Should I find a new psychotherapist?
January 9, 2012 11:38 AM   Subscribe

I think it might be time to start seeing a new therapist. My current therapist disagrees. So now I'm confused. Convince me that I'm right.

I’m a 38-year-old man (gay, if that's relevant) and I’ve been seeing my current therapist for just over 11 years, far longer than any previous therapist. I feel like I’ve done therapy "right" -- I’ve talked to death about my issues and my past, I always try to be honest with my therapist about my thoughts and feelings, including my thoughts and feelings about her, and I try to explore topics that make me uncomfortable. I try to put it all out there in therapy. I like her as a person and we have a nice rapport. At this point I feel I have a great deal of insight into why I am the way I am.

The thing is, I still can’t seem to change the way I approach my life or my issues. My issues are basically: chronic dissatisfaction with my life, overthinking, excessive fear about life, some discomfort about sexual issues, occasional thoughts of despair, being too hard on myself, lifelong inability to find a meaningful career, indecision over whether to end my relationship with my partner. (I realize there is a parallel between that last one and this particular AskMe -- whether or not to end a particular relationship -- but I put it last because I think it's a symptom of my issues rather than a core issue itself.) A lot of my problems seem to have to do with the way I was raised, but whenever I ask my therapist, “How do I get over my past?” her response is always, “By continuing to talk about it.” Okay, but I’ve been talking about it for 11 years. Whenever I ask her how much longer this is supposed to take, she never has a solid answer.

She seems pretty traditional in her therapeutic orientation -- she likes to talk about Freud, she's interested in my nighttime dreams, my childhood, etc. But that approach doesn't seem to be working for me as well as it used to.

She says I have unquestionably changed for the better over the years. Fine, but I'm still not where I want to be and I'm doubting whether she can get me there. My goal is to lead a reasonably happy and fulfilling life and I am not there. I don't want to still be feeling this way when I'm 80. I think it's time for a new approach.

I recently got a recommendation for a different therapist and I made an appointment with him. When I told my current therapist about this, she was displeased. She seemed irritated that someone else would "disrupt our 11 years of work." She also analogized it to the desire to have an affair -- i.e. escaping from the hard work of a particular relationship by starting a new one -- which frankly I was insulted by, because I have thought about this on and off for a long time and have brought it up with her several times over the years. It's not like this is a whim.

Over the course of my conversation with her, she became more resigned to the idea that I was going to at least check this other therapist out, but she still didn’t seem happy about it or think it was the right idea.

So far, I’ve met with the new therapist once, and I’m intrigued enough to meet him once or twice more. He seems less "Freudian," not as intently focused on exploring my past and my dreams. He says those are somewhat important, but he is more focused on the here and now. He also seems more interactive; when he asked me a question and I started to ramble, he actually cut me off and tried to direct me back to the question, unlike my current therapist, who I feel indulges my tendency to overthink.

Also, he is a gay man like me, so working with him might give me new perspectives on things that my current therapist, a straight woman, might not be able to provide.

I don't yet know whether he can provide what I'm looking for, but I think I need a new therapist regardless. I just feel like I need a fresh approach, even if I’m not sure what that approach should be.

I am continuing to see my current therapist right now but I want to make a decision pretty quickly because I don’t want to pay two different therapists.

Am I right here?

What are some other things I should think about in trying to decide?

(Or is this whole question a symptom of my tendency to overthink?)
posted by chameleon to Human Relations (38 answers total) 5 users marked this as a favorite
Therapy, to me, feels like one of those go with your gut type things a lot of the time. If you feel like you've gotten all you can out of your current therapist then I think it is perfectly reasonable to want to seek more, or different, help from a new person. 11 years is a long time to see one therapist, especially if you don't feel like you are getting to where you need to be.
posted by magnetsphere at 11:43 AM on January 9, 2012

Go with your gut.

The point of therapy is to move you toward making decisions on your own. Moreover, your counsellor shouldn't be aiming to keep you in therapy with her, especially if you say it isn't a fit.

As a data point, I once said to my counsellor that something she'd said/done made me so upset that I spent the weekend thinking I should quit therapy. And she then made certain to tell me that I could end therapy at any time, that it was all in my hands, that I was under no obligation, that she wouldn't be upset and that she would understand - but that she was here and happy to continue if it worked for me. I'm still with her. But think about the difference in that approach and that of your counsellor.
posted by Chaussette and the Pussy Cats at 11:47 AM on January 9, 2012 [8 favorites]

FWIW I have heard rumors that among the psychological community the Freudians will just analyze forever without regard for whether the method is working.
posted by edbles at 11:48 AM on January 9, 2012 [7 favorites]

I am nthing that it's time for a change. You can tell your therapist that you really, deeply appreciate the work she's done to get you where you are, and that you just need a different therapeutic style to move forward from here.
posted by DarlingBri at 11:51 AM on January 9, 2012 [2 favorites]

She also analogized it to the desire to have an affair -- i.e. escaping from the hard work of a particular relationship by starting a new one -- which frankly I was insulted by

Personally, I think you should be. The goal of therapy is not to be in therapy forever, in most cases, it's to get something else out of it that helps you live your life better. The goal of a relationship is often, at least partly, to be in an fulfilling relationship. Most modalities of therapy work equally well, this seems like it's been a good run for you but it's time to move on. I think you are right, personally, and I'd feel okay moving on.
posted by jessamyn at 11:51 AM on January 9, 2012 [14 favorites]

This might help you give yourself permission to switch - if the new guy doesn't work out, you can always switch back.
posted by Lesser Shrew at 11:51 AM on January 9, 2012

whenever I ask my therapist, “How do I get over my past?” her response is always, “By continuing to talk about it.”

Oof. She might as well say, "By constantly picking the scab off and pouring salt in the wound."

What she meant then, and what she means now: "Please continue to give me money."

This is entirely your decision to make. She's extremely biased on the matter. Maybe her feelings are hurt. Maybe she feels like her favourite soap opera is being cancelled. Maybe she'll miss the paycheque. Whatever her deal is, it's not your problem.

If I were in your shoes, I'd DTMFA.
posted by Sys Rq at 11:54 AM on January 9, 2012 [19 favorites]

Eleven years without a graduation certificate? I'd die.

Overthinking is a great way to keep yourself from ever doing anything.
posted by RJ Reynolds at 11:54 AM on January 9, 2012 [2 favorites]

Freud? Seriously? Eleven years? I don't even understand why this is even a question. Why would you even take the therapist's opinion on this matter into account?

She has forgotten that she is working for you, not the other way around. By all means fire her and find someone else.
posted by kindall at 11:54 AM on January 9, 2012 [2 favorites]

She's not just a therapist, she's a psychoanalyst. Their perspective includes long haul therapy. Did you know that starting out? I hope you don't compare yourself negatively to people who are seeingothers types of therapists.

It can be creative and interesting and helpful to try something else.

Because its been such a long relationship, it might be hard to consider leaving. I hereby give you permission to leave without worrying about whether she approves or not. Most therapists are open to having clients come back; not sure if she would. Might be worth asking and seeing how you feel about her response.
posted by vitabellosi at 11:57 AM on January 9, 2012 [1 favorite]

I came in here prepared to tell you to stick it out, that wanting to switch therapists is often a sign that things are just starting to work... but then I read your reasoning, and that it's been 11 years. You sound like you have all the right reasons there, and that this other therapist would be interrupting something that isn't working for you anymore, not a middle-of-hard-work-that's-almost-an-epiphany therapy.

And, yeah, ask if her if she'd be willing to see you again if this other guy doesn't work out, but you sound like you just need Different therapy, and that's totally valid.
posted by ldthomps at 12:00 PM on January 9, 2012

She is a health professional and you want a second opinion. There's nothing for her to get miffed over and it's your right to seek out your other options. If anything, I would expect her to reach the conclusion that your therapy relationship has run its course and suggest that you look for another therapist.
posted by cranberrymonger at 12:02 PM on January 9, 2012

I spent three years in psychodynamic ("talk") therapy, and like you, I found I gained a great deal of personal insight and for that the hard work (uncomfortable topics, etc) was well worth it. But like you, I also have found that the personal insight hasn't allowed me to easily change my behaviors, and I'm coming to the conclusion that talk therapy can be complemented with cognitive behavioral therapy. I haven't tried CBT yet, so this is just a theory, but you might have luck seeking out a CBT therapist. It would focus more on changing behaviors than necessarily understanding them (and you already have that understanding, it sounds).
posted by JenMarie at 12:06 PM on January 9, 2012 [2 favorites]

You and your therapist are not in a monogamous romantic relationship. She is a service provider whom you pay to provide you with something you want and need. Switching therapists is not like an affair because no matter how much you enjoy this woman's company, she is not your friend or partner. (If she wants to analogize to romance, it's more like you finding a new prostitute to patronize because your usual prostitute no longer gets you off.) If you're dissatisfied with her services, you should leave and find someone else who will actually give you what you're paying for. The fact that she gets insulted and upset, rather than concerned about your well-being, when you tell her that you don't feel any better tells me that she doesn't have your best interests in mind. She's thinking about herself and her needs and wants instead of about you and yours, and that's a really bad sign in a therapist.

By all means, quit and see this new guy. And if, after 6 months or so, the new guy isn't doing it for you, seek a third opinion. The one way in which therapy is like a romantic relationship is that most people have to kiss a lot of frogs before finding someone they're really compatible with.
posted by decathecting at 12:07 PM on January 9, 2012 [4 favorites]

I'm in agreement with ending things with the current therapist.

I’ve been seeing my current therapist for just over 11 years

11 years seems really long. Obviously, I have no real knowledge of your particular issues or needs and can't be a judge of them. But from an outsider perspective 11 years seems like an eternity to be in therapy. Are you still gaining anything from the therapy at this point?
posted by Mister Fabulous at 12:18 PM on January 9, 2012

I've been seeing my current therapist (not a Freudian) for more than 15 years. She has encouraged me to seek second opinions, to work with people who have expertise in modalities she doesn't have (Cognitive Behavioral Therapy, for instance), and to do what works best for me.

posted by Sidhedevil at 12:28 PM on January 9, 2012 [3 favorites]

I'm of the opinion that at the point where you feel that you and your current therapist are no longer making the progress that you want, you should seek out a new therapist. It'd be somewhat irresponsible in my book to just keep shaking the same apple tree, hoping peaches will fall out, especially after 11 years.
posted by sm1tten at 12:28 PM on January 9, 2012

Sometimes a cigar is just a cigar. And sometimes, change for change's sake is good. It sounds to me like a change would bring fresh perspective for you. I would transition over to the new guy after a few more weeks of dual booting both of them.
posted by JohnnyGunn at 12:34 PM on January 9, 2012

I was going to suggest that you definitely, definitely see this new therapist; also that an approach which believes you can change now, rather than in 10 years, is often more effective; that short term improvement in therapy tends to predict long term improvement (ie if you're not seeing progress in 6 weeks, then it's usually not going to spontaneously improve - this is from a study, that I can't find the reference too, drat), and that hey, worst case, you can go back to this therapist if it doesn't work out.

Then I read the response from your therapist.
I hereby modify my advice - I don't think you should go back to your old therapist even if the new one doesn't work out!
I think you should find someone who actually wants to get you out of their life!
I.e. help you make the progress you need, so that you don't have to see them anymore.
posted by Elysum at 12:35 PM on January 9, 2012 [5 favorites]

I've had years of therapy. Some useful, some not so much. One thing I've noticed is that therapist generally try to keep you as long as possible. Insurance makes it an easy billing and you are essentially a cash cow. Sorry to come accross as callous but this seems to be the case.

Sometimes its time to swich. If after 11 years you haven't made your desired goals and improvements it is time to move on.

How I've quit: I have either said "thank you for your help; I think I am done". Generally this has been followed with rehashes of my issues and concerns and a response along the lines of "you've made some progress, but I think you still have stuff to work on"
Second method of quiting is not setting up an appointment due to "busy schedule , I will call and make an apt." And never follow through. Weak I know, but I'd rather avoid the whole spiel of trying to keep me.

Not that theres a timeline for therapy, but after 11 years, you have either a ton of things to work on, or a questionable therapist.

/not a therapist, studied psychology for undergrad as a minor and dispise some of the practice. Not all, one helped me extremely well and am very grateful for him when I was in a dark place.
posted by handbanana at 12:49 PM on January 9, 2012

Yeah, the "you should stay with me" thing from a therapist is a HUGE red flag for me. Therapy should be about fixing your problems, with an end-goal in mind, not padding the pocketbook of your therapist indefinitely. Try the other therapist, try other other therapists. I like the way that Elysum put it: "Someone who wants to get you out of their life."
posted by Alterscape at 12:56 PM on January 9, 2012 [3 favorites]

The mere fact that you are asking 'us" to validate your inclination to switch therapists is in itself sufficient information to suggest it is time to switch.
posted by rmhsinc at 12:58 PM on January 9, 2012 [6 favorites]

Psychoanalytic practice, as someone mentioned above, is much more about exploring and discovering and not so much about the behavioral and cognitive changes that you seem to be focused on now. Insight is great, and it can help you as you progress through your life, but unless you have a self motivation to change AND the tools, resources and know how to effectively do so, continuing with psychoanalysis alone will not produce the results you seem to be seeking at this point; you'd be better off (IMHO) at this point seeking out someone who does cognitive-behavioral type therapy.

If your gut feeling is that it's time to change, then it probably is. Your therapist has a professional and ethical obligation to not treat patients which she is unable to treat effectively. If you are telling her that therapy is not continuing to meet your needs, then she should be exploring how to deal with that directly, not thwarting your attempt to do so.

(Disclaimer: I have an undergraduate degree in social work and did work in that field for about 8 year many years ago, but I am by no means an expert and this is merely my personal view.)
posted by BigHeartedGuy at 1:13 PM on January 9, 2012

She's thinking about it wrong if she wants to compare it to relationships; you aren't cheating on her -- you outgrew her. You need something more. That she would get defensive is just a sign that she's been stringing you along. If she really cared about your well-being, she would be happy to let you seek other opinions or give you referrals.
posted by june made him a gemini at 1:16 PM on January 9, 2012 [1 favorite]

Good responses so far.

Your therapist sounds needy - unable to accept that you want to move on. She shouldn't be digging in her heels. Therapists are human of course, and they're capable of childish feelings like this. The problem is that she's revealing them to you, in this very unprofessional reaction to what you've presented. She should be listening to you, not refusing to let you go (which she can't actually do, of course) because 1) her competence has been challenged, or 2) she's lonely and sad to lose you, or 3) she needs the fee, or whatever it is that's going on. Also, therapists can be lazy. They like clients who make their job easy.

I think your therapist enjoys having you as a client. You're what I'd call an A-lister - thoughtful, articulate, self-aware and insightful. You probably do most of the work for her. Therapists LOVE clients like you, but that's beside the point. It's vital that you're getting what you're paying for. It's not just the money, of course. This is your life. The hours you spend each week in her office are real hours, the actual currency of your life and time, and you can't get it back. I understand your urgency around that, after eleven years of stalled progress.

There's another element here - your affect during the sessions. Clients who are calm and not obviously in crisis, can be misleading to unobservant therapists. You're not screaming and crying - so you must be all right. A therapist should NEVER take you at face value. It's their job to delve deep, to distrust the surface. I'm picturing you sitting there, well-behaved, intelligent, alert and rational, willing to follow her lead as she steers the conversation toward intellectualized discussions of your dream work. It's possible that she sees you as a fascinating colleague, not someone who needs her help.

Of course she's WRONG about that! You mention your occasional moments of despair. Moments of despair are excruciating - even if they're infrequent. If you're having suicidal feelings, even fleeting ones, you need a therapist who can help you with that.

Don't feel guilty about seeking out another therapist. You've been utterly open with her, and a lot more patient than I would have been! If the new guy doesn't work out, don't go back to your current therapist. If she's as childish as she seems to be, she might punish you for the temporary desertion.

After eleven years, you know what she's like, and you know what you're doing. Good luck!
posted by cartoonella at 1:19 PM on January 9, 2012 [2 favorites]

I recently changed therapists after 3 years. Like you, I'd been thinking about it and had brought it up to her several times over the course of 6 months. She didn't think it was a good idea either, but I felt that her approach wasn't helping me and my gut said it was time for a change. It's been a couple of months since I decided to leave her, and while I'm still unsure if the new therapist is the one for me, I know that the old one was definitely not the one. Your therapist should be encouraging your growth and if that means that you've stagnated with her and would be better served by someone else, she should be mature enough to handle that. If she's at all reputable, she'll keep the door open for you to come back at any time. It's a big choice to move on after all those years, but it sounds like it's the right one for you. Don't let her doubts about what you know you need hold you back.
posted by Sal and Richard at 1:25 PM on January 9, 2012

People spend a lot of time wondering how to convince their therapist that they aren't a good match. I understand this; there is an argument to be made that some people may break it off with therapists because they don't like the advice they're getting.

That's fair enough in many circumstances, but not in all of them. Unfortunately, it leads to patients to conclude that if the therapist-patient relationship isn't working the way it's supposed to, then it's all the patient's fault: "It must be me, because clearly I have problems if I'm in therapy, meanwhile the doctor has a degree in Treating Problems, so the doctor is the only one qualified to determine whether or not the relationship is right." It's rarely phrased like that, but that's how it comes across in too many AskMeFi "should I break up with my therapist?" questions.

People ask around as though if the internet justifies it, then it must be okay (even though rationally, we know that a decision isn't necessarily okay just because the Incredibly Objective and Informed World Wide Web condones it). On that note, if you go to your old therapist with "I asked AskMeFi if I'm doing the right thing breaking up with you, and they said DTMFA," she's not going to turn around and say, "Gosh, well, if AskMeFi said so ..."

I hope this isn't coming across as harsh; I don't mean for it to be. (I've actually been in shoes similar to yours.) I just think that if you're polling the internet for advice on whether or not to stick with a therapist, then there isn't much of therapist-patient relationship there left to salvage.

On a slightly different note: Seems to me like you're a good match with the old therapist. Seems to me like this new one could be a really good fit. I think you know it, too — that's why you're asking us. But don't worry about justifying your new therapist to your old therapist. (Your old therapist used the analogy of "cheating" like you're in a committed dating relationship, which seems waaay off to me ... but, if we're going with her analogy, I'd respond by saying that you don't need to justify your new boyfriend to your old one.)

It's your money, it's your time, it's your life. Make sure you're getting what you want out of it.

And good luck with the new therapist! :)
posted by hypotheticole at 1:34 PM on January 9, 2012

Before everyone vilifies therapist #1, there really are good reasons not to be in simultaneous therapy with two people. From a psychoanalytic perspective, which she seems to take, this behavior is easily likened to wanting to have an affair, because the therapeutic change is theorized to come from the long term relationship. If her methods aren't working for you after 11 years, by all means switch, but being in therapy with two therapists at once isn't a good idea for various reasons.
posted by namesarehard at 1:35 PM on January 9, 2012

Response by poster: Wow -- I am so glad I asked this question. There are so many great answers here -- and they all point in the same direction. It's incredibly freeing to realize that I have the power and the right to end this therapeutic relationship if it's not helping me anymore. I have been afraid to exercise that power. I think my difficulties in ending this relationship are actually symptomatic of some of the bigger issues in my life, and this itself could actually be a good step in my psychological development.

And even if the new therapist turns out not to be right for me, doesn't mean I need to return to my old therapist or that there isn't another one out there who will be more helpful to me.

Thanks for helping me look at this situation more clearly!
posted by chameleon at 1:58 PM on January 9, 2012 [7 favorites]

You are her employer. You are not in a relationship with her. You've hired her for 11 years to get a job done, and it's not done. Seriously, Freud? Try something new, without guilt!
posted by Houstonian at 2:05 PM on January 9, 2012 [4 favorites]

Seriously, it sounds like you know what you are doing. There is no need to cast stones (because I can't spell vilify!) at the previous therapist but you sound like you have moved on at least mentally and the new guy seems like an excellent fit for you. Don't forget therapists are just people, she was comfortable, you provided an excellent stable source of income for her and it is probably a bit of an ego bruise to hear you have 'grown out of her'. However, it sounds like what you are doing is right for you. And isn't that the whole point? I (an internet stranger!) am proud of you and your progress and new assertiveness!
posted by bquarters at 2:34 PM on January 9, 2012

(Not your) therapist here. People often try to skip out in order to avoid change but my impression is that's not what is happening in this case. I think changing therapists could be a good thing if you feel stuck where you are but, let's do it right! You want her permission and blessing and she doesn't seem about to give it. How often have you expressed any anger towards your therapist? You say that you're honest with her about your feelings but I find it odd that a bunch of strangers on the internet have, at your lead, gotten much more angry at her than I hear you being. I think you're having us do this for you. You need to confront all your feelings around feeling trapped in a relationship with her and risk her displeasure with how you feel. Don't just quit her. Stay in the room and tell her you feel trapped and angry and scared and whatever else. If the two of you can't manage to navigate that kind of interaction (give it some time and try your best), she might be the wrong person to be seeing while learning to trust your independence.
posted by Obscure Reference at 3:32 PM on January 9, 2012 [1 favorite]

It's incredibly freeing to realize that I have the power and the right to end this therapeutic relationship if it's not helping me anymore. I have been afraid to exercise that power. I think my difficulties in ending this relationship are actually symptomatic of some of the bigger issues in my life, and this itself could actually be a good step in my psychological development.

After looking at your posting history, I think you might be very, very right.
I am of course, just a random internet stranger, but take that for what it is worth.

(It's starting to sound like this could be a very helpful experience for you. You get to practice being assertive, having boundaries, and ending relationships that aren't working - and unpack how you feel about it with your old and new therapists!).
posted by Elysum at 3:46 PM on January 9, 2012

The other thing to keep in mind is that it's a conflict within therapeutic ethics for two therapists to knowingly provide therapy in the same modality (individual therapy) to you at the same time. If either one of the two knows that you're seeing the other therapist for ongoing therapy but is wanting to still see you anyway, I'm very concerned.
posted by so_gracefully at 3:46 PM on January 9, 2012 [1 favorite]

This isn't about her, and how she feels. This is about you, and how you feel, or how you want to feel. You are the patient, and you make your own medical decisions. Your therapist should respect that and not be giving you a guilt trip about it.
posted by SillyShepherd at 3:55 PM on January 9, 2012 [1 favorite]

Looks like plenty of people have weighed in nicely on this already, but if another data point is helpful, I went through something similar just a few years ago (with a psychiatrist). Basically, after being assigned to her (by my HMO) for several years, it became abundantly apparent that she didn't "get" me at all, and her response to my announcement that I wanted to switch doctors was pretty shocking. Like your therapist, she tried to tell me that switching would be bad for me, etc., and even tried to convince me that I had no business trying to work out any issues on my own (or with another therapist) or through reading, etc. She wanted to be the sole channel of input I had regarding my own brain, and it was only because I'd happened by chance to have read online about several other folks' experiences with similarly overbearing healthcare professionals that I was able to recognize this as a *major* red flag.

...but in any event, what helped me the most was recognizing and reminding myself that my psych was a service provider and NOT an authority figure (or anyone I owed anything beyond payment). Just as I wouldn't keep taking my bicycle to a shop where the mechanics obviously didn't grok my bike's construction, I wasn't about to keep taking my brain to a person who clearly had no clue how to relate to it. As it turned out, I ended up switching to someone else who ended up being a great fit (and of course none of the old psych's dire predictions about my life falling apart without her came true).

Needy, manipulative, over-controlling therapists seem to be big fans of "gaslighting" their clients, and it's really helpful getting to where you can recognize this and *get out*. It's nice to think everyone who gets into that profession genuinely wants to help people, but the unfortunate reality is that in some ways certain professions *attract* folks who enjoy building themselves up into a (generally false) position of being someone else's Only Hope. And sometimes you end up having to go through a few "bad apples" before ending up with a service provider who IS genuinely helpful to you. Good luck!
posted by aecorwin at 4:11 PM on January 9, 2012 [4 favorites]

Chameleon, I officially give you permission to follow your heart, or your gut, and move on!
posted by lulu68 at 4:47 PM on January 9, 2012

So it sounds like you started seeing this therapist toward the end of your 20s, when folks are just starting to gain traction and set themselves on a path toward adulthood. That's also the time when a lot of twentysomethings are paralyzed by indecision and anxiety about this major switch in their life - the newly recognized: Quarter Life Crisis.

Without really knowing much about you, it appears that you showed up 11 years ago in the midst of your Quarter Life Crisis... and rather than giving you the swift kick in the pants or the helping hand that twentysomethings need to get over this hump, she's kept you there in perpetual limbo, waiting for it to maybe someday end. Possibly.

You need to move on and start living your life. You need to cut ties with this therapist.
posted by jph at 6:45 AM on January 10, 2012 [1 favorite]

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