Multiple Therapists: Okay or Outlandish?
February 26, 2011 7:43 AM   Subscribe

I recently asked a relationship question, and came to realize that the main problem was actually my debilitating anxiety and the fact that I need to sort that out before being able to seriously wrestle with my relationship. In one week, I met with 2 different therapists who are very different in their styles, and I have an appointment set up with a psychiatrist for next week (my primary care doctor recommended I see an actual psychopharmacologist.) I am very serious about getting help now that I realize I have been wasting so much time denying the severity of my problems and the genuine abuse I grew up with. My question is, can I see two or even three doctors about these issues? My main fear is getting only one or two perspectives on my problems, and I think I can trust the process more if I feel like I have a diverse set of views, perspectives, and mental frames. Is that outlandish or within the realm of normal behavior?

I'm not skeptical of the process, and I was remarkably open and forthcoming with these therapists, especially considering my usual social anxiety. It's just that I have no experience with therapy, and I will be sorting out long-standing issues that I have never really reflected on in this direct way. If I am in a uniquely open state, the last thing I want to do is accidentally have my experiences reframed in one particular way. I am susceptible to going along with others' views when under extreme duress, and this kind of vulnerability could put me in that state.

So: can I have two therapists, or one therapist and a psychopharmacologist, which I see weekly? Is three totally insane? I really feel like it will help, and at least initially I would like to get all the information and different perspectives that I can, so I can sort through things and try out different methods, and find what resonates with me and challenges me, rather than clinging to whatever is simply at hand. I really feel like this would help me trust the process more, but having no experience in this, perhaps others have helpful thoughts or experiences. Many thanks.
posted by wombat stork to Health & Fitness (8 answers total)
People will sometimes use multiple therapists to avoid things by the equivalent of playing their parents off of each other. If you're aware of this pitfall and are careful to avoid it (and can afford it) I say go for it!
posted by Obscure Reference at 8:01 AM on February 26, 2011 [1 favorite]

Totally normal. Trying multiple therapists is a great idea, because it can take trial and error to find someone who's a good fit for you, much like dating. I think more people would do it if not for restrictive insurance policies on who they can see, number of visits allowed, etc.

If you're prescribed a medication, it's completely routine to have both a therapist and a psychopharmacologist-- I did this when I took Ativan many years ago. I'm doing group pyschotherapy now, and many of the group members also see an individual therapist. In fact, one of our members is in two different groups!
posted by Dixon Ticonderoga at 8:05 AM on February 26, 2011 [1 favorite]

I'll add that you might see your pyschopharmacologist less often after a few initial meetings-- maybe once every month or two to monitor your dosage and discuss effectiveness or potential side effects-- while you do most of your face-to-face work with your other therapist.
posted by Dixon Ticonderoga at 8:14 AM on February 26, 2011 [1 favorite]

Most therapists won't see a client who is seeing another therapist. It could really confusing and even harmful for the client to receive conflicting information from two different therapists. Ultimately, the success of therapy is due to the relationship between the therapist and client. So, if you have to pick one, go with the one that you feel that you can really trust and be fully open with. The relationship itself will be healing.
posted by rglass at 8:32 AM on February 26, 2011 [2 favorites]

IWATNATNANYT (I was a therapist, not a therapist now, and never your therapist). I think that shopping around for a therapist is a wonderful idea. There is research that indicates that it is often the therapeutic relationship itself that helps to induce change, and a good fit with an individual therapist is imperative. There are also many styles/schools of therapy, and you may find that one suits your needs better than others.

Having said that, regularly continuing to see multiple therapists for the same concerns over a period of time sounds like not a good or productive idea. At the best, it may muddy the issues for you, and divide the time and energy you put into the "work" of therapy. At the worst, if your issues already concern anxiety, getting input from multiple therapists, and working at the problems from too many angles at a time could really up your anxiety.

I think a better solution is to look at it as "serial monogamy" versus having multiple concurrent relationships. After visiting with several counselors, choose one therapist now, along with a professional who can write prescriptions, and give it a trial of several months and reassess your progress then. If you feel that you are not getting what you want at that point, give yourself permission to "break up" with that therapist and move on to a new therapeutic relationship. I think that you will find this to be much more productive and far less confusing.
posted by thebrokedown at 8:38 AM on February 26, 2011 [1 favorite]

When my first psychiatrist retired, I decided to "shop around" for a new doctor. I ended up talking with several on the phone; some were not taking new patients but talked with me for about 10 minutes. I told them I was "shopping" for a good fit, and each one agreed that it's a good idea. I asked the ones who weren't available if they could suggest someone who was kind and not married to a particular ideology, and I got good leads this way.

I found that you can learn a lot when you talk with a psychiatrist for a few minutes. Do they listen well, ask questions, make assumptions, talk down to you, have a sense of humor, show kindness, interrupt you? How do you feel about asking them questions?

I met with four doctors. They were all smart and well-respected. One seemed to lack kindness and empathy; one was great but too nurturing for me; the third was great but 30 minutes away. This far-away doctor met with me twice and became my sounding board during the decision-making process. The fourth one told me on the phone he couldn't take any new patients into his practice. My advisor-doctor suggested I tell him I just wanted a consultation and that I would pay out of pocket and deal with the insurance company on my own. I met with him, he was great, and somehow became willing to accept me as a patient before the end of the session.

It's not weird to choose carefully, and to take your time. No decent psychiatrist will fault you for it. Their entire focus is supposed to be what's best for you, and if they don't behave that way, then you don't want them.
posted by wryly at 2:26 PM on February 26, 2011

I agree that starting off with a few, then narrowing down to the one that you really trust and respect, is likely the best approach, unless the goals are very different. When I was switching from a therapist I'd "outgrown," I was still seeing her and meeting a few others -- so it was like seeing 3-4 at a time for a couple weeks. By bringing the same issues to each, it quickly became obvious that one had a style that worked much, much better for me. After realizing that, I easily gave up seeing the others.
posted by salvia at 4:23 PM on February 26, 2011

"My main fear is getting only one or two perspectives on my problems, and I think I can trust the process more if I feel like I have a diverse set of views, perspectives, and mental frames...."

Sure, shop around at first, seeing multiple folks at the early stage should be fine as long as you can afford it. But I'd encourage you to consider that your reluctance to choose just one therapist now may be connected to the reasons why it's hard to choose just one person to marry for the rest of your life. Even if you have six therapists you still won't get every possible perspective, you'll inevitably be missing out on insights that someone else could offer you, unfortunately that's just life and decision-making-- it's hard never knowing whether you're making the best possible choice, it's hard closing doors on options and narrowing things down, but it's got to be done. And in this case, it may potentially interfere with your therapeutic progress if you're approaching it long-term with a perspective of keeping your options open rather than committing to the process with a particular therapist. (If you're able to come at it from a place where you're genuinely committing to the process with more than one therapist, that's a different story.)

So try not to let yourself get excessively worked up about choosing the "right" or "wrong" therapist-- but also try not to let seeing multiple therapists for an extended period of time drag on as a way of avoiding having to make that choice-- sometimes you just need to make the best choice you can and then just accept it and move forward. But this is a great thing to talk with your therapists about!

(I am mega-indecisive too because decisions and the possibility of "wrong choices" make me really anxious. Huge kudos to you for moving forward on this so quickly, I often just get so paralyzed that I put off doing anything at all for way too long. Even if your reluctance to narrow it down to one therapist does turn out to be excessively anxiety-based, that's a pretty darn good and productive way to be excessively anxious, you're on the right track! Keep going with what you're doing, you can cut back when you're ready and able.)
posted by EmilyClimbs at 9:17 PM on February 26, 2011 [1 favorite]

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