When does it pay off to be picky?

I’m a therapist based in London, England and I’d like to talk about some of the benefits of choosing your own therapist, rather than having one selected for you. While I’m a strong advocate for our National Health Service (when I split boiling hot water on my arm 5 years ago I was treated in Europe’s most advanced Burns Unit within hours of the accident, for free) there are some aspects that aren’t so great…as with so many things in life! The vast majority of Briton’s have little personal choice when it comes to deciding who they see regarding their health care, be it physical or mental. So if you come for therapy or counselling on the NHS, you get who you get. However, many people can afford or make the sacrifices to see a therapist privately.

Let’s think about this in terms of the numbers – by far the most influential decider as to whether or not you’ll find therapy helpful is down to you. Do you want to go? Are you committed to change? Are you there because it’s what you want or is someone forcing you to go? A whopping 40% of a successful encounter with a therapist is down to you, the client, and is completely beyond the ability of the therapist to influence. It doesn’t matter how many brilliant, sparkling observations I make or how oozingly empathic I am, all of that will count for nothing if you profoundly don’t want to be there.

The second most important factor in a successful therapeutic encounter is down to the relationship that develops between you and your therapist. My first ever therapist, Dr Sara Dryburgh puts it this way: “Therapy is fundamentally about a relationship with the therapist. Qualifications, training, theoretical knowledge and mastery of specific techniques are of course essential, but not sufficient in themselves. The essential thing which makes therapy effective is the quality of the relationship that you form with the therapist”. She and I worked together for three years, she wrote me a reference when I was applying for post graduate training and we remain in contact on a professional level. We had the chemistry. I got what I desperately needed out of therapy.

As it happens I’ve also had the experience of profoundly not getting on with a therapist. I felt I was boring to her, I shrank away from her when we were in the room together, I didn’t like her much and frankly, the feeling felt mutual. When about 4 sessions into the work she raised her voice to contradict me, I knew it was time to go.

I wish someone had told me then what I’m telling you know – If you don’t like your therapist after the first meeting, look for another one. End of story. I can’t stress enough how important this is, imagine opening up and revealing the most secret things about yourself, remember how you felt the last time you had a good cry, think about coming face to face with the things that really matter to you. Now think about doing all of that in front of someone you don’t really like. See what I mean?

So shop around, be fussy, think about whether or not you’d like to see a male or female therapist, take a bit of time to reflect on the type of therapy that might suit you best. Therapy is a major commitment in terms of time and emotional energy. You owe it to yourself to pick someone who you feel can accompany you on that adventure. This isn’t an excuse to quit when the going gets tough, it’s more than likely that it will. And it’s more than likely that at some points you’ll outright detest coming to therapy because it’s hard work dealing with old ways of relating to the world that are no longer serving you. Your therapist isn’t your friend; he or she won’t let you get away with changing the subject when things get hard. But she will stay with you, she’ll accompany you to those dark places and help you to illuminate them, she’ll show you how to chase away the shadows, and the ability to do those things with loving care comes from a solid bedrock of trust between you both.

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My name is Tamarisk and my practice website is www.twochairscounselling.co.uk. I am a London based psychotherapist who uses an existential approach in my work with clients, I am bound by the BACP’s (British Association of Counselling and Psychotherapy) ethical code as a member of the organisation. I also blog over at www.twochairscounselling.blogspot.com.