A therapist should be a listener.

Humor is good, but a therapist should not go to great lengths to "fill the room" with charm or big smiles.

A therapist may start out as a fine listener and custodian of boundaries, but over time may slide.

A very basic question to ask from time to time is, Are you getting what you are paying for? Do the conversations leave you with new insights, or just shift your mood temporarily without real underlying change.

The therapist is your employee. Is he or she acting that way?

Is the processs shifting more from listening to telling you what to do. A therapist shouldnt play pastor or guru.

Are sessions degenerating into blab fests -- and are spiritual topics slipping more and more into it from the therapists' direction?

If you state you dont want to discuss such matters, are your wishes respected?

If not--that therapist is no longer behaving as your employee and you are not getting your money's worth.

If a therapist feels confined by not discussing spiritual topics, he or she should re-tool careers and become a pastoral counselor.

A friend who is an LCSW and who regularly attends continuing education on counter transferance (counter transferance is when a therapist projects his or her issues onto the client), said "If therapy is long term, a therapist must work very hard to stay alert and focused."

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Goals in therapy must be fairly precise. After all, it costs money. You are paying out of pocket or your insurance company is. So you want to make that time worth your while.

If the goal is vague, such as 'transformation' that doesnt count as therapy. Too difficult to define and too difficult to set the boundaries and know when you have reached a point where you can dispense with the therapist.

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A therapist should not undercharge to such a degree that you fear you cannot afford anyone else.

If you feel concerned that you would have 'sticker shock' if you were to work with another therapist, the therapist who is working at low cost should respect your concerns. He or she should not give a snarky reply "So do you want me to charge my full rate?"

Some therapists do excuse a low fee saying many of thier clients have been abused and are poor and thus cannot afford to pay full fee for someone experienced.

That sounds good. But this can lead to a long term dependency for these clients unless the therapist is vigilent. He or she should be doing everything possible to assist such clients to become socially and financially empowered. Not to fleece them when they do become able to earn full livings, but to prevent these clients from becoming long term economic dependants of the altruistic therapist.

An additional danger is that a therapist who undercharges may elicit a dependance in clients who will ignore misgivings and rationalize therapist eccentricities or worse, all for fear that they could not find another therapist they can afford.

If a therapist does charge less than the standard rate for someone of his or her experience, that therapist should tell you where you can find comparably effective therapists at a same or similar rate. One reason this should be done is in case your therapist has an accident or illness and must retire, temporarily or permanently.

A psychoanalytic insitute in your area may charge lower rates if they have analysts in training. However, you may need to meet criteria at an intake interview.

In any case, therapists who charge low fee should take care to let their clients know which other therapists are also equally well trained and in a similar fee range.

Preservation of client autonomy is the Prime Directive. And that includes ensuring that clients dont fall into a trap of believing just one therapist can help them and that they can afford no one else.

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Here are signs that boundaries are becoming compromised and that you, the client are entitled to wonder whether your therapeutic process is being supported.

The therapist runs late. Consistently. He or she should stop this crapl. If not, you need to find someone else to work with.

***Boundary drift. You and the therapist negotiate meeting at a specific hour. But then drift into meeting before that time, or after that time.

Just because you show up early doesnt mean you want the session to start early. You and the therapist should begin the hour at the usual time. Sometimes a person may appreciate showing up early at the therapists office, not to see the therapist but to get an extra 15 or 20 minutes alone in a place where the world cannot intrude.

Sliding away from the negotiated starting and ending time may seem minor but it is an early sign that boundaries are becoming fluid. This is important and should be remedied.

The therapist really shoudl be the one who notices this and invites you to explore why you've been showing up early. Maybe you do actually just want a bit of time away from the nagging demands of the outside world. This can be a good opening to ID just what in your life is intruding and that you fear you cannot say no to.

If the therapist lets things slide and you are stuck bringing up that you two have drifted away from the negotiated start time for the hour, the therapist should treat this with the utmost concern and as a signal to examine his or her own stuff--and not on your dime. The therapist should not disclose personal info to you but discuss it with his or her consultancy group or training analyst/supervisor.

If the therapist jokes, treats your concern about this as silly , that is just as serious as a surgeon who is seen to be careless with handwashing and who then sneers when when warned about this.

A therapist should never socialize or try to befriend you.

A modest bit of chat about the weather or ball game is OK in the first few moments of a session--it can be reassuring and set a frame or boundary. But this should never be the major portion of a session. Just its frame. A bit of social chit chat just as one opens the door and leaves frames the end of the session.

Boundary violations or early signs of boundary blurrying are especially likely to begin right at the start of a session or end of a session.
* You get a nagging sense that your therapist's smile is no longer empathic but has become condescending.

*Changes in body language. Your therapist does micro gestures such as tipping his or her chip up very slightly, as though to "look down" at you.

*You express concerns, and the therapist smiles as though you are a small, fussy child whose concerns can be patronized and dismissed.

* You feel glad when you're suffiently ill to cancel a session. My friend said, "This is never a good sign"

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The therapist becomes distractable. Instead of assisting you to stay focused on your own emotional process, the therapist allows the session to veer off into chatter.

**You notice that the therapist "perks up" when certain topics are mentioned but not others.

Hidden or not so hidden agendas

As noted above, you may notice that a therapist perks up very much more when certain topics are discussed--vs the ones that you are struggling with and thus need to discuss frequently.

If you get a sense that your sessions (you're paying for them!) are being sidelined so as to indulge stuff that the therapist is interested in, you need to see this as signal.

Make a list. What subjects does your therapist seem to 'get off' on?

God?

Gurus?

Anything that loosens the boundary between wish and reality? This friends is magical thinking.

Does the therapist tend to recommend books by gurus or that emphasize inspirational wish fulfillment?

Especially commerical stuff? THe kind of stuff people get excited about? Books that tend to trigger conversions and become talking points for social networks?

Books that encourage the reader to distrust consensual reality?

Watch out for inspirational literature behind which there is a business model. A therapist should not recommend inspirational stuff and should not recommend religious or spiritual or transformational material of any sort. Thats a foul ball.

Its fine to read these for fun. But a therapist carries authority via transferance from his or her clients, so anything he or she recommends carries a special force.

So, politics and religion are off topic. Does a client want a spiritual outlet? Let the person find it on his or her own.

The therapist should feel able to advise patients not which church or group to go to, but how to assess whether any religion or group is supporting human dignity and autonomy.

Is the group or guru re-enacting issues the patient has described in his or her own family? That is appropriate material in therapy. Babbling cheerfully about reincarnation is not.

Does a group or guru want the client to go on a retreat and will not tell the client what will happen? Will the client be asked to give up his or her phone or car keys?

Those are good questions for a therapist to bring up. Telling a client to keep total control of his or her phone, wallet and car keys at all times is educational--and gives the client information on how to preserve his or her autonomy.

Aesthetics

When interviewing prospective therapists, you have just a few seconds by which to evaluate not only a prospective therapist but also his or her room decor.

A therapist spends hours in that room. Unless he or she is renting use of someone elses room, that room will express a lot about the therapist's tastes.

It should not be so much the therapists world that a client has to make excessive adjustments. The therapy room has to have enough that nurtures the therapist and enough to nurture and give hospitality to the clients.

If a guru's picture is in the therapy room, how can the therapist give full, evenly suspended attention to you? The imago of the guru will be competing.

If you sense something 'off, something that to you feels 'weird' just plain odd, pay attention.

We are usually told to assess the therapist. However, room decor is an expression of a therapist's life and personality.

Try to avoid therapists and therapy rooms where you must constantly normalize or rationalize incongruities. Many of us have grown up in families where we had to do exactly that. Some of us normalize incongruous or bizarre behavior so very quickly that we dont even know we do it.

If a therapist or theapists office has too many features one must ignore or normalize, this may re-enact the mental processes one is trapped in.

If you know you just dont want a New Age slant on things and your prospective therapists office is full of New age stuff, the relationship may not work out.

If the therapist is a heterosexual male and his room decor is light, with frills and fringes on pillows, flowery, feminine and he owns that space and doesnt share it with anyone else, dare to wonder why he decorates that way. (Many gay men would refuse to decorate their offices that way, btw).

But..that is what therapy can help with--if one finds a therapist who isnt triggering this sort of response.

A therapist has to find a way to create a work space that nurtures the therapist but that doenst require a client to make too many rationalizations or adjustments.

Some differences in belief may be genuine deal breakers in any relationship whether with a therapist or potential spouse.

No amount of tolerance can remedy it.

Inspiration. And inspirational speakers, writers, literature, inspirational movements.

What is your therapists' attitude toward inspiration?

Does he or she respect it but at the same time see it as something to examine, no matter what the trigger?

Or does the therapist persistently gravitate towards inspirational figures, books, literature and considers inspiration a privileged state, something that is not to be questioned, and that its purveyers should not be questioned either?

(Namely, gurus, inspirational writers, speakers, events, book?)

Worse, does the shrink persistently recommend this stuff to you and make you feel like a cynical heel because you consider inspiration all very nice but not proof of anything.

Inspiration is powerful. Like gasoline, it requires careful labelling and handling.

Used carefully, inspiration like gasoline, can help you get places and at a speed you can control, pace and handle.

But if not stored properly or used properly, inspiration, like gasoline can ignite an infeno. Inspiration, wrongly handled, led people into the stadium at Nuremberg, and into the jungle of Guyana. Gasoline, improperly handled, can burn a house or neighorhood down.

Inspiration proves nothing. It is excitement. It feels unqiue and amazing, but corresponds to certain fluctuations in neurotransmitters and certain patterns of enhanced metabolism within the brain. To learn more, read Marc Lewis' autobiography Memoirs of My Addicted Brain.

Again,

Suppose a prospective therapist or someone you are dating claims to be 'non sectarian' or 'spiritual' but actually seeks all other belief systems through the distorting biases imposed by their own sect.

This may masquerade as 'tolerance' but it is not.

What if you value evidence based thought and are prepared to examine even the most inspirational social movement and teachings as all very nice, but one social movement among many, while your prospective therapist (or worse) your therapist grooves to this stuff and wants you to thrill to it, too.

That not only smuggles snake oil into pschotherapy; it indicates an emotional need on the part of the therapist so great as to ignore boundaries.

I might suggest this is also something to examine if you seriously think of wishing to get married to someone or into a business partnership.

Attitudes towards money and family are recognized as important issues to discuss in premarital counseling.

**Corboy suggests that attitudes towards inspiration should be discussed when considering not only a therapist, but also when pondering whether someone is a potential spouse or business partner. (A potential spouse is a potential business partner, btw.

So..take this is part of marriage or LTR counseling.

Do you consider inspiration a pleasant feeling but proof of nothing, while the the person you consider marrying considers inspiration to be unquestionable, that it is in and of itself unquestionable, that inspiration equals proof, legitimation and anyone who provides it has to be believed?

A lot of people call themselves seekers. Some like to call themselves 'finders.'

But very many are actually looking for inspiration.

As long as you treat inspiration as energy and pleasure but not as proof of anything, you're probably going to be OK.

But if you consider some inspiration peddlar to be the answer to your woes--watch out.

Jim Jones got a lot of social welfare work done, but it ended horribly.

And even when the ending is not castastrophic, inspirational/charismatic leaders often leave problems for their successors. There is a considerable literature on issues that come up and must be addressed when a charismatic leader retires or dies. They are a difficult act to follow.

By uniting people through inspiration, much is done, but the leader too often fails to teach skills such as negotiation, conflict recognition and conflict resolution--all skills needed to function successfully in the absence of inspiration.

Empathy, Reincarnation, Levels of Realization

Suppose, a therapist or potential spouse sincerely and fervently believes in reincarnation?

And you, the client, prospective client, or prospective spouse, do not share that belief.

Let us can use an article about Anthroposophy by Sharon Lombard as starting point for some deep thought. It may be applicable to other belief systems.

Quotes from [www.waldorfcritics.org]-

I think Sharon Lombard's article can now be read here:

[www.google.com]

A shorter article, Our Brush with Rudolf Steiner by Sharon Lombard can also be read here

[www.waldorfcritics.org]

Sharon Lombard did not want a religious upbringing for her child. Her local Waldorf school did not inform her that it was in fact, based on a religion, Anthroposophy, originated by Rudolf Steiner. Anthroposophy has a doctrine of reincarnation and karma. Its adherants believe that creating an environment based on Steiner's principles will actually attract good karma and that even persons completely unaware of Anthroposophy will, if placed in such an environment, get good karmic influences that will be to their future benefit.

And that therefore, it is quite all right to conceal this from people who would, if told all this up front remove themselves from this wonderful karmic influence..

Lombard found to her dismay that Anthroposophy based schools are training lodges in Steinerian ritual. Because she did not know what these people actually aimed to do, she had a sense that what she did as a volunteer was not meeting specifications--that somehow in a way she was not told about, she was falling short.

Anthroposophists, among other material, have a doctrine of reincarnation and of karma. And quite a few other groups do--and take this stuff seriously.

Lombard writes:

Quote

How I, who values life as extremely precious because it is most likely finite, found myself, along with my husband and daughter, participating in a religious movement that embraces reincarnation as a main doctrinal tenet?

Therapy Issues--Empathy

So what does this have to do with selecting or deciding to remain with or leave a psychotherapist?

A) If a therapist or boss or prospective spouse persistently obtrudes reincarnation into the relationship, this is grounds for concern.

One can neither prove nor disprove reincarnation. It doenst belong in modern science, which is the mindset on which training and licensing of therapists depends.

Reincarnation is RELIGION or spirituality. Now, do you wanna pay heavy money per hour for that? If you want to, okay. But if you see a troubled friend and urge your friend to consult this therapist of yours who thrills to reincarnation--what if your friend does not share that viewpoint?

If you, the client or prospective client, consider that we have just one life that counts, you may well take things more seriously and feel much more concerned about justice in this life, vs a therapist whose trust in reincarnation gives a more relaxed attitude.

There is the matter of empathy.

empathy - definition of empathy by the Free Online Dictionary ...Identification with and understanding of another's situation, feelings, and motives. (The free dictionary)

There has to be a modicum of shared common ground--not identification-but at least some shared common ground/perspective for empathy to be possible.

How can a therapist who believes in reincarnation --that we will get a chance in another life to rectify the horrors of this life--how can a therapist with such a belief system be empathic with the sufferings of a client who considers that there is only one life to live?

The reincarnationalist has an escape hatch. Sure, things can gnarly. But...matters are not capable of tragedy.

A client who considers that we have only one life is going to see matters far more seriously. And may have much more concern about seeing justice done in this lifetime.

A client who is perturbed by family horrors, who has a perpetrator in his or her life or social group who has 'gotten away with it', a client who perhaps has served with the Peace Corps, Doctors Without Borders, has come home from combat and has seen horrors and who does consider that there is just one life to live, will have a sense of anguish not shared by someone who buys into reincarnation.

How can a reincarnalist therapist have depth of empathy for and with a client whose anguish is all the keener because that client considers one life to be what matters?

This is important stuff folks. And demonstrates that all religions are not the same underneath.

A very important dimension is--a belief systems sense of time.

Do we have endless time and opportunity? Or not?

"If you know what life is worth, you will look to yours on earth.

And then you see the light, you'll stand up for your rights--JAAHHH!

Bob Marley

And...some groups not only believe in reincarnation but have remarkably elaborate maps and doctrines and levels of reincarnation. Madame Blavatsky posited one such system in her religion of Theosophy and there are very many more road maps of that sort out there.

If a therapists system of reincarnation and karma regards even the worst horrors visited upon a human being are 'a lesson' or the product of karma from a past life that must be worked through, that may interfere with empathy for a client who does not share that belief, and whose perspective and who considers one life all we can know.

And there are indeed social justice implications.

Parents perturbed by Waldorf schools have reported that at such schools children who are bullied are not given protection because the bullying is regarded as their karma. (It may not be quite as bad at US schools. But in UK Waldorf schools, this point was brought up a lot.

[www.google.com])


What if a therapist so believes in reincarnation and karma that, without telling the client, he or she believes the clients sufferings are a 'lesson'?

This will give an enviable and remarkable equanimity to the therapist. The client may marvel at the therapists groundedness and perhaps feel inferior.

But not know that this is not the result of wisdom but from a mere belief system that offers an escape hatch, but little opportunity to develop moral heroism because it bypasses tragedy.

Aeschylus:

Pathei Mathos -- through suffering/ordeal, learning/mastery.

Agamemnon

Leaves of Realization?

Anthroposophy and many other groups have schemes that assign people to a rank ordered, hierarchical level of development. Similar to the military, except that in the military, you know what is going on.

Terms differ, but the devout take this rank ordering very seriously. Whether these are termed 'levels of development', 'planes', 'tiers', all this is taken seriously. Chogyam Trungpa used to give out insignia pins.

But..lets have a look at therapy.

Suppose a therapist is in some religion or sect and has been told that he or she is at some higher level of realization. Or actually gets promoted /recognized as having attained some higher level of development.

Now, what if this therapist is seeing a client. The client may be in the therapists group (dual relationship!!) or not be in the therapists group.

How can the therapist/occultist have real empathy for a client whom he or she considers at a lower rank of realization? Suppose that client says something challenging to the therapists own ego defenses?

If a client is in the same lodge the therapist is, and knows the therapist is considered to be at a higher level of realization or knows the therapist has been promoted, how can the client find the courage to question the therapists interpretations?

And suppose the client is troubled by something happening within the lodge. How can the client feel safe in sharing his or her concerns with the therapist and be certain the therapist will maintain confidentiality and can protect the clients privacy if questioned by the leader of the lodge or ashram.

If a therapist holds high rank in some lodge or ashram, other members may seek to become clients hoping that doing so will improve their own prospects of promotion/initiation within the sect.

How can a therapist in this predicament have the same empathy and respect for clients who do not share his or her beliefs as for those clients who do?

Such are the hazards of dual relationships.

At the very least the therapist must, in cases of conflict, be ready at all times to put client welfare first and foremost even at risk of being punished or ejected from the lodge or ashram.

And a therapist must have a consultancy group of professionals who are not in any way tied to the lodge or ashram. That is most important for maintaining perspective -- and not becoming an inmate.

I have not tried the website named at the bottom of this article, but it may be an interesting resource.

[www.secularhumanism.org]

Still, any time you are looking for a therapist, always check your state licensing agency to see if your therapist or your therapist's training supervisor has a clean record.

Quote

"Meanwhile e-mails such as this one kept coming: “I have been to three therapists in the last two years and all of them tried to talk to me about spirituality, God, religion or New Age shit. Where the hell do I find a therapist (who) uses non-superstitious methods?”

(Glum)

If you decide to start therapy with someone, list your goals and include what you want and do not want from a therapist. Give the therapist a written copy and review it each year.

If you do not want God, gurus, paranormal or indoctrinational human potential stuff (such as large group awareness material) to be part of your therapy hour, state it.

It sometimes happens that a therapist might go through a time of vulnerability and be recruited into a cultic/LGAT organization. Therapists are potential high value recruits.

Keep a copy of your goals and deal breakers and review it each year.

And...if you get some kind of icky feeling that a therapist is pushing something at you, becoming condescending and intrusive in ways that deviate from your working alliance, be prepared to exercise autonomy, even if it means getting out.

[www.psychologytoday.com]

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I began helping people and soon found that it is almost impossible to determine if a therapist is truly secular and uses evidence-based methods. A therapist may be well-trained, he or she may have received advanced degrees from the best schools, but that does not guarantee they are not influenced by belief in supernatural beings or New Age ideas. Many people wrote me saying they went to a therapist for months only to have the therapist recommend that they pray, go back to church, or use some New Age method...

Even someone who graduated from Michigan State or UCLA may not be secular. The school a person attends says little about their supernatural beliefs. Once a person is in practice, they may start using untested and non-evidence based methods. Methods that have not seen clinical testing and peer review.

Corboy note:

Some persons may come under the influence of a guru or charismatic therapist who uses non evidence based methods. These proteges may then go and obtain training to become therapists themselves, but conceal the extent to which they are still using a Magic Parent imago (aka guru) to self soothe and regulate their own moods.

They may actually be quite immature in terms of self formation, and be unable to relate to clients at the level of conscious maturity needed to maintain a boundaried yet empathic therapeutic alliance.

So they may graduate with distinction from excellent evidence based clinical programs, get licensed, stay up to date.

But they may retain an addictive dependance on their guru and be unable to imagine that their guru could possibly harm anyone. If the guru directs them to use the therapy alliance to recruit clients or preach, the disciple may be unable to refuse and thus draw clients into the guru's net.

In some cases therapists who share discipleship with a guru or share membership in a church or political ideology may form extensive social networks and refer clients to each other. In extreme cases, troubled members of an ashram or sangha or church may be referred by the leader to therapists who also have a vested interest in keeping things quiet and protecting the guru or leadership or ideology from criticism--even if harm is being done.

When this is extreme, a therapist who dares to speak out may risk losing many professional ties and quite a few clients.