How to Choose and Use a Psychotherapist: an open letter to anyone considering therapy

Psychotherapy is personal - it’s as personal for the therapist as it is for the client

Dear Reader, the word ‘Patient’ means ‘someone who suffers’ and few people come into psychotherapy without suffering – its the price of entry so as to speak – for the mystery of therapy is that this particular crisis becomes the key through which you discover the next stage of you life.

You may come with some life-long problem that you want to change or something much more contemporary, like being made redundant or having marital problems. You may feel lonely, isolated or that life has become meaningless. We call, this crisis – ‘the presenting issue’.

That’s the one that causes you to seek assistance and its also the one that will be key to your growth. For psychotherapy, at least the way I practice it, is about freeing yourself from being stuck and being able to move in life – to change and grow.

I look at your presenting issue against two other questions ‘who am now in this stage of my life? ‘ and ‘where do I belong?’, because, paradoxically the presenting issue, the terrible problem that you want to get rid of is the one that will guide you those answers and it will takes your work into issues of consciousness as well as problems of the psyche, for if you expand your view of who you are then, of course, your issues diminish. You may still have an issue but that of itself is no longer a problem. And guess what? When that happens; when you are no longer emotionally attached to an issue, it tends to dissolve and melt into air.

So how does Psychotherapy work. Well let’s start with the bones. I’m a fight fan, and I remember Norman Mailer saying something about boxing. He said that “the boxer needed two kinds of courage. The first is the courage to step into the ring, and the second the nerve to fight. And of the two – the first is the greater.”

Therapy is a ritual of change. Just taking that step of deciding to go into therapy is taking a great step toward health and freedom. You come to a very necessary point in human experience when you say – “I am in trouble here but this time, I can’t solve it by myself.”

Your decisions matter. It’s like the old joke, ‘How many life-coaches does it take to change a lightbulb?’ Answer – ‘One but that lightbulb must really want to change’ .

Underneath every story is the Dramatic Code, an artistic description of how a person can grow or evolve

Therapy is like theatre – you step outside life in order to examine life. Like theatre, therapy is not life. It’s where you go to examine your ideas and you habitual behaviour and return to your life renewed.

You visit a therapist at least once a week. Preferably at the same day and time every week. It’s a fifty minute session. That’s to give the therapist change-over time between clients.

You sit on a sofa or an armchair and you talk about yourself to a therapist – a professional stranger – someone who is not part of your social set. In this conversation you can discuss and examine things which you could not possibly talk about with your friends or relatives. You can play with ideas and ways of being.

I have visited patients in hospital, attended their plays, art-shows, movies, and graduations. I have witnessed their weddings and funerals, yet that relationship is never social

Your therapist is not your friend. They may like you, they may even love you, but hopefully you will not be dining together, going into business together or popping out for coffees, or eloping. The therapeutic relationship belongs in the consulting room not in the world outside. And, let me tell you, that’s also difficult for the therapist. I get very close to my clients there is a real intimacy there. But I know that once the work spills into being social, its effectiveness is lost and gains that have been made tend to erode.

To find a therapist my first port of call would be the Counselling Directory, www.counselling directory.org, that’s the UK’s largest listing of qualified Psychotherapists and Counsellors. My own association the United Kingdom Council of Psychotherapy (UKCP) also has a listing but it’s so poor I can not recommend it (and I’m a board member).

Look for someone who is near to your home or work but not too near, you don’t want to bump into your therapist in the supermarket or the pub. Check out their qualifications. This is not as simple as it looks because there is no agreed standard for being a Psychotherapist. The UKCP sets the minimum qualifying bar at a Masters Degree level. However, outside of that degree there is a lot more you have to do to qualify for UKCP status. For instance you have to do a minimum of 160 hours of their own therapy (so that you understand the journey that you are asking of you clients), they must deliver 450 hours of psychotherapy under strict supervision (at least 200 hours of supervision), and you have to have experience working in a Mental Health setting, in my case that is 7 years in the Soho Community Mental Health team as a part-time Honorary therapist. There is also a Viva to pass ….. this is not an easy profession to enter at the UKCP level. And all the time what is being examined is not are you smart – but are you safe?

Next make a list of the people who strike you are interesting, take a look at their websites, short list them and then phone or email a few. It will quickly become obvious who you like or respect. Now, arrange a preliminary consultation or a few consultations. Meet the person you will be working with. Don’t be afraid to tell your therapist that you are ‘shopping around’. Unless you are very interested in a specific type of therapy do not worry about their modality – follow your gut on this one.

I always give prospective clients a free preliminary session – and that’s a two-way advantage. I can work with most people – most people- but not everyone. I make my living doing this but it’s also my life. I do not want to take on work in which I can not deliver and so if I do not think we can do anything, I will refer you to someone who can. Also you may not want to work with me. I am a old Jewish Bohemian; not everyones’ cup of tea and I understand that. It’s fine not to want to work with me.

If you want to know if therapy is going to work then first look at the relationship between yourself and the therapist – outside of your own determination – that relationship is the single most important factor in the efficacy of the work.

Ok. Now you have chosen your therapist. You have agreed fees and session times, he or she has explained about confidentiality and ethics and all that good stuff and then the work begins. I like clients to keep notes of their dreams (if any) and to keep a journal whilst we work together. I do not like open ended contracts and so I usually suggest that we work together for 6 weeks and after 5 weeks we review what’s happening and decide between us the way forward – in that way we have an agreed contract and both of us understand and agree what we are aiming to do.

Often clients remain working for years. But thats only because they are gaining from the work. I have one client who calls it ‘his sounding board’ another whose life is so public that she justs wants somewhere to unburden herself of her thoughts and feelings.

And one last piece of advice. Therapy is not life (remember ‘the Theatre analogy’). Your therapists consulting room is a place in which you can examine your life and gain knowledge that you can use in the rest of your week but it you do not use that knowledge and put what you have realised into practice then you really are only using a small percentage of your own considerable power.

Best wishes Martin Pollecoff – 07802338773

martin@psychotherapyW2.co.uk

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