The Therapy Relationship: What Makes a Good Fit?

Research shows that the quality of the therapeutic relationship is an important component of successful therapy, along with the training and experience of the therapist. I would go so far at to say that it is the foundation of therapy and the context in which healing occurs.  Certainly, without a working relationship in place, no techniques are likely to be very effective!

Those who have experienced trauma( Big T or little t) in the context of relationships are thus faced with quite a dilemma.  Relationships in the past have led to wounding:  abandonment, betrayal, unmet needs.  Now a relationship in which to heal must be sought. It makes sense that in the aftermath of  trauma  there are a host of responses that make connection difficult.  As I have written previously, childhood trauma can cause the disruption of basic developmental tasks such as self-soothing,  seeing the world as a safe place,  trusting others,  organized thinking for decision-making and avoiding exploitation.

Does it ever feel like a double bind? To seek to feel safe in the therapeutic relationship when relationships in general feel dangerous?

How have you navigated that?

As a potential client, what cues do you look for to feel safe enough to begin therapy?

Do you start assessing even prior to the meeting? I have had some clients give me feedback that even tone of voice on a therapist’s voice mail message can factor in.

As a therapist how do you address the issue of safety and the relationship?

I find it is important first of all to name the dilemma. I acknowledge all the ways starting therapy can be a challenge.  Sometimes taking that first step is one of the hardest parts! I also believe and express to potential clients that I see trust in me and the process as something that will develop over time.  I strive to earn trust by being trustworthy: authentic, consistent, matching what I do to what I say.  I also believe that a good therapeutic relationship is not free from empathic ruptures or miscommunications. There is no perfect relationship, not even in therapy. Instead, what matters is how we address disconnections and  how we do the necessary repair work.

I’d love to hear input from both sides of the therapy relationship.  Below are a list of factors that come to my mind. What about you?

How do you try to assess a potential therapist? What makes for a good enough fit?

  1. Ease of access: How can you contact the therapist? Do you prefer phone,  email.  How quickly does the therapist respond?  Does too much phone tag turn you off?
  2. Location: I am always surprised at how many clients pick a therapist based on location alone! How far are you willing to travel? Do you want in person therapy or would some form of online therapy work for you? Do you consider the type of office space? How accessible it is by public transportation?
  3. Availability: How soon can you be seen? What hours and days are appointments available? Is the therapist available for more than one session a week? In between scheduled or crisis contact if needed?
  4. Credentials: Do you have a preference for a psychologist? A social worker? Does the type of degree or training matter to you?
    Information on types of therapists
  5. Identity Demographics: Do you want to have certain things in common with a therapist? Do you have a preference for a particular gender, age, race, ethnicity, religion,  sexual orientation? Some of these may be initially apparent, others not.  Do you want a therapist to disclose some identity information? Therapists: are you comfortable/willing to do this? How much is too much? Sometimes people from marginalized groups (like the LGBT communities) want to seek LGBT therapists.  Is it enough to know that your therapist is knowledgeable and affirming about your culture or do you seek a shared identity or background?
  6. Areas of expertise: Is the therapist experienced with the issues you present? How do you know? Is the therapist licensed? Do you know how to access that information? What is the therapist’s theoretical orientation? Are they trained in specific techniques like EMDR, found to be effective in treating trauma? Does the therapist practice trauma-informed care? If treating dissociative disorders, are they aware of the  Treatment Guidelines developed by the ISST-D?

Pragmatics like location and availability as well as a therapist’s professional training and expertise are all important factors to consider. But what about the sometimes more subjective factors? I truly believe that therapy is as much an art as a science. The therapist’s self (as expressed within appropriate ethical boundaries) factors into the equation. Being authentic, consistent, insightful, able to model expressing emotion, the ability to be present with hearing unspeakably painful truths, conveying warmth and understanding,  humor can all factor  into the healing relationship and show up in different ways in each therapist.  A therapist who is a great match for one client may not work for another.

Interviewing potential therapists to ascertain goodness of fit is crucial! You may want to write out a list of questions or concerns in advance, to make sure you cover all your bases. Dr. Bessel van der Kolk suggests that trauma survivors also consider their experience of the potential therapist: “Pay attention to whether the therapist really wants to hear the troubles you have to tell.  Ask yourself, ‘Do I feel validated? Is the therapist really listening to my story?'”

Trust your gut and intuition, but also work to sort out past triggers.  Is your gut telling you this therapist won’t work for you, or are you feeling scared of therapy in general? Can you determine that in one session or do you need several to make an informed choice? Unless there are huge red flags( unethical behavior,  lack of education regarding trauma,  homophobia/transphobia,  for example) I really encourage potential clients to share their misgivings and concerns with the therapist.  How this is addressed will tell you a great deal! It is important that any therapist listen to your critiques with empathy and non-defensiveness.

What do you look for when seeking a therapist? And how do you know it when you see it?

I’d love to hear your thoughts and experiences!

Kathleen Young, Psy.D.

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53 Responses to The Therapy Relationship: What Makes a Good Fit?

  1. Anonymous says:

    I have a fabulous therapist.

    I am pretty sure she is not queer, and I don’t really care either way. She is the best.

    I literally feel like I can tell her anything, and not because she has a weird prurient interest in sex, but because she is genuinely interested in me and concerned with my well-being. And being my therapist has been an education in kink and gender, I am pretty sure.

    I don’t know if she takes copious notes the moment I leave, or whether she has a phenomenal memory, but she remembers everything I tell her. This makes me feel appreciated and understood.

    I originally chose her because she has expertise in eating disorders and I have a history of binging and purging. Food and body image continue to be my most challenging areas, though there has been a light in the refrigerator lately.

    Lately, she’s been bringing her dog to her office, and that’s wonderful.

    • kyoungpsyd says:

      Welcome Anonymous and thanks for responding!

      I am glad you have such a good therapy experience. And good point, therapists certainly learn a great deal from their clients!

      You raise an issue I overlooked: the presence or absence of pets in the therapists office!

  2. U says:

    I had a therapist once, and it was a bad fit. She was cold and clinical and seemed more intent on maintaining a professional distance. I felt like I was less of a person with feelings, more of a task – “ok, I’ve got to get you well again”. It certainly didn’t feel like she cared, and I think that is a key factor – that the client feels that the therapist actually cares!

    I think that being able to see the humanity in your therapist goes a long long way. It’s a fundamental communication thing.

    • kyoungpsyd says:

      Hi U!

      I really appreciate you sharing what did not work. And I certainly get why that was a bad fit. Yes, at the heart of connection must be that feeling of being cared about, of mattering as an individual.

      If you were to look for someone new, do you have any thoughts about what you’d look for/shy away from in initial encounters?

      • U says:

        You know, I think it would very much be an instinctual thing. Whether I feel comfortable with the person pretty quickly or not. I think that would be a good gauge for whether it’s going to work or not… but I wouldn’t rule a therapist out from the first meeting – sometimes it takes awhile to get used to a person.

        I think some cultural commonalities would be an advantage, but from my past experience, this would not the be all and end all.


  3. acomo says:

    When I found my therapist 5 yrs ago, I had no idea of all the factors I would now weigh carefully. What I liked was her website, that she had a website, her picture, and that I felt she might be able to identify with me and my cultural/family background. I also factored in location. Fortunately, I was extremely lucky – she has been a wonderful balance of warmth, authenticity, professionalism, and healthy boundaries. In the beginning she was much more available Mostly email, some phone), and later it tapered off in what I felt was an appropriate way.

    If I were to do it over again, I would look at theoretical orientation, location, expertise, etc. I might be less picky in some ways (i.e., identity demographics), but probably more picky in others (i.e., orientation). Ultimately, I would rely heavily on my gut.

    Regarding the trust issue, I think I may have had an easier time, given that I’d been highly enmeshed (emotionally) with my mom and presented with a very dependent personality. Trust? No problem. Learn to self-sooth & take care of my own needs? Deal w/ the fact that my T could not meet those needs outside of therapy? That was more the struggle for me, although I am happy to say that I’ve come a long, long way 🙂

    Thanks for the interesting post!

    • kyoungpsyd says:


      Thank you for the thoughtful response, and welcome!

      I am glad you have such a good experience and that you are able to rely on your gut instincts.

      Yes, internet presence is becoming more of an issue and a way to get a sense of therapists in advance of meeting. Interesting to hear that seeing a picture help. In years past therapist colleagues used to be concerned that pictures were not a good idea. But every non-therapist I’ve talked to about the issue is in favor of it.

      Thanks again for your input!

  4. justme says:

    I once had a bad first visit with a therapist. She sat behind her desk during the session and I noticed a Bible prominently displayed on it. Given that I grew up with abuse stuff related to Christianity, that was a deal breaker at the time.

    So the religion of the therapist was important to me, but only because it was so visible.

    • kyoungpsyd says:

      Welcome to my blog, justme.

      I can understand why that experience was a bad fit for you! Not only was there the religion trigger, but it also sounds like you had a reaction to the therapist behind the desk. Talk about distant!

  5. Ralph says:

    I tried therapy for a year once. I originally saw a woman who was knowledgeable and seemed like a good fit, but after a handful of sessions I realized there just wasn’t good chemistry.
    She transferred me to another psychologist in the firm and she was great! She was easy to talk to and as you mentioned in your article, her humor helped in all the right ways.

    I think that location is a key factor for me. Also, a current website with a picture, I find to be helpful, as well.

    This is a great article! I look forward to more dialogue!

  6. kyoungpsyd says:

    Thanks for stopping by Ralph!

    It sounds like you were able to advocate for yourself, and seek a better fit? Good for you!

    I wonder, is this hard to do sometimes? Has anyone wound up staying in therapy (or just dropping out altogether) rather than address problems in the relationship?

    How can we as therapists empower our clients to have these tough conversations with us?

    • Andréa says:

      My college’s counseling department is ever-changing, and I stuck with a therapist who may have been qualified, but with whom I couldn’t really connect, because she didn’t seem to be about to change jobs (and I’d already had a few therapists/counselors who left). It took me about a year to get up the courage to try someone else, who I thought was an excellent match for me, but she decided after a handful of sessions that we weren’t right for each other. I was surprised, because I got so much more out of those few weeks than I’d gotten out of the last year of counseling. She sent me to someone with little experience in trauma issues, and I started going less and less.

    • EN says:

      Necroposting here :-). Long ago and far away, I started in therapy with a gentleman who was a hardcore behaviorist. His private psychotherapy practice was a bit of a “sideline” to his other pursuits involving such things as hostage negotiations and assisting law enforcement officers in certain other circumstances. He did a lot of evaluations for the military and law enforcement agencies, and so relied heavily on testing instruments, especially the MMPI.

      I wound up with a clinically invalid MMPI. He decided I was a confabulator or malingerer and never believed another word I said. I didn’t know or understand any of this for a long time. I only knew that I felt his condescending, preachy style every time I walked into his office….But I had no idea that this was not how therapy was supposed to be. I just got more miserable all the time.

      Eventually–it took a year–he referred me to someone else. We made a great connection and that’s where I’ve been for a very, very long time. I went back to him for some closure a couple years into my work with my current therapist, and that’s how I found out about the clinically invalid MMPI and his crappy attitude.

      It was so scarring that today, as a psychology student, I have a strong emotional reaction any time behavioral therapy comes up in class work.

      • I am so glad you were able to go on and have a positive therapy experience after that! Since you are now a psychology student, looks like it didn’t turn you off the field entirely. Thank goodness!

  7. In choosing a therapist (my first and only time) the following were important to me personally:

    a. Fee – I had to know that I could afford it.
    b. Had to be a male. Thankfully he is a younger male vs. old and grey which I think would have scared me.
    c. Was available for night sessions.

    For a good enough FIT…

    a. I think there has to be some type of inital connection. You either feel someone understands you or you don’t. You either feel like you could potentially trust someone or you don’t – that type of thing.

    I think a good enough fit is that you find a match that suits who you are, and I think we would generally pick people that we would either like to be or would like to be friends with – from a comfort level. If we’re not comfortable, what’s the point in even going?

  8. kyoungpsyd says:


    Welcome to my blog! I welcome your participation!

    Affordability is of course an issue, thanks for mentioning that.

    Yes, I think you are describing much of what I was getting at, that “felt sense” of clicking with another.

  9. Crystal says:

    I worked with a therapist for about 7 years on all sorts of recovery issues. She was too willing to let me crawl into her lap and eventually that was all she was about to me – a place to be physically comforted. Obviously bad boundaries on my part, probably on her part, as well. So I’d want someone that would stick to a handshake.

    • kyoungpsyd says:

      Thanks for posting Crystal.

      I believe very strongly that it is my job as the therapist to make sure healthy boundaries are maintained. There may be all sorts of reasons clients do not know how to establish boundaries that work for themselves.

      Any kind of touch in therapy is a complex subject, even more so for trauma survivors. I think your experience illustrates that even when something seems comforting in the short term, it may not be in one’s best interest overall.

      I am sorry you had that sort of bad experience. It sounds like that may be an issue you’d seek to clarify up front in the future?

  10. Crystal – I am shocked by your experience. Not that some type of physical connection is to be fully banished from therapy, but I have to admit I’ve never heard of such an experience. I do everything I can NOT to touch my therapist or be too close, out of a regard to maintain that boundary of physical separation. Even during payment I try not to touch his hand or anything.

    • kyoungpsyd says:

      It is a really loaded topic, isn’t it sanityisknocking?

      I am thinking this might be a good subject for it’s own post and conversation!

      • PosterPiaget says:

        Necropost, but I’ve only just found this…

        When talking/using AAC to a friend who is a therapist, to seek advice for a referral to someone with whom sessions would be less ethically problematic, in relation to childhood abuse, at difficult points he did engage in physical contact in ways we’d previously established weren’t problems wrt our respective disabilities or anxieties. Usually touching one of my hands while offering verbal reassurance or asking questions to check I was still ‘present’.

        I think touch does have its uses and place in association with experiencing that level of difficulty, as long as any specific issues around touch are dealt with in a mutually acceptable way. Since sorting out the referral, I don’t try to avoid incidental contact with the therapist, and he doesn’t act such that incidental touch would occur in a triggering location or manner, but neither of us directly seek physical contact with the other without a reason.

        I know that my boundaries aren’t always appropriate, but I also found Crystal’s experience shocking, solely because I can’t remember ever feeling okay with that level of physical contact, even with primary caregivers in infancy.

        I realise it has been long enough that Crystal is likely to not return, but in the improbable event that she does… Thank you for sharing. This is a very different perspective to mine and it is interesting to try to understand.

  11. Crystal says:

    You know, SIK, I am laughing at the huge difference between you dropping the check on the table rather than hand it over vs. me cuddling and being held. Wow! Don’t know that I could do it again with no touching at all but certainly I’d insist we each sit in a separate chair.

  12. Crystal – you should totally blog your experiences! So many people would be interested to hear and read about it I’m sure!

    It really shows the vast difference in the experiences of clients and the techniques of therapists…which is good in that there is something out there for everyone’s own individual needs…but a little scary.

    Crystal, how do you feel the touch aspect affected the therapeutic frame of the therapeutic relationship? Was it discussed what would be appropriate and what wouldn’t be? I am still trying to get my mind around it – to be honest – just becasue we’ve had such vastly different experiences. I like boundaries in that (like children!) they let us know what to expect.

    • kyoungpsyd says:

      I know you were not asking me, so I hope Crystal will return and elaborate if she wishes.

      In work with trauma survivors ( and really just everyone) I err on the side of caution regarding touch. One way I see the therapy relationship as different is that we do not just do things, we talk about them in order to understand their meaning and impact. So regarding touch, I’d want to make sure it was something discussed and understood with the individual (and their internal system if applicable).

    • Crystal says:

      Yes, it was discussed, and I initiated the contact. We discussed it in that I questioned maybe stopping it and the therapist assured me it was OK to continue. I actually, while driving to her office, used to convince myself that I would sit in my own chair without touching but then would cave in upon arrival. But, yes, I became very doubtful that it should continue but my therapist convinced me it was what I needed.

      As for blogging? I don’t know very much about it and prefer to drop in on other people’s!

      I think the touch affected the relationship by making it less equal and making it hard for me not to feel dependent. I actually used to say “I am addicted to your body” to her. On a positive, when re-hashing nasty abuse issues, I doubt I could have done the work I did without the contact…

      • Thanks for sharing – what an interesting experience and I’m glad that you feel it was helpful in that you could rehash abuse issues because of it, and work through them.

        About blogging – it’s so simple…especially @ wordpress. You definitely sound like someone who has a more than unique story to tell – which is why I suggested it! Thanks for being so honest with your comments…learn something new everyday!

  13. MeMyself&Who says:

    I started to write out a response to this but I think I’m gonna try and make it a whole separate blog because I keep thinking of things haha!
    I came to update my blogroll and got sucked into catching up with your posts, so hopefully by the end of this I haven’t forgotten to do what I came to, add you to the list. Ha!

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  15. Tears says:

    Hi Kathe…

    I found this Blog today and can not stop reading it! I think this is wonderful; exactly what I need right now.

    I am struggling with the touch issue. I chose my current therapist because she practices Holographic Memory Resolution, a therapeutic approach I find very helpful. I believed she understood sexual trauma. But right away she started calling me on my lack of eye contact and my not wanting to be touched (boundaries I keep to avoid vulnerability). She said she was challenging me to look at my behaviors (something I want in a therapist). We talked about it for a few sessions but I felt like she was trying to convince me it was okay to relinquish my boundaries (very perpetrator-esk). We did not come to a consensus on the issue because the more we talked about it the more I feared she was trying to manipulate me. The subject was dropped.

    We are currently using energy work that can help with dissociations and hopefully integrate all my parts together during therapy (good stuff) but it involves touching!….She’s trying to be respectful but sometimes she forgets. It makes me wonder if she understands sexual trauma survivors at all.

    I think it would be great if you posted more on the subject of touching during psychotherapy.

    • kyoungpsyd says:

      Hi Tears-

      I am glad you are finding helpful material here.

      It sounds like you are having some questions about your therapist’s approach and whether it is a good fit or retraumatizing you in some ways, am I reading that correctly?

      I am not familiar with Holographic Memory Resolution, so I am not qualified to speak about its efficacy. I would recommend doing some research about it and whether it is accepted by reputable organizations, such as the International Society for the Study of Trauma and Dissociation. It sounds like you are seeking help for a dissociative disorder? If so, you might want to refer to the ISST-D treatment guidelines: ( information about touch in therapy is all the way at the end).

      I do encourage you to continue to discuss your concerns with your therapist and to pay attention to you gut instinct. Sometimes it is hard to know the difference between discomfort because the therapy work is challenging vs. discomfort because it is not helpful or even worse, retraumatizing.

      In cases like this sometimes people find it helpful to seek outside consultation, with a therapist with trauma expertise. I am available for such consultation, for clients and therapists alike. I can be contacted via my website:

  16. Tears….thanks for sharing! I know nothing about this “touch therapy” and am surprised by your and Crystal’s posts. Just wanted to let you know I appreciated your disclosures…it is always interesting to know the different ways in which people seek out help with their issues.

  17. Crystal says:

    Tears- What is Holographic Memory Resolution? And energy work? Sounds interesting.

    And regarding touch- I just don’t think a while lot of it belongs in the therapy relationship. I’ve done some research and certainly my experience is frowned upon in most places I’ve studied. I’ve found a few fringe theories that recommend it. While at the time I liked it and craved it I wish it hadn’t started in the first place.

  18. Tears says:

    Holographic Memory Resolution or HMR is very hard to explain.

    But before you try any of it please make sure you are in a safe place, well held emotionally, maybe while in a therapy session, with someone you trust that will be strong and can handle the situation.

    I use HMR to picture and imagine my childhood and I picture or create a different outcome. I can picture my mother coming in and throwing my abuser off of me. I can picture her taking me to the doctor and the doctors pressing changes. I can picture the social workers talking to me and helping me to understand that it was not my fault. Basically, I create a new story, the story that should have been.

    Then I sit in that feeling of being well held and heard and safe. And I send that safe feeling through my body from the top of my head to the bottoms of my feet. I let myself know what it was supposed to be like. It is not a denial of the incident. It is not a denial of the injustices I experienced. It is a way of caring for me now like I should have been cared for then.

    Sometimes are better than others-that’s why it is crucial that you are in a safe place before ever trying something so emotionally changed. And when I started doing this I had to do only small pieces at a time.

    It is an amazingly powerful tool of self-empowerment.


  19. Tears says:

    The new form of therapy that involves touch is called Brain Integration Technique or BIT.

    I do not have as much experience with BIT as I do with HMR. BIT is the therapy that involves acupuncture touch on various meridians in the body and touch through muscle testing. I lie on a therapy table and she either touches the meridian points or I do. She also touches my forehead and the back of my skull during the balancings. It is not a cuddling, comforting touch but vulnerable all the same.

    The hope with BIT is that when I’m finished with the therapy I will be able to process difficult memories faster and remain present (not disassociate) when stressed.

    Both HMR and BIT are forms of energy work.

    I hope that helps.


    • Crystal says:

      It sounds so different than just sitting and talking and talking and sitting. The HMR sounds more like you are actually doing something – empowering yourself. Thanks for explaining.

  20. Kerro says:

    Hmmm, wish I’d found this post a year ago!

    I have learnt that really the only thing that matters to me is my gut. Do I feel comfortable? And am I willing to go back?

    I know now that if my gut isn’t happy, then it’s not my fault – it just isn’t a good fit and I should run for the hills.

    Of course, there are things that contribute to my gut being happy – like the therapist having a sense of humour, not being “wet”, not touching me….

    And then there’s the basics, like the therapist actually having a qualification of some sort, being reasonably easy to get to, and fee. But the gut reigns supreme.

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  22. Kit says:

    Great topic!! In my early pursuit of therapy, I wish I had known about ” fit” issues. I spent too many years in therapy with a good Dr. who was just tempermentally wrong for me. He was well educated and totally ethical, but a horrible match for me. I had a consultation and another Dr. pointed out that I really needed someone “warmer and fuzzier”.

    Breaking it off with the cold fish was painful as I was deeply attached, faults and all. However, I found the “better fit” and the new Dr. has been with me for many, many years now.

    I knew I wanted a male Dr. because my trauma issues center around a female caregiver. Although having a gender preference always makes me feel like a bad person, like I am a discriminating “employer”. But past experiences with female therapists lead to fighting and petty disputes over language nuances etc.

    Also, just as important, I wanted a therapist who wouldn’t just stare at me when I cried. I know that touch is a delicate subject, but for me it needs to be an option on the table. Even physically moving closer can help. But a blank stare from across the room just escalates how horrible I feel. My current T is masterful at using all kinds of ways to help me feel cared about, touch may be rare but it is not out of the question if I ask and I am clear about what I am looking for.

    I feel so lucky to have a rock-solid therapy relationship. It is the difference between feeling in constant pain and feeling a general sense of comfort.

    I would urge anyone to find that better fit if your “gut” tells you something isn’t right.

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  26. Nikii says:

    One of the biggest factors in finding my therapist was the fact that she made the effort to call me back and get in touch with me after I left a message on her phone. She answers her own phone…I may have never started if I had to deal with a receptionist, or answering service. Her presence on the phone was friendly, warm, and present. She has a great website with good information. All the fee particulars were handled prior to the 1st session, and she sent a welcome email to me; as well as, a link to a secure client website to fill out intake forms and read required privacy policies, and other neccessary information. When I walked into our 1st session it was about therapy and not about forms and fees (who wants to pay $$ to fill out forms and talk about money).

  27. bearscaralot says:

    I have worked with my therapist for 7 years, off and on, for past trauma. Her expertise is in trauma and she uses DBT and EMDR. She is really amazing. She is thoughtful, hears me and remembers things even from long ago; I feel like she can handle my moods well, even when I’m angry- we’ve worked out many miscommunications and she has never made me feel bad for being angry with her; she takes it all in stride but also knows when to make the hard decisions to keep me safe; she has never been shocked or surprised by anything I’ve said; she’s warm; she has worked with me on the fee, decreasing it right now since I’m unemployed and on disability; she returns my phone calls the same day most of the time and has never rushed me off the phone; she’s consistent and keeps very good boundaries which I’ve told her from the beginning is really important to me; she says she is “boringly consistent” which is totally true and I really need 🙂 ; she’s validating, no matter what the emotion or thought is; and I’ve just really learned to trust her, and even when I get angry and question her motivation or intention, I know that she’s safe enough to talk to about it. I’ve left a few not so nice phone messages and she always takes it in stride and listens and we talk about it. She’s a great model for what a healthy relationship is supposed to be like.

    Not so good therapists I’ve had in the past. One man spent a lot of the session talking about his relationship with his mother, which I got upset about it. I’m not paying him for him to tell me his life story. Maybe he was trying to share things with me to make me feel more comfortable? I don’t know, but I didn’t like it. Another therapist I saw did many things that I felt were really inappropriate or just not very thoughtful to where I was coming from. He knew some people at my work place and asked me to drop off some business cards with one of my co-workers; his office was laid out in such a way that to get out of the office I would have had to go through a table and directly in front of him; he actually walked me to my car which was extremely triggery for me and made me feel very unsafe. I never went back to him and even wrote him an email telling him how it made me feel. I haven’t had therapists like this, but I’ve known of two through friends of mine, who say my friends for therapy and then later became friends with them. Neither of my friends thought this was a big deal, but I have a HUGE problem with that and if my current therapist should any sign of wanting to do this with me it would damage the relationship irrevocably. I need those boundaries, and I think with trauma especially, you have to have those boundaries.

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  29. I have been seeing a great therapist for 2.5 years now. I was very lucky to find her. At first I didn’t realize that I had stumbled upon a gifted and compassionate person to help guide me through some of the toughest times in my life. I did not trust her in the beginning due to my past experiences with being tortured in a psychotherapy cult for 21 months starting at age 14. Over the years I had seen one evil psychiatrist (yes he truly was evil) as well as a few counselors who plainly did not believe what I had to say; they didn’t seem to be interested in helping me. For years I “wrote off” the entire psycho-therapeutic industry as a fraud or perhaps a poor gamble.

    Near the end of a book called “The Road Less Traveled” there is a short section devoted to how to search for a good therapist. I followed Dr. M. Scott Peck’s advice and that’s how I found my therapist. I won’t write all that is written in that section of the book, but it is really good advice. I suggest everyone read that book, it is very insightful.

    I decided to give it one more try after several years of insomnia and pleading by my family doctor. I am so happy/lucky that I made that decision. I finally found a compassionate professional who really wanted to help. She has made a world of difference in my life.

  30. Butterflies says:

    Great post! I was very interested in the responses to touch in therapy. I have complex PTSD and am working through CSA issues. Both my therapist and I are female and I have seen more progress in myself while working with her than I have with anyone else. I use several body-based modalities with her including somatic healing and would not have been able to get through some pretty intense sessions without some physical contact(holding hands/a hug if I ask). She is a little bit younger than my mom and I feel totally comfortable with her. It takes at least 45 minutes to get to her home office(in another state) but well worth it. She is warm, dependable, sets good boundaries, cares about me, and is always willing to learn more in order to help her clients. I just have this gut sense of feeling very safe with her and I know she has my best interests at heart. We have been able to repair ruptures and I know I can tell her anything. She challenges me and I try to work very hard because I want to continue to feel better. I feel so blessed to be working with someone so highly trained in CSA as well as complex trauma. She is not afraid to be authentic or honest and even though I have had past issues of insecure attachment with my father, I feel securely attached to her. I know there are some “not so great” therapists out there, but like yourself, there are also many WONDERFUL ones! I am coming to believe that it is possible to heal from complex trauma as well as CSA because I am on that healing journey. It has been extremely difficult at times but also very rewarding. Thanks so much!

  31. Pingback: How to Avoid an Abuser: Understanding Grooming | Dr. Kathleen Young: Treating Trauma

  32. Pingback: Reader Question: Treating Emotional Numbness | Dr. Kathleen Young: Treating Trauma in Tucson

  33. Dave L says:

    A therapist who turns up a second time would be a start.

  34. Pingback: #TBT: The Therapy Relationship | Dr. Kathleen Young: Treating Trauma in Tucson

  35. Joseph says:

    Hi, Dr. Young. I’ve read a number of your posts over and over again–they are helpful. I realize this is an old post but it fits me pretty well.

    My (our?) dilemma is I don’t (or didn’t) think I felt much of a connection with my therapist, whom I have been seeing twice weekly for seven months. The dilemma is: how do I know if the perceived lack of connection is a result of my trauma experiences (CPTSD for sure) preventing relationship, or an actual failure of the therapeutic relationship?

    I brought it up in the last session. She was very surprised and I’ve felt bad about it ever since. As I reflected on our session, I even ended up feeling that I have LESS of a connection with her than anyone else in my life. That’s manifestly absurd, given what I have shared, so I’m thinking now that what I perceive as a lack of connection is more a misunderstanding on my part of what ‘connection’ means. I guess I expected that ‘connection’ would be something good and happy instead of painful and difficult. But considering the ‘connections’ I had with my primary caregivers, which are connections that last until today (even though they are all dead), there is certainly no reason for me to expect that ‘connection’ for me would be happy. Don’t get me wrong: I like and trust my therapist, I think, and I have learned a lot from her. But this lack of connection I feel has been troubling. Of course, it’s better after I brought it up. Off subject: One thing I noticed last night when I was trying to focus on her to try to connect in my imagination, I had the same tightness in my chest I have in session, and I suddenly realized that I was not breathing. I may be doing that in session too, but was too distracted to notice it

    Your other questions: I just picked the one from the Psychology Today website. Since I don’t know what I’d be looking for or how to even identify what I feel, the idea of therapist ‘shopping’ makes no sense to me. She was close by, specialized in my issues, and shallow though it may be, she was the prettiest!

    Again, thanks for your site.

  36. Janet says:

    I am so glad I found your article. I have been in therapy a few times in my life. Only once did I refuse to go back, that was because the therapist was so negative. Now I’m in therapy for inner child grieving and traumas not worked through…….I chose this therapist because of high recommendations in these areas. I’ve been 4 times now. The third time I went, she let me out earlier than the first two times. Last time I went, she kept looking at her phone when it buzzed and excused me 15 minutes early. The connection I felt was possibly forming is now gone. From reading your article, I’ll talk to her about this and see what the reaction is if I can get up the courage, but I’m sure feeling a NO. I know what a good therapist/client relationship feels like and it’s not forming like I hoped it would.

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