It appears that several of the readers of this blog have gone through the wringer in terms of finding a good trauma therapist. When you are interviewing new therapists, in addition to clarifying that they have the skills and training it takes to provide proper treatment for your trauma issues, it is also important to ask about their approach to trauma work.
Make sure their views match or blend with your own views, otherwise there will be conflicts ahead.
There are a number of different approaches to trauma work – just as there are tons of different recipes for how to make a loaf of bread. It isn’t that one way is “THE” right way. You and/or the therapist may have very strong opinions for what works best, but the point that matters is if you agree with how your therapist approaches the issues with you.
For example, if someone said to me, “Help me get rid of all these pesky little parts that are irritating me. I want them totally gone and removed from my head.” Oh, well, you see… there are some therapists that would gladly approach therapy work with that goal in mind. I, on the other hand, would have a cow. A really big cow. If someone wanted me to help rid them of their insiders, I couldn’t do it. I wouldn’t do it. I don’t agree with that approach, and just couldn’t be convinced to go there. In that case, this person and I would be a therapeutic mismatch. We would not be aiming for the same goal, so it would not be a good idea for us to work together.
Before you share very much of your personal system information, please take the time to interview the therapist very closely.
You must be VERY sure of the safety of the therapist before you disclose about yourself on those deep levels.
There are lots of great therapists out there. There are also lots of clowns claiming they are trauma specialists. They may not be dangerous people, but they can do a lot of harm by not actually knowing how to treat trauma-related issues.
Please be aware, there are also “double agents” out there – people who claim to be a helping person, but are actually working to support the dark side. Interview all therapists very very closely to make sure you find someone who is both safe and qualified.
When interviewing new therapists, some of the important areas to consider are:
Direct Experience:
- How many years of experience do you have in working with trauma disorders?
- How many dissociative survivors have you met?
- How many survivors with dissociative identity disorder have you treated (as the primary clinician)?
- What percentage of your practice has been filled by clients with trauma-related issues?
- Do you have a web-site, any books, articles, or outside referral sources that can confirm your experience?
Education:
- Where did you first learn about trauma and dissociation?
- Who have you studied with, and/or who mentored or supervised your early years of trauma work?
- What conferences and training programs have you attended?
- What have you done to build and develop your expertise in the trauma field?
- Where do you go for help if you have a clinical question?
- Do you have a valid mental health license, and can you verify that your license is in good standing?
Approach:
- In your opinion, what are the most important aspects of trauma work?
- In your opinion, what do people need to do to process their trauma?
- In your opinion, how long does it take to work through trauma-related issues?
- What do you do if someone is stuck on a particular trauma-related issue?
- How do you manage issues related to self-injury?
- What are your office policies for emergency situations?
- What are your policies and guidelines for regular therapy sessions?
- If I need additional support between therapy sessions, what do you recommend?
- What do you think of “so and so’s” approach to therapy? (insert the names of your favorite trauma therapists or authors)
- What are your thoughts about ritualized abuse, cult abuse, and organized abuse?
Dissociative Specialty Questions:
- How do you define Dissociative Identity Disorder?
- In your words, what is involved in the treatment process for Dissociative Disorders?
- When do you approach trauma / memory work?
- In your opinion, when is a client not ready to do memory work?
- What are your beliefs / perspectives about who the alters are?
- Do you speak directly to insiders? Why, or why not?
- Do you prefer all communication to go directly through the host / adult / front part? Why, or why not?
- What kinds of homework will you expect my system to do outside of the therapy sessions?
- What are your beliefs and approaches to integration?
- How do you define “success” in terms of treatment goals for DID / MPD?
- Have you ever worked with mind control issues? If so, what do you do?
Of course, as you go through the interview process, be sure to ask clarifying questions about the answers you are being given. Any therapist that understands trauma disorders is going to understand why you need to check them out thoroughly. Needing time to build trust is obvious, and having the same theoretical foundation is critical.
These are not personal questions.
Keep your questions focused on the type of work that will happen in the therapeutic environment, and not on the therapist as a person.
Before you get emotionally attached to a therapist, please make sure that their approach fits with how you want to proceed with your own therapy.
Your healing journey belongs to you.
You get to decide how it will look, and what paths you will take. Working with a therapist that fits with what you want is critically important. Otherwise, you will waste a lot of precious healing time struggling with opposite or conflicting goals. The journey will go much smoother if you and your trusted therapist approach your healing process from the same wavelength.
Warmly,
Kathy
Copyright © 2008-2017 Kathy Broady MSW and Discussing Dissociation
I havee been thinking a lot about something today. I wish we had had this list back in 2008-2009 when we were searching for a new therapist after the first one dumped us. Husband said we had to be in therapy even though we didnt want to go to anyone else.
We saw a bunch of duds. Sa couple were downright nuts.
There were eight we tried to see. Some older, some younger, some specializing in anorexia, some supposedly specializing in trauma, some were just a warm body with ears. None of them were very good. A couple we walked out after a few minutes,
One was quite promising. We were sent to him through a friend at church. We met with him, he was so easy to talk to, he understood DID, he was kind, we were actually looking forward to seeing him. Then he said something about “So i have a good person to refer you to…” and we almost jumped out of the chair,
Turns out he was only there to consult and refer,
We were not told that.
So we turned and left. And met our husband in the parking lot, we were crying so hard, and said we were just DONE, done.
Thankfully we hung in there a little longer, because next time we tried to find a therapist, they were the best for us there is, and one we should have been seeing all along, worth the wait.
But boy do i wish we could have had this list, and asked people on the phone, before we spent time traveling to their offices, writing them big checks, and wasting our time,
Finding a good therapist is proving to be extremely hard..I am in the Uk and in a remote area..i won’t bore you with the long story, I have been working by phone (as the options to travel to someone are just logistically practically impossible until I can drive again and afford a car) with someone who has at least covered the bases for your first lists..but I haven’t asked all the questions on the speciality list..I find your blog very illuminating and helpful..if a bit overwhelming at times there is just soo much good info not sure where to start.
This therapists key text is the Haunted Self..Is this one you know? even the extended title made me go ugh..I bought a copy but can’t get myself to read it..I am Rogerian trained..and used Peter Levines Awakening the Tiger as a key book for myself..along with Babette Rothschild work…we had to take a break to see if I could get my treatment funded..I find out later this week if that has been approved..I am looking forward to getting back to work with him ..but worry that might be coloured by how tough it has been without anything in the interim period. I could start looking again locally but they would all be people new to working with DID , so I know it isn’t a perfect situation but I think there are things that can still come out of working with him..and can prepare me to start hunt for another therapist or in time there may be someone nearer to me with experience as the knowledge pool on DID grows here..but I do wonder if the haunted self is so cognitively based I will soon struggle..and feel I am being mentally manipulated? Guess it comes down to is something that isn’t a perfect fit better than no support at all? Any thoughts would be appreciated
We are aware this is an old topic but it is something we came across with. Were going currently to therapy, yet there are huge red flags going on. We see ourselves as individuals, each with an personal existence. This benefits for us and make things probably more organized and validated. Its almost an natural process so to say.
We had….5 sessions now I think, not sure about that. There an couple of red flags going on
one “alter” introduces himself and she refers to our bodyname. when we told her not to she went “how should i call you then?” while the one introduces himself/herself short before the question, when we didnt told her, she would refer back to bodyname as if the presenting was not even there. Our system is in lots of turmoil, anger is surfacing fo us right now, frustration, inner turmoil and we feel were more harmed then being healed in an way. It confuses us. Its our second therapist now. We somewwhat are aware it gets worse before it gets better, but were really doubting we should go another session and our system ( several laters ) have drawn the line of enough is enough.
I think we need to ask her for an list of references to specialists. She claims to have experience in trauma, yet there are no boundaries it seems. like coming 10 minues late, sessions of half an hour once in 2 weeks because its an busy schedule.
her feelings are not our buisness so to say, but the thought we should find another therapist again is somewhat ugh, She stated also that “it was an harsh letter as there were good moments aswell”. it messes with our head.
Think we will go take this list and use the magical powers of disconnection and amnesia, stepping like an freshmen and just interview her i guess. Our system is just in lots of turmoil. Trauma and dissociation therapists her in the netherlands seem to be scarce and maybe thats why we comment.
Sorry for the ramble, we just needed to comment and needed it somehere typed out.
Dear kathy,
I adore my therapist, she is wonderful, and was the first person to ever diagnose me with DID, even though i knew already that i had it, i just kept it to myself for fear that it would mean i’d be locked away. I never had to ask my therapist any of those question, i basically just told her she had 5 sessions and if i thought we weren’t a good match then i would like a list of references to see someone who would be a better fit. Of course my therapist is expecting a baby soon, and will be out for 2 months, while on maternity leave we will have to see another therapist. We don’t want to and are worried about it being someone who doesn’t understand trauma but i will use youre list of questions..
you know..
Krystle Olivia
Hi Kathy,
Yes, that is what they meant… We tend to freeze at the first interviews as it feels too much like an assessment!
We’re librarians, so we live and breathe copyright… lol. Ok, so some of them now want to know whether you’ve assigned a Creative Commons or Copyright status on your blog – they can’t find it and you really should have one in addition to your liability disclaimer.
Take care
Sophie 🙂 and M. (who does most of the library work)
Hi sophie, 🙂
Hi M… (nice to meet you)
Oh good question! I am going to have to check that out myself and get back with you! …. Off to do my homework…. (can you believe it?? Sophie and M are giving me homework!!! 🙂 )
Kathy
Another commenter brought up some good questions to ask therapists. For example, how many holidays will be taken, what are the typical lengths of their holidays / vacations, what are you expected to do for sessions while the T is away, is there a back-up T, (or not), what happens if the T is called away for an unexpected emergency, etc. There can be any number of unexpected (or planned) reasons that a therapist becomes unavailable to do individual session work, and yes, knowing what to expect, having a plan for when that happens, and having a sense of how often the T will be away is quite important to a lot of people. Good point.
Also, knowing the rules / boundaries / limits / expectations about contact between sessions is important. I know a bunch of different therapists, and they all have their own opinion on what works for them, so… you will see a very wide variety of responses on that. But it is important to know, and that’s a great area of discussion.
I would certainly encourage folks to discuss these kinds of topics with their therapist of now too – not just a new therapist.
A third area mentioned by this commenter was asking therapists about their own personal therapy. You’re going to find a wide variety of opinions on that topic too. Of course, some therapists speak openly about their therapy experiences. Some therapists advertise themselves as “wounded healers” or recovering addicts, for example, while others have been required to go through a form of therapy in obtaining their education.
Other therapists, however, are going to see that as a huge boundary issue, and are going to emphasize the word “Personal” in the phrase personal therapy. Therapy is very personal. And private. And, they might not care to share that with anyone. Yes, highly qualified, experienced, effective therapists may choose to keep their own therapy experiences private to themselves, and they may not be willing to share that with their clients. That is ok. I really don’t think anyone has to share their personal therapy with anyone else, so… taking a less black and white “this is required information” stand on that issue might be necessary. Or, maybe this is a deal-breaker area between you and a potential therapist?? If so, that’s ok. To each his own.
The idea of finding therapists who have been through enough adversity in their own lives to have compassion, patience, and understanding is a very good point. However, there are other ways to learn this about therapists than to demand to know about their personal therapy experiences.
Kathy
Thank you for this great list Kathy… now we just need to find the strength to able to ask them!
As a slight tangent – would it be unreasonable to give these questions to a therapist prior to a session and ask that these questions be the basis for that first session? We ask as we’ve never been able to question a therapist, so want to find ways to ask them that is safe for us.
Take care and hope you have a good holiday season…
Sophie 🙂
Hi Sophie 🙂
Are you saying, to use these questions as the main topics of discussion during the first session? If so, then yes, absolutely, that would be ok. In my opinion, that would be reasonable because it protects you more. It keeps your system safer, and at a distance while you are still deciding who to work with. In my opinion, it really is ok if the first session is more about interviewing the therapist than the therapist interviewing you. I’m sure that there are clinicians who would not agree with that, but I think it is critical and important that trauma survivors have the chance to first make sure that the person you are exposing your system to is someone that feels safe to you and has an approach that is workable for you.
One way to make it easier would be to have two printed copies of these questions (be sure to keep my copyright on them though!!!). Give one copy to the therapist, and keep one for yourself. Use the pages as an outline for your discussion material.
Think of it as taking steps to protect your system. Be courageous for them. Believe me, if you get connected in with a therapist with views strongly different from yours, it can lead to a nightmare. And remember, there are no value judgments here. Everyone is allowed their own opinion. The point right now, is for you to find someone that matches with yours.
Good luck!
Kathy
Thanks Kathy – I really like the co-therapy idea. It’s something I may be forced into by the lack of an available specialist until later in the year so its great to hear that it’s not an unusual concept!
🙂
btc – I like the co-therapy combination myself. It’s a win-win-win situation for everyone, when done properly. The client has two therapists available to them, each therapist has a back-up therapist, and the workload gets shared between everyone.
I have been the adjunct therapist– the trauma or DID specialist — in many different situations around the country. (For that matter, I’ve had clients in other parts of the world as well.) I like the opportunity to do what I do best, knowing there is a local therapist available for the person for other needs. It works well. BUT, it is critical and crucial that the two therapists stay in close communication while doing this. Otherwise, there is the potential for “borderline splitting” to occur (where one t is designated the “good guy”, and the other becomes the “bad guy”). If that kind of manipulation occurs, the overall therapeutic process needs a quick and thorough re-assessment.
I hope you find a t that works for you – please let me know if there is anything I can do in this regard.
Kathy
“Please be aware, there are also “double agents” out there – people who claim to be a helping person, but are actually working to support the dark side. ”
Kathy, that’s a pretty scary statement, coming in a post talking about looking for therapists (which I am). Any chance you could explain what this means? Do you mean that there are therapists out there who – actually, I’m just going to ask you what you mean.
Many thanks!
Wynne.
Hi Wynne,
Yes, this is a very scary thing – I totally agree with you. What I’m saying is this. Predators come in all forms — in all shapes and sizes. They show up in every profession in the world, and they walk amongst you appearing to be a “survivor” as well. You cannot assume someone is safe just because you have met them in what appears to be a “safe way”. You will have to assess each and every individual to see if they really and truly represent good things. And yes, some people who hold a license that says they are a helping professional will be very dark-minded. What better place to snag up a meandering survivor than to pretend to be a helping professional??? For that matter, some pastors and clergy are “dark-minded”. Some doctors, and lawyers are too. Ok, so it’s not so hard to believe that many lawyers are dark-minded, lol. But the point being…. it is very very important that you check out each person as an individual. Even within groups of people you generally can trust, there can be bad apples. SO… please be careful.
I can and will write more about what this means in more blog posts, but until I do, I’m gonna refer you to read RockingComplacency’s series on “internet predators” posts very very closely. Many of those points don’t have to apply to just the internet – they apply to predators of all kinds.
And keep reading, Wynne. You are much better to take things slowly, and to wait and make sure you work with someone safe, than to rush into working with someone that causes you harm.
There ARE good therapists out there — so don’t be discouraged about that.
And Wynne – in the meantime, if you have some individual questions you’d like answered or addressed privately, please know you can contact me through AbuseConsultants.com, and do some individual consultations that way. I do online work, phone sessions, etc. I’d be glad to do whatever I could for you while you are looking for a new t.
Warmly,
Kathy
he is very good with trauma and dissociation. He knows me and understands me and my parts.
not that i am looking for a new one.
how can i be multiple without knowing it?
what if you didn’t know you were a multiple before entering therapy and you have already become emotionally attached.
How can you enter therapy knowing absolutely nothing of who you are or what has happened in your life?
hi haberlach,
This happens to a number of people. Many people enter therapy without realizing they are multiple, and without understanding just how dissociative they are. That’s ok. It’s just great that you got to therapy, for whatever reasons that took you there in the first place. A good therapist will help you understand more about the dissociative stuff as you go thru’ your healing process.
The fact that you know very little about what has happened in your life is a very big flag about how dissociative you are. A therapist is going to hear that and recognize it as a sign of something to work on in the therapy. Keep working at it. I can hear that you are just in the early steps of the process, but it will be ok. It’s an important journey for you to take.
Sending lots of warm thoughts going your way,
Kathy
@ haberlach – this has recently happened to me. IMHO it depends on the capacity and skill level of the therapist you are working with. I’m afraid in my experience the inexperienced therapist inevitably re-traumatises the client in some way. Despite the attachment that comes with most therapeutic relationships you have to extricate yourself as soon as this mismatch becomes apparent.
Hi Kathy – thanks SO much for answering my question. Alas I don’t think I’m going to get the chance to use most of these, as I have only found one DID therapist and she has no availability.
I will however be integrating some of these excellent questions into my general therapist-grillings over the next few weeks/months so thanks again.
BTC.x
hi btc – it’s always good to hear from you. 🙂 And you’ve made a great point. Sometimes, somewhere along the lines, it is important to work with a therapist who truly understands dissociation and all the complexities involved in that. It really is a specialty of its own, and as caring and kind as a non-trauma therapist might be, they just simply won’t know what to do, nor will they recognize the correct timings for when to do various bits of work (and when to not touch it), etc. I feel a little badly for the people I worked with in my first years as a DID therapist — I didn’t do a bad job because I was being closely supervised by Colin Ross and his treatment team every step of the way — but oh my gosh, I could do soooo much better now, after all the years of learning more about how to work with dissociation.
For that matter, at some point, a non-trauma specialist therapist should recognize that they are treading into areas they don’t know… and they really should encourage their trauma clients to move on to a specialist.
What I have seen, that really can work, is a co-therapy type of process, where a trauma specialist works on the specific DID / dissociative issues, and the non-trauma specialist works on everyday type issues. If the two therapists stay in good communication and work as a team for the client, that can give the best of both worlds.
Don’t be afraid to be creative in finding options that work for you. The main thing is that you can keep progressing forward in your healing journey.
Thanks for posting —
Kathy