With the exception of the contact information and perhaps the welcome page, this short essay here is the most important part of this website for people interested in starting therapy.
Even people who contact me after a show, or a class, or after talking with a friend will be directed here. Why? Well, many people have the mistaken belief that therapists come in one-size-fits-all packaging. Or that one particular type of therapy works for everyone.
From my own personal experience, I think that the best therapy comes from a good personality match between client and therapist, and this match often depends upon their respective personality types.
I didn't fully appreciate this until I started doing more stage hypnosis shows. Prior to those shows, most of my clients came from the internet and referrals. These clients were mostly a good match for me, much more so than the clients I was assigned to work with during my pre/post docs. At first, I thought this was because the internet advertising brought in more higher-functioning people.
Then, when the shows started, the flood gates let loose, and many more people wanted to start therapy with me. Once this happened, both the quality of therapeutic relationships and my overall success rate took a bit of a nose dive.
Now, you might think that perhaps the reason this happened was because I took on too many new clients? Yet I still maintained a good track record for those who came in after reading my website.
Perhaps the stage audience weren't as high functioning? Yet most of my shows occurred at corporate events--typically with high functioning folks!
Then it hit me--of course! In years past, when people booked appointments through the website--the website acted like a filter. I made the website a reflection of me--my style, my personality, my approach to psychology. People who didn't quite match that style usually went to some other site, some other therapist. People who liked and appreciated the website were more likely to both set an appointment and have a good personality match with me once we started.
So I made three changes. First, I added more details to the website. Second, I added a section (this page here) documenting who I tend to work well with. Third- I make sure that everyone who calls me after seeing a show or hearing about me from a friend visits this website!
The great thing about Los Angeles (besides the fact that you can be at the beach, the mountains, or the desert all in less than an hour) is that there are many, many people. That means many potential clients and many potential therapists. So we can all be a little choosey in who we pick. So take a little bit of time and explore at least this page here and ideally, the other sections about my therapeutic techniques and my specialties. If you find yourself agreeing with my Own Personal Brand of therapy and you believe you could benefit from our therapeutic relationship, book an appointment! But on the other hand, if you don't think we're a match, send me an e-mail describing what you're looking for--and I'll give you some names of therapists who might be a better match for you.
It's much better for a therapist to specialize and have a niche rather than try and be everything to everyone. Better to focus on your training and work with people who relate to you. If you have an intractable printer jam, it's better to call a person who specializes in printers than call a guy who does all sorts of computer or electronic work.
In the world of therapy, the buzzword is "toolbox." As in, have many tools (i.e. types of therapy) that you can pick and choose from based upon a particular client you have. The problem with this model is that therapists typically pick a few tools, really master them, and then end up letting the lesser used tools drop by the wayside. Then, when there's a new client with an issue best served by a tool the therapist haven't used it years, it's just too tempting to use the more familiar tool.
The model I prefer is that of track & field. In this world, people are born to run short bursts, others are born to run long distances, while others are born to, well, throw things. The athletes in track & field realize this and specialize early in their training. If my muscle structure matches short, energized bursts and my training focuses on sprints, I can do all sorts of events well. Not just sprints but relays or even hurdles. If you ask me to run cross-country or in a marathon--it'd be a stretch, but I could be flexible. I might get outside help (consultation). If you ask me to throw discuss or javelin, I'll just refer you to a teammate who has much more training in it than me. Likewise, I specialize in therapy in working with particular people with particular problems. People and problems well suited not just with my expertise, but my personality type as well.
Now, that's not to say I'd abandon a client if I've been working with him or her for a while and a new issue pops up that I haven't dealt with before. For one thing, the techniques I use can be used with a somewhat large variety of issues. But also, I have experience collaborating with other therapists on a particular client's issues. So, for example, if a person has performance anxiety and an eating disorder, I'm likely to continue to work with the client on the performing anxiety while referring him or her to a therapist who specializes in eating disorders, while working and collaborating with the therapist. This occurs mostly with physicians who prescribe medications then send their patients off to me to resolve the underlying issues.
Nor does it mean I'm rigid in regards to a treatment regiment. Quite the contrary: specializing means that I can have greater flexibility because I have more experience dealing with my particular niche. For example, I've seen virtually every variation of performance anxiety there is, and I've seen every type of reaction to it! Knowing the therapeutic techniques so well allows me to make variations and some often-needed customizations.
To show what exactly I specialize in, I've made four categories to give you a rough idea. This is not written to be exhaustive or even complete and it might change in the future! But so far, here they are:
Category 1:
These are mental health issues I enjoy working with. I've researched them, have clinical experience with them. And even if I were to retire, I would still work with these issues on some level (part time, of course).
They are:
Generalized Anxiety
Social Anxiety
OCD
Specific Phobias
Performance Anxiety
Self-Esteem/Self-Image, especially as they relate to relationship issues
Adjustment Disorders
Category 2:
These are mental health issues that I have experience working with, but don't work on them as much, simply because I spend so much time in category 1.
They are:
Smoking Cessation (including marijuana)
Weight Management
Depression (mild to moderate)
Sleep disorders
Category 3:
I will work with these mental health issues inasmuch as they relate to an issue described in category 1. I have some experience in these issues, but I'll typically have another therapist work on the primary issue, while I'll work on the co-morbid anxiety or relationship aspects.
They are:
Eating Disorders
Pain Disorders
Somatoform Disorders<
Conversion Disorders
Depression (cyclothymic, dysthymic, sever depression)
Bi-polar Disorder
Drug/Alcohol Addiction
Impulse control disorders
Category 4:
Not much experience at all, will only work if there's an acute crisis or emergency. I'll refer as soon as a more qualified therapist comes along.
They are:
Psychotic Disorders
Personality Disorders
Autism-Spectrum Disorders
Oppositional-Defiant Disorder/Conduct Disorder
Mental Retardation
Dissociative disorders
Cognitive disorders (Dementia, Amnesia, Delirium)
So to clarify, these category divisions are simply on the basis of what I'm experienced in treating and what I choose to focus on. There is often an overlap that's based upon context. For example, I might work with someone who has Oppositional-Defiant Disorder whose doctor specifically wants me to address particular anxieties. I'll typically refer someone who has a phobia if the person has delusional attributes to the phobia (e.g. doesn't believe or accept the possibility that the phobia is irrational when anyone else would agree that it is.
Also, as an aside, I don't give legal advice, or medical advice, or medication advice. Such issues are best left to the lawyers, GP's, and psychiatrists, respectively.
Now that we've explored what I specialize in, the next question is: what type of therapeutic techniques do I use? The short answer is Cognitive-Behavioral Therapy (CBT) with hypnotherapy, when applicable. But you'll want to read the longer version before you commit to anything! Even in the world of CBT -- and especially with hypnotherapy--there is considerable variation in what's known as "therapeutic attributes"; how one therapist is different than another. Let's look at some common distinctions with therapists, and I'll point out where I stand in each area.
1: Crystals vs. Cufflinks
Many hypnotists have crystals in their office and talk about auras. Actually, some psychotherapists do that as well! Others are more convention or medically oriented. That's me. I'll use hypnosis to help a person quit smoking or as a way of relaxing, or imagining exposure events (e.g. visualize yourself in an airplane). I don't use hypnosis to help a person relive a past-life or talk with deceased relatives. That's not really a judgment call; I'm not here to say if past-lives exist. I used to have a wonderful relationship with a hypnotherapist who would send me all of her phobia clients and every time someone asked me to help them explore their past lives, I'd send them her way. And from the follow up, I think she really helped them! Now she lives up in Canada.
2. Person-Centered Therapy vs. Goal-Centered Therapy
This is, I think, the demarcation line in the world of therapy. Many people believe that therapists are divided into either CBT or psychodynamic. That's somewhat artificial as they're both really a series of tools, and often therapists pick and choose from both categories -- again using the toolbox metaphor. An example of this would be interpersonal-therapy, which is considered psychodynamic but is very much oriented to the CBT mentality in its directive approach. Sometimes I'll go days without using a CBT exercise if a client is not quite ready for them.
Where CBT and psychodynamic differ in their tools, the person-centered therapist and the goal-centered therapist differ in their orientation.
The person-centered approach revolves around a therapeutic relationship that is non-judgmental, empathetic, and congruent. The idea is that in the context of that relationship a client can understand his or her past, explore any feelings, and then make their own decisions about what changes to make. In other words, the relationship that occurs in therapy becomes a reflection, which guides the client.
The goal-centered approach revolves around structured, goal-oriented activities. As with the person-centered approach, a good, solid therapeutic relationship is necessary but it's not the focus of therapy. Rather, the therapist works to establish a relationship and then introduces structured activities that directly relate to the symptoms of the client. Change comes from internalizing new, healthy mental habits.
A metaphor to show the person-centered approach would be talking to a long-lost uncle who is very warm and understanding of your problems. He'll ask some key questions and sometimes reflect on what he notices. He won't tell you what to do but rather ask some probing questions to gently guide you along your way. After awhile, you notice that perhaps you could change this or that in your life.
Keep in mind that's just a metaphor and I'm skipping many details. After all, there's a big difference between an uncle and a well-trained therapist!
A metaphor to show the goal-centered approach would be talking to a fitness coach about a specific problem area you want resolved. He develops a good relationship with you, determines a sequence of activities to do to resolve the problem based upon your situation, and directs you to do them, for homework. After awhile, you notice that you're moving steadily to your goal in a step-wise fashion.
Keep in mind that's just a metaphor and I'm skipping many details. After all, there's a big difference between a fitness trainer and a well-trained therapist!
Both approaches are very popular. Both approaches are very effective. But 9 times out of 10, a person will have a clear preference for one approach over another. Some people are interested in therapy to explore an aspect of their lives or to come to terms with an issue. An example would be someone who experienced a divorce as a child and still feels emotions that were never really resolved or a person who wants to explore how to live better or achieve a sense of peace. These examples would go well with the person-centered approach. Someone who has a specific problem that needs to be resolved or a particular issue to be solved might take a goal-centered approach. Perhaps a person has anxiety before a performance, or gets trapped in bad relationships, or eats food out of boredom.
Also, sometimes a person will take a person-centered approach for a general issue and then later on take a goal-centered approach. In this fashion, the person-centered approach is there to understand "why this happened" and the goal-centered approach is there to do the clean-up. Other times, a person may take a goal-centered approach to quickly resolve an emotional issues -- to put out the fire-- and then use a person-centered approach to explore just why it happened.
Interestingly enough, you might not need the goal-centered approach, sometimes just understanding an issue can resolve it. On the flip side of the coin, just resolving the symptoms or just changing behaviors, is often enough to resolve an issue, without any need to have a deep understanding of an issue. When I help people with their fear-of-flying, it's generally not necessary to understand exactly how the fear developed. Doing the techniques just based upon symptom reduction is usually sufficient.
So which approach is for you? You might already know by now. If not, do this simple exercise to figure out: take some time and write out (either on paper, on your computer, or as a mental list) your goals for therapy. Now look over your goals. Are they more explorative or are they specific, concrete, measureable?
Examples that would fit into the first category might be:
Explore why my mother and I feel anxious around each other.
See if I can live my life with more calmness.
Understand what led me to feel anxious in my life.
Examples in the second, more concrete category would be:
Feel less anxious when I think of my boyfriend going out at night without me.
Be able to sleep throughout the whole night.
Reduce the stomach pains and anxious feelings I have in my life.
Notice how the goals in the second category are much more measureable.
Now, I couldn't call myself a psychologist if I didn't already know that the vast majority of you readers out there didn't actually stop reading to physically write out those goals. That's okay. Just consider in general: are your goals for therapy measureable? Do you really have specific goals? Or would measuring yourself to derive goals be weird or inappropriate for you? If you could create measureable objectives for your therapy, the goal-centered approach might work for you. If it feels "off" to measure your goals, or to even write out goals in the first place, the person centered approach might work for you.
As I'm sure you've guessed by now, I'm squarely in the goal-centered approach. I'm sure by now you have a better idea which category you're in. So if you like your therapy directive, goal-oriented, and structured, we might be a match! If you're still unsure, keep reading!
3 Talking vs. Checklist
A third distinction is between the focus of each session. The person-centered approach will focus on talking (hence, the talking cure). The goal-centered approach will focus on: homework!
Now of course, that's not to say there's no talking in our sessions just that much of the talking will be based upon going over the past sessions' homework and assigning more homework for the next one. After all, most goals aren't achieved in one hour a week but rather through repetition.
Here's an interesting example. For people with a fear-of-flying, I'll assign them to go have lunch at the In-and-Out™ on Sepulveda right at the airport. From that restaurant you can see planes come in and land at LAX. For their homework, I'll have them make a note each time a plane lands and each time a plane crashes into LAX. I'll also have them record the amount of time they are there and instruct them to stay for at least 30 minutes. During the next session, we'll then calculate how many planes on average land in LAX each day, month, year. It serves as a concrete reminder that most planes land safely. People tend to think of that experience at In-and-Out™ during takeoff rather than some abstract statistic.
So part of each session will be going over homework, just like the aforementioned example. As you can see, homework is based upon concrete activities. It's not too different from a personal trainer meeting with you once-a-week and assigning exercises in between sessions. Not doing the homework will often grind progress to a halt, or at least slow things down.
Imagine you're seeing a therapist and he assigns you that homework, or something similar. Let's say doing relaxation exercises 20 minutes a day. Think about how well you'd be able to do that homework. If you think you would be able to do that--remember to do it, set time out of your schedule, and follow through--the goal centered approach might be for you! If the idea of doing homework seems to conflict with who you are, or you literally have no time for any therapeutic or personal growth activities apart from the one hour you can give for a therapy session, the goal centered approach might not be a match for you!
4 Blank Slate vs. Level of Collaboration
Rather than approach this category from a dichotomy--x vs. y, let's explore this concept by looking at some of the common therapist types. I'll briefly describe each one and rank where I stand in regards to each figure, on a scale of 1 (not similar at all) to 10 (virtually identical). Keep in mind most therapists follow more than just one category. Also, as far as I know, these categories exist only in my mind and in this website.
Therapist type: The Blank Slate
Example: Freudian Psychoanalyst
My level of emulation: 2
Ever wonder why some therapists never say anything more than "uh-huh" or "tell me more?" Well the traditional idea of psychoanalysis is that by being mostly silent, not saying or revealing anything, the therapist becomes a blank slate, by which the client can project all sorts of things, which the therapist then points out to the client. When the therapist becomes a figure -- such as Mom or Dad, this is known as "transference." By seeing that a blank slate can become a parental figure and seeing what happens to the relationship, the client can then process those feelings, known as "working through."
Fascinating! But completely opposite of the cognitive/behavioral model, in which you can directly change thinking and behavior habits to create positive emotional change. In other words, you don't always have to know why something happened in order to resolve it and, in many cases, knowing why something happened doesn't necessarily lead to its resolution. Because of this (and the time needed to really bring about true transference), the psychoanalysis process can take years. One reason Freudian Psychoanalysis has fallen out of favor in recent years.
What makes me a two on the emulation scale? I won't be a blank slate just so that transference can occur. Rapport with the client is much more important, and I think some self-disclosure is necessary for this. Knowing that, yes, the therapist is human too -- with his own fears and anxieties, creates a very important sense of empathy and understanding. Of course, I won't disclose too much about my life, but I will be talking during the session!
Therapist type: The Unconditional Positive Regard
Example: Rogerian-esq
Unconditional Positive Regard is a powerful therapeutic tool that's an essential feature of person-centered therapy. It means always showing warmth and acceptance regardless of what the client says or does (with the exceptions of behaviors that threaten physical/mental harm). By having this, a patient can grow and discover themselves with the therapist without any fear of judgment.
On one hand, it's very important to have empathy and warmth. There needs to be trust. The client needs to feel he or she can say anything. Nothing feels quite like having a person you can go to each week to express your deep inner thoughts, safe with the knowledge that he won't tell anyone, or judge you, or abandon you.
A direct example from my specialty: as much of anxiety relates to a fear of social rejection (e.g. fear of being seen as a fraud), a key exercise I do with my clients is to go over the worst case scenario (e.g. sing horribly at an audition) and then go over who would reject the client because of this and who would still be there. Many people believe on some level that everyone would reject them. It's a great first step to explore that I -- the therapist -- would not be one of them and then use that example as a spring board to explore who else would be accepting vs. rejecting.
On the other hand, I always make a point to check homework and approve or validate any attempts or completion of said homework. I certainly can't approve of a client doing homework without, on some level, implicitly disapproving of not doing homework. Obviously, I won't do anything to break rapport--just explore what kept the activity from being completed and make adjustments. Maybe do a token "tis-tis."
Sometimes it happens that the only reason clients do their homework is to gain their therapist's approval. I'll typically setup both rewards and punishments (e.g. get a manicure vs. clean out the fridge) to help internalize their motivation. But ask any behaviorist and you'll learn that what truly motivates human behavior is acceptance & accolades, especially from a peer or authority figure. As the focus of the relationship in the goal-centered approach is skill building, which involves homework, my compromise is to provide extra accolades for homework completion, while all-the-while having a background of empathy and positive regard. That's why rather than having unconditional positive regard, I emulate what you might call directional positive regard.
Therapist type: Command Directive
Example: Medical doctor/ fitness trainer
My level of emulation: 7
You go to a medical doctor, the doctor says take these pills each morning and to quit smoking. You leave. Many people see CBT in a similar vein: you see a therapist complaining of a fear of dogs, the therapist tells you to go visit a dog pound an hour each day for a month, and you leave with a list of local dog shelters.
I'll be the first to say that therapy with me is directive. Meaning, I'll direct us to do certain activities in the office and then direct you to do certain activities at home. There's no question I'm much more like a personal trainer than the traditional Freudian psychoanalyst who sits behind a couch out of sight. In many respects, my therapy is similar to physical therapy except all mental and not nearly as painful.
Cognitive-Behavioral therapy is also a bit more complicated because for most people, a cookbook or cookie-cutter approach doesn't work. CBT is a variety of tools, some of which work better for one client vs. another. A sense or rapport and empathy is required because it's much more complicated to participate in virtual reality for 10 sessions compared to just popping a pill. Because of this rapport and empathy, it's better to be at the client's level rather than serve as some all-knowing authority figure. Which brings us to:
Therapist type: Egalitarian
Example: this website
My level of emulation: 9
Think of a personal trainer. If you're like me, the best personal trainer is a person who knows what he's doing--he can assign the right weights for you. But you can also relate to him. I wouldn't want a trainer who had a chiseled body since he was 12 who, just for fun, works out 4 hours a day. I'd much rather have someone with a little experience losing weight, who himself has to struggle a little sometimes to schedule in a workout session. Someone I can relate to!
Likewise, I strive to be authoritative (without being authoritarian) so the client knows that I know what I'm talking about. Nothing is better to address concerns about me knowing how to help people with phobias than to direct them to my virtual reality equipment or the airlines seats in my office. At the same time, I'll be the first to admit that doing homework can be a challenge at times.
The egalitarian therapist can best be described as a partner who will guide you as you work to resolve whatever issue you might have. The ultimate goal of the egalitarian therapist is client empowerment: internalizing the homework, internalizing the relationship, and knowing what to do to maintain the new sense of freedom.
5 Past vs. Present
The distinction between a focus on the past and a focus on the future would be a close second in terms of distinguishing therapists, right behind person-centered vs. goal-centered approaches.
There are some therapists who feel that understanding your past (i.e. past events, past memories) is a requirement for personal growth and change. There are other therapists who really only explore the past in order to help clarify what's wrong now, similar to a doctor asking about how you broke your leg so he or she can best set it.
I'd be squarely in that second category. In fact, I think that exploring the past to much can be counterproductive at times because in focusing on the past, it reinforces the idea that we're being controlled by events now beyond our control, when this really isn't the case.
There's more information in the cognitive-behavioral section but the "gist" of CBT is that negative thoughts and behaviors lead to negative emotions through irrational cognitive biases that become habitual. In plain English: we get into the habit of thinking about the world, ourselves, and our future through negative interpretations, only these interpretations don't represent reality.
To change these thinking habits the client should first discover that they are there, identify them as irrational, and then dispute them, using evidence. Is it important to understand how the mental habit developed? Yes, in some cases. But it's not the end-all-be-all. Knowing how a habit developed can certainly help in devising a treatment plan but it's not essential for the treatment itself.
I can't tell you how many times I've helped people with their fear of flying where they had no idea how the phobia developed. In fact, for many people phobias just seem to randomly pop up since childhood. Yet, there doesn't seem to be any correlation between understanding how the phobia developed and its successful resolution. In other words, just because a person knows that the phobia developed from a bad flight doesn't the therapy go faster or be more effective.
Even with more abstract concepts, for a given client with low self-esteem, I'd much rather have a list of his or her current self-statements (e.g. I'm worthless, I'm no good at anything) than a biography.
That's not to say they are mutually exclusive. In fact, I'll delve into the past to explore what other negative thoughts or behaviors might exist in the present (e.g. where did you learn you're worthless... your father? What else might you have learned from him?). Just that the focus of the sessions is not going to be on the past, but rather the present and future.
Many people believe that if you just focus on current habits or thoughts without addressing the underlying issue, the habits or thoughts will just sprout up somewhere else. A classic example of this would be hypnotizing someone to stop pulling their hair out, to which they then start picking their finger nails. This is not typically what happens. Addressing behaviors directly resolves issues typically without complications, and, many times addressing behaviors leads to a corresponding change in emotion.
So in review, my present/future-based focus means that we'll be spending most of our time dealing with current symptoms and emotions. The emphasis will be on getting rid of current habits that are dysfunctional, irrational, or just not helpful. Much less emphasis will be placed on how said habits developed. Again, research and my own clinical experience has shown focusing on the past is not as essential as once thought and often takes time away from dealing with current symptoms. From what I've seen, the quicker current symptoms are dealt with, the happier and more empowered the patient is.
There's a good chance that after reading all of this, you have a better idea not only of which type of therapist you're looking for, but if I might be that therapist for you. You can always e-mail me to let me know when you'd like to start therapy or to put you into contact with a therapist more suited to your own personal style.
Still not sure? To learn more about personality matches between therapist and client in general (and me in particular), let's turn to chapter 4.
Now, you might be asking by now, "why on earth would a therapist be so selective in whom he picks for clients?" Think of a therapeutic relationship like any other type of relationship. Virtually everyone will pick a business partner or a romantic partner based upon personality matches. In many cases it's best to find a business or romantic partner who has a different personality type than yours. That way they complement each other's weaknesses. So a lawyer who's great at legal research may partner up with a lawyer who loves taking clients out for sporting events. In terms of therapy, I think it's the reverse. You'll want a therapist already comfortable in your world so that the therapist can easily translate things. You'll want a therapist who can take your strengths and apply them to your challenges. A great analogy is that of a tutor or a mentor.
I enjoy doing the stage shows, so I'm more likely to say "yes" when asked to do one. Shows typically have between 50 and 200 people and there's a decent percentage of the population that has a phobia or anxiety but never knew to seek therapy for it. And hey, "why not a hypnotist who's also a psychotherapist"? So if I took every person who wanted to see me, I'd never see the light of day.
Additionally, my type of therapy is actually quite brief compared to the more traditional therapy that lasts for months or years. In fact, the average session length is 15, and that includes those who come in for one session. The mode would be closer to 20, meaning most therapeutic relationships last 20 sessions, not including the occasional follow up session that might occur every few weeks or every few months.
So, as I've become more focused on personality matches as they relate to therapy and have seen now quite a lot of clients, I figured I'd study a little bit to determine if I can find a pattern. One day, I took a random sample of client notes to see if there was a pattern as to who ended up being a good match therapeutically. I compared some basic demographic information (i.e. race, gender, age) to see if there was a pattern. Turns out, what jumped out was a considerable difference between occupation and a good therapeutic match. In other words, a person's occupation seems to be pretty good at predicting whether that person and I are going to be a good match in therapy.
I think this makes sense and is (in retrospect) predictable. I have a particular type of therapy that goes well with people of certain traits or dispositions. And people will often pick occupations based upon their traits and dispositions, just as they might choose a mate or a field of study.
Now, at first, I was just going to list some of the occupations. But I saw an immediate pattern in the occupations. They are all occupations that I, if circumstances were different, might find myself in. The occupations of those I didn't quite match with therapeutically were more likely to be in fields I would never, ever, be involved in, even if I were paid handsomely to do so (that's not a judgment call, again, it's just my disposition).
Another pattern in these occupations is that they match career recommendations based upon the Myers-Briggs Type Indicator (MBTI), which is a personality test designed to measure your personality based upon four different variables. For more information on the MBTI, go here. To take a short version of the MBTI that has somewhat good validity for estimating your type, click here
I'm what's known as an INTJ. I've found that the people I work best with aren't necessarily INTJ's themselves but tend to work -- or aspire to work --in occupations recommended for those who are INTJ's.
They are:
Scientists
Engineers
Professors and Teachers
Medical Doctors / Dentists
Corporate Strategists and Organization Builders
Business Administrators / Managers
Military Leaders
Lawyers / Attorneys
Judges
Computer Programmers, Systems Analysts and Computer Specialists
Click here for more information.
I haven't worked with many judges, but I have worked with many lawyers, and typically most judges started out as lawyers. I also haven't worked with many military leaders, but that's mostly because I'm in L.A., not San Diego, and I never worked at a VA hospital.
Conversely, there seems to be a group of people where we either aren't quite a therapeutic match or we are, but the techniques don't seem to be as effective. Sometimes if there's a good rapport, and I believe the client will benefit, I'll actually switch to a more person-oriented approach.
As my MBTI personality type is INTJ, the opposite of that would be ESFP. Career recommendations for the ESFP's include:
Artists, Performers and Actors
Sales Representatives
Counselors / Social Work
Child Care
Fashion Designers
Interior Decorators
Consultants
Photographers
Click here for more information.
And true to form, I seem to have more of a challenge building rapport with those in the above mentioned careers and assigning homework can be somewhat of a challenge.
Three important caveats.
1 This is a general theme, not applicable to each person. I've worked with computer programmers where we discovered quite early on we wouldn't be a good match. And I've taught a class for actors on performance anxiety and worked with many of them in individual therapy.
2 Many people have pointed out that, though I'm an INTJ, I enjoy performing on stage and project a sense of confidence while I do so. That's not a contradiction! After all, many INTJ's like to be an expert and enjoy self-expression. But the confidence I project on stage was developed over the years and after a long show and the time spent afterwards asking questions, I'm ready for a nap! In other words, I act in order to perform well, not the other way around.
3 If you've seen me on stage and want to work with me on your stage skills that's not a problem. I've worked with many actors who've seen my show and want to project a similar level of confidence. This makes a lot of sense. After all, you wouldn't want to see a therapist for performance anxiety who's never been on stage any more than you wouldn't want to see a therapist about fear of flying who's never flown before! Just know that the activities and homework involved will be more outside of your "comfort zone," so progress might take a little longer.
In other words, my therapeutic style and modality reflects an INTJ mentality. The techniques can help (regardless of what your type might be) but they involve homework. I've found that with my clients, the closer your career path is towards the ESFP career recommendations, the more energy is required to complete the homework. But that doesn't mean it can't be completed. ESFP's tend to be natural performers and entertainers. INTJ's are not. It takes a lot more energy for an INTJ to perform for an hour than for an ESFP. Yet, I'm still able to do a performance. It just takes a lot more determination.
Once I discovered this phenomenon, I sought out the perfect ESFP therapist, a lady who somehow tailors the CBT homework for the performer disposition. She also has pretty busy schedule, so she'll send me the scientists types. I have absolutely no problem referring people to her, as I've reached the stage where I'd rather work with people with my disposition than be overbooked with clients where we're not able to relate to each other. So if you feel we might not be a match, contact me and I'll arrange for a referral.
Still uncertain? Perhaps you're not in either category? Let's look at some specific matches in the next chapter.
Reflecting upon those who progress well in my type of therapy (again, comparing client notes with their demographics), I've found some specific trends. Those who appear to get the most out of therapy are typically:
Those who have stability in their schedule
It's important to have a somewhat stable schedule, so that you can make time for a weekly session. Also, as there are often homework assignments to be completed once a week and sometimes, once a day, it's important to have a system to remind you to do the assignments and to have the actual time to complete them. Think of it as scheduling therapy homework the way you'd schedule exercising. The more consistent you schedule it, the better. I seem to work well with teachers, doctors, and personal fitness trainers because they are somewhat schedule oriented and appreciate the homework.
Those who can argue and dispute things well
This can be explained better in the CBT section, but much of therapy involves seeking evidence to dispute a negative thought pattern. An example might be reacting to the self-statement "I'm useless" with "what evidence is there to support this? What would those close to me say? Are they all lying? Was [that person] being accurate when he said that, or just emotional? If I was useless, would I still be have X or be working at Y?" and so on and so forth. It goes without saying that lawyers and judges can easily relate to this (though not all lawyers; not everyone's a trial lawyer).
Notice how my therapeutic matches always seem to include those who do well with setting goals and establishing routines.In addition to the personality matches described in the last chapter . There are some groups in particular that I match with, again either because of my personality as a therapist or the nature of the therapy itself. They are:
The Younger Crowd
Research into differences between client and therapist and their effects on quality of relationship has found that age, to a greater extent than gender or even culture, has a strong impact on therapy. Researchers found that in general the closer in age, the better. As of this writing, I'm rapidly approaching 30. Typically, it's easier to relate to those in between 20 and 40, with more difficulty as you travel further away from that age group. I look young for my age, and I'm quite young for a psychotherapist so children and adolescents feel more comfortable around me, though I don't specialize in those areas. Conversely, people significantly older than me (e.g. 40 years my senior) think I'm the same age as their grandchildren. It's difficult to follow homework assignments given by your grandson.
Occasionally a person with a fear of flying, a performance anxiety, or panic will want me to accompany them on a flight, a performance, or to cope with large crowds (e.g. Venice, 3rd street promenade) respectively. It helps to have the therapist your same age so it doesn't look out of the ordinary.
Certain Ethic Groups
For a little bit of self-disclosure, I'm a white, high-ses male that seems to relate well to the Stuff White People Like blog. However, research has shown it's not very helpful to assign client to therapist just based upon ethnicity. My own personal experience has shown this to be true. If anything, any adjustments in therapy should relate more to the level of socio-economic scale (a fancy way of saying upper/middle/lower class) than ethnic qualities. An example of this would be recommending in-patient treatment centers for drug abuse treatment or an eating disorder that range from community centers to luxurious, ocean-side treatment facilities.
In terms of therapy, there appear to be ethnic differences in who does well with what. African Americans seem to prefer an egalitarian relationship with their therapist. Asian Americans seem to prefer a more directive approach. CBT is well known for being both egalitarian and directive. Hispanic Americans seem to prefer what's known as Personalismo, which is more of a chit-chat, warm, charismatic approach. My ability to project personalismo is somewhat hit or miss as is my ability to speak Spanish. I typically will refer rather than use a translator because 1. Much of what is said will be lost in translation and 2. When a translator is a friend or family there becomes a dual relationship, which can be problematic. In essence, the more a person (of whichever ethnicity) seeks an egalitarian but also directive relationship with their therapist, the more apt they are to do well as a client of mine.
(Not so) religious groups:
Don't let the last name fool you! My mother is Jewish, making me Jewish, at least according to the tenants of Judaism. My father was raised Catholic. I'm neither. I'm not religious. At all. I couldn't quote a bible verse any more than I could quote a scripture from the Talmud. Though I'm more spiritual than in my past, I'm generally agnostic. This will probably present a problem if someone comes in with issues directly relating to their particular faith (e.g. anxiety about sinning). In fact, my only experience in dealing with religious issues is dealing with people coping with the consequence of their religious past (e.g. resolving shame).
That doesn't mean if you're religious we shouldn't work together, only if your religion is the focus of your therapy. In other words, I once helped a priest with his fear of flying; religions never came up, though he did pray shortly before his flight. And during turbulence.
Sexual Orientation
I'm straight, yet I have much more experience with working with the LGBT community than any other minority group, as a sizeable part of my pre-doc internship was with a Gay and Lesbian Center in Hollywood. Also, my office neighbors West Hollywood, and I performed a few shows there to support No on Prop 8 (and will probably do some more to repeal it). So a sizeable percentage of my current clientele are in the LGBT community. Of the LGBT community, I have the most experience with working with gay men and the least experience with transgendered. As a side benefit of my complete lack of religious stigma, therapeutic training, relatively young age, and knowledge of "the interwebs," there is virtually nothing about a person's sexuality that would surprise, embarrass, or shock me. Reveal all that you care to, safe in the knowledge that years of being on the internet have desensitized me to all but the most bizarre of sexual peculiarities. No, hypnosis cannot make a gay person straight or a straight person gay. Also, I've met enough people to know it's not safe to assume a person's sexual orientation. I'll typically ask about sexual orientation during the biographical inventory, which occurs early in therapy.
Thank you for reading this! I managed to write this on a very long flight home and it very much passed the time! I hope that this gives you a very good idea as to whether or not you and I might have a good therapeutic relationship. Like every other type of relationship, not everyone is going to be suited for one particular person. It'll save you time to not have to come in and realize we might not work well together, and as I get quite a few hits from both the internet and people from the stage shows, it allows me to single out those who I would work well with, and refer out anyone else.
A good rule of thumb is that if you've managed to read this all in its entirety (or at least most of it) and am still interested in therapy with me as your therapist, we'd likely be a good match. Otherwise, again, I have a knack for referring people to well suited therapists. So, if you'd like to explore more click on a link to your left. Otherwise you can get in touch with me through e-mail or through phone/texting.