Archive for January 22nd, 2010

How can you choose a therapist who’s right for you?

Here’s what to look for:

1. Your therapist should be actively engaged. I was surprised,  years ago, when I read an account by Theodor Reik, an early psychoanalyst, of his analysis with Freud.  The founder of psychoanalysis didn’t just sit there, stroking his beard like a sphinx.  That’s a myth.  Reik described their work together as a 50/50 give and take, a conversation about what Reik was thinking and feeling.

Another myth is the “strict Freudian.”

There’s no such thing as a “strict Freudian.”

Freud wasn’t strict – or grim and serious all the time, either.  He was adventurous, exploratory, flexible, and constantly questioning what he was hearing and seeing, and what he believed was going on.  No one wants a therapist who acts like a punishing father-figure, or just sits there and nods.

That doesn’t mean your therapist should be talking about himself all the time and distracting from your joint task of exploring your thoughts and feelings.  Every good therapist knows that sometimes his job is to shut up and listen – especially when a patient is full of feeling and needs to get something out.  But you should be working together.  Actively.  If you ask him “what do you think?” he shouldn’t just say “what do YOU think?” back at you.  That’s a cop-out.

2. He should enjoy what he does. Every therapist has to look at the clock sometimes.  But if he seems to prefer looking at the clock to looking at you, it’s a problem.  This isn’t a job you do for money – trust me on that.  You do it because you were born with a strange gift – like mathematics or playing the violin – and you feel drawn to it.  And because you love it.  I hope to die sitting in that chair, listening to a patient telling me his thoughts and feelings (or maybe right after he’s left – I wouldn’t want to traumatize him.)

3.  He should welcome all your feelings – including your anger at him. A good therapist needs you to trust him enough to tell him the truth, even if the truth is that you’re unhappy with the work he’s doing.  He doesn’t need you to love him.

It is his honor and privilege to have your trust, and share your secrets.  You pay him.  That’s enough.  He’s not your guru.  He’s your therapist.

4. He should admit his mistakes. We all make them.  Nothing shows you can trust a therapist like his admitting he isn’t perfect.  If he gets something wrong, or chases an idea that’s off the mark, or just has a bad day – you should be able to say so, and he should be able to own it.  No one’s perfect – not even The People’s Therapist.  But any therapist becomes a better therapist if he’s willing to admit he’s human.

5.  He shouldn’t just be the President of Hair Club for Men – he should also be a client.

A good therapist has put in his own time in that other chair, and shed a few tears and had some anger too.  That’s how you get to be a good therapist.  You don’t learn most of it in classes, or from a book.  You learn it by doing it.  A good therapist has had his life profoundly changed in positive ways by psychotherapy.  He wants to share that opportunity with you.

5. He should be a bit of a kook. The best therapists are a little nuts – but good nuts.  Part of the joy of living is reveling in your own uniqueness – enjoying being you.  Lena Furgeri – my first therapist -dresses in flowing purple dresses and lots of big jewelry.  I love it.  She loves it.  She loves opera, too.  She’s a lot of fun.

Freud was a bit of a kook, too.  His office was filled with weird little statues and doo-dads from various primitive cultures.  He loved that stuff.

He was also hopelessly addicted to cigars.  And he was willing to chase any crazy idea if he thought it might lead him to somewhere useful.  He knew you have to get lost sometimes if you’re going to find your way to someplace new.  He came up with a lot of theories, and some were doozies.  Others changed the path of human thought.  But he had to be a little nuts just to take the risk of “thinking different.”

6. He should be a non-conformist.

Psychotherapy is improvisational.  Every patient needs a different therapist, which means every therapist has to be a different person for each patient.  A good therapist loves that challenge.  But you can’t improvise if you’re just reading the notes on the page.  You have to break free, and be yourself.  The best improvisation – think of jazz – balances an established structure with freedom and personal expression.

That’s why your therapist should be a gangsta.  He shouldn’t be afraid to drive close to the edge, take risks, stretch a bit.

The so-called “gangsta rappers” – folks like N.W.A., Eminem, Lil’ Kim, Snoop Dogg, Dr. Dre, 2Pac, the Wu-Tang Clan, Slick Rick and The Notorious B.I.G. – are a loosely-aligned group of musicians and poets whose work has combined a mastery of rhythm and verbal fluency with a desire to surprise their audience and challenge its assumptions – often by taking on sacred cows in ways designed to stir controversy.

In this sense, they’re not so terribly different from other musicians and artists, poets and comedians over the years who have intentionally challenged the “acceptable” in order to show us truths about ourselves – people like Jeff Koons, John Cage, Sam Kinison or Allen Ginsberg.

Your therapist should be like that – willing to take the critical and philosophical tools of psychotherapy and apply them to your life, and your world – the world you live in right now – in a way that makes them fresh, relevant and powerful.

Freud was bucking societal norms just by admitting he was thinking about the stuff that fascinated him – sex, the unconscious, primal drives.  It’s amazing he was able to get away with it, let alone found a new profession.  He was clearly a gangsta.

Just for the heck of it, I’ll close with a musical selection by one of my favorite non-conformists:  Frank Zappa.

Zappa broke plenty of rules.  A brilliant musician – a child prodigy – he took doo-wop music as seriously as symphonic music, and wrote both, as well as pop songs, art songs, chamber music, jazz and outrageous parodies, like his classic, “Valley Girl.”  Zappa did his own thing.  There’s no doubt he was a gangsta.

Here, then, for no apparent reason other than the sheer fun of it, is a Frank Zappa composition titled “Sofa” as played by – you guessed it! …a Bavarian brass band:

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The other day a patient posed a simple, but troubling question:  “What am I supposed to do with all this anger?”

This guy had plenty of good reasons to be angry.  His childhood was an experience I wouldn’t wish on anyone.

But that all happened decades ago.  Both his parents were long dead.  He wondered if he was wrong to still feel this way – if it was time to move on – forgive and forget.

I didn’t think so.  I told him what my first therapist, Lena Furgeri, told me years ago when I asked for advice on how to handle my roiling emotions:

“Keep coming,” Lena said,  “and keep talking.”

You can’t just forget your feelings.  And I’m not a great fan of the term “forgiveness” either.  I’m not even sure what it means.

There’s an interesting documentary, from 2006, called “Forgiving Dr. Mengele.”   It’s about Eva Mozes Kor, a woman who, as a child, was tortured by Josef Mengele, a Nazi doctor at Auschwitz, during hideous experiments he performed on prisoners.

Eva Mozes Kor says she “forgives” Mengele for what he did to her.

This statement has triggered controversy and outrage.  You don’t forgive a Nazi.  Mengele was a monster.

Or do you?  This leads us into a metaphysical morass, attempting to chart the contours of sin and forgiveness.  Perhaps the Catholic Church can attempt such a mission, but that’s not my job as a therapist.

My work is comprehending human emotion.  And I know you can’t just forget anger because you decide to “forgive.”

Anger must be metabolized.

The focus is not on the person who caused your anger, or his actions.

It’s about you – and your emotions.

To metabolize anger you must not fear it.  You must contain it – feel it, study it, learn from it – but not succumb to the temptation to go unconscious and act on it.

When you act unconsciously on anger you “act out” – discharge aggression.  Or you act in – shutting down and refusing to act.

It is tempting to act out (or in) because discharging aggression feels good.

We don’t often own this truth.  But pay attention when you hear that something bad happened to someone you don’t like.  You’ll catch the corners of your mouth pulling up.  You are smiling – a primitive simian indicator of pleasure.  Unconscious sadism is a powerful force. Smashing things is fun.  Violent movies are fun, too.  Most of us are angry most of the time, about something.  Anger co-exists with other emotions, and it doesn’t have to have a logical explanation – it just is, and it gratifies you.

There is a good evolutionary reason why discharging anger feels good .  It’s the same reason sex feels good:  because the animals who were aggressive (and enjoyed sex) lived to reproduce and pass on their genes.

But in the modern world, discharging anger can get you into trouble.  “Losing your temper” – a euphemism for acting out unconsciously by discharging aggression – is like getting drunk.  It might feel good at first, but there’s always a hang-over.  We all know how easy it is to vent anger at the person who happens to be nearest to you, usually the one who cares the most and least deserves this treatment.

The mass unconscious discharge of aggression is commonly known as war.  At some level, it feels good too.  And leads to untold horrors.

That’s why metabolizing anger is a better strategy.  You put the anger into words, and start to understand it.  This process converts raw emotion into communication.

The poet, Rainer Maria Rilke, wrote,  “Let life happen to you.  Believe me: life is in the right, always.”

Feelings are like that – even anger.  You  have to trust them.  Let them in.  Let them happen.

No one can say when you will be ready to move past these feelings – that is up to you.  But the organic process – the metabolizing of feeling – is necessary and unavoidable.

Eva Mozes Kor may or may not have forgiven the horrid Dr. Mengele, but she has metabolized her anger, turning it into words that achieve good for mankind.  She has devoted her life to speaking publicly on the events of the Holocaust, teaching the importance of tolerance and understanding.

In this regard, she resembles another angry person who metabolized his anger to make the world a better place:  Martin Luther King.

Dr. King felt a passionate anger at the injustice of racial segregation.  Like Eva Mozes Kor, he chose not to act unconsciously and discharge his anger in violence.  But he didn’t forgive and forget either.

He metabolized his anger into words.

Inspiring words.

Don’t fear anger.


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