Hi everybody,
Thanks for all your comments!
Some more semi-random thoughts re: "My Life in Therapy" and choosing a therapist:
We are still recovering from the Freudian era when therapists were trained to be as opaque/neutral as possible. Unfortunately, all that training did was to make therapists believe they were being opaque/neutral. And make it even harder to decide, in the first few months, whether one had made a good choice or not.
In that era, the best one could do was to go a therapist with a good reputation amongst his/her peers. You went and assumed from day one they knew more or better than you did. Of course, there was never any objective test whether this was true or not. And anything you noticed that bothered you or was hurtful was, of course, transference.
And credentials? When I first went to Mass. General Hospital, I was young and naïve (23!), and I assumed since I was going to one of the best hospitals in the world (Harvard Medical, etc. etc.), my mentors would be among the smartest/wisest therapists in the country. While they were all relatively bright, and certainly accomplished people, what they turned out to be were the most politically astute therapists in the country. Furthermore, just as in graduate school, one could not ask challenging questions or practice in a different way without being labeled as a troublemaker, an ingrate, and/or a dolt behind one’s back (and, of course, behind closed doors). Nor could you ever get ahead in the “system” (i.e. better credentials) unless you were political. For example, I was told by my unit chief that essentially there was little chance of my getting ahead (credential-wise) unless I worked in the head of psychology’s private consulting business. When I asked how that could be, he said: “Welcome to the adult world.” Whether or not this was true, I never learned. But what this meant was: choosing a therapist on the basis of credentials was likely not only pointless—it was possibly downright self-defeating.
So how to choose? Get a name from a friend in therapy? In the 30 plus years I’ve been doing this, maybe twice did one of my patients (reluctantly) offer my name to a friend (who never came in). (This reminds me of a variant of the old Henny Youngman joke: "Take my therapist, please".) This may mean I’m a lousy therapist—but if you ask my patients, they will say they simply do not want to share me (and, of course, complicate matters with their friends), although they will break down and occasionally send beloved family members to me.
So, how will the Daphne Merkins of the world finally find a “good-enough” therapist? As you might have guessed, I think the Web has great potential for this purpose. So much can be revealed about a potential therapist, for better and for worse, if they only wrote essays with human sentences (skip the psychobabble), and revealed themselves. The problem is: very few therapists are doing it. For fun (?) recently, I visited 10 or so therapist web sites in Massachusetts. Boring and completely un-revealing. I certainly couldn’t choose a therapist based on these sites—because I discovered almost nothing about the person behind the credentials. Perhaps Board members have discovered sites where the therapist is revealed. If so, definitely post them so that we can take a look. I think the Web is the best opportunity the public has for making good matches with therapists—if only therapists would have the courage to reveal themselves as human beings.
Richard
