Is Liking Your Therapist Enough?
When my son Dan's self-diagnosis of obsessive-compulsive disorder was confirmed by his longtime pediatrician, the doctor suggested he see a therapist. So off he went to the most popular clinical psychologist in town, the one all the teens liked. Dan liked him too. He drove to his appointments alone, and while I spoke with the therapist on the phone a few times, we never met. Dan was sharing very little about his OCD with us at the time, but he did tell me and my husband that he was very pleased with his psychologist and thought he really understood him; he felt better after every session. What more could we ask for?
Eight months later our son was so debilitated by severe OCD he could not even eat. As I became more educated about the disorder and its proper treatment, I realized that not only had Dan's therapist not known how to treat OCD, the "talk therapy" he used had exacerbated Dan's illness.
His next therapist worked at the world-renowned OCD residential treatment program Dan attended. Our son spent nine weeks there and bonded big time with this psychologist, who definitely knew how to treat OCD. His stay at this program became complicated, one of the issues being Dan's unhealthy dependency on his therapist. Our son became unable to think for himself, deferring instead to his psychologist's recommendations as to how he should live his life, even when they conflicted with Dan's lifelong dreams. When I tried to discuss the situation with Dan, he said, "It's hard not to be attached to someone who has saved your life."
I know bonding emotionally with health-care providers is not unusual, but I wonder if it might be more of an issue for those with OCD. We know OCD sufferers often deal with social scrupulosity, a type of hyper-responsibility. Those with social scrupulosity obsess over hurting others' feelings, and often believe that giving their opinion, or being assertive in any way, will cause harm. Could this translate into excessive loyalty? How could you question your therapist, or even worse, leave him or her, if you think this way? How could you even think that this person, whom you probably really like and admire, might not be the best one to help you?
These are just two of many situations when I think it's best to move on. While in the first example we were oblivious to his therapist's shortcomings in treating OCD, I have no doubt if we'd suggested looking for another health care provider, Dan would have insisted on staying with his hometown one. In fact, when he first left for college fifteen hundred miles away, he opted for phone calls with this therapist instead of searching for a new one (another mistake). In contemplating the second scenario, I would think that the staff would have recognized, or at least considered, that Dan was dealing with social scrupulosity, yet that was not the case. We had to forcibly remove our son from this residential treatment program.
It can be an ordeal for those with OCD to find the right therapist, and Dan's experiences illustrate just a few of the many issues that might arise. That is one of the reasons families need to become educated about OCD and its proper treatment: their support in finding a therapist is often critical. Children and teens, as well as adults whose OCD is severe, will likely require a loved one to make that initial call. If you're lucky, you will have some qualified health care professionals to choose from. Unfortunately, that is not always the case when it comes to treating OCD.
OCD is complicated, and sometimes it can be difficult to recognize when your current therapist is not helping you. Again, this is when the support of family and loved ones can be beneficial, as they can step back, be objective, and talk to you about moving on, if necessary. Also, it is important to keep in mind that when you do find the right therapist and are together for a long time, your relationship will likely evolve. Dan's last therapist was a great fit for him, and they worked together for four years. Toward the end of their time together, they rarely needed to address Dan's OCD, instead concentrating on the many issues facing today's young adults.
While it can be easier to stay with a therapist that is not working for you than starting from scratch with a new one, I believe it is still necessary to move on when, for whatever reason, you are no longer making progress toward recovery. You might like, respect, and admire your therapist, but if your OCD is not improving, I think it is time to search for another. Because, at least in my opinion, merely liking your therapist is not enough.