what I need in a therapist

what do you, personally, need in a therapist? Is this something you have given a lot of thought to, or something you have learned along the way?

For me, this is something that I just kind of stumbled over, and I think it is important to my recovery, so I've been thinking about it a lot and sort of letting it stew until a few ideas kept surfacing over and over. So, here is the beginning of my list of requirements:

I need a T who understands complex trauma and the attachment, trust, and dependency issues that go along with it.

I need a T who is familiar with the DBT skills. I don't think I actually need to be in DBT at this point, but I think it would be helpful to me to keep those skills fresh and to use them, in and outside of therapy.

I need a T who sets clear boundaries (or limits, as they are called in DBT) and maintains them consistently. At the same time, I need a T who will temporarily extend her limits in a crisis.

I need a T who is consistent in other areas as well. Consistency is a really big part of this for me, because I think I'm figuring out that I don't feel safe if I can't predict Ts actions or reactions. I mean, every T is human so they will say and do things that we don't expect. But I need to not have to wonder which version of T will get every time we interact.

I need a T who is willing to seek the help of her supervisors and/or consultation team if we have difficulties in our relationship or whatever other difficulties may arise in my therapy.

I'm not sure if I need a T who is available by phone between sessions. If I'm not in DBT, that probably won't be a requirement, and maybe what I need is a T who is available only in times of extreme distress. I think what is going to be vital for me here is that T is consistent in this area as well. If she takes phone calls, make it clear what types of calls are ok and when, etc.

I need a T who is a woman.

I need a T who will address TIB in session. It doesn't work for me to have her point out my own TIB outside of session but then tell me I have to wait until we meet to discuss it. It also doesn't work for me to have T not address my TIB until it has reached a point where she is getting burned out. The other side of that is that T needs to also address her own TIB, and make efforts to stop engaging in it once it has been identified.

I need a T who will push me toward change while at the same time being mindful of meeting me where I am.

I forgot this one, but it's a big one:
I need a T who will see me long term, as long as I need it. My experience of being in time-limited therapy has been that the knowledge that therapy HAS to end, that it WILL end, at some arbitrary point has kept me in this place of insecurity, of trying to hold on tighter so I don't lose T. I think if I hadn't had that idea of therapy ending hanging over my head this whole time it is possible I would have been ready to end it on my own terms sooner, or that I would be closer to being ready. Time-limited therapy may work for some people, but I am convinced it is not effective for me.

zoo, that's an excellent list! You know what you need. So, your T doesn't meet those needs, right? It seems like she doesn't want to lose you. I don't understand her insistence (I'm referring to your other thread) on you seeing HER, when she definitely has shown in past months that she couldn't be there for you. Is her personal crisis or whatever it was, over now, and she wants to make it up to you?

It sounds to me like you want to check out other Ts and find someone who meets your criteria. Do you think so?

Also, what is TIB?

yeah, I'm definitely going to be looking for a new T, and I think it's important for me to have an idea of what I need in a T in order to find a good fit for me.

sorry, TIB is therapy interfering behavior. I'm not sure what it is called or how it is viewed in other types of therapy, but in DBT decreasing therapy interfering behavior is a high target area, second only to life threatening behavior. Linehan is very open about the fact that TIB can occur on both sides of the couch.

TIB on the part of a client could be things like not attending sessions, not calling T for coaching, calling T too often, not being willing to change, etc. TIB on the part of the T can be rescuing the client, avoiding talking about difficult subjects in therapy, not answering phone calls (or delaying returning phone calls), not balancing acceptance with change, etc.

I don't think my current T can meet my needs at this point, no. I am coming into some acceptance of the fact. I think she WANTS to meet those needs, and I am sure she does care about me and wants what's best for me. What we want to do and we are capable of doing are sometimes not the same thing, and that's what I'm working on accepting. My T can be a great T, a wonderful person, and she can care about me and want to help me, and still be just incapable of doing that. It doesn't mean I don't deserve it. It doesn't mean she is just being difficult or that she just doesn't want to help me. She can want to, and I can want her to, and it can still just be impossible.

That said, I don't expect any T will be able to meet ALL of my needs. I'm not looking for that (I mean, it would be nice, right? But unrealistic). I just thought that starting a dialog here about it would be helpful to me as I start the process of T shopping.

PS I am considering sharing my list with T if I do see her again, partly because I think it is important for her to know, and partly because I am hoping to get a referral from her and if she knows what I'm looking for it may help her decide who to refer me to.

Thanks for defining TIB for me. At some point I wonder if I should do DBT but I can't afford more therapy than one.

You sound better, having made the decision to switch Ts. That's how I felt when I decided to leave my former T. It wasn't her fault; she's a good person, and wanted what was best for me, but she and I went as far as we could together, and she wasn't what I needed anymore. When I made my decision, I felt in control and free. You sound that way too.

I think you have a very good chance of getting a lot of what you want in a T, though it depends if you live in big city or place with many Ts available. Good luck with your search! Did you look at the PsychologyToday site? That's how I found my T. I hope your T won't give you a hard time about asking her for a referral. She shouldn't, but she sounds a little possessive about you right now, from what you wrote about her saying you need therapy with HER. No T should say that, IMO.

a wonderful list, zoo, I think you are clear headed about what you need and I wish you well in finding it. you are probably right that current T wants to be, but cannot be, what you need.......
for me, I simply need compassion......and firmness and clear boundaries....and I have that.

I live in a small town with hardly any Ts, which is why I travel an hour each way to see T. I imagine I can find someone else in that area, though. I think my biggest hurdle is going to be funding. I've talked about this on here before, but I'm on state medical and so they really want me to see someone in my own county. Since I live in such a rural county, though, they pay for me to travel to the city where T is, because at the time when I started it wasn't hard to show that I needed DBT and there is no DBT available here. So I may (probably will) have to have another meeting and explain to someone why I need to see a different "special" T (vs just seeing my case manager for therapy, for example. Which is what they want me to do, but, really. My CM is nice but she's a social worker, not even a T, let alone a T specializing in complex trauma.)

Then, if I do get the funding approved, it will be a matter of finding a T who takes state medical, which really limits me. If I do find a T that I can work with I may end up having to pay out of pocket. Which I would do, if at all possible, because it's worth it.

I need a gay female T.
I need a T who is older than me.
I need a T who gives hugs.
I need a T who is comforting/supportive when I cry.
I need a T who is genuine and makes me feel like she cares about me.
I need a T with whom I feel as strong connection and bond.
I need a T who does long-term therapy- ending needs to be MY choice.
I need a T who is consistent (keeps appointments, is on time, sticks to promises she makes).
I need a T who lets me be in control of my sessions (I decide what to talk about, I can bring in things I've written to share with her, I can ask her to do particular exercises with me, I decide where I sit and where she sits, etc).
I need a T who will let me call between sessions or give me an extra session if I REALLY need it (this is very rare, but I need to know the option is there).
I need a T who does not do e-mail (at least not with me).
I need a T who is comfortable with the fact that I get fairly attached to my Ts. I need her to be wililng to talk with me about this and help me manage it, rather than create distance between us.
I need a T who I can trust and who makes me feel safe. I need to know that she's on MY side and, if I needed her to, she would stick up for me and defend me.

Some of these things I knew ahead of time- I purposely chose my T because she is a gay T who does long-term therapy. However, I didn't know ahead of time that I needed a T who gives hugs. But, after getting hugs from my T, I couldn't go back to NOT getting them. I also didn't know that I needed a T who allows phone calls between sessions or extra sessions (if necessary). While this is something I've only done maybe 3 times in the past year, those 3 times really helped. And, even more than that, simply knowing that option is there makes me feel safe and supported to the point where I can often avoid calling precisely because I know I COULD call.

After making this list, I feel extremely fortunate. My current T is every single one of these things! I really couldn't ask for more. I heart my T.

I need a T who I respect.
I need someone who won't patronise me.
I need one who will call me on my bs.
I need a T who will push me and understand when I can't push back.
I need a T who has a sense of humour (and can understand mine).
I need a T who will understand how insecure I am.
I need a T who will NOT GIVE UP... even when I do.

Since you asked...the only thing I expect is a T who is competent.

I have what I need. My Pdoc. She is by far the best and I love her for all of the things that she has done for me.

Your list is awesome zoo!! What a great step to take. I think it just goes to show how much you've grown, that you are so able to identify what you need and that you plan to go after it.

A lot of your needs are my needs too, but here's a few things I need from a T.

- a balance between "cold" and "warm" personality type. Cold T's freak me out and make me clam up. Warm T's make me feel smothered and trigger even more fear than the cold T's, because they could take away their warmth. More to lose, more dependency needs get triggered. I need a balance.

- I need a T who will NEVER touch me. The most touch might be a handshake when we first meet, and MAYBE a goodbye hug at the last session. But I have to initiate the hug.

- skill with metaphor. Someone who is CRAZY good at catching me in convoluted logic traps, and actually showing a way out that I can buy. And I'm a hard sell. Plus if you call my thinking distorted I will want to rip out your eyes, so they can't use that crap on me.

- skill with complex trauma. The willingness to process that crap but on my terms always.

- honesty. transparency. respect. I need a T who doesn't think one thing and say another to me. I will be able to sense it, and trust will fly out the window.

- solid, trustworthy boundaries. And NO teasing with little boundary crossing allowances! Not even in crisis. Because then I will deteriorate. To create crises. Just so I can have just one more taste.

this struck a chord with me. I keep coming back to it in my mind, and thinking about it. I think that my attachment scares my T. Or, I don't know, maybe I shouldn't try to guess what she's feeling. But I CAN say that T responds to my attachment/dependency by pushing me away. She has described to me how she moves away from when she can feel me clinging too much.

The idea that there is another way for a T to respond to that, the idea that there could be a place where I am not punished and shamed for daring to attach, it is...wow.

I'm talking about this with my T tomorrow. I'm going to tell her I need her to be willing to talk about the attachment with me instead of just pushing me away. It's going to lead to a discussion of getting a referral to a different T, and I'm okay with that.

Someone who will leave me better than they found me. I guess that's pretty broad.

These are great list that people are making !!!!

Need in a T: (thankfully I have a T who is already these things!!)
someone who knows that DID is real/believes in it (some dont, some tried to medicate me to try to make the voices go away...etc.)
someone who allows hugs/ touch
someone who emails/ keeps in touch with me/ will put up with the inside kids emailing/texting her all the time
someone who respects me and doesn't think I'm "sick" or "ill " or "crazy"... I just happen to have DID and there's nothing wrong with that

Thanks for posting this... all I know is... one time my T said to me...

"we are not worried about what mistakes YOU make right now... I'm here to
talk about what others have done wrong to you"

although that is important, I think I need a T who can balance unconditional positive regard with "tough love" (not the exact term I was looking for but, I hope you get it) its important for a T to be nice but, it can also be just as important for a T to be nice enough to tell you the TRUTH..to save you a lot of headache and turmoil in the long run.

I think T's do this partly, because.. they dont wanna just offend clients. and not have business...but, thats not what I'm talking about...I think gentle, caring feedback can go a long long way ! as many times, its not about what we say but, how we say it.

- they would need to respect my spirituality and not overly question it
- one who does not overly change all my worldview and realizes not everything is just a defense mechanism for me
- one who understands I don't need sympathy, i just want to deal with some issues
- one who does not push meds. not interested. end of. let's not waste time here.
- one who can push be outside comfort zone.
- preferably no feely-goody-huggy relationship. I pay you, you are professional. I need advice, not care.

I like my T because I'm getting what I need, like:

Someone who believes me about what happened, because in the past I went through a lot because people didn't want to think such a pillar of the community could have done what he did to me

Someone who stays calm and safe, because even the littlest things trigger me sometimes

Someone who understands and respects the main aspects of my life, like my faith and how I respond to it, without judging it or having to need me to explain it all so he understands

Surprisingly for a female with a long history of SA from males, I want a male T who appears very authoritarian. At times, it helps me feel safe, like I know he'd be able to protect me, and at other times it's because I know its keeping me from developing a phobia of men.

Hi Zoo,
I've been on vacation since Thursday and am just now catching up on what's going on...hope you're feeling a little better

I need my T to:

Be a woman.
Be relatively young.
Be able to work with SI and self-esteem issues.
Be able to give hugs.
Be able to help me figure out why those hugs are triggery for me.
Be willing to go in great depth with me. This is probably amongst the most important.

I know there are more than this, I'll edit them in if/as I think of them.

I found this very helpful as I am in a place where I need to put together a set of expectations for my next therapist. I can use this entire list. Thank you

Sorry to ask a stupid question but what is TIB

therapy interfering behavior?

I guess what I need, more than anything else, is someone who doesn't give up on me. Everyone does... I just need someone who won't.

I need someone who'd call me on my BS.

Someone who respects me, and the contradictions that come along with being me.

Someone who understands how hard it is for me to open up, and why I instinctively use sarcasm and humor to get out of talking about myself.

Someone who will weather it when I lash out at them and understand that I do this because she's getting too close.

Someone who will occasionally make jokes, because I need to know (s)he's human too.

Someone who's relatively young.

Someone who could command my respect and trust.

Someone who can make sure I know that she knows what she's doing. If you're as lost as I am, it's worrying.

Someone who could take me bringing up things out of the crevices of my past that I've never mentioned before in stride.

Someone who understands how lost I feel.

Someone who will antagonise me when I refuse to work.

Someone whose kindness is evident by their disposition.

Someone who will not let me give up.

What I want in a therapist.

Not take me so literally when I am obviously under tremendous stress and just talk to me. Ask me what is going on that has me so rattled.

Someone who does not consider relationship something not to be discussed except what the boundaries are.

Someone who is not averse to any form of touch at any time.

Someone who is willing to follow up when content is significantly overwhelming.

Someone who will work with the transference that comes up instead of detaching or becoming defensive aggressive.

Someone I can allow myself to be connected emotionally

A woman

I guess that is a start. As far as reasonable, well I do not have to be when wishing.

This should be a sticky!

Thanks for starting this thread, zooropa! Even though I'm far too cynical and jaded (read: fragile) at this point to reenter therapy after my last experience, thinking critically about what I would want or need in a new T seems like a good jumping-off place. If I've learned nothing else from my most recent stint in therapy, it's that my screening process...kind of blows. So here's my first attempt at a revamp:

I need a therapist who is advanced enough in both years and experience to...

(1) reliably determine whether my psychological make-up reflects borderline personality disorder or "merely" abuse,

(2) accept and deal with whatever countertransference reactions arise in therapy with me because striving to understand both myself and my T is too much damn work,

(3) understand that any positive or appealing attributes I might possess in no way compensates for the abuse I suffered as a child, nor for the 20+ years of enduring a horrifically painful medical condition (not that it was the first time, but my last T admitted to having allowed my physical appearance, accomplishments and the more glamorous details of my past to totally overshadow the darker - and substantially more influential - ones), and

(4) create as open-minded and non-judgmental a therapeutic environment for me as humanly possible so that I might find myself trusting enough to reveal all that happened in my last therapeutic relationship (and, of course, all that I've felt about it) since it's the only way someone else is going to stand a chance of helping me through it.

Incidentally, I'm inclined to think that a male therapist would be more capable of maintaining objectivity in processing some of my experiences, so I'd likely go in that direction first this time.
If only Charles Cohen or Vance Sherwood were available...