|The Search for a Good Therapist
Searching for a good therapist "You aren't DID,"
the therapist announced. I felt immense relief. This was a
specialist in working with PTSD and DID, and the referral for a
large Christian counseling group in Southern California.
"You couldn't be," she continued, "because I lose
time when I become uncontrollably angry, and I'm not DID."
I blinked at looked at her. She then proceeded to disclose
during the next half hour about her childhood of torture by her
older brother, including sexual abuse, and his forcing her to
help him cut up small animals. Knowing that children often learn
from their parents, I asked her the logical question. "What
were your parents like?" "I don't know. I don't
remember them at all. It's a complete blank." I went home
that day, and told my husband I had decided not to see this
specialist in DID anymore. He angrily asked me if I was avoiding
therapy. "No, I'm just worried when I'm healthier than the
therapist", I answered.
This is a true story from much earlier in my healing process,
and shows the problem that faces survivors of severe childhood
trauma when they are looking for a qualified therapist. The
"experts" may not be as good as claimed. Large full
page ads in the phone book proclaim a therapist's expertise,
while others are given as a referral from an organization when
called. Telephone numbers can be gathered from the net, from
professional organizations, and from friends. But how does the
person dealing with a wounded psyche know which is the competent
therapist? To complicate the process, how does the survivor
believe that they DESERVE good therapy, or recognize it when it
is present (or its absence)? This article is an attempt to help
answer some of these questions.
First, the problem of insurance needs to be addressed. If a
person has insurance coverage, they may need to contact their
provider first for a referral. Often, there will be several
options given, and the client will need to choose one.
Others survivors have no insurance. In this situation, which
is all too common, they may be at the mercy of a MHMR system
that in some localities (but not all) refuses to treat DID, or
free clinics where the quality of care may vary from marginal or
poor to excellent. Sometimes, therapy can be received through
Medicaid, or Medicare if the person is on disability, and the
survivor can contact therapists who take these plans for
reimbursement. Okay, insurance is looked at, now how do you find
Try asking friends who have been HELPED by therapy, and are
getting better. This is a great credential for any therapist.
You can also try contacting the ISSD (link is available under
"links" here) for a list of therapists in a locality.
The ISSD does not guarantee that the therapist is competent in
working with DID or trauma, only that they are a member of their
organization, but it is a starting place.
Organizations that work with survivors of trauma may also be
able to give a referral, as well as hospitals and/or units
dedicated to DID and trauma. Therapists who are well known and
respected, and known to be safe, can be another source of a
Think about whether you would be more comfortable working
with a female or a male therapist, before starting to interview
one, since this may narrow your choices down.
The next step is the phone interview. Before seeing a
therapist, try doing a brief interview with them, and ask a few
questions. Your goal should be to do a phone interview with at
least 3 therapists initially. Questions you might ask on the
phone should include: *Are they accepting new clients? How long
is the wait before being seen?
*What about fees and how insurance claims are handled? Check
whether the fee is paid up front and the client contacts their
insurance for reimbursement, or the therapist handles billing.
You may also need to contact your insurance company for
PREAUTHORIZATION in order to be reimbursed. This means the
insurance company wants to approve the therapist first, or they
won't pay you if they see them. Does the therapist have a
sliding scale if there is no insurance? How long are sessions?
Does the therapist ever go over, or give extra sessions, and if
so, how does he/she handle billing? How far away is the
therapist's office from where you live?
*Experience: what kind of credentials does the therapist
have? Experience working with survivors of trauma and/or ritual
abuse? Do they understand DID? What kind of license do they hold
(LPC, MSW, marriage and family counselor, etc.)? What school did
they go to? How long have they been a therapist?
*How available is the therapist? How does he/she handle
crisis situations, or after-hours calls? Suicidal ideation in
the client? Does the therapist work alone, or with a group that
has rotating call? How does he/she view hospitalization? The
role of medication? How far ahead should appointments be
cancelled (24 hours is usual)?
*Discuss their personal philosophy of healing: how they
became interested in working with survivors of trauma, how they
view the healing process, and how they help clients work towards
this goal. What is their belief/faith system? Do they pray with
clients? How do they view spiritual warfare? Are they directive
or nondirective ? What do they do when a client disagrees with
them, or the direction therapy is going? Do they believe that
ritual abuse is real? How do they help clients deal with
flashbacks? What does he or she feel about integration (or not)?
Does she respect the client's wishes in this area? How does the
therapist feel about switching during a session? Are they
willing to learn more? Go to conferences?
If the phone interview goes well, and both of you feel that
you could work together, then the next step would be a personal
interview at the therapist's office. Here, you can see the
therapist in his or her working ambience. Remember, the
therapist is working for YOU, not the other way around, and it
is okay to go with your gut instincts. You deserve to find
someone that you feel comfortable working with. At this point,
you might want to ask: How does the therapist take care of
his/herself to avoid burnout? Do they have supervision, or
others they can vent to? Do they have a sense of humor? What are
their views on boundaries? Giving hugs? Confidentiality? What
will they do if you see each other in a public place?
Is the office comfortable? Private?
Ask yourself: how is the therapist relating to me? Do I feel
I could become comfortable working with him/her? Am I treated
wiith respect? Does the therapist listen non-judgementally?
Once you have found a therapist that you feel comfortable
with, as time goes on, it also helps to have realistic
expectations of the therapy process. Ritual abuse is a severe
type of abuse, and the therapy process is often long and
involved. It is important to not expect that the therapist will
be able to "fix you" or "make it all
better," instead, the client needs to realize that THEY
will be the one making changes, with the therapist as a
supportive facilitator. Also, a therapist cannot and should not
"reparent" the survivor, who may have had an
emotionally deprived childhood. Instead, the survivor will need
to learn new self-nurtering skills, and practice them while at
home and between visits.
A good therapist is an invaluable aid to the healing process,
and it is well woth the time and effort to find one. The
therapist I mentioned at the beginning of my article only lasted
two visits, but later, I learned to ask the questions above, and
to be careful in screening who I saw. I am glad I have, because
over the past few years I have met excellent professionals who
are competent, caring, with good boundaries, and who have made a
huge difference in my own healing process. I believe that all
survivors deserve good therapy during the process of healing
from ritual abuse. My hope is that this article will help others
in their search for a therapist, and that they can avoid the
pitfalls that I went through early in my own search.
Copyright Svali Used by permission
you are going to work with ritual abuse survivors, you
must also get educated if you want to be effective. And
you must learn to be humble. Trauma survivors do not need
to be around ignorant, modern-day Pharisees. Survivors in
pain need people who will connect with them on an
emotional level, get right down in there where they are,
and listen. --Kathleen Sullivan