When you inquire, you risk this person asking why you want to see a therapist. “What’s wrong?” this person might say. “Is it your marriage? Are you depressed?” Even if people don’t ask this aloud, every time they see you, they might be silently wondering, What’s wrong? Is it your marriage? Are you depressed?
If your friend does give you her therapist’s name, there might be unexpected checks and balances to what you say in the therapy room. If, for instance, your friend recounts to this therapist a not-so-flattering incident that involves you, and you give a different version of this same incident—or omit it altogether—the therapist will see you in a way you haven’t chosen to present. But you won’t know what the therapist knows about you, because the therapist can’t mention anything said in somebody else’s session.
These caveats notwithstanding, word of mouth is often an effective way to find a therapist. You can also go on PsychologyToday.com and sort through profiles in your area. But however you do it, you may need to meet with a few before you find the right one. That’s because clicking with your therapist matters in a way that it doesn’t with other clinicians (as another therapist said: “It’s not the same as choosing a good cardiologist who sees you maybe twice a year and will never know about your massive insecurity”). Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of “feeling felt.” This matters more than the therapist’s training, the kind of therapy they do, or what type of problem you have.
But I have unique constraints in finding a therapist. To avoid an ethical breach known as a dual relationship, I can’t treat or receive treatment from any person in my orbit—not a parent of a kid in my son’s class, not the sister of my coworker, not a friend’s mom, not my neighbor. The relationship in the therapy room needs to be its own, distinct and apart. These rules don’t hold for other health-care clinicians. You can play tennis or be in a book club with your surgeon, dermatologist, or chiropractor, but not with your therapist.
This narrows my prospects dramatically. I’m friendly with, refer patients to, go to conferences with, or otherwise associate with numerous therapists in town. On top of that, my friends who are therapists, like Jen, know many of the same therapists I do. Even if Jen referred me to one of her colleagues that I don’t know, there would be something awkward about her being friendly with my therapist—it’s too close. And as for my asking my colleagues? Well, there’s this: I don’t want my colleagues to know I’m seeking urgent therapy. Might they hesitate, consciously or not, to send referrals my way?
So while I’m surrounded by therapists, my predicament conjures that Coleridge line “Water, water, everywhere / Nor any drop to drink.”
But by the end of the day, I have an idea.
My colleague Caroline isn’t in my suite, or even in my building. She’s not a friend, although we’re professionally friendly. Sometimes we share cases—I’ll see a couple, and she’ll see one of the members of the couple individually, or vice versa. Any referral she’d have, I’d trust.
I dial her cell at ten to the hour, and she picks up.
“Hi, how are you?” she asks.
I say I’m great. “Absolutely great,” I repeat enthusiastically. I don’t mention the fact that I’ve barely slept or eaten and feel like I might faint. I ask how she is, then get right to the point.
“I need a referral,” I say, “for a friend.”
I quickly explain that this “friend” is looking specifically for a male therapist to keep Caroline from wondering why I’m not referring my friend to her.
Through the phone, I can almost hear the gears turning in her head. About three-fourths of clinicians who do therapy (as opposed to research, psychological testing, or medication management) are women, so it takes some thought for her to find a man. I add that the one male therapist in my office suite, who happens to be one of the most talented therapists I know, won’t work out for this friend because this friend doesn’t feel comfortable doing therapy at my office, where we share a waiting room.
“Hmm,” Caroline says. “Let me think. It’s a male patient who wants the referral?”
“Yes, he’s in his forties,” I say. “High-functioning.”
High-functioning is therapist code for “a good patient,” the kind most therapists enjoy working with, often to balance out the patients we also want to work with but who are less high-functioning. High-functioning patients are those who can form relationships, manage adult responsibilities, and have a capacity for self-reflection. The kind who don’t call daily between sessions with emergencies. Studies show, and common sense dictates, that most therapists prefer to work with patients who are verbal, motivated, open, and responsible—these are the patients who improve more quickly. I include the high-functioning bit with Caroline because it broadens the range of therapists who might be interested in this case, and, well, I consider myself to be relatively high-functioning. (At least, I did until recently.)
“I think he’d feel more comfortable with a male therapist who’s also married with kids,” I continue.
I add this for a reason too. I know this isn’t a fair assumption, but I’m afraid that a female therapist might be predisposed to empathize with me post-breakup and that a male therapist who’s neither married nor a father won’t understand the nuances of the kid part of the situation. In short, I want to see if an objective male professional who has firsthand experience of marriage and kids—a man just like Boyfriend—will be as appalled at Boyfriend’s behavior as I am, because then I’ll know that my reaction is normal and I’m not going insane after all.
Yes, I’m seeking objectivity, but only because I’m convinced that objectivity will rule in my favor.
I hear Caroline clicking away on her keyboard. Tap, tap, tap.
“How about—no, scratch that, he thinks much too highly of himself,” she says of some unnamed therapist. She goes back to her keyboard.
Tap, tap, tap.
“There’s a colleague who used to be in my consultation group,” she begins. “But I’m not sure. He’s great. Very skilled. He always has insightful things to say. It’s just—”
Caroline hesitates.
“Just what?”
“He’s so happy all the time. It feels . . . unnatural. Like, what the hell is he so happy about? But some patients like that. Do you think your friend would do well with him?”
“Definitely not,” I say. I, too, am suspicious of chronically happy people.
Next Caroline names a good therapist I also know relatively well, so I tell her that he won’t work out for my friend because there’s a conflict—therapist shorthand for “Their worlds collide, but I can’t reveal more.”
She clicks around again—tap, tap, tap—then stops.
“Oh, hey, there’s a psychologist named Wendell Bronson,” Caroline says. “I haven’t talked to him in years, but we trained together and he’s smart. Married with kids. Late forties or so, been doing this a long time. Do you want his info?”