I need a therapist, what should I look for in one in my case?

Hi,

Depression is the bread-and-butter of most therapists. However, one of the problems is that today, most therapists are focused on brief therapy that generally puts a band-aid on the real issue by covering it up with specific tools designed to mask the symptoms instead of getting at the underlying issues.

For LGBT people, shame, lack of belonging, and the self-worth issues that come with that are pretty core to depression. There can certainly be other contributing factors as well; family-of-origin issues such as lack of support and unconditional love play a big role.

Here's the rub: There are a lot of really crappy therapists out there, and it can be a challenge to find the ones that are really sharp and capable. Telling the difference, for someone without a lot of experience, isn't easy. Looking for someone whose style is eclectic, who practices existential, insight-based, or psychodynamic work but also has background in CBT... that would be a great starting point. If it were me, I'd specifically try and find a therapist deeply familiar with Brené Brown's work on shame and vulnerability because, for me and for pretty much all the therapists I know and work with, we've found it to be so core to the LGBT issues that it's hard to do really good work for people without a theoretical basis, and a lot of self-work by the therapist, in that work... which a lot of therapists don't have.

Will you be private pay, or will you need someone specific that is covered by your insurance? If you have some options that you've found (that have websites), you could PM me the links and I could at least tell you what I can see from what they say.

Also, you should be able to call and have a 15 minute phone consult with anyone you're considering. Talk to them... ask them about their approach... discuss their experience, background, experience with LGBT issues... get a real feel for how they sound and how you feel talking to them.

Don't be afraid to try three or four therapists to find the right one. Sometimes you luck out and the very first one is amazing, but often, it might take a couple of tries.

 

Not to be harsh here but your sexuality is, if not the root of the depression, worthlessness, and suicidal feelings, absolutely playing a major role.

The very fact you haven't told anyone indicates that there's deep shame there. If you didn't have shame, you wouldn't be uncomfortable telling people directly.

You need to be completely honest with your therapist. It will be a complete waste of your time to go to therapy if you aren't willing to do so, because the therapist's advice, recommendation, course of treatment, and every aspect of what s/he can do for you is reliant on understanding you and what you're going thorough, and failing to mention your sexual orientation is going to completely undermine that.

I know this is probably not what you want to hear. But it's the voice of experience. You don't have to blurt that out in the first session, but you should be prepared to tell him/her pretty quickly. Otherwise, as I said, you're not going to get the help you need, and you'll be wondering somewhere down the road why you're not feeling better.