Your shoes and your shrink: the importance of fit

Pop quiz time.  How is a therapist like a pair of shoes?

Either you’re scratching your head by now and wondering how you ended up on this blog or you’re generating a dozen different theories about this comparison.  I’ll go ahead and fill the blank in on this one, but I’d be curious to hear what else you came up with… so feel free to share.

My answer:  If they don’t fit well, you’ll be standing in the exchange line pretty soon.

If you are considering therapy for the first time and you’re someone who likes to do her homework, you have probably encountered the topic of “fit” in other articles that talk about selecting a therapist.  (If you haven’t yet, give it a try—I’m sure lots of other people have an interesting take on this process and its importance.)  Every other profile on Psychology Today says something about matching or fitting with your therapist.  What are all those therapists going on about, anyways?

Well, I’ll tell you.  If we want to take this shoe/therapist metaphor a bit further, consider therapy as a journey.  Do you want to be walking that whole way in uncomfortable shoes?  In other words, do you want to be working with a therapist that you don’t trust, respect, or like?

At the start of your therapy, you should have the beginnings of a good relationship with your therapist.  You should be sitting across from someone that helps you harbor some confidence and hope about your situation—and there are many ways that a skilled therapist can foster this.  In essence, you should feel heard and understood.

I’m not saying that you have to feel buddy-buddy with your therapist the moment you walk in the door.  I’m also not suggesting that you have to like your therapist all the time as therapy progresses.  (In fact, it’s important to be able to feel irritation, anger, or disappointment in your therapist if you need to, and to feel safe enough to talk about these feelings as they emerge.)  It’s perfectly normal and really quite reasonable to enter your therapy feeling at least a little bit uncertain.  Strong relationships build over time, not overnight.

So, in case I haven’t been clear:  you don’t have to be your therapist’s number one fan in order for therapy to be effective.  But, you do need to feel reasonably comfortable at the idea of working with your therapist.  Research has shown over and over again that the quality of the relationship between the client and the therapist over time is the single most important factor in having a “good” therapy.  You want to start off on the right foot by picking someone who seems to mesh well with you from the get-go.

Also, the question of fit doesn’t magically disappear after therapy begins.  You should reserve the right to examine how things are going periodically, and to talk about this openly with your therapist.  Some therapists attend more closely to the quality of the relationship while others may focus more on the details of your life and what you’re doing “out in the world” to achieve your goals.  Regardless of your therapist’s style, it is quite reasonable – and some would say, very important— to comment on how you feel your relationship is developing with them.

And, it sometimes happens that something occurs in the therapy later on that may leave you questioning whether you want to continue working with your therapist.  While it can be a great healing or learning experience to process miscommunications, mistakes, and hurt feelings with the therapist in question, sometimes that is not possible or advisable, particularly in the case of ethical misconduct on the part of the therapist.

So, with all of this talk about the importance of fit, you’re probably wondering now how to tell if you’ve found the best therapist for you.

I will let you in on a secret.  Nowhere in the world does there exist a “best” therapist—this concept is a false notion for two reasons.  First of all, there are a number of therapists with whom you could work well and achieve great results.  Secondly, everyone needs a different sort of “best” which is why there are so many therapists out there in the first place.  People need different stuff!

It is fortunate that there are many different therapists to choose from when you are considering who to invite on your therapy journey.  But, it can be a little daunting trying to pick from among them when you’ve decided to try therapy.

With that in mind, we will talk in more detail next week about how to find the best therapist in Austin (or anywhere!) for you.