Welcome to Back from the Abyss, where we bring you stories of hope and healing, recovery and redemption.

I'm Dr. Craig Hickok, your host and resident psychiatrist.

Today we're doing a mini episode, why it's so hard to find or be a good therapist.

If you're looking for a therapist to hear you, to support you emotionally or validate you,

that's not so hard to find.

Lots of therapists are good at what we call holding or creating a safe space for openness

and trust, and that can be incredibly valuable and healing.

However, if you're looking for a therapist who can help you pull out of the dark depths,

someone who can catalyze meaningful change,

that's a whole different beast. And here's why. Being a therapist who can catalyze change is really,

really hard and basically requires that the therapist do at least five crucial and complicated and often simultaneous things as the session progresses. Therapist challenge number one.

The reason we have anxiety, the purpose of anxiety, is to get us to do something, to act.

Too little anxiety and we're passively accepting our present reality.

Think weed or video games or alcohol or other numbing agents.

Too much anxiety and we're paralyzed.

Therapists have to continually decide moment to moment throughout every session whether to sit

with the client's anxiety level or to help them dial it down by soothing them or most difficult

of all whether to dial up the anxiety to get the client to move towards change.

What do I mean by dial up anxiety?

A good therapist can recognize when a patient is too relaxed or avoidant or chit-chatty or finger pointing all the blame,

and the therapist will consciously decide to turn up the flame to make the client squirm a little

with increased anxiety, but not too much anxiety or the client will shut down or flee.

...