Should You Trust Your Therapist or Yourself?

Have you hooked up with the wrong therapist or counselor?

Posted Jun 15, 2014

It can be hard to trust your judgment in therapy. The power balance is unequal and the patient or client is always more vulnerable.

How can you evaluate the questions or doubts you  may have about your therapist or counselor?  Consider this example.

After meeting six times with a psychiatrist for depression, Sonia came to my office for a consultation and told me this:

 "Dr. S. makes me uncomfortable. In our last meeting he said that I was a very desirable woman and that I wasn’t able to accept my sexuality. I was just talking about wanting to lose weight, and I felt his comment was out of the blue. When I got up the nerve to share my discomfort, he said that I was pushing him away because I had been sexually abused as a child. The abuse is why I’m there--so maybe I can't trust myself. My gut says leave, but Dr. S. warns me that I'll get worse if I shop around for a new therapist. My husband is also encouraging me to stay because he's heard good things about this doctor who has an excellent reputation"

Sonia had many questions. “Is it possible that I'm distorting reality? Am I ‘resisting’ therapy? Can I hurt myself by leaving?”

It made sense that she was struggling. Starting therapy is an anxious business. An individual's fears, fantasies and projections can easily run amok. It's not easy to be objective about therapy or a particular therapist. So, yes, Sonia could be distorting--as could anyone in her shoes.

Still, I encouraged her to trust her gut reaction and leave. The fact that Sonia had a history of sexual abuse was absolutely no reason to discount her feelings. Indeed, her painful history may have sharpened her radar, helping her to be especially sensitive, alert and self-protective.

I advised Sonia to seek a consultation with one or more therapists until she found someone with whom she did feel safe and comfortable. The fact that this particular psychiatrist had a stellar reputation said nothing about whether he was the right person for Sonia. Reputation or status is no guarantee of competence in this line of work.

I’d advise anybody to be wary of a psychotherapist who warns that you will get worse if you try another therapist or treatment. A good clinician will share an honest perspective while respecting your wish to "shop around" so that you can gather the facts that will allow you to make the best treatment decision on your own behalf.

As I explain in The Dance of Fear, we need to honor our anxiety and gut reactions which may signal a need to pay attention or change course.  Sonia’s decision to honor her anxiety proved to be an act of strength and courage. She told her psychiatrist that she didn’t think the therapy was a "good fit" and that she was planning to consult with someone else.

When Sonia was abused as a child, she didn't have the power or the ability to say, "No, this is not right for me. I am leaving. I am going to protect myself."  Children can't take control of an unsafe situation. But as an adult Sonia could—and she did.