Ask an Expert: My Therapist is Good, But I Don't Like Him

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Ask an Expert: My Therapist is Good, But I Don't Like Him

By Dr. Richard Juman 08/30/16

Our expert answers whether dumping a therapist because you don't like him—even though he's good and the treatment is working—is a good idea.

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Ask an Expert: My Therapist is Good, But I Don't Like Him
"I have no warm feelings toward my therapist."

I've been seeing a therapist for a couple of months now. He has a good reputation, is clearly very smart, and uses a cognitive approach that makes sense to me. The problem is that I just don't feel very warmly towards him, and as a result, I don't look forward to our sessions. Should I look for another therapist? 

Dr. Richard Juman: Your question is an important one, and the situation that you are describing is not uncommon. When people ask me to recommend a good therapist, I usually give them the names of two or three clinicians and suggest that, if at all possible, they schedule an initial consultation with each one. The reason is that a good rapport between patient and clinician, the formation of a solid therapeutic alliance, and a climate of warm positive regard are all correlated with good results in treatment. And obviously, in order for therapy to be successful, the client needs to stick with an often challenging process, which is much more likely when the conditions noted above are present. Particular therapy techniques are usually found to be less important to outcomes than variables that are common to most therapeutic encounters—empathy, the feeling of being understood and other factors that characterize the clinical experience. 

Having said that, and taking into consideration the fact that your therapist is well-regarded in the community and works in a style that resonates with you, there are a few things to consider before you decide that it's time to look for another therapist. I don't know if this is your first therapy, but most clients bring a certain amount of anxiety to the clinical relationship that can interfere with the quick establishment of a positive connection. The therapeutic relationship shares many features with all other intimate relationships between people, but there are important differences too. Good therapy is often hard work, because difficult issues are on the table, and it can be difficult to distinguish between trepidation around dealing with those issues and one's feelings about the therapeutic relationship. 

Working in your favor is the fact that in therapy, it's entirely appropriate to bring up your concerns and ambivalence about the process of therapy in your sessions, including your concern that the therapist might not be the best fit for you. A good therapist will welcome your honesty around the fact that you don't look forward to the sessions and help you tease apart the possible reasons for that. If it turns out that a referral to a different therapist makes sense, then your current therapist will be in a good position to guide you in the right direction.

Richard Juman is the editor of Professional Voices, a weekly feature on The Fix designed to provide a forum for addiction professionals to discuss critical issues in addiction theory, treatment, policy and research. He is also a former president of the New York State Psychological Association and a longstanding member of its Addiction Division Executive Committee. Full bio.

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