First off, huge, huge fucking props for having the strength to be real and admit that shit hurts, and you want change. It's brave as fuck to ask for help. The overwhelm and the vastness of it all can feel like so much sometimes. And I'm so sorry that you've had to go through what no person should ever have to feel or endure. It's hard as hell and it's real as hell. I was rejected in the final intake for a ketamine trial because my treatment resistant depression was too high variance for the intake thresholds. I haven't tried EMDR but I've had family members with good things to say. While both seem promising, the world of therapy is very wide, I've dealt with many facets, and here are the things I think it is most helpful to know: * Therapy, when effective, is spectacularly, transformatively so. The same feelings that send us to therapy can cause us to doubt it. But therapy can work crazy well. It doesn't always feel like things can get better, but life can surprise us in good ways too.
* With that said, not every pony's a pegasus. It's very common to get a therapist you don't vibe with, have a null or even negative time, and put it off as baloney. Attempt to reject this instinct.
* "Therapist" is not an occupation, it is a relationship, and therefore requires a certain degree of chemistry. Neglecting chemistry is the therapy equivalent of fighting a trip for the steering wheel: a reliable shortcut to an unpleasant time. Every regret I have w/r/t therapy is in one of two categories: waiting too long, or staying too long. The deepest recesses of your psychology are unlikely to accept help from someone you do not trust or respect. Especially tricky are reasonable-seeming people whom you feel you ought to like. CBT has a great reputation and would probably work for me, but it turns out not to work when administered by Jerry Smith, because I don't take life advice from guys my lizard brain would be scared to turn out like. (the other side of this coin: a therapist is your advocate but not your friend. Temper your expectations and be receptive to hearing things you don't like.)
* Good chemistry is probably more important than a particular school/style of therapy, because it creates emotional investment, which creates stamina and excitement and effort, which turn out to be the whole game. Don't worry too much about the "one true optimal therapy tek". The tek for you is the one you find intuitive and want to return to. * We can't expect to eyeball therapist chemistry without having found it before, and can't exactly go looking for it via direct properties, like true love from a tinder bio. It's to be approached in a specific way: you must "date" a lot of therapists. Seriously. Go on no fewer than 6 "first dates" (20 minute intro calls). Get a feel for who's out there. Be willing to try some people out. But, per above, if you know for a fact you could never really trust a person due to some property of theirs, save yourself the time. This includes protected classes. Be real about your biases, don't add a headwind you don't need to. You're shopping on behalf of the real you.
* By far the best barometer, IME, is unexpected crying. I met with a lot of therapists this last round (about a year ago). We talked about all the trouble I was having with my now-ex wife. My anger, my insecurity, all these very real things that were wrong with me that I knew were big problems and that I was specifically there to fix. And then somehow I ended up with one guy talking about how I'd taken some ochras a few days earlier, and found myself looking up at the night sky. I never go outside when I trip. They felt different. And how looking up at the stars, and seeing the twinkle of my patio lights, reminded me of all the nights I'd spent in the warm california breeze, a 20 something alcoholic who felt the whole world ahead at his feet. Surrounded by friends and prosperity. Before I had to quit. Before covid. And suddenly, somehow, I was heave-sobbing about a loss that, 90 seconds earlier, I hadn't really let myself think about. We had achieved a vibe. I trusted this guy enough to be vulnerable enough to actually open up and explore. This is a key prerequisite that enables doing work on all the big ticket items. This doesn't have to happen in session one. But it is the equivalent of striking oil. When things start bursting out, you might be clear to switch from looking mode to digging mode. * The second barometer, which helped with my first therapist (before I knew all that other stuff), is that they have ideas which are unexpected, which you could not have mentally simulated in your own head, yet which seem shocking and true once introduced. I was very torn between two people. I visited both of them weekly for like 3 weeks (this is possible! You don't have to tell them at first either! I recommend it if you're uncertain, but after some weeks you do need to decide, and they'll tell you this too if you ask). Anyway, one day I ask this guy what I'm supposed to do, and I had all these preconceptions about what I expected him to say, and he said a thing that was basically the total opposite, except in a framing that was like "holy shit.... actually yes, I would expect any OTHER human to need this thing, but I have been running nonstop since kindergarden and done exactly zero of this so.... you sonofabitch". So that's how I broke the tie. * Okay concretely: psychology today is the linkedin for therapists. They are all on there. The one place. This makes it easy. You can go and filter for people in your area and see their backgrounds and the things they focus on. Aim for "in the ballpark". If they exclusively focus on jewish couples or teenage girls with eating disorders, or something that's not you at all, skip. But don't look for the perfect fit. Grief, loss, trauma, mens issues, big buckets.
* I would strongly bias you towards in-person therapy if it is at all possible. Therapy is about living, and living is physical. Remote therapy can work, but again, minimize elective headwinds where you can. * The one mostly unavoidable suck: therapy is almost always cash only (no insurance) and expensive as fuck. You might be able to work something out with your insurer re:reimbursement, and I strongly and unironically recommend you upload your health plan PDF to Claude or ChatGPT and ask them to advise. They make mistakes but they also have the entirety of human knowledge about healthcare PDFs which.... nets positive. It is worth it if you can swing it, and there are low cost alternatives like regional support groups, etc, which can be great. Anyway sorry for the absolute fucking novella here, but I feel a certain obligation to share the gospel since I have been in such a place and therapy has helped a lot. DMs are wide open for absolutely anybody reading this. Strangers are rooting for you <3
Edited by Rasmodius (05/07/26 01:09 AM)
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