Is your therapist helping you?

This is a re-posting of a piece I wrote in 2005. I am re-posting it now because I have had a number of comments from readers about “Oh you poor dear” and I thought this would explain some more of where I stand on the subject of therapy and specifically how people can tell if they are seeing a therapist who is doing them good.

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Psychotherapy can be good. Very good. Among other things, it can help people sort out their feelings, heal old hurts, learn how to deal with difficult family members, enable them to make better choices, help them to form a more realistic self-image. As a marriage and family therapist, I feel that psychotherapy often is the key to people living healthy, happy lives. Sometimes we need a sounding board or someone who can look at things from a different perspective. Sometimes we need someone to help us sort things out or to encourage us to try out new behaviors.

Unfortunately, not all psychotherapists provide the help that people need. I include in the term psychotherapist all of the following: psychotherapists, psychiatrists, psychologists, social workers, family therapists, counselors, life coaches, spiritual advisors, clergypersons and any others who engage in similar activities. There are large numbers of individuals in all of these fields who are capable, competent, ethical, and effective. No field has the monopoly on effectiveness. Yet, in all of these fields, there are individuals who are not capable, not competent, unethical, and even harmful.

Those psychotherapists who do harm to their clients may do so not out of incompetence (although there is plenty of that around) and not because they intend to do harm (because most believe that they are altruistic and helpful), but simply because of economic realities.

In many large cities, the number of psychotherapists per thousand people is greater than the demand. That means that many psychotherapists must work very hard to make a living. Many will have two or three or four different activities that bring in money. Some will teach on a high school to graduate school level, they will give seminars to lay people or professionals, they will supervise other therapists, they will engage in research, they will do therapy groups. In short, they have to hustle to make a living.

Then, into their office walks a client. Clients are not easy to find, and so the therapist, in his or her desire to help the client and to retain the client, becomes very welcoming and spends time getting to know the client and his or her problem. So far, the “good” psychotherapist is indistinguishable from the harmful one. Here are some ways that the lay person can tell the difference between them.

1. Does the therapist tell you that actually your problems are much more complex than you thought?
2. Does the therapist suggest that you see him/her more than once a week?
3. Do you think that the therapist is the most important person in your life?
4. Do you leave the office feeling weaker and more wounded than when you came in?
5. Does your therapist encourage you to believe that no one can understand you the way he/she can?
6. Does your therapist keep you oriented to the past (working out past hurts)?
7. Did your therapist “help” you to recover memories?
8. Does your therapist summarize from time to time the progress you’ve made and where you are in the therapy?
9. Are you working on a specific goal?
10. Overall, are you feeling better than you did when you first entered therapy?
11. Does your therapist encourage you to think of yourself as normal and healthy?
12. Do you have any idea as to when the therapy will end?

If you answered more than two of the first seven questions with a “yes,” and/or any of numbers 8-12 “no” it might be a good idea to talk with someone you respect about whether this therapist is doing you good or whether perhaps, you are helping the therapist to solve some of his/her problems.

Remember, the money that you spend on a therapist is the least expensive part of the investment. As you spend time with an ineffective or unethical therapist, you are wasting time in your life that could be spent healing and living