disclaimer that i’m deeply critical of Psychiatry and i’m also not addressing issues of access/affordability here, but if you can find it, voluntary, individual outpatient therapy can be incredibly helpful, even life-saving. here’s what i’ve learned to look for in a therapist:
an explicitly political framework: mental illness is a social phenomenon–socially caused, socially identified, socially experienced, socially treated. it is the systems of power to which we’re subject that make and keep us “sick.” especially if you experience greater marginalization or oppression, this understanding is essential in a therapist. no hyper-individualization of mental disorders. therapists might say they have feminist, lgbtq-focused and/or social justice oriented treatment approaches… in the real world, this is a good sign.
roughly similar age, or same generation: i think this helps even the power imbalance somewhat. a much older therapist can feel (and act) more like a parent than a peer. also, graduate/clinical training has gotten better over the years, so a younger therapist is likely to have benefited from that evolution. and, millennials in the field are generally more aware of issues of power than like an older gen x or boomer (generations are fake and this isn’t always true but…)
active participation in your sessions: it shouldn’t feel like old school psychoanalysis where you’re laying on a couch rambling about your life to a bearded academic. a therapist should offer ongoing affirmations, reflections of/on what you’ve said, suggestions, questions, etc.. they should seem interested in collaborating w you.
adaptable w treatment techniques: they might practice cbt, dbt, act, mi, emdr, or any manner of acronym, but you want someone who adapts their approach to you, rather than trying to squeeze you into their preferred technique. clients’ needs vary. therapy isn’t just a cbt lesson or whatever, it’s a reciprocal relationship, and therapists should have the skill and openness to honor that.
a certain je ne sais quoi: there’s a chemistry factor in the therapeutic relationship that can’t always be accounted for rationally. do you feel like this person gets you? do you look forward to seeing them, even if the work is hard? do they feel like an ally in your struggles? is it mainly awkward or does dialogue flow? do you feel safe? there is no perfect therapist, but most of these answers should be yes. if they’re not, you may tragically have to go back to the drawing board
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