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Ask a Therapist: Dr. Emily Anhalt    

Ask a Therapist: Dr. Emily Anhalt

On November 12th, The Local Optimist Hotline welcomed clinical psychologist and co-founder of therapy start-up Coa, Dr. Emily Anhalt. We put together this special edition of the Hotline Roundup to share some of Dr. Emily’s most helpful responses for those of you who weren’t able to participate. Check out her answers below, and thank you to everyone who submitted questions.

If you have any other questions, connect with us by texting The Local Optimist Hotline at 310.299.9414.

I need advice for finding and picking a therapist. How do you recommend finding the right therapist?

So, there are a couple of things here. If you’re in the position to pay the going rate for full fee therapy ($120-300 per session typically), the best thing to do is go through referrals. 

So, if you know anyone in your life who likes their therapist, ask them to ask their therapist for recommendations (since you don’t necessarily want to see your friend's therapist, but they should be plugged into the network). 

Coa, my company, also solves this problem if you live in CA or NY! We essentially have a therapy matchmaking service. You’ll have a free call with a matchmaker (who is a therapist) who will connect you to a highly vetted therapist in our community. From there, you’ll have a free 20 min call with the therapist to see if it feels like a good fit!

If you are looking for more affordable options or trying to go through your insurance, one tough reality is that many therapists don't accept insurance. And those who do tend to be less experienced or are fully booked with clients already. Still, an option would be to call as many as possible under your network and see if any are open and a good fit.

I also recommend sliding-scale clinics. Simply google “sliding scale clinics + your city” to find some in your area. There are therapists there who accept payments based on your income. Many of those therapists are still training while being supervised by experienced clinicians. 

With all that said, truly, the first step is to commend yourself for being willing to reach out for support. It's hard to do, and none of us should have to manage everything we feel on our own. 

How do I know if a therapist is a good fit for me? Can I ask them about themselves?

First of all, you are allowed to ask anything you want! There is nothing you can’t say, feel, or ask that isn’t allowed. The therapist will decide if there are things they don't want to answer. 

For assessing if they’re the right fit, I believe it’s less about what the therapist says and more about how you feel with them. You should have some sense of comfort being in a Zoom room or real room with them. You certainly can ask about specialties or experience working with your specific struggles and population. But, it's more about you reflecting on how it feels to be with this person. 

I will say it’s hard to tell after just one session. If possible, give them a handful. My truest test is - can I tell them when something doesn’t feel right? How do they respond if I tell my therapist, “I don't like how you answered that '' or, '' I want you to ask me more questions.” If they are defensive or overly apologetic - it’s not a good sign. They should use your frustration as an opportunity to learn about you, and about how the two of you will work together. If you have a frustration with a therapist, you will most likely have a similar frustration in other parts of your life, so that should be a good opportunity to learn more about yourself. 

How do I know if therapy is working?

What a great question because it can look like a lot of different things! 

There is a quote I love that goes like this, “therapy is a little like music lessons... for many years it feels like nothing is happening and then suddenly you’re a musician.” It's not linear. In fact, some people feel worse before better because you're unearthing things you’ve previously turned away from. 

For me and my experience within therapy, I noticed that things in my life just started to feel more satisfying. I grew my self-awareness, formed healthier relationships (and previous relationships grew stronger), gained stronger boundaries, better communication, was more able to be vulnerable but strong. Maybe your inner critic grows quieter, and you talk to yourself in a kinder way. There are endless things. Overall, you should feel more equipped over time, and should feel better about yourself and your relationships.

One misconception is that therapy is about being “happier.” But therapy doesn't make you happier. It increases the authenticity of your happiness and creates a space to feel all of the other important human emotions. It’s a space to feel sad, angry, disappointed, grief. It’s less about one emotion and more about the ability to feel in a deeper way and to learn to make choices from an authentic place. 

At some points in life, I feel like I need a therapist, and at other times I don't. Do therapists ever meet with someone and think that it is unnecessary? 

So, there are different kinds of therapy. Some therapy is geared towards helping you manage symptoms, mainly that tends to be in the CBT group of therapy. Seeing that kind of therapist without “symptoms” you are hoping to fix may result in them telling you they don't want to take your money for what you don't need. 

But the type of therapy I practice, psychodynamic therapy, is not about quieting symptoms or fixing “broken people,'' but about helping each person know themself better, improve relationships, live more authentically, level up in general, and heal from the inside out.

This can be done without crisis or problems and, in fact, is easier to do when life is going mostly fine. When we’re not in crisis, we have the space and resources to dig deeper, learn our patterns, build resiliency and give ourselves strategies to prevent many struggles that would have sent you to therapy to “fix” later. 

Find a therapist who is excited to work with you wherever you might be and know that you're investing in a healthier self, just like going to the gym is helping invest in a better body! 

I'd like to start therapy but feel embarrassed because no one in my family does it. How do I start that conversation?

You are not alone there. There is a lot of stigma about therapy, and it runs deep. I wish there were one thing we could say to change someone's mind, but there are all sorts of cultural and complicated reasons for folks’ resistance to it. It takes a lot of courage to be first in a community, whether that’s your family, friend group, neighborhood, etc. 

Firstly, you get to decide if you share that fact. You don't have to tell anyone (and your therapist can’t legally tell anyone either). But, if you can summon the courage to talk about it, it can often be the first domino to start to change folk’s minds and give others permission to think about therapy for themselves. I’ve matched over 600 people into therapy at this point, and it’s usually from talking about myself as a patient, not a therapist. I share what being in therapy has done for me, and why I think it’s worth it. This gives them permission to think about trying it out for themselves.

Another option is to go to therapy for a while until you start to see the difference it's making in your life. Then you can tell your family what you are getting out of it. Something like, “It was hard for me to tell you this, but I know you want what is best for me, and this has been a wonderful type of support I've given myself.” 

Then, your community may start to consider it as well. All that said, I promise you're not the only person you know in therapy. As you talk about it over time, you'll find other people to say ‘me too, me too!’ The more we talk about something, it gives others permission to explore it. 

If you you’re hoping for financial support from your family… I would say something along the lines of, “One thing that I’ve come to understand is that therapy isn’t for people who are broken, it's for anyone who wants to benefit themself and put in work to make their own life better. I’m ready and excited to do this and I would love your support to make that happen.”

How do you break up with a therapist?

If a therapist feels wrong for you, you can just tell them. I believe that the end of a therapy journey is one of the most important parts. If you've been working together for a while, the ending represents every loss, change, and death you’ve experienced in life. I recommend you have a conversation with your therapist to tell them that you are thinking of ending. Have that discussion together and if you decide that's the best choice, give yourself time to process, reflect, and think about how to move on without this person in your life. You’ll get a lot from that phase. It’s always the patient’s choice, but you will do yourself a big favor by [having it be] a collaborative process.