On August 31, I sat down with my therapist, Amanda Atkins to ask her a few questions. Since the sudden death of my husband, I’ve benefited immeasurably from bi-weekly counseling. I look forward to having a place to divulge the private, messy, and heartbreaking parts of grief. Through our sessions, I have also come to find support and encouragement for the woman I am outside of this tragedy. With Amanda, I feel comfortable asking candidly: how do we get more people on board with seeing a therapist regularly, and break down the taboos surrounding mental health?
Anjali Pinto: I found you through a recommendation of a friend who is a therapist, but not everyone has that resource. What is a starting point for someone who has no idea where to begin or what to expect when seeking a therapist?
Amanda Atkins: I say this to all my clients, but fit is so important between a client and their therapist. You have to find someone that you connect with on a personal level, who will challenge you as much as you want, who is as gentle and compassionate as you want. Maybe you have to interview a few. You may not connect with the first one, and that’s fine. A good therapist should understand that.
A great way to start in finding a therapist is to ask a friend, look online, or check out Yelp reviews. On a therapist’s website, examine the voice that comes through—is there anything that draws you in or sparks your interest? Keep in the back of your mind you are interviewing them, and at any point you can speak up and say “This isn’t a good fit, I want to try somebody else.” It might take meeting a couple therapists before you meet someone you like.
AP: For someone who may not have the financial resources to explore several options, what are your thoughts on digital therapy as a starting point, or apps that could be helpful?
AA: I honestly don’t know a whole lot about it. I’m not a big of a fan of the therapy via only text messaging, because I think so much of therapy is in the relationship. Even in silence there can be therapeutic healing, and texts just feel so impersonal. I definitely think that teletherapy or video chatting is effective. In that, I would say the same rule applies. Meet with an online therapist and see if there’s a fit. If not, seek someone new. Just keep working to forge a connection.
AP: I struggled with finding a therapist, being a woman of color and identifying as queer. My intro session with my first therapist ever, I had an immediate disconnect and felt like the woman I sat across from really didn’t understand me.
There’s a huge cultural barrier to accessing therapy—in a lot of groups it’s simply seen as being weak. There’s a perception that therapy is only for rich, white women. How do we break through this barrier? How do we make this resource available to more people?
AA: There have even been studies that show discrimination among therapists in returning phone calls to set-up an introductory session. White therapists were more likely to call back after hearing voicemails from white clients based on the sound of their voice.
For me, reading that, it was a wakeup call that I need to be checking my biases. I need to be looking myself in the mirror, as a 35-year-old white woman, and identifying if any of my practice has been operating on assumptions. I want to be fair across the board. It felt so important to me in hiring my associates, one a woman of color and another identifying from a minority religious group. It’s unfortunate that responsibility falls on a new client to seek out a therapist that appears to hold that value, but that being said, do not be afraid to be upfront in an initial email with a therapist about what it is you’re looking for.
AP – That’s what I had to do after my first bad experience. Just lay it out there: Hi, I’m an atheist, queer, brown woman and my husband’s dead. I want to make sure your practice makes me feel comfortable in expressing all parts of my identity.
AA: Yes! Just in putting that out there, you’ll be able to gauge by the therapist’s response, if they are completely open and accepting. On my website, I want to make it clear to someone who may be cautious in pursuing therapy because of some defining factor in their life, that my associates and I will create a safe space.
AP: I have an easy time with confrontation, so after my first session went awry, I felt comfortable sending an email apologizing for scheduling a second session and asking to cancel it because I didn’t feel we had a connection. I emailed saying, I’m sorry, I’m going to go in another direction.
AA: It can be as simple as saying: I need to cancel my next session and hold off on scheduling.
AP: When I first met with you, I felt an intense pressure to tell my entire story during an our first meeting. The idea of summarizing everything that had happened to me in 60 or 90 minutes was impossible. For someone who is dealing with difficulty spanning over months or years, maybe their whole childhood or marriage, what should they expect in a first session that is successful?
AA: In your case, you were able to give me enough of an outline to understand what happened. For someone who may want to talk about their whole childhood, they have to pace themselves. Not only is it impossible to describe everything in one session, the client needs to go at their own speed. I remember in our first session, asking, “How did he die, do you feel okay talking about that?”
I was worried that you may feel like you had to give too much information, or walk away from our first meeting feeling like “Oh my god, that was a lot.” Any time I’m counseling someone who has dealt with trauma, I provide reminders to pace the conversation. “It’s okay if you do not get it all out today, we have time. ” It is a process of getting to know each other, and easing into their story.
Some of the healing in therapy is done in the process of telling your story. It’s not as simple as writing out what happened on a piece of paper and presenting it to the therapist, then we work on making things better. No, part of the healing is talking through what happened or reliving it. I remember when you played the audio clip of the EMTs in your house after Jacob died, that was such a powerful moment for me to experience with you. It took time for you to reach a point where you feel comfortable sharing that amount of your story, and it should. Your story is private, and meaningful. You have to establish trust before you feel comfortable sharing it all.
AP: I knew as soon as my husband died, at some point I would need to seek therapy. I had to prepare myself for several months to be open and ready. The idea of being honest and vulnerable with a stranger face-to-face was very intimidating. It took me five or six months.
For someone who has been contemplating going to therapy for a while, hoping it would help them, what could they do to be at ease and prepare for a first session?
AA: I would say if you have any specific questions for your therapist ahead of time feel free to ask them. Everyone’s anxiety manifests differently. For me, for example, I would want to know about parking. I know my anxieties, and if I ask, “What’s the parking situation at your office?” I’m managing expectations and imagining physically getting to therapy, which makes it less stressful and there are fewer unknowns. There are 1000 things that can get in the way of getting to therapy—what do you need to get yourself there?
Going back to fit, the therapist should put you at ease. The therapist’s presence should help you feel safe and comfortable to talk. When setting up your first session, ask questions about what to expect and and pep yourself up, it’s such a brave move to seek help. Remember that you are in control—if you’re not happy with a first session it is okay to not come back.
AP: I grew up with mental health as a discussion in my house, my father is a psychiatrist. And yet, I never sought any sort of counseling until this major and tragic event in my life. Even though I was exposed to healthy discussions of mental health on a regular basis, I held on to the stigma that therapy was only for people who would struggle deeply without it, that therapy was some sort of crutch. I realize now, having it as part of my regular routine, that down the line when things are easier and maybe my sessions are less frequent, I would still benefit from having a space dedicated to working through problems related to my career, or my relationships with a professional who is interested in my wellbeing. What do you think is a major misconception about therapy?
AA: Definitely what you said, the idea that therapy is only for “crazy” people. In the media, there is a portrayal that therapists are scary, cold, or we’re not real people. In reality, most therapists adore their clients, in a healthy way. We chose this career because we love seeing our clients succeed, come to realizations about their life, make a brave decision, or even make a mistake and be able to recover from it.
There is a misconception that therapists are not invested, that we’re watching the clock and rushing people out the door. It’s just not like that. I have the best job in the world, I am doing exactly what I think I am best suited to do, and I get joy from my clients. I learn from clients, I feel honored to do my job, and I’m certain most therapist feel the same way. I’m excited for people willing to take the risk to start therapy. I want deeply to see my clients happy in life.
AP: I have friends who are not loving their therapists. Maybe it’s not a good fit, or maybe after a long period of time their sessions became less professional. I know there are industry guidelines for what’s appropriate, but what sort of professionalism should a new client expect from a therapist? What are some red flags? For some people, fit may be hard to gauge if their not familiar with the practice.
AA: That’s such a great question. It is easy for the line to get blurred, because you should enjoy your therapist. As therapists, we like our clients too. A good test would be—do you know you can show up to therapy that your needs are going to come first?
Another way to look at it is, are you making progress? Does your therapist challenge you, or offer new insight? The classic trope of a therapist is that we’re just nodding along saying “mm-hmm.” When I am approaching a client, part of my job is listening, and part of it is offering insight. I ask questions, I’m trying to push my clients in ways they may not be challenged elsewhere. I’m not just a friend, I ask uncomfortable questions and offer insight that maybe they haven’t arrived at independently.
From the client’s perspective, therapy shouldn’t feel like just reporting: first this happened, then this happened. Yes, some weeks you need space just to vent and recount what’s going on in your life. Other weeks, there needs to be time for self-reflection and questioning. There should be more to the discussion, space to examine what you’re dealing with or struggling to understand.
AP: Before starting therapy, I didn’t understand this unique type of human connection. You do feel like a friend, a supporter, but I know that I can come here and be the sole focus, without having to shoulder anything or take anything home. I don’t have that in real-life friendships. It feels rude to meet up with a friend and spend an hour venting without asking a single question about how they are doing, but I have that here and treasure it. I never feel selfish for making it all about me.
AA: That is so important. If I were to come into a session and say, “Ugh, my husband and I got in a huge fight today. So how has your week been?” I know you would worry about me, or want to follow up or check in later to see if I was okay. That’s not why I do my job, I do not need that from my clients. That’s a healthy boundary to draw.
Even with this interview, I wanted to make sure that it was comfortable to do it in my office, because I view this as your space. It’s too easy for you to be a caretaker, and shockingly for many clients that’s true. They are out in the world caring for everybody else, and it would be so easy for them to come into my office and deflect the care that I am here to provide by asking me about my life.
The beauty in therapy lies in this: it is a space where you can talk about anything in the whole world, and I will be here to listen. I will not judge you for it, I may challenge you on it. I do that because I care about you.
AP: I entered therapy with no timeline or idea how long I would feel the need to go, but is therapy a good solution for people that are looking for short-term assistance with life’s challenges?
AA: My thought is: come as long as you’d like, get the tools you need to deal with life’s difficulties and then leave. That’s fine. I have lots of people that I would see for a year, and then they feel like they’re in a good place to take a pause. Maybe down the line they get engaged, or a family member dies, or there’s a breakup and they want to revisit weekly sessions. There should be no commitment or pressure. I think for someone who has a very specific short-term problem, therapy can be such a great tool for them. Come in for five sessions, get the space you need, and walk away feeling like “that was really helpful.”
AP: Is there anything I did not ask that you’d like to add? How can we encourage people to seek counseling?
Therapy can be such a gift in someone’s life. It can be the one space where you don’t have to be polished. It’s okay to just come in, be awkward, cry or sit in silence. Sometimes people think they have to come in with an agenda or know what they’re going to talk about. They feel pressure to be polished and have it all together. Therapy is the one place where we don’t have to be perfect, we can just exist. There’s someone across from us who wants to listen and wants to help. The only job you have in coming to therapy is to be who you are, be willing to talk. It is my job to string the ideas together, step back and look at the whole picture.
Talking openly about the parts of ourselves that are shameful or private takes away from the negative power that those ideas have over us. Therapy allows us the space to celebrate ourselves and discover who we are when we can be 100% real. It is beautiful and empowering to let someone witness that.
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