How to Choose a Therapist

July 26, 2011


-The decision to see a therapist can be a hard one to make, as I discussed in my last column, “It’s All In Your Head” ( Once you’ve made that decision, the next challenge is finding the right therapist. How do you go about that?

Most people begin by soliciting referrals. You ask your friends, your doctor, you troll online, search directories such as Psychology Today or American Psychological Association, etc. Pretty
soon it becomes apparent that there is a wide range of varying choices. How do you select among them a therapist that’s right for you?

Here’s one way to think about it that might help simplify the process:

There are essentially three basic criteria to examine before you choose a therapist. Meeting the criteria won’t guarantee success, of course (if anyone EVER gives you a guarantee in this business, run, don’t walk, in the opposite direction!), but it does provide a solid basis from which to work. The three criteria to look for in a therapist are: competence, integrity, and “chemistry.””

Professional licensure is designed to assure a level of competence through qualifying exams and the requirement of continuing education, so make sure the person you’re considering for your therapist is licensed as a psychologist, social worker or psychiatrist. Checking out their schooling and number of years in practice might give you some more comfort on this dimension.

This is hard to ascertain in advance, but it is a vital component in allowing you to feel safe and secure in the therapeutic relationship.

You’re looking for a therapist who can help you. In other words, you’re trying to hire a therapist,
and all those names you’ve gathered are applicants for the job. But the “job” of a therapist is unique in some respects. While in most situations, job applicants can supply a potential employer with references, it’s not possible for the therapist you have under consideration to suggest that you contact a former patient to learn about her work. However, one thing you can do is call and ask for some time on the phone to talk with the therapist about what you’re looking for. If he or she won’t give you ten minutes on the phone to help you make this important decision, then move on. (They may not be free to talk the moment you call, of course, but the therapist with integrity will suggest another convenient time). That phone conversation is where “chemistry” comes in.

Talk to several therapists. See how the conversations go. Ask yourself: Do they ask good questions? Do you like their answers? How about their tone and attitude? Do you feel comfortable? Do you relate to their outlook on psychotherapy? Do you think they might be able to “get” you? Do you feel you can be honest with them? Do you think the two of you can work together? Your answers to these questions are all aspects of “chemistry.”

Psychotherapy is a cooperative project. You and your therapist are a team working on your behalf, engaged in a process that takes commitment and hard work, but can also be joyful and liberating. Once therapy has begun, it’s important to stop from time to time and evaluate—together—the progress you’re making. That way therapy can keep pace with your growth, and the team can continue to be effective.

Therapy is hard work, but when you’re working with the right partner, important, meaningful change can take place. Good luck!

Renee Garfinkel, Ph.D. is a clinical psychologist practicing short-term, solution-oriented psychotherapy in downtown D.C. She is affiliated with the Institute for Crisis, Disaster and Risk Management at The George Washington University. For more information, check out or

It’s All in Your Head

Roaring Red

A savvy commercial photographer once shared the secret of his success. “It’s simple,” he confided. “I always try include something red in every photograph.”
Red. It’s the color of sunsets, the color of passion and, in China, the color of good luck. Red is the badge of courage, the color of royalty, of power and of sex. Apparently red is more “primary” than the other two colors in its category, yellow and blue.
Here’s something new about red: According to the results of a study published in the latest issue of the Journal of Experimental Psychology, women find men in red to be more attractive, more powerful and more sexually desirable.
In the study, women were asked to rate the status and sexual desirability of men pictured wearing different colored clothing. They rated the men wearing red as being higher status and more likely to earn a better living, as well as more appealing.
Even when the comparison was made between pictures of men merely surrounded by a red matte with those of men surrounded by a white matte, the women rated the men surrounded by red to be more pleasant and more attractive. The difference was small —just one point on a nine-point scale — but it was statistically significant. Remarkably, the appeal of red held true for women in the U.S. and England, as well as in Germany and China.
The authors speculate about why women might prefer red. It seems other female primates do, too. The authors say that the red preference goes even further down the evolutionary scale, with some red-roaring crustaceans, fish and birds!
Are women just hardwired to be attracted to red by the blind call of biology? Or is it culture that draws their attention, having taught us to associate red with power and status and fame? Who hasn’t watched the glamorous stars walk the red carpet to get to the coveted prize, the Oscar?
Men write songs about women in every color. Their Devil can have a Blue Dress On. But if these researchers are to be believed, women have eyes for red.
So, men, if you’re planning to buy something new for the new season, keep science in mind when considering your wardrobe choices. That shade of brown may bring out your eyes, and black may make you look slimmer, but a little touch of red is where you want to be; it will get her attention and make you look your best.
Although we can’t be sure of the reasons, we now know this to be true: women go for the guy in the red tie.

Love Potion #9: The Dark Side of Love

Oxytocin is the original love potion.

Oxy (it’s the “love hormone,” so I’ll give it a friendly nickname) has its way with us by working down deep, below consciousness, beneath intuition. When oxy speaks to us, we “just know” it’s true. Released in the brain, this love hormone generates trust and empathy and promotes bonding throughout our lives. It encourages intimacy. It increases altruism. Oxy makes us act generously to strangers, and romantically toward lovers.
Oxytocin is released during childbirth. It was first identified by its association with lactation, and the deep, adoring bond of mutuality between a mother and her breastfeeding infant. The discovery of the love hormone made the magic of mother-infant bonding just a little less mysterious, but no less marvelous. Not just for moms and little babies, oxy also plays a role in sex, friendship and social ties of many kinds. Oxytocin is the organic love potion we make ourselves.
The more we learn about the love hormone, the better it looks. It promotes monogamy. It makes us feel secure. It brings us contentment in our relationships. As they once used to say in L.A., it’s all good.
Or is it? Centuries of poetry warned us of something that biological research recently confirmed: love has a dark side, too.
When subjects inhaled oxytocin before playing a competitive game they became more envious when their opponent won, and more gloating when they were ahead. Although it may not seem like a match made in heaven, love and jealousy are the conjoint oxytocin twins.
The hormone plays a role in international affairs as well, a recent Dutch study suggests. Even as it influences people toward self-sacrifice on behalf of their own group, it also encourages them to be aggressive against a threatening outgroup. Oxytocin is why conflicts between groups escalate when the other group is perceived as threatening. Happily, when physical barriers or other means of separation makes them feel less threatened, conflict escalation is less likely.
Here in D.C., where politics rule, we ignore biology at our peril. Biology is not essentially political, and it does not take sides. But it does help point a way. What are our bodies telling us, and what does science say, when it comes to playing it right in love, in friendship, even in international relations?
Since I have no wish to be a guru, I will warn you that the answer is deceptively simple: it’s more of a direction than a destination.
The answer is balance. Philosophers and poets would agree, yes, being close is good — oh yes, very good — but closer is not always better. We each need to keep our balance with the light and dark sides of love. We need to season oxytocin’s closeness with the right amount of distance. The very same hormone that inspired Shakespeare’s sonnets of love is the one that reminds us to heed Robert Frost’s wise advice, as well: Good fences make good neighbors.

Renee Garfinkel, Ph.D. is a clinical psychologist practicing short-term, solution-oriented psychotherapy in downtown D.C. She is affiliated with the Institute for Crisis, Disaster and Risk Management at The George Washington University. For more information, check out or

How Can You Tell if it’s Time to See a Therapist?

September 22, 2010


-Life is messy and often confusing. Sometimes you’re up, and then you’re down. You have a plan, and life throws you a curve. Life can feel like it’s just too much, and it can make you question, “Is this all there is?” No one is happy all the time. No one’s life is perfect.

So how can you decide that your particular situation is one that might be helped by psychotherapy?

You might be lucky enough to have a close friend or family member who has had a positive experience with therapy and is comfortable enough with it – and with you – to make the suggestion. Other people can often see your distress more clearly than you can yourself, so consider their recommendation seriously.

But even if no one has said anything to you here are some signs that it’s time to see a therapist:
• When the same kinds of problems recur in your life. You may have conflicts at work or repeated “misunderstandings” with your friends. You may have disappointing romantic relationships or frequently feel that you don’t fit in. Or you might notice that people become annoyed with you, and you don’t really understand why. The key here is that when a problematic situation becomes familiar and you recognize that you’ve been in the same spot before, that’s when it’s time to see a therapist.
• You’re having trouble sleeping.
• You notice a change in your usual sleeping, eating or drinking habits.
• You’re having trouble concentrating or motivating
yourself to do things.
• You’re irritable or anxious and searching for something to blame it on.
• You feel physically unwell, but your doctor says you’re okay.
• The things you used to enjoy are not much fun anymore, and nothing else positive has taken their place.
• You’re trying to figure something out or to move forward with a work or family issue, and you’re stuck.

The list is by no means exhaustive; rather, it is meant to be suggestive. Besides paying attention
to the way you are feeling and thinking, it is important to recognize that certain life situations,
while normal and even desirable, can be so stressful that they put you at risk.

It’s easy to understand that a death in the family or the breakup of a relationship makes you emotionally vulnerable, but it is also the case that life transitions, such as leaving school and starting work or moving to a new city, are challenges that shake up your life and make new demands at the same time as they remove you from your old friends and other supports. These transitions can often be navigated more smoothly with the help of a therapist.