The other day I got an email from someone I respect very much asking me for some referrals. One of his questions was, “What makes a good trauma therapist?”
Good, good, good question. An important one.
If you’ve ever had to look for a good therapist I bet this is something you’ve had to explore.
Here’s the list I came up with. I’m wondering what you think and if I’ve covered it all.
What would you add? What has your experience been as you’ve walked the path of healing?
- Trauma training: The most basic question is whether the therapist has the fundamental skills to deal with trauma. What kind of post graduate training has the therapist had, especially in trauma treatment. And who did they train with? Is it all cognitive behavioral or is the therapist versed in some of the body oriented therapies. I don’t think it’s possible to heal trauma without knowing the body or knowing how someone’s internal world is disorganized so that it can be reorganized.
- Dissociation: If you’re dealing with dissociation issues then you do want to have a therapist who understands the entire spectrum of trauma. On the one hand traumatic symptoms can range from one time, adult onset trauma to early, chronic trauma. At that far end, dissociation adds a different level of complexity.
- Attachment issues: We now know that trauma doesn’t resolve without reorganizing relational patterns of neglect, rejection, humiliation, shame, abandonment. Knowing that I’d also be curious about whether the therapist understands the underlying attachment and intersubjective issues that complicate trauma processing.
- Payment? This has come to be a deciding element for many people. If you need or want to use your insurance keep that in mind as you initiate the process. Also consider if you are paying out of pocket what kind of payment range you can work with. You may want to lead with asking the therapist if they take your insurance before you divulge any personal information. I would want you and all your parts to feel safe reaching out. So, find out if the structure is there to even start a deeper conversation. That boundary is whether your payments would work for the therapist. The other issue is whether they have times that would work for you.
- Skilled in listening? Does the therapist listen — not just to the story you tell but to the multiple layers of the communication. As the therapist listens do you feel heard and understood?
- Resonance? Is there a connection, a resonance between you? Or do you feel like a “patient” – someone who has problems and that the therapist has never had a personal problem or encountered anything like this. Personally, I prefer the “wounded healer” therapist – someone who has walked in similar kinds of shoes, encountering issues like I have. On the other hand, you might want to be with someone who has established themselves in the field.
- Compassion and Respect? As you interact with the therapist do you, and your parts, feel that your process is understood and respected? You want to know that the therapist attends to you compassionately. Respect does need to be earned; it doesn’t happen immediately. You do want to have a felt sense that you can respect the therapist – and more importantly, that they respect you. Is there a foundation for respect? Do you get the sense that the therapist can help you? Does the therapist have the training to do so?
- Therapist steadiness? Healing trauma and attachment wounding is a long and windy road. Do you get the sense that the therapist has the internal steadiness and solidity to stay in it with you as you explore what one of my favorite theorists, Daniel Stern, calls the “sloppy” path of therapy? And this comes from Barbara Mulhall, a therapist in Dublin, Ireland, who added important considerations: has the therapist been to therapy? Do they seek out consultation (or therapy) when they need to?
Does the therapist have a support system, a supervisor or mentor? And finally, is the therapist committed to continuous professional development. Barbara stresses (and I agree!) this is important as new advances continue to be made in this field all the time.
- Hope? And perhaps more than anything, does the therapist impart a sense of hope that you can find the healing that you want? Are they confident that there is a way through? Can they communicate the markers on the healing journey so you don’t feel like you’re flailing aimlessly. Richard Schwartz, the founder of the Internal Family Systems model says he’s a “hope merchant” selling people on the possibility of change/transformation. I’m all for that as well.
I’m really curious what you think?
How has your experience with therapists been? What’s it been like to look for a therapist?
In the inquiry above have I covered what works? Is there more you would add? What am I missing?
Leave a comment below — let’s think this out so we can help others on the path who are just finding their way.