A good therapist doesn’t invest too much in your story. They listen, they show empathy, but they take a position of equanimity and they will gently challenge assumptions and test your perspective without being invested either way - neither in you being right nor in them knowing better.

They will make you feel welcome and they will establish trust such that you can feel safe to share things with them. (Careful not to project and confuse your own internal feelings of being unsafe to share or being judged onto the therapist here.)

They will listen to you. If you tell them that you don’t want to talk about something or that you don’t see the point in going into a topic, while they may challenge you (e.g. “Is it because it feels unsafe to address?” “Is this your better judgment on the matter or is this a way to avoid digging into the deeper issues?” sort of thing) they will also take you seriously.

I think a good therapist should focus on the somatic aspects as well, such as asking you if you are feeling tension or noting that your breathing has changed etc.

There is a lot more but my communication battery is completely zapped. I’ll try to come back to this to flesh it out more or you can ask me stuff and you’ll probably prompt me to give you more of a response.

I like to think of good therapy as existing within a fairly narrow window. Just like if you’re at the gym and you’re doing stuff that feels like you could do it all day without breaking a sweat, you’re probably not making progress but on the other hand, if it’s excruciating then you’re probably doing damage rather than working out and if it takes you days or weeks to recover then you’re probably going at it too hard. Good therapy is like that - it pushes you outside of your comfort zone and it’s a strain but it’s not something that depletes you in a major way and it’s not something that should cause an injury (a psychic injury, I guess? Lol)

I have a tendency to intellectualize (shocking news!) and I know when the therapy is in that goldilocks zone because I will slip into intellectualizing but it won’t be a complete shutdown/dissociate/full-tilt intellectualizing response but instead it will be drawing out my defense mechanisms but it won’t be associated with panic or terror, it will just be the sort of avoidance like when I’m trying to do a tedious task and suddenly I remember that I need to reorganize my media library on my hard drive or some shit. If I’m “wandering off” in a metaphorical sense then I know I’m digging deep enough to be making progress but also I’m not digging so deep that I become an emotional wreck blubbering on the floor.

No shame to anyone who has become a blubbering emotional wreck on the floor of a therapist’s office btw. Sometimes breakthroughs come that way and sometimes it’s the only way that they can occur but generally speaking it should be uncomfortable enough to make you want to have a cigarette break or to comfort eat or to just space out and stop talking or whatever your go-to coping mechanism is but without it feeling like you must do it or you’re gonna have an emotional breakdown.

A good therapist will circle back on things you have previously raised ans they will connect dots that maybe you haven’t connected before too.

Edit: Should have read the body of the post instead of just the title before responding. Ohgodohfuck. Sorry. I’ll try and get to a red flags list later. My brain is pretty exhausted.

All my best therapists were matronly lesbians in their 50’s who imparted wisdom and kindness while also taking no shit if I started to spiral and lash out. A great therapist guides you through tough feelings, then eases you out of them by the end of the session.

Also I prefer to avoid younger therapists in general because they tend to be afraid of pushing through hard emotions.

I’ve disliked these kinds of therapists in the past:

• Disengaged, overwhelmed by their caseload, looking forward to lunch or the end of the day or retirement. A therapist should be actively listening better than I can as someone who didn’t take classes in that skill. I try to schedule appointments around 0900 or 1300, when they’ve had their breakfast or lunch but aren’t burned out.

• Offering wellness solutions, pseudoscience, or self-help like a blog post about being sad. Therapy should be evidence-based and the therapist should understand how your dialectical relationships shape you. If they’re selling you placebos or gurus or anything other than the current science’s best practices, it’s a huge red flag for me.

• Not respecting boundaries. Therapy feels more invasive to me than outpatient surgeries I’ve had. It’s invasive when it’s bad, it’s more invasive when it’s good. A bad therapist will only understand your issues clinically instead of as a human responding to inhumane things. They’ll probe sensitive things too deeply before you’re ready, stick to the strict schedule if you’re in a bad headspace for intense therapies, and say callous things.

• Being too professional. I’ve worked in medicine, and inpatient/outpatient psychiatric at that, so I also get trapped in the clinical headspace whenever I smell it. It forces you into a world of customer service voice, corporate restraint, and reciting textbooks to each other in Latin. You have to mute the human part of your brain as a coping mechanism, but the patient shouldn’t see that. A bad therapist will be so formal that you just feel like you’re being analysed by a computer. There’s no conversation, they don’t remember any details about you appointment-to-appointment, they aren’t easy to talk to like a trustworthy friend.

• Liberals. I once had a liberal therapist, in early 2020, tell me that I shouldn’t worry about COVID because it’s outside of my control and things will be fine. I should take up meditation instead of reading about it. I told her that the difference in our perspective is that I was a destitute student living with six libertarians and she earned at least 5-10x my current income working from home which insulated her from the things I was scared of. Those things all happened, even worse than I anticipated. Class blindness from a mostly bourgeois profession makes liberals in medicine as infuriating as liberals in academia. Not understanding sociopolitical or sociocultural theory makes it really hard to talk about plainly observable things on the level of a hexbear post without them writing it off as paranoia. It’s considered bad clinical boundaries, especially in a sensitive field like psychology, to ask them personal questions but their politics should be decipherable from their office/specialty/conversation.

The only therapists I’ve liked enough to stick with them long-term have been:

• A social worker doing EMDR. They don’t rush it and try to fit an intense therapy into the rest of my life. Talking with them feels casual and friendly, while every question they ask is sensitive and the right question for that moment. They recommend additional resources and wellness practices, but those things are secondary to a proper care plan around an evidence-based therapy. They’re at least radical enough to talk bluntly about the world in ways I can agree with even if I don’t know their politics.

• A social worker doing Emotionally Focused Therapy. They’re a good listener and always have a calm response which challenges me on a deeper level without making me defensive. They don’t push for hard sessions on bad days, and they know when they need a sick day. They only push one evidence-based programme and their wellness advice revolves around doing more of what I already do. They’re also radical enough to talk bluntly even when I don’t know their politics.

• Two psychiatrists who balanced the need to try new things with my fear of drug interactions and neurotoxicity/addiction/side effects. They were more formal and clinical, but I wanted Latinslop from them. They did small incremental steps with drugs and always stayed cautious. They didn’t recommend drugs that I wasn’t comfortable with, and let me try something new when I wasn’t comfortable on a higher dose of something that didn’t work. They could enthusiastically talk about the science behind those drugs and the brain, but also asked about my dog with genuine interest.

the major one i’ve experienced is giving boilerplate solutions after you explain your problems. like, if im talking about having low executive function, and their suggestion is to try journaling. like journaling is good, sure, but it doesn’t really help for all things

also if they push certain moral things (religion is a really bad one but kinda obvious, but also like, if they push you to forgive your abuser so you can heal for example) a lot then that’s not great

Yo, I think you posted on my recent thread about breaking up with my therapist. It did NOT go well for me. Happy to talk about any misgivings you might have. Shoot me a DM!

If you see a bust of Freud you should leave.

The sign for me that I needed a new therapist was when I would sit there the whole hour and listen to her talk pretty much the entire time. My new therapist has me for like thirty minutes, but I talk waaay more than I did the whole hour with the other one. Still not sure how helpful this one is, but she’s not going to out me to the government or report me for being a socialist. Not yet, anyway.

I may see a therapist for the first time soon so I too would like to know