Finding the Right Therapist

I read this morning a post by Emily http://emilyfirstgirl.wordpress.com/2008/06/12/milestones-in-treatment-for-trauma-everyone-is-a-fingerprint/#comment-264  that inspired me to write about finding the right therapist. Although things had gone well for her (it seems) something wasn't right and she stopped with that therapist.

How do you know that you have found the right therapist or counsellor? Wouldn’t it be ideal to have a check-list that you can tick off when you set out to find a therapist? Sadly, it doesn’t work like that. I spent years of researching how services shape the recovery from sexual abuse; and here is what I found out:

A pre-condition for progressing in recovery from psychiatric disturbances (for example depression, anxiety, addictions, dissociation) has been to start abuse-focused therapy. Recovery, according to participants in my research, started to advance only once they felt they had met the right therapist who helped them to deal with the legacies of sexual abuse and provided emotional support and care.

Clients began to notice progress when they started to receive emotional support and care, respect; and when they felt valued and appreciated.  They soon observed an improvement of their trauma response inasmuch as their psychiatric disturbances diminished, their thinking and perceptions of themselves became less contaminated by the abuse, their social functioning improved, and their sense of responsibility and autonomy grew. 

This in turn strengthens their positive sense of self and led to an increased sense of self-confidence, self-respect, and self-esteem and they knew that they had grown stronger as persons. Feeling stronger and more positive about themselves had a direct impact on the improvement of their trauma response (the psychiatric disturbances they suffered from).

Recognition theory (Honneth, 1995b) considers emotional support and care as the form in which recognition through love is provided. Recognition through love is essential for the development of a person’s self and the formation of identity. It represents dynamics between people that are needed for building a positive self-understanding and for developing self-confidence. When people receive love, care, and support, they experience that they are worthy of love and care.

Emotional support and care have been identified by participants in my research as the main agent that facilitated recovery. It has also been depicted in the literature as crucial for human relationships and as a pre-conditions for human community (Engster, 2004; Honneth, 1995b; Mead, 1934; Noddings, 1984).

Participants knew they had found the right therapist when their therapist believed in them, had hope for their recovery, understood them, and was there for them. They felt supported and cared for. The examples from Anna and June (both pseudonyms) demonstrate the significanceof finding the right therapist. 

The very beginning? Meeting my therapist! Finally meeting … someone who was skilled, someone who knew about the specifics (of Dissociative Identity Disorder) and who understood, someone who was committed and who was strong. All those things. And it was like Halelujah…Finding the right match for our particular needs and trusting that we could handle everything. (Anna)

The first thing that comes to my head is my therapist. Because I had attempted before and it was her and who she is, somehow, I could trust. Not completely, but enough to get started. (June)

They had a sense that they had succeeded in their search for the right therapist when they felt their therapist’s skills matched their needs and they could go about developing trust in the herapist and in their own ability to cope with the tasks of recovery.

To be ‘right’, therapists needed to be skilled and knowledgeable about the specific needs of survivors with a history of sexual abuse and needed to be able to establish a good relationship. It was most important for their recovery that they felt a fit, a connection, with their therapist. Thus being the ‘right’ therapist was not just about therapists’ skill level. More importantly was to be recognised by the client as being skilled in the field of sexual abuse and being able to establish a human connection.

To be perceived as ‘right’ required therapists to care about participants, to respect them, and to provide emotional support. Once participants were able to recognise these qualities in therapists, the mutual recognition between participants and therapists fuelled and facilitated the recovery process.

Ruth knew she found the right therapist when she attended a group therapy session and saw the therapist working with another person. She felt that his approach and his way of working was what she wanted and needed for her own therapy.

I wish that was me, I want to do some work like this. And he said I’ll stay for another hour, can you stay? And I was so frightened I ran, I said no I can’t, I can’t, I can’t stay. So then I had the courage and I rang him in that week and I started working with him. So, that was the beginning really. (Ruth)

The need for victims of sexual abuse to find the ‘right’ therapist with understanding and skills in the area of recovery from sexual abuse has also been expressed by Herman (1992, p. 133) who stated “In the words of an incest survivor, ‘Good therapists were those who really validated my experience and helped me to control my behaviour rather than trying to control me”.

‘Finding the right therapist’ indicates how recognition through love in the form of emotional support is indispensable for recovery. Prior to the beginning of their recovery and in the absence of emotional support participants had been close to giving up the will to live and some even attempted to end their lives.

However, once participants had found the right therapist and were able to establish mutual recognition, their recovery proceeded through the emotional support and care given in the form of believing, creating hope, being there, and understanding. The most important conclusion is: It is not WHAT is done in therapy but HOW it is done.

References:
Engster, D. (2004). Care Ethics and Natural Law Theory: Toward an Institutional Political Theory of Caring. The Journal of Politics, 66(1), 113/135.

Honneth, A. (1995b). The Struggle for Recognition: The Moral Grammar of Social Conflicts (J. Anderson, Trans.). Cambridge, Mass.: MIT Press.

Mead, G. H. (1934). Mind, Self, and Society: from the Standpoint of a Social Behaviorist. Chicago: University of Chicago.

Noddings, N. (1984). Caring: A Feminine Approach to Ethics and Moral Education. Berkeley: University of California Press.

Comments

[Emily]

Gudrun

I am honored to have you use my post as a launching point into some very good thoughts and research. You have given me some more valuable thoughts for finding a new therapist.

Thank you for your research - you are terrific!

Emily
http://emilyfirstgirl.wordpress.com/

[Beth Fehlbaum]

Awesome post. Thank you. I have a wonderful, skilled, caring therapist. It's cool to recognize him in the descriptions you provided.

Beth Fehlbaum, author
Courage in Patience, a story of hope for those who have endured abuse
http://courageinpatience.blogspot.com
http://www.kunati.com/courage-in-patience
Chapter 1 is online