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What to consider when starting psychotherapy

By Dr. Jeffrey Chernin

If you are considering therapy, I'd like to dispel a few myths and offer you some ideas to consider in finding the right therapist for you. Of the myths, probably the hardest one to overcome is that to be strong means to be able to solve problems on your own. As LGBT people, we have a tendency to get help when we need it, but some people simply won't. Paradoxically, however, admitting your weaknesses and asking for help is a sign of strength.
Another myth is that mental health professionals do something to make people change. As great as this would be, individuals are ultimately responsible for making their own changes. Therapists help clients make the changes they desire.
A third myth is that therapy can be accomplished in a few sessions. While some problems are eased by short-term therapy, most people gain by having a longer therapy experience. A large survey by Consumer Reports (October, 2004) noted that overall the longer people stayed in therapy, the more they improved. People who stayed for more than six months reported greater gains than those who left earlier.

Survey respondents said that therapy helped in three major ways:

* Eased the presenting problems
* Helped them to function better
* Enhanced personal growth. This growth included better self-esteem, more confidence, and enjoyment from life

Another part of functioning better is developing insight into unconscious thoughts and motivations. Some thoughts are automatic, and we need to slow them down in order to fully understand them. Slowing thoughts down changes brain chemistry is similar to meditation or yoga. In fact, several studies have shown that long-term therapy is as effective as medication for treating depression and anxiety.
When entering therapy, therapists should welcome questions, such as education level, experience working with LGBT people, and type of therapy. Regarding whether to ask a about their sexual orientation, many therapists are already out, so their sexual orientation is already known. But if not, you can certainly ask. A therapist may not answer all personal questions; but he or she should explore the meaning behind the questions. A consultation or the first session is a good time to ask questions you have.
Should you see a LGBT therapist? There are several advantages, such as seeing someone who may have a greater understanding of your issues. There are some advantages to seeing a non-gay therapist, especially if you'd like to have a nongay perspective. Suffice it to say that you should avoid seeing a therapist who is in the closet.
After one or two sessions, you should be feeling pretty comfortable about opening up. If you don't feel comfortable, bring it up in session. If your therapist becomes defensive, continue your search. If not, maybe the two of you just aren't the best fit. In either case, a discussion is a good way to look at what's going on.

Look for certain qualities in selecting a therapist. It should be someone who:

* Considers your individual needs
* Encourages you to voice any concerns
* Is licensed and had good credentials
* Points out options and possibilities but never tells you what to do
* Is able to form a respectful, professional relationship

If a therapist suggests that your problems are related to your sexual orientation, question your choice. If you have challenges that stem from your orientation or gender, it is oppression – not your orientation – that is the problem.
Over the course of therapy, the major focus should be on you. Therapists should talk very little about their personal lives, and even then it should be with an intention to be helpful. Practitioners should not talk about their current problems or spend time with you outside of sessions. Even though we sometimes feel like we live in a small town, that's no reason to be invited by your therapist to social events or for your therapist to attend yours.
Because you're delving into very personal areas and have found someone who understands you, it's not unusual to develop feelings for your therapist. If you do, your therapist should help you sort out and understand your feelings.
He or she will never mention a reciprocal attraction – this is a red flag and you should contact another therapist for a second opinion. Also, think about asking your therapist for a referral if you cannot give up your attraction and find yourself hiding personal issues in order to "look good." In any case, a qualified therapist remains professional at all times and you can either try to work through these feelings on your own (as many clients do) or bring it up for discussion.
Sometimes people are reluctant to enter therapy because they fear it will be painful. Although there are times when it may be uncomfortable, therapy – like crying – actually helps release the pain. And releasing pain is only a slice of how a therapist can help you. As you address the issues that brought you into therapy, it presents you with the possibility for better coping skills and greater self-esteem as well as much growth and discovery.

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