I saw my first therapist when I was seven or eight. She was a grief counselor. I played with toys in her office and sometimes we talked about my mom. Then I would sit in the waiting room while she talked to my dad.
Sometimes I wonder if my life would be different if I had been honest with her. I never told her about the hateful voice in the back of my head that picked apart my every thought and action, until I tugged at my hair and hissed in vain for it to shut up. I don’t know if I was afraid of what would happen if I really opened up to her; I think I just didn’t have the vocabulary. I know there were times when I consciously told her what she wanted to hear. I wanted to be good.
I’ve seen a lot of therapists over the years, at student health centers and clinics and occasionally private practices. I don’t remember all of them clearly. I do know that certain patterns emerged early:
1. They expect you to just walk in there and talk. This can probably be blamed mostly on insurance policies that only cover so many sessions. You don’t have time for the slow process of building trust and a sense of stability. You’re supposed to sit down with this stranger and rattle off your inner dreams and demons like a list of symptoms.
2. Many of them don’t seem to understand why #1 might be a problem. I’ve seen therapists who seemed genuinely confused when I skipped appointments or refused to open up. I don’t know if I’m weirdly recalcitrant or they’re weirdly comfortable with emotional topics. I do know it’s hard to feel understood by someone who doesn’t seem to get the inherent bizarreness of a therapy session.
3. For my own part, I also make #1 harder than it probably has to be. My vigilant awareness of other people’s reactions goes into overdrive with therapists. The slightest hint of boredom in their eyes or posture will shut me up. Any word or tone of voice or question that could possibly be read as criticism will have me skipping appointments as some kind of petty revenge. I know it’s counter-productive and childish, but it always feel perfectly justified in the moment that I do it.
At least, that’s how it used to be. When I returned to school in January, the health center referred me to a therapist who coincidentally turned out to be perfect for me. I have been extremely lucky here. In case anyone happens to be wondering for personal or professional or pure curiosity-related reasons, this is what makes a therapist work for me:
1. She has actual conversations. One of the things I always hated about therapy was the artificiality, the constant barrage of questions, like you’re the subject of the most boring TV interview ever. Just a few moments of give and take, something resembling a conversation between two people, can make an enormous difference.
2. She acknowledges the weirdness. She does this by being patient, by not pushing too much, and by having a sense of humor about this artificial situation we have found ourselves in.
3. She knows enough to understand what I am telling her. Instead of giving me a broad diagnosis and trying to fit me in with many other people – people who may or may not be able to relate to me – she listens and notes the details of what I am telling her.
4. She is warm. Some people just have the ability to be comfortable in a room with another person, and she is one of them. I do not know that this is a universal requirement for being a good therapist. I think there are some clients who may actually prefer a more clinical, detached approach from their therapists and doctors. But for me, this is exactly what I need.
The standard dating advice people like to give is about kissing frogs. Apparently a similar rule can be applied to therapists. I have seen one who made a surprised, uncomfortable face when I told her I’m gay. I’ve seen another who dismissed all of my concerns about medication and borderline bullied me into an increased dosage. I’m glad I kept trying.