Getting the Most Out of Therapy

Once I started becoming more “known” from my radio program and books, I had to give up my private practice.  Folks would come in for sessions and expect me to work magic in three and a half minutes.  It became clear to me that I couldn’t be as effective one-on-one anymore.  So instead, I wrote books and did my show because I thought that those were the best ways I could help people.  

However, there are times on my program when I tell callers that they need to do a little more extensive work.  I can give them a jump-start, but they need to pick up where we left off in therapy.

Therapy can be a very complicated process, and there aren’t many therapists who do it well.  When looking for a therapist, there are a few things you need to do.  First, and most importantly, you have to form a relationship with your therapist.  When people call in to my program, they generally have listened to me for a while.  This means that they have already developed a kind of relationship with me in their minds.  When you go into somebody’s office for therapy, it usually takes a while to form that relationship. Without it, there isn’t going to be trust.  Although it seems like I receive instant trust from the people who call in to my show, that’s not really the case.  Most callers have been listening to me for a long time (sometimes 20 years or more), and therefore, the trust part is pretty much all squared away. 

Your clinician also needs to be a good fit for you.  Not every therapist makes the same choices or has the same personality and expertise. For example, when I was involved in private practice, I would not deal with anyone’s insurance companies.  They paid for their sessions, and I signed the insurance papers for them to submit.  I did this because I didn’t want my fights with an insurance company to interfere with our relationship.   

In addition, I believe that your first session should be free and on the phone.  It’s not really a session – it’s simply you asking a lot of questions.  You can always look up somebody’s license and credentials, but you still need to ask them about their expertise.  A lot of people get psychology licenses of various kinds and then claim that they can do anything.  However, there are specific areas of expertise.  Make sure you ask.  If you’re nervous about asking questions, first write them down on a piece of paper.  You may be less afraid to ask them if you put them in writing. 

This process may be uncomfortable, but if you don’t feel safe and comfortable with the therapist at first, you are not likely going to meet your goals with them later. 

Personally, I think that if you are seeking marital therapy, you should ask if the therapist is divorced.  Statistically speaking, when a therapist is divorced, he or she is more permissive of divorce.  And if they’re more permissive of divorce, it may impact how you perceive your marriage.  It’s the same old thing – if other people have done it, we feel like it’s more acceptable.  So, be sure to ask if they’re divorced and for how long.

Also ask about their ethics and how they’ve continued their education.  Once you’re done asking everything you want to ask, repeat this process with three to five more therapists.  See who gets defensive and who answers your questions openly. 

I know it can be intimidating or feel like you’re being impolite, but you must ask questions.  The truth is, your therapist is your hired help.  And if you do hire them, you’ll want to be able to ask them honest questions later, such as, “I don’t understand how this is helping; can you please explain it to me?” 

Nevertheless, you must also remember that the therapist does not assume the entire burden.  Therapy is hard work, and in order to improve, you have to do the work.  It’s the same principle as playing the piano – if you don’t practice, you’re not going to play very well.  You may notice that I often give assignments to callers on my program.   That’s because change doesn’t happen in one session – it happens outside of the session.  It’s an active process.  You can’t expect to go to therapy once a week and then not give it a moment’s thought until the next session.  The sessions are important but so is your effort to reflect on the content of those sessions and apply it on a daily basis. If you don’t make progress, it could very well be your own fault.  As I’ve said many times on the air, “Hey, I’m not going to work harder on your life than you are.” 

Finally, you need to expect that at some point during therapy, things could become extremely painful, uncomfortable, or unpleasant.  There are often blockages you have to work through.  You may start placing some of your past relationship issues on your therapist or treat them as if they were your mother, father, sister, etc.  Sometimes you’ll want to quit therapy or wonder why you’re bothering to spend money to be in pain.   You might even develop a habit of arriving late to sessions as a mechanism of avoidance.  However, when you start freaking out or getting defensive, you absolutely must go back and talk to your therapist about it.  Say, for example, “After opening up to you last time about ___, I became very vulnerable.”  Really good therapists are trained to understand and deal with your concerns.   

To bring it full circle, this is why establishing an initial relationship with your therapist is important – you need to be able to discuss anything and everything.  If you don’t trust your therapist or don’t feel like they believe in you, there will be no change.  You’ll simply reenact the same patterns with them and everybody else.