So much love for your in depth response to this question, Clare!
I just recently started working with a psychodynamic therapist in May this year, and I feel like the sessions and my therapist have been so supportive for me.
What you said about “staying close with yourself” is exactly what I’ve come closer to as a truth in myself throughout the last few months and the journey with my therapist.
We recently had a rupture, and for a few days afterward, I wasn’t sure if I could or would go back. Part of me was furious and angry, another part felt decimated inside.
Eventually, I reached a place in me of: ‘I am going to look after myself, regardless of what happens here and this may mean not going back and I’m okay with this in some ways, *and* I know we’ve built trust and I have begun to have trust in his care and the relationship, and I would like to keep working with him if that’s possible.’
It took me a few days to reach that space where I could hold both parts and feel the truth of them in me though, but I’m glad I did.
That session was one of the best sessions we’ve had. And the one following. I’ve also realized it’s amazing what is possible when someone is willing and able to own any mistakes they’ve made, is willing to make amends, and still shows up with their care and boundaries too. And when both parties can.
I think for many of us, we don’t expect to receive that, and maybe haven’t received it from anyone before, so for a therapist to stay in with us and meet us like this, I’ve realized it can be not only transformative personally, but also seems to deepen the therapeutic relationship as well. I’m really grateful to and for him and the work we’re doing. It’s not easy sometimes, but it is life changing and life affirming.
By staying close with myself, and giving myself the space and compassion to work through what comes up for me inside the room as well as outside too, I’ve realized I can show up more fully for myself and in my session too.
So that’s definitely made it on my list for any future therapists or similar that I might work with. And also as part of my own approach in life.
Also, it’s helped me have a bit more distinction around my therapist and I as different human beings, and that therapists are human beings too :)
They’re going to make mistakes, forget things, get things wrong, miss the mark sometimes. A good therapist will take responsibility for this and repair in the moment, or thereafter, once they’re aware of the situation. And we can practice forgiveness and compassion, and standing up for ourselves too.
P.S. For the last few years, I’ve been working as a relational coach and workshop facilitator, not a therapist, but I have told clients that I feel honored to be with them in these vulnerable places, and to be a part of their exploration and journey.
It’s always deeply touching when someone shares their world with me in this way. It’s a hallmark of hope, I think, and sometimes trust (but not always,) and I always want to hold this as sacred.
Not that that’s helpful to hear when you’re crying, I agree! (I feel really bad for you on the timing of that.) <3
Thank you for this beautiful comment, Sandi. I've also had those moments of rupture and repair in therapy, and they led to some of the best sessions I've ever had. To be honest, I only really learned to do the whole 'rupture and repair' thing *in* therapy. It was never a part of my life before that.
And yes, therapists are human and humans make mistakes. Just as I, as the client, have also made mistakes or been unkind/unfair. But we can take accountability for our failings, and move forward (hopefully stronger) in the aftermath.
I imagine this comment will also be helpful to other readers who are trying to find this kind of therapeutic relationship. It takes time to feel your way through all the emotions that therapy surfaces, but giving yourself the time and space to do that can allow great things to unfold.
Thanks again for this deeply thoughtful comment, Sandi. It was such a pleasure to read 💕
Great advice Clare. I liked your lists of qualities and things to avoid. I have been through the bad therapists too and I have complained loudly to mental health charities about this - to be told its my issue by those same mental health bodies ☹️
Examples of bad experiences - someone who kept trying to get me to talk about heavy abuse memories while it was lockdown, I had no job and no one else to talk to and there was a coup d’etat in Myanmar where all my income had come from for years and I had lots of friends. That sent me spinning into dark places.
I stopped seeing another after she told to cut off contact with my parents(so glad I didn’t).
I also got told how are you still functioning with so many traumatic incidents but I found that quite helpful as so many people in my life made me feel like I was exaggerating.
For me, feeling really grounded came from a mix of good therapists and especially seeing someone qualified to treat trauma. That has set me free from so much over analysis and expanded my window of tolerance.
I would add to the above - it is not just about the therapist it is about setting boundaries and telling the therapist what works or doesn’t work clearly. It is not all up to them. It is your mental health. You decide where you go in a session and how to use therapy so it works for you. That makes a massive difference.
This is great advice, Catriona. Thank you for sharing it.
I've certainly had moments of blaming or getting frustrated with therapy, and it was important for me to remember my own agency in those moments. In a lot of ways, I think therapy worked for me because I was willing to face all the hard things in my life. That determination made healing possible, and only I could decide to do that.
I'm sorry that you've also had negative experiences of therapy. I've also gotten the "you're so high-functionning" comment a few times, which always feels like a weird thing to say. Is it a compliment? A critique? A warning? I dunno.
Anyway, thank you for being here and for sharing your experiences. I apprecaite it. 💕
Thanks for sharing your experiences. As a therapist practicing for over 20 years, reading the stories you shared was very sad. I can’t believe you’ve had such negative experiences with so many practitioners. It’s a shame. I’m sorry that you’ve gone through that.
Thank you Selda. They were horrible experiences, but I’m proud to have grown beyond them. Now, I just hope that my story might help someone else. Thank you for being here 🙏
This is an excellent piece of guidance, Clare. But some of those inappropriate five therapists sound like they ought to be struck off! It shouldn’t be this hard to get good support. Oh, I liked your non-watery website criterion.
In Ireland , mental health services are not very well regulated. Some people have studied for years and worked hard to develop their practice. Others have done a weekend course and feel ready to guide clients through their deepest traumas. It's wrong that clients (who are often looking for help in a scary or vulnerable moment) have to navigate this system, and I agree that it shouldn't be so difficult to find the proper support. Hopefully this piece (& other resources) can help clients navigate this mindfield and to feel less alone as they do it.
I'm not sure why I was so against water on the websites, but I guess my gut felt like that was an indication of something that wouldn't work for me!
Thanks for being here Ros, I appreciate your comment!
I wanted to add that I found it empowering to ask - what is your background + training in trauma?
I found that many therapists had taken a workshop on being trauma-informed, which is not enough to be considered a trauma therapist and to guide me on my journey. So, I asked for their education and experience up front to weed out the folks who just don't cut it. (I don't know if this is an American thing - if standards for labeling are more stringent elsewhere.)
Edited to add: Also, a red flag for me was anyone asking me to share me entire story in the first session. This should be paced, especially in trauma therapy, to avoid re-traumatizing oneself. Headlines should suffice until there's more trust + safety established.
Anyone can label themselves as "trauma-informed" and that term means different things to different people. ("I did a weekend course on trauma" vs "I did my dissertation on cPTSD and have completed 200 hours of work with clients who've experienced sexual violence").
I wish practioners better understood the risks of re-traumatising clients too. I know medical doctors an oath to 'do no harm', but it doesn't seem like people working in mental health hold themselves to the same standard.
Thank you for being here Leigh. I appreciate your comment!
Thank you for a great and informative article, Clare.
I am an Addiction, Anxiety and Depression Counsellor, and I think anyone looking for a counsellor/therapist should follow your excellent advice.
Carl Rogers wrote about the importance of the therapeutic relationship, and research has shown this to be a significant factor in determining client outcomes. Therapy should be a partnership on an equal level, not a doctor/client basis.
Do your research, interview the counsellor—not the other way around—ask them THEIR background and qualifications, and papers/books they have written, and most importantly, their therapeutic approach.
I come from a Cognitive Behavioural Therapy approach, which is entirely different to, for example, Psychoanalysis, so do your research on this, too.
This is so important to get right, you’re right! And I will restack this. Thanks for sharing, Clare :)
Thank you Mark. I apprecaite you sharing your perspective.
One of my mistakes during the process I wrote about is that I didn't really understand the differences between all the different modalities. To be fair to myself, I was in a lot of pain and wasn't really able to do the intellectual work of trying to understand what would be best for me. It's also true that sometimes we don't know until we try things. But this is excellent advice and I'd certainly advise people to do their research before committing to a new therapist.
You’re welcome, Clare, and thank you for your kind words. I totally understand anyone not understanding the modalities, especially when they’re in pain, but it makes all the difference. In my example, above, CBT is usually short-term treatment 10-weeks with specific agreed objectives/behavioural outcomes at the start, which is good for addiction, anxiety and depression, because these outcomes can be measured. However, Psychoanalysis, can take literally years, with no specific outcome or goal identified at the start. I am not saying one is better than the other, just that it is important to know where the therapist is coming from. They should be willing to explain that before you pay anything, particularly when therapy is so expensive, and give you some idea of how you may benefit from it and the timescale. Well Done for sharing your experiences, Clare, which I know isn’t easy, and helping others.
This is great advice. It reminds me of when I was referred to a psychiatrist in my very early 30s through my healthcare provider. I felt I had to believe in him because I wasn’t paying directly but he kept banging on about my relationship with my mother even though that wasn’t why I was there… after a number of sessions I was at a restaurant with my mother and he was at the next table and I pointed him out to her and my mother and I burst into laughter spontaneously together… it was at this moment I realised that he had so totally misjudged our sessions that I stopped seeing him. It was not until this year at the age 55 when I had unexpectedly met a lady with whom I felt a connection with and I have started counselling sessions with her. I wish I’d had your advice all those years ago so I had been confident enough to find someone else to help. I have no doubt your post will help others in this way so thank you!
So much love for your in depth response to this question, Clare!
I just recently started working with a psychodynamic therapist in May this year, and I feel like the sessions and my therapist have been so supportive for me.
What you said about “staying close with yourself” is exactly what I’ve come closer to as a truth in myself throughout the last few months and the journey with my therapist.
We recently had a rupture, and for a few days afterward, I wasn’t sure if I could or would go back. Part of me was furious and angry, another part felt decimated inside.
Eventually, I reached a place in me of: ‘I am going to look after myself, regardless of what happens here and this may mean not going back and I’m okay with this in some ways, *and* I know we’ve built trust and I have begun to have trust in his care and the relationship, and I would like to keep working with him if that’s possible.’
It took me a few days to reach that space where I could hold both parts and feel the truth of them in me though, but I’m glad I did.
That session was one of the best sessions we’ve had. And the one following. I’ve also realized it’s amazing what is possible when someone is willing and able to own any mistakes they’ve made, is willing to make amends, and still shows up with their care and boundaries too. And when both parties can.
I think for many of us, we don’t expect to receive that, and maybe haven’t received it from anyone before, so for a therapist to stay in with us and meet us like this, I’ve realized it can be not only transformative personally, but also seems to deepen the therapeutic relationship as well. I’m really grateful to and for him and the work we’re doing. It’s not easy sometimes, but it is life changing and life affirming.
By staying close with myself, and giving myself the space and compassion to work through what comes up for me inside the room as well as outside too, I’ve realized I can show up more fully for myself and in my session too.
So that’s definitely made it on my list for any future therapists or similar that I might work with. And also as part of my own approach in life.
Also, it’s helped me have a bit more distinction around my therapist and I as different human beings, and that therapists are human beings too :)
They’re going to make mistakes, forget things, get things wrong, miss the mark sometimes. A good therapist will take responsibility for this and repair in the moment, or thereafter, once they’re aware of the situation. And we can practice forgiveness and compassion, and standing up for ourselves too.
P.S. For the last few years, I’ve been working as a relational coach and workshop facilitator, not a therapist, but I have told clients that I feel honored to be with them in these vulnerable places, and to be a part of their exploration and journey.
It’s always deeply touching when someone shares their world with me in this way. It’s a hallmark of hope, I think, and sometimes trust (but not always,) and I always want to hold this as sacred.
Not that that’s helpful to hear when you’re crying, I agree! (I feel really bad for you on the timing of that.) <3
Thank you for this beautiful comment, Sandi. I've also had those moments of rupture and repair in therapy, and they led to some of the best sessions I've ever had. To be honest, I only really learned to do the whole 'rupture and repair' thing *in* therapy. It was never a part of my life before that.
And yes, therapists are human and humans make mistakes. Just as I, as the client, have also made mistakes or been unkind/unfair. But we can take accountability for our failings, and move forward (hopefully stronger) in the aftermath.
I imagine this comment will also be helpful to other readers who are trying to find this kind of therapeutic relationship. It takes time to feel your way through all the emotions that therapy surfaces, but giving yourself the time and space to do that can allow great things to unfold.
Thanks again for this deeply thoughtful comment, Sandi. It was such a pleasure to read 💕
Great advice Clare. I liked your lists of qualities and things to avoid. I have been through the bad therapists too and I have complained loudly to mental health charities about this - to be told its my issue by those same mental health bodies ☹️
Examples of bad experiences - someone who kept trying to get me to talk about heavy abuse memories while it was lockdown, I had no job and no one else to talk to and there was a coup d’etat in Myanmar where all my income had come from for years and I had lots of friends. That sent me spinning into dark places.
I stopped seeing another after she told to cut off contact with my parents(so glad I didn’t).
I also got told how are you still functioning with so many traumatic incidents but I found that quite helpful as so many people in my life made me feel like I was exaggerating.
For me, feeling really grounded came from a mix of good therapists and especially seeing someone qualified to treat trauma. That has set me free from so much over analysis and expanded my window of tolerance.
I would add to the above - it is not just about the therapist it is about setting boundaries and telling the therapist what works or doesn’t work clearly. It is not all up to them. It is your mental health. You decide where you go in a session and how to use therapy so it works for you. That makes a massive difference.
This is great advice, Catriona. Thank you for sharing it.
I've certainly had moments of blaming or getting frustrated with therapy, and it was important for me to remember my own agency in those moments. In a lot of ways, I think therapy worked for me because I was willing to face all the hard things in my life. That determination made healing possible, and only I could decide to do that.
I'm sorry that you've also had negative experiences of therapy. I've also gotten the "you're so high-functionning" comment a few times, which always feels like a weird thing to say. Is it a compliment? A critique? A warning? I dunno.
Anyway, thank you for being here and for sharing your experiences. I apprecaite it. 💕
Thanks for sharing your experiences. As a therapist practicing for over 20 years, reading the stories you shared was very sad. I can’t believe you’ve had such negative experiences with so many practitioners. It’s a shame. I’m sorry that you’ve gone through that.
Thank you Selda. They were horrible experiences, but I’m proud to have grown beyond them. Now, I just hope that my story might help someone else. Thank you for being here 🙏
This is an excellent piece of guidance, Clare. But some of those inappropriate five therapists sound like they ought to be struck off! It shouldn’t be this hard to get good support. Oh, I liked your non-watery website criterion.
I agree!
In Ireland , mental health services are not very well regulated. Some people have studied for years and worked hard to develop their practice. Others have done a weekend course and feel ready to guide clients through their deepest traumas. It's wrong that clients (who are often looking for help in a scary or vulnerable moment) have to navigate this system, and I agree that it shouldn't be so difficult to find the proper support. Hopefully this piece (& other resources) can help clients navigate this mindfield and to feel less alone as they do it.
I'm not sure why I was so against water on the websites, but I guess my gut felt like that was an indication of something that wouldn't work for me!
Thanks for being here Ros, I appreciate your comment!
I wanted to add that I found it empowering to ask - what is your background + training in trauma?
I found that many therapists had taken a workshop on being trauma-informed, which is not enough to be considered a trauma therapist and to guide me on my journey. So, I asked for their education and experience up front to weed out the folks who just don't cut it. (I don't know if this is an American thing - if standards for labeling are more stringent elsewhere.)
Edited to add: Also, a red flag for me was anyone asking me to share me entire story in the first session. This should be paced, especially in trauma therapy, to avoid re-traumatizing oneself. Headlines should suffice until there's more trust + safety established.
These are great additions Leigh, thank you.
Anyone can label themselves as "trauma-informed" and that term means different things to different people. ("I did a weekend course on trauma" vs "I did my dissertation on cPTSD and have completed 200 hours of work with clients who've experienced sexual violence").
I wish practioners better understood the risks of re-traumatising clients too. I know medical doctors an oath to 'do no harm', but it doesn't seem like people working in mental health hold themselves to the same standard.
Thank you for being here Leigh. I appreciate your comment!
Thank you for a great and informative article, Clare.
I am an Addiction, Anxiety and Depression Counsellor, and I think anyone looking for a counsellor/therapist should follow your excellent advice.
Carl Rogers wrote about the importance of the therapeutic relationship, and research has shown this to be a significant factor in determining client outcomes. Therapy should be a partnership on an equal level, not a doctor/client basis.
Do your research, interview the counsellor—not the other way around—ask them THEIR background and qualifications, and papers/books they have written, and most importantly, their therapeutic approach.
I come from a Cognitive Behavioural Therapy approach, which is entirely different to, for example, Psychoanalysis, so do your research on this, too.
This is so important to get right, you’re right! And I will restack this. Thanks for sharing, Clare :)
Thank you Mark. I apprecaite you sharing your perspective.
One of my mistakes during the process I wrote about is that I didn't really understand the differences between all the different modalities. To be fair to myself, I was in a lot of pain and wasn't really able to do the intellectual work of trying to understand what would be best for me. It's also true that sometimes we don't know until we try things. But this is excellent advice and I'd certainly advise people to do their research before committing to a new therapist.
You’re welcome, Clare, and thank you for your kind words. I totally understand anyone not understanding the modalities, especially when they’re in pain, but it makes all the difference. In my example, above, CBT is usually short-term treatment 10-weeks with specific agreed objectives/behavioural outcomes at the start, which is good for addiction, anxiety and depression, because these outcomes can be measured. However, Psychoanalysis, can take literally years, with no specific outcome or goal identified at the start. I am not saying one is better than the other, just that it is important to know where the therapist is coming from. They should be willing to explain that before you pay anything, particularly when therapy is so expensive, and give you some idea of how you may benefit from it and the timescale. Well Done for sharing your experiences, Clare, which I know isn’t easy, and helping others.
This is great advice. It reminds me of when I was referred to a psychiatrist in my very early 30s through my healthcare provider. I felt I had to believe in him because I wasn’t paying directly but he kept banging on about my relationship with my mother even though that wasn’t why I was there… after a number of sessions I was at a restaurant with my mother and he was at the next table and I pointed him out to her and my mother and I burst into laughter spontaneously together… it was at this moment I realised that he had so totally misjudged our sessions that I stopped seeing him. It was not until this year at the age 55 when I had unexpectedly met a lady with whom I felt a connection with and I have started counselling sessions with her. I wish I’d had your advice all those years ago so I had been confident enough to find someone else to help. I have no doubt your post will help others in this way so thank you!
Those who liked this might like my piece on what good therapy looks like - https://johnmoyermedlpcncc.substack.com/p/what-does-good-therapy-look-like?r=3p5dh