New York State Psychological Association Member
Common Questions
- How do I know if you are the right therapist for me (or my family)?
- There are loads of therapists, how do I make a choice ?
- I'm anxious about making the first phone call. I don't want to feel as if I'm making a commitment the moment that I make the call.
- What if I don't feel comfortable with the therapist?
- Will the therapist try to convince me to come to therapy even if I don't feel comfortable or am ambivalent about it?
- How long will the therapy take?
- How will I know if it is helpful?
- I feel intimidated just walking into a therapist’s office since it feels like I’m already making a commitment the moment I enter the office.
- How will I know what is the best “orientation” for my problem?
- Will the therapist be honest with me if he doesn’t know much about my type of problem ?
- I'm not really sure that I need therapy. I just have a temporary problem that I would like some feedback on. Should I bother going to therapy for that.
- Maybe all I'll need is one session. Is it ok to do that?
- How do I know how a therapist thinks. I don't want to feel judged, but isn't that what they do the moment that you walk in?
- Don't they start "diagnosing" you immediately. That makes me feel uncomfortable.
Every one of these questions and concerns is normal and reasonable. In fact, you SHOULD be asking yourself some of these questions. I had similar concerns when I went to therapy. In fact, I have the same questions and concerns whenever I contact any doctor for any problem, especially in a world where we are often considered to be "billable visits" rather the people. Here’s how I think about some of these issues.
When teenagers come into my office and tell me that they don't tend to trust people, sometimes their parents tell them that they should "trust the therapist because he can only help you if you're honest with him.". I suggest that, as wonderful as it is to trust someone, I would never trust anyone who told me to trust them. Trust should be earned and YOU have to judge when it is earned.
How would I start to know if I thought I could “trust” the therapist, or trust that the therapist could help me?
I would start off by wondering how does the therapist “think” about the therapeutic process. Does he/she accept and respect the fact that I might be ambivalent about having come to the session and might need to "test" him or her.
Here are some of my "thoughts" about the role of the therapist.
I think that it is critical that the person entering therapy always feels in control of the situation. I am there to serve your needs and you should always feel that that is the case. I encourage you to use a trial session to test me out… to see if you feel that I can understand what you believe are the critical issues and if I can provide you with something… advice, an idea, a specific plan, a course of treatment, that makes realistic sense to you and that you believe will be helpful to you.
The goal of most therapy is to have a greater sense of conscious control over your life so that you can feel that you are making the best choices that you can at the given moment. There are many different “levels” of understanding of any problem. I think that one of my jobs is to help you to determine the level at which your issues need to be addressed and then encourage you to choose the option that you prefer.
Sometimes, all that one needs is some simple advice or a direction of which way to approach a problem and that is sufficient. Other times, a few sessions can help to resolve an issue or set someone on the path that he or she needs, and that is sufficient. Sometimes, some cognitive strategies and/or different ways to understand an issue are all that is needed. This might include such things as different ways to “interpret” my initial perceptions or thoughts since many of our feelings are based on how we “interpret” or “perceive” a situation. Sometimes we have to change our habitual ways that we “perceive” or "interpret" situations, and that alone can help us to solve many problems. We also often have developed "typical" ways of dealing with situations. Sometimes these solutions have worked very well for us in the past, but they might not be working for us at the present time. Becoming consciously aware of how we interpret and approach problems can sometimes help us to consider more adaptive ways to understand and approach problems.
When these types of more conscious, rational, cognitive approaches don't resolve the issues, then one might need to further explore the obstacles (external or psychological) that interfere with resolving the issues through these techniques and strategies. More in-depth psychodynamically oriented therapy is only indicated when such cognitively based solutions don't seem to work or when one wants, or needs, a more in-depth, introspective, therapeutic experience to have a better understanding of one’s inner world. (Note that the term "in-depth" does not imply “better”, but rather, more introspective and attentive to exploration of unconscious factors.)
Some situations are more clear cut. There are clear methods and programs for helping youngsters to deal with some of the symptoms of Attention Deficit Hyperactivity Disorder. There are also specific programs for teaching youngsters with ADHD or those on the Autistic Spectrum, social skills. There are books filled with ideas about many typical issues regarding parenting of children and adolescents.
Despite all of the books and charts and programs to address these issues, I’ve often found that there many reasons that they are sometimes more difficult to implement in reality than they seem to be. In such cases, my job is to help you to understand your obstacles that interfere with implementing what you know that you need to do.
Does the therapist "judge" or "diagnose" you ?
I feel somewhat like a detective who is always trying to understand “what is going on” at a number of levels at once in order to better understand the person and the situation. I always have to consider possible, tentative, diagnoses because in some instances, this helps to provide a better understanding of the problem and the indicates preferred treatment options. I am often required to determine a diagnosis for the purpose of completing insurance forms. However, we are all much more complex and individualized than any diagnosis can explain so diagnosing someone is not the main focus of attention. I would also replace the word 'judging" with "attempting to understand" the reasons that we think and feel the way we do since our thoughts, beliefs, and behaviors were all determined by our histories and experiences. Some of our "solutions" have been very adaptive and have worked well for us while others have not. Some solutions used to work for us, but no longer do. For me, therapy often involves understanding which coping mechanisms have been adaptive and why; which ones might no longer be adaptive; and learning how to develop healthier, more adaptive ways to deal with the (internal and external) world.
What about the best "orientation" for my particular problem.
My resume indicates that my experience and training has been quite varied. I've been involved in the evaluation and treatment of a wide variety of populations from children to adults. Having been through an extensive psychoanalytic treatment (which I found to be one of the most invaluable experiences in my life) I will always consider the psychodynamic aspects of every situation. This means that I believe that there are always multiple unconscious elements underlying our behaviors and motives and these affect every aspect of our lives (how we feel about ourselves and our relationships). However, many situations do not require this type of insight into our behavior, but rather, require more conscious, cognitive strategies or behavioral plans to resolve immediate problems.
I attempt to flexibly adapt the most efficient and functional "orientation" for the particular problem.
I must note that there are some times when it is very helpful to select the therapy by the orientation. If one knows that one needs a more specific solution to a particular problem, a more cognitively oriented therapy would probably be most efficient and appropriate. If one knew that one wanted to better understand their view of life and relationships and felt a need to resolve existential issues, a more dynamic approach would probably be more appropriate. However, many times we find out that the problem that we thought we went to therapy to resolve was more complex than we had thought. For this reason, it might be more helpful to "review" with the therapist if the particular "orientation" that you are engaged in continues to appear to be the best orientation for you as you progress. It is critical that you don't feel that you would be "betraying the therapist" for raising such considerations. Your ability to honestly raise doubts and reflect on the process of your treatment is an important part of therapy.
A not so minor detail that must also be considered…
There is that other factor that plays a large part in the implementation of any "orientation" and the success of the therapy… the "personality" of the therapist.
There are some people whom you will immediately like, dislike, feel that you can trust, or distrust, feel comfortable with, or uncomfortable with… etc. Your feelings about the "personality" of the therapist will likely play a part in the effectiveness of the treatment for many people. This is one of those many "intangible" factors that are very difficult to quantify. This is the reason that you should meet a therapist and "get a feel" for your own impression of him or her. If you've felt uncomfortable with a thousand therapists, it might be time to consider that this might be "your" issue and you might not want to trust your judgment. However, usually you'll have to factor your feeling about the "person" into your decision.
Some of My Thoughts about Therapy
I am not "thinking" about theory or diagnosis in the midst of a session. Most of my energy is directed towards understanding "what is happening" in the session. I will consider much of the diagnostic, theoretical issues upon reflecting about it afterwards. I don't encourage people to "tell me everything", but rather, when inhibited about saying something, to respect that feeling and to simply consider their reasons for not mentioning something. It is important that you feel in control of what you are revealing and why you may choose not to say something until you are ready to.
While I take our human concerns very seriously, I also use my sense of humor at times. This is sometimes what I have found to be my own adaptive defense (or coping mechanism) to help to deal with some of the insanity of everyday life. Other times, I use it to help to decrease the tension in order to more effectively resolve a problem.
I can never tell anyone how long "therapy" will take. I will encourage you to continually assess the effectiveness of the therapy and to honestly discuss any concerns that you have about any aspect of the therapy. I can tell you what issues I believe are important to address and give you an idea about how to approach issues, but I can't determine what level of "resolution" of a problem is sufficient for you. My role will be to honestly tell you what I think. However, it is also my job to respect your choices about your therapy.
Since I tend to be quite transparent, you will most likely "know" what I think about most situations and I encourage you to discuss any thoughts that you have.
I hope that this narrative was able to give you some "feel" for who I am and how I think. I hope that this helps you to determine if you feel comfortable or interested in scheduling a "trial session" to see if I could be of help to you or your family.
Photos
office
The Century Building
