Here is it — your list of qualities found in an really good therapist. It’s a really loooooooooong list !! There are almost 150 descriptions of what an exceptional therapist looks like, and the kind of therapist that DID trauma survivors need. Very thorough! 🙂
Remember that discussion in the Our Complicated Selves area?
Well…. I’ve combined the answers provider by YOU, the readers of Discussing Dissociation in response to the question — What makes a good therapist?
Your responses have been put in alphabetical order, and very slightly edited only for consistency in reading presentation.
Now that the list is all together — do you still agree?
Descriptions of an exceptional DID therapist:
A good listener.
A good teacher.
Allows for communication outside of sessions. Emails, texts, phone. But have clear communication about what level of responses will be given. For example, be clear if they don’t have time to give in depth answers or dialogue.
Allows for longer sessions or double sessions.
Allows for parts to come out and speak as needed even if the host is not present.
Allows parts to safely say negative things without correcting them. I felt safe telling my T some of the darker emotions and feelings. She did not shame or try to change them which allowed me to process some stuff without shame.
Always checks who is driving home and gives time for grounding.
An experienced DID T is better than an inexperienced one. That said, I would take a good solid T who was a very good match for me but had less experience with DID over an experienced DID T who did not fit well with me.
Asks tough questions. Without pushing… those are the ones that we really need to be challenged by.
Be a compassionate and empathetic person. Our lives were devoid of compassion, understanding, reassurance, caring, genuine affection and the list goes on. My T needs to be someone who is sure enough of themselves that they are not afraid to show compassion and empathy for all of my parts.
Believes that DID is a real, credible disorder. It is my sincere belief, you cannot find healing with a therapist who does not believe in DID. You might need such a T as a stop-gap solution to help you in crisis while you look for someone better. But, they are not the T to stay with long term if you want to find healing.
Believes your alters are real and that they have an equal place in the therapeutic relationship. As a DID client, you cannot leave parts out in the waiting room. All parts must be welcomed into the session.
Believes your inside kids.
Be relaxed and confident in her own self and willing to (within appropriate boundaries) share a little about what makes her tick. It makes her more real to me. It might be a therapeutic relationship but it still has to be real.
Be solid in their own work and sense of self. I appreciate that we all have stuff going on and Ts are no different. But, ideally, Ts should have worked their deep stuff out already before trying to work with us. And, be professional enough to leave it at the door if something is happening in their lives. I am not saying that they cannot be human. I am just saying that there is only room for one client in the room (maybe especially when that client is many).
Be someone who genuinely wants to work with me.
Be strong enough to hear the hard things. Our stories are brutal. They are not easy to speak and they are not easy to hear. Just being willing to listen and say “I believe you” is incredibly impactful. I think that’s true for all of us.
Be willing to be flexible about times when you get “stuck” in therapy to problem solve and look for solutions.
Boundaries need to be established and maintained. As much as some of our alters may wish to push the boundaries or even rewrite the boundaries in the therapeutic relation, it is important that the T stands their ground and maintains these boundaries. As a DID client, you can be sure that our boundaries were viciously violated in the past to the point of us not knowing what boundaries are for ourselves. So, the T needs to model this behaviour and set clear boundaries. That way we will know if a boundary has been broken or not and can feel secure in understanding just what the boundaries are. I know that this can be a tricky one because we get so attached to our Ts that we want a boundary-free relationship with them 24/7. But, that is not good for a healthy relationship for the T or us. That does not mean that the T cannot be flexible in times of serious crisis for example, but, the bottom line for me is – boundaries are essential.
Can be moved by artistic expression. You can tell if someone feels it in their heart and bones or if they do not. Art is it’s own language. It doesn’t matter if it is music, textile arts, sculpture, painting, etc. They have to have a heart for such things because it is often how I can communicate. It’s how I can share my heart. If they don’t have some appreciation for it, some understanding of that language, they will not really understand me.
Checks in with host / main person before session ends.
Doesn’t bail. Ok. So we know a therapeutic relationship isn’t meant to last forever. But don’t bail on us. ESPECIALLY after you said you wouldn’t. Bad deal.
Doesn’t force work and trusts the system to know when it is time to start or stop talking or switch.
Doesn’t get tied up in a 50 minute hour and can fit sessions to how you need them.
Doesn’t give up on you.
Doesn’t hide sh*t. Be someone who will answer honestly when asked if something is wrong. We who are DID have big huge antennas so you might as well fess up.
Doesn’t leave you.
Doesn’t let personal bias (on religion, politics, etc) influence their care to their client.
Doesn’t make you regret trusting them with your stories.
Doesn’t play mind games.
Doesn’t try to make you feel bad for how hard you’re making their job.
Doesn’t try to persuade the client towards their point of view, for example: you need to get divorced, you must do this or that.
Doesn’t try to trick you.
Does what they say they will do.
Emotionally available to the client as they may have limited support in their current situation.
Ensures the person is fully present, grounded, and safe before walking out the door.
Every time I walk into my T’s office I do so with the intention to be real. To be honest and authentic. To let down the walls, take off my cloak, to simply be real and who I am. That requires a good fit and a lot of trust to allow someone to see me just as I am. Having someone with experience in DID and has loads of compassion and a strong confidence in herself and a basket full of options and things she can share and teach me….that combination is priceless.
Experienced in helping people with some very serious issues. It makes me feel safe.
Fearless. Okay, this is really a lot to ask of anyone but the T cannot be scared by what we are saying or how we may be saying it. I am not saying that sometimes we may catch them off guard, but they should be open and strong enough to hear our stories. I remember that my insiders were elated when we met our T because not only was she very book smart (had the solid academic training behind here) but she was street smart (i.e., we know that she could take anything that we said and that we could not hide the truth from her because she was smart enough to see through any deception that we might try to pull on her).
Forward thinking. I remember a really rough session and my T asked, “How are you going to take care of yourself after today? What will help you get through the weekend?” I had never thought of that. To plan to be gentle with myself and have concrete things in my “basket of safety nets.”
For where I am right now, I need, desperately, a T who understands DID.
Gently challenge me to look at something differently or to change something, explore places of resistance, or simply ask questions that are hard for me to answer because it’s just so blessed horrible. Her asking the tough question tells me that she’s willing and able to HEAR the tough stuff and that it is okay for me to open up and let the words out. I appreciate this.
Gives a lot of warning when taking time off work, and helps find extra supports during that time.
Gives fair warning about vacation times, holidays etc.
Gives short term goals or short term specific focus — I appreciate this! My T comes up with some pretty creative ideas. If I deviate from the weekly goal it really doesn’t matter, but it’s so incredibly helpful to have her say, “I’d like you to work on this….what do you think?” or “Do you have a focus for this week?” We work out what the focus will be together. That way I am not overwhelmed by trying to tackle everything all at once, nor floating about not making progress because I’m stuck or not trying new things. She gets specific. “Try this _____ (fill in the blank.) Notice if you feel resistance, how strong it is, how long it lasts, what the trigger might be. What emotions to you feel? Or the goal might be to create something or to read a book or simply to rest and be gentle with myself.
Gives warning time before session is about to end.
Gives you regularly scheduled times so you know when you get to talk again to them.
Has a head that can wrap around things we explain or can ask questions about what we are talking about.
Has a strong backbone, can take criticism and learn from mistakes.
Has a warm heart… and is prepared to give hugs.
Has clear expectations for the client.
Has different kinds of toys and stuffies. This was so huge to make all parts feel comfortable.
Has good energy (basically they make my parts feel comfortable so they can be free).
Has the ability to know when we just need space and time.
Have a solid grounding in the field (i.e., proper educational achievements and accreditation) and be willing to continually upgrade their professional understanding of DID, trauma, therapeutic techniques, etc. I have experienced Ts of all kinds of educational/training backgrounds. I am not saying that there is a single route to this end but there should be some academic/training background here.
Honest, even when things get tough.
Honest about the therapy process time frame.
Honest with clients in all things.
Keeps abreast in current research on what they treat.
Keeps a comforting office (items for child parts, blankets, lighting that is soft).
Keeps appointment times consistent (my OCD part hates change).
Keeps attention on body language – especially to catch switching so they can change their direction/type of questions and responses.
Keeps consistent appointments (at first I didn’t have this, and I’d constantly feel like she was going to abandon me or didn’t care about me when I had to keep asking for the day/time).
Keeps good therapy notes/goals for patient success.
Keeps your privacy.
Kindness, kindness, kindness with patience for the slower to trust parts. It is hard to feel safe so patience because sometimes it gets confusing.
Knows how to laugh and doesn’t have to be serious all the time.
Knows how to talk to your inside people in different ways that they need to be talked to, like talks to the kids like kids.
Lets you avoid eye contact if it triggers without shaming. I had times where I felt so sick to my stomach during sessions and too triggered to deal with someone looking at me. It was a lot of shame.
Lets you communicate with them through email or call if in crisis (within reasonable limits. I feel like this is a big gift of time they give but very needed).
Loves their “job” as a therapist.
Makes sure the patient is safe, and knows of resources available to them for emergencies.
Mindful of the needs of the various alters. Because our alters are of various ages, the T needs to be flexible and creative in their approach to flow with the needs of various alters, their ages, interests, feelings, traumas, etc. There is not a one size fits all solution to working with DID folks.
Most important thing is they are educated in trauma.
No expectation of quick healing or meeting specific goals on time. I feel like that stops progress because there is no guarantee what will come up. Again it can be very confusing when material comes up that is new or a part is more distant. Sometimes I don’t even understand until much later what we are processing.
Not afraid of the truth. All of it! Sometimes we just need to say the hard stuff and disbelief doesn’t fly. Be willing to hear the hard honest stuff without judgement or appall.
Not afraid to hug a client once in a while after a difficult session (I may not be able to accept it, but it would be a nice gesture).
NOT doing these bad traits: a loud noisy office, bright lights, assumptions about condition, too many compliments, too much guidance, constantly writing or looking at the time. not addressing the DID, lack of knowledge about trauma or rudeness.
Obeys HIPAA laws.
Offers candy for kids (I never told her how much this was appreciated) Probably not what makes a counselor good but I think it was nice.
Open to learning more about DID, and stays on top of new information.
Patient with all parts.
Picks up on body language. This helped me so much to become aware of how dissociated and physically numb I was.
Practices radical acceptance of all parts (even if some are un-likeable).
Practices self-care to prevent burn-out.
Prepares you for leaving therapy because if you switch or don’t know you are dissociated it is very dangerous to just leave a session.
Respects those who do not believe in traditional forgiveness. Let me decide who I wanted in my life including my own mother at the time. My T did not make me feel I had to feel anything I did not feel. I was allowed to not be punished for my anger. That is a big deal to me because it is not safe for all victims to forgive. Sometimes it can put you in a lot of danger. No one should force you to forgive people because there are those who will not stop harming you if given the chance. We know who is safe. Trust a counselor who trusts your system to know if someone deserves your forgiveness. Also no counselor should tell you it is needed to forgive to heal. We have a long road to travel in dealing with the harm done so no one knows what the end result will be. I could talk a lot about this because I have experienced feeling safe in forgiving and being harmed by those who saw opportunity in it to hurt me again. I trust only my feelings on it now.
Sense of humor and an ability to have a lightness of heart from time to time. Not at all talking about laughing at something, but that ability to smile and laugh and simply be lively.
Shows up when they say they will.
Someone who clearly likes doing the work she does. Not every day…no one does…but showing some appreciation and enthusiasm for what she does makes it more engaging for both of us
Someone who loves the natural world. The earth has a tone. It resonates and speaks its own language. All of it speaks from the stones on the lakeshore to gardens to the wildlife in our forests to the weather and the way the air smells before a storm. Moss under my feet. The way snow sounds different depending on the temperature. Fireflies. Starlight. Northern lights. Love of the natural world in one form or another helps the connection because my T gets that very strong part of me.
Specialist in childhood abuse.
Thinks out of the box for ways to help.
Treats child parts like children (I think this is very important so they feel safe to talk).
Trustworthy. Well, we have to trust our T to be honest, to not gossip about us, to be there when we need them (within the therapeutic contract), to be on time, to not take a million holidays, to give us sufficient notice when this is going to happen (to help prepare our alters and ensure no one feels abandoned), to name a few things.
Unafraid to talk about sexual abuse . My counselor made sure I knew she would never assault me. She let me know my physical and emotional reactions were normal to memories.
Understanding if a part is late or tries to avoid going. Sometimes parts block sessions or will not drive to the right location. That used to happen a lot and it was never held against me.
Understands that wants and needs may be specific to the client. Knowing a little about what works for us is helpful.
Understands that you are the expert on your system and your inside people.
Understands why you act the way you do or at least tries to figure it out.
Uses art therapy. That helped me more than I can ever express. So so much of my healing has been assisted by art. It connected me to parts, gave me an outlet for my anger for flashbacks. It was key to even knowing I dissociated.
Verbally welcomes system or parts when it is safe.
Willingness to admit when they are wrong and tells you.
Willingness to learn. If we want more therapists to work with DID folks then we have to give them a chance to learn. And, we have to accept that even the most experienced therapists can and will make mistakes. That is what makes them human and that is what we want – genuine folks working with us.
Willing to wonder, willing to say so if they are uncertain. “Let’s think about that a bit” or “What does this mean to you?”
That’s a LOT — but YES, these are reasonable and important needs and requests for dissociative trauma survivors. Frankly, I agree with you! Absolutely. All of these qualities and attributes are truly important. There’s no doubt about it.
At the same time, it’s asking a lot of one person to be all of these things. Or is it? Is it truly possible for your therapist to be all of these things, consistently, for years of time, without messing up, even a little?
What do you think?
Now that the list is all together — do you still agree?
Do you have more to add to or remove from the list?
Does your therapist represent the ideas presented in this article?
Is your therapist a good fit for what you need?
Let me be sure to remind you….. if your therapist is even close to being able to be this kind of person …. HOLD TIGHT to them, and treat them with as much mutual respect and kindness as possible. You’ve found a beautiful, beautiful therapist, and make sure they know how much you appreciate them while you walk together.
Anyone who can be this good to you deserves the VERY best you’ve got in return.
I wish you AND your therapist the very best in your healing journey.
Copyright © 2008-2018 Kathy Broady MSW and Discussing Dissociation