Dr. Sarah (00:02):

Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

(00:41):

Hello, we have another episode of Beyond the Sessions segment on the Securely Attached podcast. I’ve got Dr. Emily Upshur and Dr. Rebecca Hershberg here. Welcome back.

Dr. Rebecca (00:55):

Hi.

Dr. Emily (00:55):

Hi.

Dr. Sarah (00:58):

So this, I’m excited about this question. It’s a little bit de

Dr. Rebecca (01:01):

ep. Ready? Ready.

Dr. Sarah (01:05):

Okay. So this woman wrote in, I found your contact information via your podcast and website, which I found because of your interview with Dr. Jacob Ham. I’m a devoted fan of you, your website, your podcast, everything. I’m wondering if you could explain in more depth in an episode how to discern if a therapist is safe. I think I probably have unresolved complex trauma. I find it impossible to judge these things. Even when I try to let time pass to think more clearly, I still find that I get so activated by other people in particular when I’m alone with the other person in a room when it’s a therapy situation. It has become immensely activating at this point because I’ve tried it over and over again. For some reason, I keep being very trusting and I open up immediately like a child trying to be good. And then because I don’t have many social supports or friendships or relatives, I become very sensitive and focused on the therapeutic relationship. Take care. And a million Thanks for your work.

Dr. Rebecca (01:59):

What a nice question. It’s so touching when people feel comfortable enough to be so vulnerable, this listener is saying, I heard this interview with a master therapist and I want one of those. What do I do?

Dr. Sarah (02:14):

I know. Well, to be fair, listening to Dr. Jacob Ham, do anything is going to make you want to find, well, that’s why I said a master therapist like him.

Dr. Rebecca (02:23):

Exactly. That’s the way to know if your own therapist is falling short. High bar though.

Dr. Sarah (02:31):

But also, one thing I also really love about this question is that it’s not explicitly about parenting or child development, but it still feels so relevant to the things that we speak about. Because first of all, anybody who is a parent could relate to this experience. But also there’s so much about parenting and reparenting an inner child that I feel like it gets, it parallels onto parenting in so many ways. And when we’re talking about trauma, we’re talking about relational trauma or complex trauma. We’re talking about seeking out a safe relationship with another person like a therapist. All of these themes just feel so connected to the core of what we talk about on the show.

Dr. Rebecca (03:21):

And that this person has clearly, I forget exactly how they phrased it, but have tried so many times. They’ve tried so many times to go to therapy. And I mean, there’s just so many examples of people who say, well, it must not, excuse me, it just must not be for me. I’m not good at it. Or there’s no therapist out there, or the whole thing is, yet this person’s able to say, I want to keep trying. And that’s so courageous, especially if you’ve been through trauma or complex trauma.

Dr. Emily (03:53):

Well, and I think it shows that was exactly my first instinct too, Rebecca, and it also shows a little bit of insight. What am I doing? How can I show up in a way that’s going to be more productive for me or more helpful? Is there anything I can do too? They talk a little bit about trying again and again, and some of the patterns they get into. And I think that’s also really helpful is like, okay, so it’s a two person thing. I have to make sure that therapist is the right fit for me. But I also might have to show up in some ways that are different or brave in ways that I haven’t done before.

Dr. Sarah (04:31):

And actually I think to break down what this person’s asking and try to answer it, which is one, how do I discern if a therapist is safe? And that’s a lot of ways that we can answer that question, but we are going to dive into that for sure. But I’m also, Emily, to your point, there’s a question of what am I bringing to this that I can become aware of that I can start to shift or maybe ask for help with in what do I say to the therapist, not just how do I tell if someone’s safe or not, but how do I kind of decide if I want to work with somebody? So one thing that this person is really landing on very clearly in this question is that they’re noticing patterns in the way that they’re showing up with these one-on-one interactions.

(05:26):

They become very trusting and open up immediately. They’re trying to be this good child or good student, but then it’s overwhelming for them. And the first thought I have is, and we can get into the sort of logistics of how do you find a therapist and how do you vet them and all that stuff, which we should talk about. Well, let’s say we’ll rewind and let’s say you’ve done all that and now you’re sitting in the room with somebody if you have insights about things that become patterns in past therapeutic relationships or just patterns, past relationships, and you’re worried that you’re going to kind of fall back into them because it kind of is an autopilot threat response. If you can share that with your potential therapist upfront and say like, Hey, I’ve noticed that I do this thing. And for example could be anything, but in this case it’s this sort of a fawn response.

(06:18):

I’d call it. I’m going to kind of be the good therapy patient. I’m going to want to please you. I’m going to say everything I think you might want me to say and I’m just going to dump it all. But I’m actually moving too fast for my own pace to say that piece, that meta communication of there’s this thing I’ve noticed, I do, I get in a situation where I’m supposed to disclose things about myself appropriately because that’s this relationship, but I go too fast for myself. And I just, I’ve noticed that. And so one ask I have for you is if you notice me doing that, could you help me slow down and pause? Could you help me be an external regulator or a brake system for me so that I don’t go too fast for my own pace? Because I think sometimes people think that I totally understandably I get how this happens, but I think people think that as therapists, we can sort of read the minds of our clients a little bit, or we just know what to do in all these situations, or we can see what’s happening as it’s happening.

(07:23):

And a lot of times, at least for me, and I’m curious for you guys, a lot of times it’s usually after a session where I’m reflecting back and I’m like, what happened there? Then I can look at identify something that might’ve been a threat, actually a threat response or some sort of dysregulated behavior in a session. But in the moment sometimes I’m not able to say, Hey, let’s slow down. I think this is happening. Certainly not in the beginning of treatment when I don’t know that pattern yet. And so giving your new therapist kind of like a cheat code on how you can show up and things you’ve learned about yourself and be like, Hey, I need you to do this when I do this can be really helpful. And that’s very hard to take up space like that in a new relationship and ask them to do that for you, but you have permission to do that. I think that could be a helpful way to approach something like this.

Dr. Rebecca (08:17):

Yeah. The other thing, so I mean, I just want to say as a therapist, it’s such a gift when clients come in and they say, even forgetting what their patterns are, it doesn’t even have to be at that point. But when they say, I’ve never really had a successful therapy experience. Even if you don’t know why this person’s question acknowledges one pattern, maybe that’s all that’s going on. Maybe there’s 10 other patterns that are going on. Or maybe a client will say, I usually do this. Please help me do this. But actually as a therapist, you’ll say, well, I actually don’t know that that’s going to be the most helpful thing for you. Here’s what I think. I think this collaboration that can start when you come into therapy, if you say, I don’t want to give up on therapy, but I’m going to be honest with you, you’re the sixth person I’ve seen in three years. It’s so enlight. It’s like, let’s talk about that without throwing other therapists under the bus. I mean, I hope, and unfortunately it’s not always the case that this listener and other people haven’t had a traumatic experience with a therapist. Even if it just sort of hasn’t been the right fit or didn’t feel that useful or let’s dive in, that’s a great place to start.

(09:30):

So yeah, no, it’s really rich information and really helpful to share that even if you don’t know exactly why it went south, there’s usually information in that.

Dr. Sarah (09:45):

I think that’s really good advice. I wonder too, with you guys, what do you think, because obviously how to discern if a therapist is safe is such a subjective experience for somebody, right? Because a therapist, hopefully intention is always to feel safe with someone, but especially if you have a history of complex trauma, the things that could all of a sudden trigger a sense of lack of safety could be really subtle or unobvious to a therapist or could be so unique to your own trauma experience that a therapist might not know how to prevent activating that. But then I’m wondering, yeah, are there some hallmark things that you want to look out for?

Dr. Emily (10:41):

I think in terms of seeking safety, seeking a good match, there’s a lot of different ways you can go with this. I think just from a very high level, you got to do a little research. I think it is important that you’re going to a licensed practitioner that at least, at the very least they have, say they’ve done sort of training or some professional development in the area that you’re looking for. In this case, trauma, potentially even complex trauma, which is a smaller cohort of specialists. And really doing a little bit of that vetting should help you with your first step, right? That’s step one. And it’s very high level and intellectualized. And then of course, the other bucket we talk about a lot in here is really fit. And I think we were talking about here, I’m a really big advocate of clients interviewing us to, as clinicians, seeing if we are a right fit for them as well. So ask questions about their trauma training, ask questions about their style. I think it’s really okay, and there seems to be a very natural power dynamic. It sounds like this patient also, this client also gets, there’s a little bit of performance and trying to be good and compliant. That sort of falls into that. And I think trying really hard to remember that you’re interviewing this person too and you’re trying to figure out if this is a good match.

Dr. Rebecca (12:24):

And I think, I’m sorry, I didn’t mean to interrupt you, Emily. Oh

Dr. Emily (12:26):

No, go ahead.

Dr. Rebecca (12:28):

I was just going to say, and I clearly was eager to say it, that one red flag is actually if a therapist is not open to your interviewing, if a therapist gets defensive that you are potentially looking at other therapists or looking around to my mind. And occasionally there’s someone who has a really good basis for that in some sort of theoretical background. But most of the time I find certainly as a therapist I can say, I’m never trying to sell myself to you. The work isn’t going to be effective if we don’t click as a good match. And you want to be wary of a therapist who seems to kind of change their answers based on your questions and is almost like, and I’ve used car sales mini, just really wanting your business. That’s not what therapy is about. You have to feel safe in order for the work to be effective. And that doesn’t happen when someone’s just trying to sell themselves to you. And so if you go in and you say, I’m meeting with a few different therapists because I want to find the person that I think is the best fit, and someone really has a negative reaction to that, that’s information

(13:45):

And important information because a therapist, whether they end up being your therapist or not, should want nothing more than you to find what you are looking for.

Dr. Emily (13:55):

And I think to add on to that, Rebecca, specifically in the realm of trauma, trauma-informed therapy, there is a lot of variation from talk therapy to much more somatic sort of body oriented. And I really think what’s so important is that the clinician, the therapist meets you where you are. If there’s a dogmatic, this is how I do this, this is the treatment approach I do, and that feels like a lot for you as the client. And I really think it’s so, so important that the clinician is able to slice it thinner, meet you where you are, and be able to not push their agenda. There are a lot of specializations within trauma, and they’re not right for all people. And so I think that’s a really important kind of red flaggy thing to Rebecca, to your point of.

Dr. Sarah (14:52):

Yeah, that brings up an interesting point, Emily, that yes, you want to vet these people, but also I understand it can be really overwhelming to decipher what all these words and letters mean. And so one thing to be a really educated consumer of therapy and different services would be to familiarize yourself with just broad strokes, some of the different common therapeutic approaches that are sort of frequently used in the blank of the thing you’re trying to treat. In this case, trauma just getting, and honestly, a quick Google search be like, what are the most common treatments that are used for unresolved complex trauma? Right? Put that in Google, see what comes up. You’ll see a number of names of treatments start to come up really at the top right? E-M-D-R-I-F-S, somatic experiencing psychodynamics psychotherapy.

Dr. Rebecca (15:57):

I would just alter what you said, just I want you to continue, but evidence-based not what are the most common, what are the evidence-based? I think that’s an important,

Dr. Sarah (16:07):

Yes, good call. That would be the better keyword.

Dr. Rebecca (16:10):

Right? That was worth my interrupting you as opposed to when interrupted Emily before, I’m having a hard time today, but I would just change the search to that. I think most common is unfortunately not necessarily what you’re looking for, sadly.

Dr. Sarah (16:24):

Yes, good call. So edit, Maya would suggest diving into Google, what are the evidence-based clinical interventions for fill in the blank point of treatment. And then from there, you just want to get a, and again, it’s not your job to become an expert in these treatments, you just want to know big picture. So understanding what do these different types of therapies feel like in real time so you can be able to, and these are also questions you can ask therapists to say, what does it feel like in a session with you? What are the kinds of interventions that you might do in the beginning? Are we going to be doing a lot of talking? Are we going to be doing other types of interventions? You’re allowed to ask these very technical questions. And to your point, Rebecca, if a clinician can’t answer these or doesn’t want to answer them, that would be a…

Dr. Rebecca (17:21):

A red flag.

Dr. Sarah (17:22):

A red flag, and a green flag would be someone is not just welcome your questions, but really wanting to make sure you understand and being curious about how does it feel, what I’m almost checking in with you, how does that sound to you? Does that feel like something really checking in and having this be like a two-way dialogue, that’s always a green flag. I think they’re just as interested in making sure this is a good fit for you as you are.

Dr. Emily (17:51):

I think it’s great to be a little bit informed. I also want to sort of highlight the latter part of what you said, which is a well-informed trauma therapist knows a little bit about a lot of treatments, even if they don’t specialize in all of them. So you to lift the burden off you as the client, you’re going to an expert, they should be able to tell you a little bit about the different expertises. That should be a little bit of what happens. And I think that’s really important. And I did want to add on one really important thing, which are the cultural sensitivities that a therapist has, particularly in these different types of treatment that require different types of interpersonal interactions. I think that you as the client have to think, does this work for me? How does this fit in? Are you a clinician that’s sensitive to those types of cultural differences potentially between us or that type of thing, which I think is not always highlighted on a website or whatever it is that you’re researching from the outside.

Dr. Rebecca (18:54):

Yeah. Oftentimes when practitioners specialize in something like trauma, they’re trained in more than one modality. And so they can talk to you about them and then you can potentially collaborate on where you want to start. And I think that idea, the idea of collaboration is really key at this stage of therapy. When per the listener, you are looking to find a therapist, you are looking for someone who can collaborate with you to make sure it works, not works, not works, make sure I’m fixed, but make sure that the process feels okay and that the process is working and the pace. And I certainly when I meet with clients, and I’d be happy if a client suggested this, let’s check in with each other, let’s meet for three times and then let’s talk about how does it feel, how is the pace, how is the style? And again, I’m not going to say because then I’m going to completely change my style for you, my style might be my style, but that doesn’t mean that there can’t be collaborative adjustments moving forward. It really is. It’s a relationship. And I think sometimes that doesn’t get described as well as it could or portrayed in the media. It’s not one person sitting there, as you said, and reading the mind of the other.

Dr. Sarah (20:21):

So just to tie this also back to the idea of parenting, we talk about that a lot on this podcast is this idea of discerning if someone feels safe or not has a lot to do with attunement. I think if to really get to the essence of this question is can I feel truly seen by you? Is it safe to be fully present and authentic in this space? Are you going to be attuned to my needs? Are you going to meet them or at least be aware of them? And I think that that’s a really similar dynamic that happens in the parent child relationship. Not that therapist patient or therapist client is the same thing as a parent child relationship, but if you have unresolved complex trauma, there is a bit of, you can’t disentangle attachment blueprints from coming into the therapy. And so I think for a lot of people, they need to know that their therapist can attune to them. And that is also something, it’s kind of a felt sense. It’s not something that I could sort of say, this is how you Google for a therapist being able to attune to you. Some of it is just like a feel that you get when you’re with someone. And so, like this person also says it’s really hard for them to judge these things. And I think that’s because of complex trauma. Your blueprints for how to anticipate how people are going to receive you and respond to you and see you and meet your needs is kind of distorted because of the trauma. And so a therapist who’s able to understand that and help you create a new blueprint, I think that’s part of the work too.

Dr. Rebecca (22:18):

And that all makes perfect sense, Sarah. And a lot of times our felt senses don’t necessarily, and I think you sort of just said that they can be confusing and they don’t necessarily lead us to something they feel really uncomfortable because it’s boundaried. And we grew up in a family, let’s say, that had no boundaries. And so love or safety feels like it should have. No. So I don’t know the answer because I think felt sense is tremendously important, and it’s something I base a lot of my decisions on. But I also know that our compasses can be broken in different ways at different times. And so we have to balance those things, which is why it can be really tricky.

Dr. Sarah (23:06):

Absolutely. And that’s why I’m saying I don’t, especially if someone who has this sort of, their blueprint isn’t working right, their compass is a little bit broken, it’s not pointy north, and they can’t always trust their felt sense that it’s important I think for the therapist to be able to have good attunement skills because sometimes they’re going to have to be attuning for the both of you. And so again, that’s something that will show up in working with someone. But if you’re feeling like every time you walk into the room, the therapist is meeting you for the first time and isn’t holding you in there is this sort of disconnect between them understanding and getting you and being curious about you or just being able to read your energy levels or your speed. If someone is clueless to the fact that you’re going way too fast and isn’t able to say, wait, let’s slow down for a second. Someone who can co-regulate, I guess.

Dr. Emily (24:12):

Yeah, I mean, I’m going to wrap. I’m sort of contain this I think with a little bit of a tip, which is I think what we’re talking about is a really hard thing for someone like this person who’s asking this question to discern. And I think maybe a happy medium is continuing to show up and tolerating it for a few sessions to see if that feeling mitigates a little bit. Or if you’re a therapist, to your point, Rebecca and Sarah, if there’s a little bit of, you could start to feel it a little because the anxiety and the sort of emergency status that you are in as a new client sort of begins to start to attenuate a little bit. So I think a thing, I love what you said, Rebecca. I say this to clients all the time, which is, let’s put a number, let’s do three to five sessions and then let’s check in again. I think that does give somebody, it’s not too long that they’ve devoted a lot of time and effort to a treatment that’s not really, isn’t a good match, but it also allows you to stick in it long enough to see if those initial scaries, those initial feelings, if they’re sticking around or if those are just sort of your trauma response. And I think that sort of just gives you a little bit of a roadmap, just it’s not a hard and fast rule, but I would put that out there.

Dr. Sarah (25:39):

That’s really good advice. I do think sometimes it’s like not just a quick consult call is enough. Sometimes it’s okay to have a couple sessions with someone and still decide, Nope, not for me, but I’m going to keep looking. Or can I tolerate this and can it work? But sometimes it takes a little bit more than just a 20 minute phone call. It could be a couple sessions.

Dr. Rebecca (26:02):

Yeah.

Dr. Sarah (26:04):

Awesome. Well, I hope that this was helpful and I really appreciate this person writing this in, and we will see you all next week with another question.

Dr. Emily (26:14):

Bye.

Dr. Rebecca (26:15):

Sounds good. Bye-bye.

Dr. Sarah (26:18):

Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.