.”

Traumatic childhood experiences embed themselves in our brains and bodies, and put us at risk of mental health conditions. But scientists say that epigenetic editing may offer hope of removing those memories. “Just as gene editing is promising new therapies for everything, from heart disease to cancer, there are those who believe tinkering with the epigenome could help us reverse the damage done by trauma — essentially giving us a way to physically edit out the scars of the past,” writes Ida Emilie Steinmark for the Guardian.

A new generation of for-profit group gatherings say they’re trying to remedy what’s been dubbed the “loneliness epidemic” — or “the friendship recession” — by serving people’s need for real and meaningful social networks. These wellness initiatives are catching on in Silicon Valley, the workplace and in unexpected sectors — for a price.