Anouchka Grose is a writer and psychoanalyst, practising in London. She is a member of The Centre of Freudian Psychoanalysis, where she regularly lectures. Her books include ‘No More Silly Love Songs: a realist’s guide to romance,’ (2010), ‘Are You Considering Therapy?’ (2011), and ‘From Anxiety to Zoolander: notes on psychoanalysis’ (2017). She also contributes to The Guardian.
It’s very easy to suggest to someone that therapy might be a good idea. It’s much harder to give sound advice on how to find an actual, living therapist. There are all sorts of variables involved — from where a person lives, to their degree of introspection, to the state of their finances.
The options for a person seeking talking therapy can seem overwhelming. Even if you’re in a state of crisis, you can spend up to two years on an NHS waiting list before being given six weeks of Cognitive Behavioural Therapy (having to make do meanwhile with the criticized ‘Beating the Blues’ computer programme). Would it be better to shell out upwards of £50 a week to speak to someone sooner, who insists that you must be angry with them if you turn up five minutes late? (This is a technique often practised by therapists schooled in ‘object relations’.)
If both of those options sound bad, what can you do instead?
If you make the difficult decision to go ahead and talk to someone, you can suddenly be faced with an anxiety-inducing array of choices. Not just NHS or private, hypnosis or psychodynamic. What about a warm therapist who seems easy to talk to, or a bossy one who promises to knock you into shape? Or you might think it would be better to choose the opposite of what you’re drawn to; you’d much rather speak to a woman, so you force yourself to see a man.
Having spoken to a few friends, and perhaps done some online research, you might come to the understandable conclusion that it would be easier to simply pick a name out of a hat. Or even just not bother at all.
Here, then, are some tips from someone who’s chewed through a few therapists in their time.
I’m a working psychoanalyst: my mixed experiences didn’t put me off the profession for good. I’ll focus more on the ‘therapy user’ side here, in the hope that an insider account will show you can get it ‘wrong’ here and there without facing dire consequences.
First of all, it’s a good idea to be frank with yourself about what’s likely to suit you. If you like to deal with problems by exploring them out loud, and enjoy making lateral connections between ideas, psycho-dynamic therapy might suit you. This style will give you time to explore how your childhood experiences may be informing your present state of existence.
If you like to tackle issues by getting things out in the open with others, try Gestalt therapy (where you get to act out conversations with the important people in your life, altering the script in order to bring about change).
If you’d like to see how other people deal with similar problems to yours, peer-support groups can be brilliant.
A humanist therapist will be trained to respond to you empathetically. A psychoanalyst will probably be more reserved. Any of these can be found by googling, and by searching the UKCP, BACP, BPF and College of Psychoanalysts websites. These are professional bodies, offering officially accredited therapists.
You can also ask your GP for help seeking a therapist. Even if they aren’t able to refer you for the type of therapy you’d prefer, they may be able to suggest organisations locally, who you could then contact yourself. If you need to see someone cheaply, it’s also worth checking local organisations who offer low-cost places. It’s possible this will involve working with a trainee but, if so, they will be in supervision so you will have two minds on your case instead of one.
Best of all, though, could be to go with a personal recommendation. If you have a trusted friend who can put you in touch with someone whom they can personally vouch for, give it a go.
I found my first therapist, when I was in my early twenties, through my GP. He was a psychoanalytic psychotherapist, trained in the ‘object relations’ school, practising from our local hospital. (Later on I realised he must have been a trainee as he was quite young, and his training organisation offered NHS placements.) He seemed quite opinionated and argumentative, and he related everything back to himself: ‘You’re trying to frustrate me. You think I’m upset with you. You’re disappointed in me for taking a break just when we’re starting to get somewhere.’ I didn’t know it was a technique he was applying; I just thought he had a very inflated opinion of himself. After six months he put me in a therapy group, which I took as a terrible slight — so much so that I got ‘better’ immediately and left.
Soon after that I went to see a Relate counsellor with my boyfriend at the time. His father suddenly died and so he, understandably, got all the attention. Anything I said seemed extremely trivial. At the end of our eight allotted weeks of therapy, we split up.
A few years later, I went to see a very old Lacanian psychoanalyst. Lacanians are often thought of as the Surrealists of the therapy world. He certainly lived up to that reputation, finishing each session on a strange pronouncement that was loosely strung together from things I’d said. Somehow this worked very well on me — in fact, I liked it so much I started to train.
After finishing my training, and my Surrealist analysis, I found myself in another very difficult relationship and decided to go and speak to a woman this time: another Lacanian, but less overtly surreal. This was perhaps the person who made the most difference to me. She was responsive and kind, but not afraid to get a bit theoretical here and there. Although I cried and said embarrassing things, as one does in therapy, it also felt like quite a grown-up experience. She was never patronising, nor did she resort to clichés; for me, this was definitely ideal therapy.
My main advice to anyone would be to try to see someone like this. I’m sure they exist everywhere, irrespective of which style of therapy they practice. It’s really helpful to have conversations with a sensible, intelligent person who listens carefully and then responds with something interesting.
It’s perfectly acceptable to meet up with a few therapists before you decide which one to stick with, and it’s also OK to pick the one you like talking to, as opposed to the grandest, or the one who gives you the hardest time. Don’t let them hector you into making a quick choice.
Since that excellent experience, I have seen two more therapists. One I chose because she practised two streets away — I needed to work through a crisis; the other because my partner and I wanted to see someone together. Both were fairly dreadful — the first because she got it into her head that I was a victim of abuse and the other because he was a bit of a drip. Still, I’m sure in both instances it helped to have somewhere to offload temporarily and, ultimately, no harm was done. Both kicked up a bit of a fuss when I said I wanted to stop coming — ‘You’re running away from the marvellous work we have just begun!’ — but it’s easy enough to ignore people when they are plainly wrong.
There is a rather mythical idea that therapists are extremely powerful so, if you choose unwisely, you will be delivering yourself into unsafe hands. It’s probably worth remembering that, as with priests and professors, therapists are only as powerful as you let them be. All of them are human, with the potential flaws that implies.
On the bright side, if you choose one who belongs to a professional body, they will be bound by a Code of Ethics that will oblige them to treat you without exploitation and to keep your secrets. If, in the end, you decide that they aren’t wise enough/kind enough/weird enough to handle you and your problems, it’s still quite likely that a spell of uncompromised talking will have been helpful. At least, this has consistently been true in my experience — even with therapists I didn’t like at all.
So there you have it — a mildly pessimistic, non-idealised guide to getting started. Rest assured that, in my opinion, talking therapy is so intrinsically helpful that even the more imperfect versions of it are still worthwhile. And if you give yourself the time and opportunity to crack a good one it can make all the difference to your life.
The therapists who have helped me have helped me loads, and the others haven’t exactly hindered. In the end, I’d say it had all been worthwhile.
Looking for help? Our Information Service can guide you towards local services you can use for a loved one’s mental health, and your own.
For more information about choosing talking therapies, see National Mind’s advice page.