Therapy: What No One, Says

*Everything I write is from my own personal experience. I am not a medical professional or therapist. What you read is my journey*

I do not want to my mince words, going to a therapist for the first time is daunting. There will be a time, likely while traveling to the appointment, where you think over and over and over and over about how you are meeting with a person you didn’t know, until recently, existed; then you will be expected to share the deepest depths of your being with them; and at the end they’ll ask for your money. A lot of people say, “Nope.” Which I think is an appropriate response to such an emotional approach to therapy. This is not your fault.

Therapy is surrounded by unhealthy expectations, and until we dispel them and have a more positive outlook on therapy it will continue, I want to focus on two:

Unhealthy Expectation: everyone should go to therapy

Life exists on an ever-changing spectrum: on a microscopic level we are not the same person now as we were ten seconds ago. On a macro level every year we are a different person than we previously were. This is to say that the you of five years ago may not have been able to accomplish anything in therapy and therefore shouldn’t have gone, but that could mean that the you of now does posses the skills to utilize therapy and grow from it. We tend to keep this rigid view of ourselves and apply it to every situation. Therefore, everyone should most definitely NOT go to therapy, but if it is right for you then you should go.

You are the only one capable of knowing when you should go to therapy. The feeling will be natural and empowering. That is not to say it will be easy, or without an emotional response, but you will know in every fiber of your being that the time is right, and you are on the correct path.

Unhealthy Expectation: you need therapy to be happy

The answer is just, no. You need internal balance to be happy. Therapy is a tool that can help you learn the skills needed to keep this balance. I want to be clear, a therapist does nothing for you. You do everything. The therapist is there to help you explore the areas you either do not know how to explore or do not want to. Once you have those skills you do not need the therapist any longer. Let this sink in before continuing further: you are the only person that can make yourself happy.

We must re-frame how we approach therapy and part of that process is accepting that seeking therapy is all about you. Michael Rosenberg did a lot of work teaching people how to appropriately express emotions and “happiness” by itself is an inappropriate expression of emotion. It is unhealthy to attach a single action, or even a group of actions, to your happiness. It is also unfair to yourself. Let us look at a healthy expectation for therapy and how we can achieve that goal.

Healthy Expectation for Therapy

The common theme among these two unhealthy expectations is the externalization of what is an internally intimate process. Healing, from any abuse, is as unique as one speck of snow from another speck. There may be similarities, and from a great distance it may look like it is all the same, but there are distinct and measurable differences to how each person heals. The labor of healing is that there is only one person who can recognize these differences: you. The therapist’s job is to guide you along this path: if you are expecting them to do the work is losing the battle before it begun. This process begins with speaking.

Conversation

Trust and Compatibility are the key to the therapist patient relationship:

Trust is built not inherited: just because you are paying for a therapist does not mean you have to automatically trust them. There are certain laws (HIPPA) that help foster trust, and certainly the longevity, schooling, and expertise of a therapist will play a roll in how you build trust; putting all of that aside you do not have to trust your therapist from day one, and at no point should you tolerate a therapist questioning your trust of them. Trust should grow organically and at the pace you set.

Compatibility is the most important thing you are looking for on that first session --you may not be fully compatible after the first session: human interaction is not a science. You are not obligated to return for another session (ever): a well trained, and professional, therapist should never pressure you for another session, make you feel shame for not returning, or in anyway pass judgement on you --they may follow up if they haven’t heard from you.

What Does This Look Like?

How you define compatibility is subjective to your own needs and wants. Rather than write an Encyclopedia of different ways to find compatibility with your therapist I’ll talk about how I approach therapy and what I look for in that first session –I too have had a few incompatible therapists prior to figuring out what works for me:

I am a big fan of Psychology Today’s database for finding therapists and that is where I begin my search –I have two separate therapists-- after identifying what I most need out of therapy: for me it is someone who has experience with male sexual abuse survivors and sexual healing. In North Carolina there is only one psychologist with experience in male sexual abuse that is practicing in the State. As far as sexual healing, therapists are rampant in North Carolina so I will use that search as my first example.

For this one I did not actually use Psychology Today because what I was looking for was specific and there are a lot of therapist in this field. I did a Google search and then began to weed through the results:

1.       Do they have a website?

2.       Are they a LCSW or Psychologist?

3.       Do they have a physical office separate of their home?

4.       Are they male (important for me because I do not like opening to males)?

5.       Do they have a good bio?

6.       Do they have a picture (no picture = no go?

I use a website as a qualifier because it helps me learn as much as I can about the therapist and the more knowledge I have about a person the more comfortable I will be around them.

I have had therapy with LCSW’s (Licensed Clinical Social Worker) and I haven’t found one that works well with my personality.

I do not feel comfortable spilling my deepest secrets in a person’s home and the distinction of a separate physical place helps me.

Having a male therapist also helps me learn appropriate male relationships.

The biography and picture show me about the person and whether I would be comfortable around them: maybe I see a picture of a person and feel warmth but read their bio and feel distance or vice versa.

For the first session I am open only about what I am looking achieve from therapy. After establishing goals, the rest is a conversation where I seek to learn a few things:

1.       Ease of conversation

2.       Comfortability

3.       How the therapist guides conversation

4.       Their body language

5.       Do they dominate the conversation?

6.       What is their story?

7.       What is their philosophy for therapy?

For the sake of brevity, I will not go into these in detail. The whole goal is to have an open and honest conversation and see if you click with the therapist. One of the key things that is stuck out to me with my first session with Carolina Sexual Wellness Center was when my therapist talked about how they had regular weekly meetings to discuss strategies and difficulties in sessions. This information was not anything I sought, and was not pushed by my therapist, it organically came out of conversation. At first it put me off because I felt threatened that someone could be discussing “my business” with other people: I had to rationalize the situation and when I did, I recognized that this showed a quality group of therapists that were dedicated to their job.

Finding a therapist is a more comprehensive process than getting a name and number. The entire journey, right through the last minute of that first session, is your interview of a therapist that you are looking to invite into the deepest parts of your soul.

Conclusion: You Are the Captain Now

You oversee the journey to healing. Ultimately, everything comes down to you and what your wants and needs are. Only so many guides, books, and blog posts can be written about therapy before it becomes pointless because eventually you must take the reins. The best advise I can give you is to give thought to what you need/want out of therapy. For example, I had a therapist that helped me learn to work through anger, he wasn’t a good fit for me on anything other than helping me work through anger, and when I finished his anger management course we never spoke again. That is the goal! You never want to speak to your therapist again – I exaggerate a little. From time to time you may need maintenance for certain things, but you want therapy to have an end. To have a clearly defined end you must have a clearly defined beginning. I think the best place to start is with you. No one says, “you are the Captain, now” that is a mantle you must take up on your own time.

Safety: The World is a Dangerous Place For the Victim of Sexual Abuse

*Everything I write is from my own personal experience. I am not a medical professional or therapist. What you read is my journey*

“What are some happy memories of childhood?” There were a few seconds of silence from me when this question was asked in a therapy session. Looking to my left I poured through my memories to see if there was a happy memory. Nothing. I replayed the memories a second time, nothing. I chuckled out loud and smiled -a defense mechanism. “I don’t have any.”

A few more sessions would help unveil a few of those happy memories. Though, at the time of writing this I cannot easily recall these memories -it takes incredible effort and guidance to recall most happy memories. Perhaps these inconsistencies are why I have a fascination with neuroscience: “How can I so vividly remember the terrifying moments of sexual abuse and not the moments of happiness?” On a physiological level the answer is beginning to come clearer for neuroscience: decreased white matter. Or more appropriately, lack of connection inside the brain. Yet, my experience tells me that this does not explain it all.

When I was first abused at the age of 5, the best I could do to protect myself was to view everything and everyone as danger. At the age of 5 the entire world became dangerous. The shape of my whole being was to protect myself from these dangers. How do you truly have time for happy moments?  Abuse, whether it be physical, emotional, or sexual, destroys a person’s safety -especially when the victim is a child. Think back to when you were a child and you hurt yourself, one of your parents comforted you and helped you feel safe again. After the abuse, I lay in the fetal position holding my baby blanket and sucking my thumb: no one came to comfort or provide safety for me. Obviously, those do not compare, but nothing can compare my childhood with most peoples. To understand what a victim of childhood sexual abuse is recovering from you must learn to recognize the key events in your own childhood that encoded safety into your view of the world. And you must understand that basic needs that were met for you were not met for that child -even with the world’s best parents, after abuse, the world is a dangerous place.

My recovery then has been learning to appropriately recognize danger and safety. A lot of that is about building up the stamina to exist in moments that are not inherently dangerous, but feel dangerous, and allowing myself to explore them and learn that they are safe. In my sessions I have often returned to the concept that I didn’t get to learn to view the world in a healthy way like children are supposed to and now I must return to that as an adult and do this work.

Most men who seek to recover from sexual abuse wait much longer than I did -my first therapy session was when I was 19. A lot of this is because society has not made it a safe place for men to talk about abuse -especially if the perpetuator was female. Society needs to learn about abuse and the effects it has on the victim. There are troves of information and stories out there for anyone to learn from. Often, it is the victims that use these materials. I encourage you, dear reader, to learn about sexual abuse. You do not know who you may be interacting with that doesn’t feel safe and will need an understanding friend when they begin to rewire their worldview.