Finding a therapist who can best help you starts with choosing the right person, but not necessarily the right therapy.

Bruce E. Wampold, PhD, a professor of counseling psychology at the University of Wisconsin–Madison, analyzed data from 6,000 patients seeing more than 500 therapists and found that all schools of talk therapy can work—if the therapist is competent and in sync with his or her patient. Watch this top psychiatrist explain why it’s important that you feel liked by your therapist, and why a growing number of experts are recommending a cognitive behavioral therapy approach for depression.

“It’s important that you agree on the purpose of therapy and how you will accomplish that,” says Keris Myrick, 46, of Pasadena, Calif., who has treatment-resistant depression and is a veteran of the mental health system. But finding the right mix of chemistry, experience, and area of expertise can be elusive.

Ask, “Have you been here?”
“I’m a little biased here, but I think you should go with someone has had to go through the process of therapy,” says Jayne Bloch, a psychoanalyst and member of the National Psychological Association for Psychoanalysis Institute in New York City. “You’re taking this journey to places unknown; it helps to go with someone who’s been there before.”

Some patients, like John Head, of Berkeley, Calif., luck out. “I chose a therapist the wrong way, based on who was closest to where I live. I didn’t ask any questions about methods, training, philosophy. But as it turns out, I got someone very good.”

Joseph, 55, had a different experience. He cycled through four therapists in his 25-year quest to find relief for debilitating depression. “I went to one old tweedy guy who said you have to commit to coming for two years. I never returned.”

“Then I went to a woman therapist who wasn’t bad, but she was very laconic and we never connected. Every time I brought up antidepressant medicine she would turn around and look it up in the Physicians’ Desk Reference. It was not very reassuring.”

He suffered unnecessarily for years as this therapist tried and failed to help him. Eventually, he says, “she threw up her hands and referred me to another, more aggressive therapist who I couldn’t stand but went to anyway until he eventually died.” Joseph finally landed in the office of a psychopharmacologist who put him on the correct medication. “Three weeks later I felt normal,” he says. Watch this hilarious video and see evidence that this subspecialty doesn’t take itself too seriously.

Keris Myrick has found success with a therapist who works as a collaborator when she feels well, but who is willing to take the reins when she is in the depths of despair. “Sometimes he says, ‘You’re not well enough to make this decision now, you have to trust me to make this decision, and when you are well we can discuss it.’ I like that,” she says.

While it may be impossible to avoid such experiences, agreeing on goals and a timeline in the very first session can help.

It’s also a good idea to ask what your therapist will expect of you. Myrick switched therapists when the homework her cognitive-behavioral therapist assigned made her feel childish. “For example, we were to read a newspaper, pick an article, and talk about it. This was to help with concentration, but I was feeling worse at the end of therapy sessions.”

Research suggests that shared goals and the feeling of being liked and deeply understood are better predictors of a good outcome. “Therapy will be unnecessarily difficult if you and your therapist don’t get along, don’t like each other, or are working at cross-purposes about the goals of treatment,” says William C. Sanderson, PhD, a professor of psychology at Hofstra University in Hempstead, N.Y.

Personal style matters too. Says Seeman: “You don’t want someone who really needs to unload and solve problems to be working with a therapist who sits there nodding.”

What makes a good therapist?
Some people may feel more comfortable with either a male or a female therapist, or one of certain race or age. John Norcross, PhD, professor of psychology at the University of Scranton in Pennsylvania, believes that in some patients, very specific preferences can make a difference.

“There is nascent, emerging evidence that if a patient has a strong preference of therapist, that should be honored,” Norcross says. “Some of that makes perfect sense. If a woman’s depression is due to sexual assault, she may feel more comfortable with a woman therapist.”

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Those Aren’t Fighting Words, Dear

LET’S say you have what you believe to be a healthy marriage. You’re still friends and lovers after spending more than half of your lives together. The dreams you set out to achieve in your 20s — gazing into each other’s eyes in candlelit city bistros when you were single and skinny — have for the most part come true.

How many of us only tell the truth to our partner when absolutely necessary? I talked to someone today who was in a fender bender 6 months ago. She was driving down the street when the woman in front of her slammed on her brakes. She hit her. They stopped and checked for damage. The woman who was hit had no damage. My friend had a small dent. They exchanged information and drove off. Last week (a full 6 months later) my friend was stopped by a policeman for speeding. When the policeman checked her record, he told her that her license had been suspended. Luckily, she had her small child in the car so the officer let her drive home with the understanding that she’d contact DMV in the morning. Imagine her surprise when she found out her license had been suspended due to an unreported accident resulting in an injury! But that wasn’t the worst part. She had explained the small dent in her car to her husband as someone probably hitting her in a parking lot while she was shopping. Oops. Now she had to tell him the truth, the whole truth. Why? Well, not only was her license suspended, but her husband’s license could be taken away as she was driving his car.

How common is it to tell a lie if we think we can get away with it? And why do we feel the need? Fear? Embarrassment? I remember taking our brand new car out for the first time and backing into a mailbox. I was 22 and newly married. When I got home I didn’t say a word. My husband noticed the dent the next morning when he got in the car to drive to work. He was furious. I’m not sure I ever copped to the truth. I was way too scared.

What else do women commonly lie about? The most common lie I hear is women who hide new clothes for a couple weeks. When they finally wear the new clothing and their husband asks, they simply reply: no, this isn’t new. I’ve had it awhile. (Well, it’s kinda true.) I have to admit, I’ve been there. So glad that’s all in my past. It’s way too stressful.

The way we work with couples and the way it usually works out is a few sessions of very honest communications. Each person puts their concerns on the table and we work through them. It usually starts with some skill building as very few people are good listeners. The other half of that communication skill is learning how to own what is going on inside you without blaming your partner. Most people don’t even know they are blaming the other and find it difficult to own their own feelings.

After practicing these skills it comes down to being honest about what you don’t like in the relationship and what you would need for it to go forward. It hurts to hear what is being said but if you can get through it and agree to any changes, compromises or requests, then your relationship has a greater chance of succeeding. Sometimes, the clear communication allows both parties to understand what is happening and change happens with an agreement that it really isn’t working. Then the mutual ending is a smooth and oftentimes peaceful one. The last scenario is one where one person doesn’t agree which leads to a lot of sadness in the breakup.

The best outcome, no matter which of these three descriptions happens, depends upon the honesty of both parties. You need to speak your truth but should always make it the “sweet truth”. Don’t go out of your way to make yourself feel good but strive for mutual respect. By doing this you guarantee the best possible outcome, which is always growth.

Well, what if you could be happier? What if it felt like life became smoother? What if you felt like you had a partner who always had your back, who had your best interests at heart? A wise man once said that a great relationship was one were each person took care of the other persons needs, so much so that the first person didn’t even need to think about what they wanted. That way they never needed to worry about what they needed because it was taken care of. This might be an ideal to strive for, or not but it does make one think. There really is no end or finish line for a good relationship. It can just keep building, developing, growing and deepening. 

With today’s incredibly fast-paced and over scheduled life you might believe working on your relationship is a good idea but not for you or not right now. I would like to suggest trying to put just a little more attention on your communication or affection, something that would demonstrate to your partner that they are important. It doesn’t take any effort and hardly any time but the rewards are tremendous. Why don’t you try it, you’ll like it.

The answer is….. making the other person feel heard. What that means is that you temporarily put aside the point or points you want to make and listen to what they have to say. Hopefully they will know how to talk about how they feel without blaming you. You can then repeat back or paraphrase what you thought you heard. Your partner will tell you whether you were right or not. If you were right ask your partner to say a little more. Keep the process going for a few minutes. You will be able to tell when your partner is done. There will be a visible sign like a deep sigh, maybe a smile or they might say they have nothing left to talk about. At this point you could talk about what was going on for you OR you could just let it go, appreciating the fact that you are both on good terms again.

After practicing this for a while it would be good to have a discussion about who goes first next time. In a good relationship both partners take turns bringing the relationship back from the brink. That means that when you see something start to escalate between you, one of you takes responsibilty for the relationship and calms it down. That means listening to our partner, backing down from your position or just telling your partner that you love them and don’t want to fight. It takes two people to fight and if one of you is not participating then there is no fight. Would you rather be right or would you rather be happy?

Oprah did a show recently on how to meet a man if you’re over 35. Fascinating. The number one thing mentioned was women, if you want to meet a man, never go out of the house without dressing up and looking hot. Short skirt would be nice, and a little make-up, even if you’re just running out to get a newspaper or a cup of coffee. The women balked, of course. Why should I get dressed up if I’m just going to run out and do an errand. That’s not realistic. But the guys replied that as a general rule, they are extremely visual. That doesn’t mean that they’ll expect you to dress up every time they see you. It means, if you want to meet a man, and you’re just running to the store for some bread, why not do double duty… the errand and the opportunity to meet Mr. Right? If you want to make every trip out of the house an opportunity to meet a man, take the extra time to put yourself together before you go out. Okay, I can buy that. Maybe not a mini skirt and make up, but not tattered sweats and bags under your eyes, either. My question is: what about the guys? Why don’t they take a minute to put themselves together before stepping out their front door. Why the double standard? We can appreciate the beauty of a well put together man every bit as much as they can appreciate us. True, many women feel they can fix their guy once they’ve caught him, but what about those of us that would rather he already have this skill? Why can’t we expect the same visual candy as the guys who want us to be dressed to kill? 

Next, men want women to give them some indication that we’re interested in them. This, according to the men, was done all through the eyes. Men say they can tell with a single glance if we’re interested and they’ll follow up on that glance IF THEY’RE INTERESTED. In other words, if you’ve caught a man’s eye, he will make the next move. If he doesn’t, he’s not interested. No need to make another advance. Men, like women, do not want to risk rejection. Show the man you would like to talk, and he’ll follow your lead.

Another interesting point, go where the men are (golf course driving range, hardware store) and ask for help. Men do not mind being interrupted. In fact, they like it, assuming of course that they are available. (Check for a ring.) Men like the chance to interact with a woman without that fear of rejection. Important: do not talk on the cell phone while you are out by yourself and wanting to meet a man. They will not risk interrupting your phone conversation to talk to you. Many women talk on the phone while out alone so they don’t appear to be desperate or obvious. Do not do this. Think about it. Would you interrupt a man talking on his cell phone to ask him to help you swing a golf club? Another hint, if trying to meet a man at the local Home Depot, do not hang around the paint section with all the other women. Go to the lumber section, or the section with with the rows and rows of screws. Much easier to find a man and ask a question…

Bottom line, women must be willing to put themselves out and not wait for Mr. Right to approach them. Men fear rejection just as much as we do. Start with the eyes…..show your interest. If you’re brave enough to take another step, ask for their assistance. They assure us they’ll do the rest.

This is especially true for men. We need to diminish or remove those feelings, so we get the ‘fight or flight’ syndrome down pat. We can fight either verbally, physically or emotionally. We can take flight either physically or emotionally by just shutting down. Intense feelings are something men just want to get rid of and they will do it any way they can. Boys don’t cry and men don’t express feelings. If we would take just a few minutes to let our partner know what is going on, our relationships would be taken to a new level. It does not mean we need to become girly men. It has been said that it is easier for a man to go to war than to deal with his feelings. When intense feelings come up we feel we are out of control and need to regain the upper hand immediately. We are not out of control. We are just lost in territory that is beginning to be explored. Dealing with some upset in the moment, as it is happpening, prevents it from becoming bigger. Taking control of your life means dealing with it, not avoiding it.

Exploring your inner life with your partner is one of the most rewarding and intimate acts you can bring to the relationship. Take a risk and if it doesn’t work the first time don’t stop. If you keep going the rewards will outstrip anything you can imagine.

Do you ever stop and think about what your predominant thought about your partner is? Do you wake up in the morning thinking “oh, I’m so lucky to be in this relationship?” Or do you focus on what you’re not getting? I wish we’d have sex more often? I wish he/she wouldn’t spend so much money. Why can’t we ever have dinner at home? go to a movie? take a walk together? I find it amazing that most people feel that their predominant thoughts about their partner are loving, yet when they actually stop and think about it, they realize how negative their thoughts are. One of the fastest ways to improve your relationship is to focus on what your partner is doing right. Even if they have a list of behaviors you’d like them to change, focus on the behaviors you appreciate. Mention the things you love about them. I promise you, if you can do that consistently, the list of behaviors you like will increase. An added bonus: you’ll actually get happier and start loving them more. Try it for a week and let me know what happens.