How to Find the Right Therapist for YOU
Dra. Ortiz describes the process as being a lot like finding the perfect shade of lipstick
In the first part of this interview, Doctora Ortiz explained her journey to becoming the head of a thriving practice amidst the global pandemic. She also explained how she is now able to serve the Spanish-speaking community, illustrating that the stigma around mental health help is finally crumbling!
Read Part 1 here:
In Part 2, we’re covering the importance of having a therapist that you trust to understand the nuances of your culture, and how to find that therapist.
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The Importance of a Cultural Connection in Therapy
Paulette: I have never had a Latina therapist. All of my therapists have been white, even the marriage counselor I saw with my husband.
And now that I'm reflecting back on that—by the way, I think marriage counseling is the best thing in the world to do before you get married. I'm a huge proponent of it. I credit it with establishing a foundation for me and my husband to not only survive being locked up together for two plus years five years into our marriage, but also enjoying each other's company during that time. Because I know not all marriages made it.
Mildred: There were so many separations, divorces, breakups during that time. Absolutely. And there was an influx in domestic violence. There was an influx in just violence overall, substance abuse, and just a lot more conflicts in the home environment. And it wasn't something that I was just seeing in my anecdotal work with my own clients. But also, insurance panels.
Kaiser and Health Net, these big corporations started to see the trend and started to create some flexibility for couples to access services too. And I know that for Kaiser, they still are offering it and have extended a lot of their resources out to just the general public as well, not just their recipients.
But yeah, I agree with you. Even as you're saying that, I'm also reflecting back on the times that I've been in therapy too, because it is important that I have to keep my own stuff in check.
And historically, yes, the therapists that I saw have been white or some descendants of Caucasian some way, somehow. There are really good providers out there that are Caucasian, that are attuned with the differences, who are able to talk about the cultural differences that exist within the therapeutic setting.
The responsibility stands on both though. As a therapist, I have a responsibility to address those differences, and I do. And as a client sitting on the other end, I also took it upon myself to address the differences as well. And even with clients that speak Spanish, speak Spanglish, that look like me, I never assume.
I never assume because we may speak the same language, we may look similar, we may have some similarities, but I don't know your background. I don't know how you grew up and what are some of those traditions and values that exist outside of like the general spectrum. So I still have those conversations with my clients that identify as Latino or to a specific Spanish speaking country.
Paulette: It wasn't until I was doing the research for the podcast episode where I talked about seeking mental health help that I realized I'd never had a therapist who wasn't white. And I've had some very good therapists, but I've also had some very bad ones. I think it's a process of finding what fits.
But it released this memory from the vault about a conversation I was having with one therapist. And she really could not understand the scenario I was painting for her of family dynamics. And I was so confused as to why she couldn't because I was in my 20s and she was in her 50s. I'm like, “you have so much more life experience. How have you never experienced this?”
And I can't tell you what the specifics of it were anyway, but thinking back on it, I'm realizing maybe it's because she lacked the cultural awareness.
And I don't think that unless someone points it out to us, that we know to seek it out. Because I would not have thought to find a Latina therapist before I did that research.
It's always made sense to me to try to get a woman doctor. I know men are dismissive of certain things [about] women, and I just don't want to put myself in that situation. I'm not saying all men or all doctors. I'm just saying I'd rather speak with a female doctor.
It's funny how you end up making those connections. And from this point forth, I think I will always try to seek out someone who looks more like me because of those little nuances.
And like you were saying, we're not a monolith. We don't all have the same experiences, but there are cultural variances that we're a little bit more sensitive to.
Mildred: And that I agree. Because, like I said, in the start of me just being available in private practice, a lot of the clients that I started to see were Latino.
And almost to the T, the initial start was, “it's refreshing to talk to somebody who understands me. I have been seeing someone and they just didn't understand.”
Therapists, we all have different schools of thought, meaning theoretical backgrounds. And there are some therapists who come across as like, this “blank slate.” They don't want to taint the therapeutic process in any way. They want it all to be the work of the client who comes in.
But Latinos, generally speaking, we are dynamic, meaning that we like to have conversations. We like to know who you are and where you come from, and we like to have dialogue conversations.
And that was the other experience that a lot of clients have spoken to me about even now, that it didn't seem like the therapist was engaged. “They never said anything to me, or it felt like they were falling asleep on me.” So many things on the spectrum and then feeling again, that sense of like, “it's refreshing to be able to talk to someone and you actually talk.”
Yeah, I do.
Paulette: Now thinking back, yes, I would do most of the talking and just get a head nod or a hmm. And I've been in therapy on and off for the last 20 years. I'm not saying that my experience is obviously the only one that makes sense. In speaking from my experience, I'm like, “Oh yeah, yeah. There's another aspect of this I wouldn't even have thought of.”
Mildred: I think it's so important to find somebody that you mesh well with. It's like anything else. [Say] you're looking for that perfect shade lipstick, right? And that red, right? And you're not just going to get the very first red because you're at CVS and that's the brightest red that you see.
You're going to shop around until you find the ones that you really are looking for. It's the same thing with therapy. You should really shop around for the therapist that you feel the most comfortable because it's supposed to be a safe space. And I've had those experiences as well.
I'm not for everybody and I don't want to be for everybody.
It's refreshing to talk to somebody who understands me
How to Shop for a Therapist
Paulette: In that vein, how do you recommend that someone shops for their therapist? Do you Google them? Do you set up some consultation appointments? Is that something that is done?
Mildred: Well, one of the things that I tell clients, when you're searching for a therapist, you have to do it for yourself, not because anybody else is asking or telling you that you need to go to therapy.
Because when you go to therapy, the first thing they're going to ask you is, so what do you want to work on? What do you want to gain out of therapy? And when you're done with therapy, what are the tools you want to leave with? So it's got to be something that you want to do, that you are ready for.
And then it's really paying attention to like, are you looking for someone who is a man, a woman? I know you said you prefer women doctors. And so paying attention to those levels of comfort as well.
It's also important to also pay attention to whether the person has certain levels of openness or levels of expertise working with particular populations as well. So, if you identify within the LGBTQ+ community and you want your therapist to be understanding of that, then you search for someone who is open and understanding of that.
If you are closely connected to your spirituality and you're looking for a therapist who has that knowledge and incorporates spirituality into the therapeutic process, then that's something that is going to be important to you. So being aware of what you're looking for.
Oftentimes people are hung up on like, oh, CBT, EMDR, psychodynamic, and all of these other jargon type therapeutic approaches. You may [say], “Oh, I'm looking for a CBT.” Okay, great. But you don't know whether that's actually going to work for you.
You may be more of a process type of client. And what I mean by that is you just want to talk. And if that's really what you're looking for, to have a conversation and in you talking it out and processing coming to your own conclusions and self-awareness in that way, then CBT is not the one for you.
So I think people get hung up on these therapeutic approaches. And it's really about giving the therapist a little bit of that control. Let them guide you and use their therapeutic tools based off of how you're coming into the therapy process. So that's the other thing that I say is let's not get too hung up on like the therapeutic approaches.
I think it's more the relationship. At the end of the day, it's a therapeutic relationship. How comfortable, how safe do you feel when you're meeting with this person? If culture is something that is important, being able to talk about certain traditions and make that clear. I think as therapists, people assume that we're psychics too, like we know it all and we're able to like read your mind and no, we're not.
So if there's something specific that you're looking for in a therapist, it's your responsibility to communicate that to us because otherwise we don't know. We only work with what you give us, what you're communicating to us.
And as far as searching, there's so many different ways to approach it. If you have insurance and you want your insurance to pay for it or to pay a portion of it, go through your insurance, call your insurance, log into your insurance portal.
You can search directories. They kind of function like a Facebook where there's a picture, a profile. Popular ones are, here's another shout out for LatinxTherapy.com is a big one, if you're looking for a therapist that speaks Spanish or is of Latino backgrounds and culture, ethnicity. There's also Psychology Today, you can Google as well.
Word of mouth too. If you feel comfortable talking with certain peers or family members about your interest in accessing therapy, or you know someone who is, and you feel comfortable having those conversations, ask around.
Paulette: Is it okay to tell your therapist that you're looking, you're shopping around, so to speak, that maybe you might go to one or two sessions with other people?
Mildred: Yeah, absolutely. I think it's important to be honest and be your most authentic self. I think another way to look at this too is—at least for myself, when I meet with a client for the first time—I'm also determining that, too. Am I able to work with you based on what your presenting issues are? Because I may not have the level of expertise to be able to work with the particular issues you want to work on, so I am also doing the very same thing.
So it goes both ways. And those are conversations that are important to have. And it opens up dialogue for “what are you looking for?”
It helps the therapist also normalize that process as well, because this kind of service is voluntary. It's not like anybody's telling you you have to— unless you're court mandated.
As I mentioned to you earlier on, therapy should not be sought out if your partner, your siblings, any family member, your friends are telling you that you need to go to therapy. It has to come from you.
So, have those conversations and if you're using your insurance, check in with your insurance and make sure that they're okay with that. Because some insurances will not cover all of the different therapists that you're talking to and so you may have to pay out of pocket for some of it as well.
Paulette: And that is kind of one of the barriers of entry to receiving health care in the mental health field, which is unfortunate because not everybody has the means, but like you were saying, there are county programs that fill the gap.
Mildred: I'm glad you mentioned that because therapy is a process. It's not like going and seeing your doctor, your medical provider, your primary care physician, where you go, like, once a year, once every six months, check up, okay, all good, great. Therapy is intended to be like a weekly thing, at least an hour a week.
And what the bureaucracy of insurances has created is another system where therapy now is watered down. It's not the same process that it was in the earlier years of the psychotherapy process. Insurance has opened up this resource for many who would not be able to, is the upside to it. But the downside to it is that, especially in community mental health or for the county, they want you to use evidence based practices, which means some of their programs are manualized.
So let's go through like a manual and work through the issues that you're presenting and let's go through a series of steps or a time frame, like, okay, let's see if we can get this all in down and settled by like the end of six months or a year or so. So, that's what I mean by watered down. It's not the same process that it used to be.
I haven't encountered that yet with the insurance panels that I'm under. They do allow for flexibility. I have seen clients that have been, actually I just recently ended with a few, that I've seen since the start of me in private practice, and there has been real work done.
It's not just like le estas pagando la renta a la doctora (translation: you’re not just paying the the doctor’s rent).
Paulette: For the office space, right?
Mildred: No, like we're talking about real issues. And that's what I mean. Therapy is intended to be like an extensive process. It's not intended to be like these brief processes. And it doesn't mean that all clients will be in therapy forever, either.
It is possible to end therapy within like a six to eight month range as well, because I have, and successfully too! Because that's the other thing: I always tell my client, at the start of therapy, when we're developing therapy goals, I want to know what we're working on. I want to know what the goals are, because I'm already thinking about the last day of therapy, when you no longer need it.
And the goal of therapy is not getting rid and eliminating the issues, or getting rid of anxiety. It's just learning how to manage it. Because the reality is I don't know how to get rid of trauma. It's not possible. So instead, it's let's figure out healthier ways to cope. And while also understanding that you may experience moments where you're triggered, but now you know and understand what's going on for you when that happens.
And now here are the tools.
Paulette: That was very interesting how you put that. You can't fix trauma. It's not going to go away. You're providing the tools for managing it. Which is, I think, something that people really need to hear in that you're not going somewhere to be fixed. You're going somewhere to learn how to manage your specific situations, quirks, scars, but you're not removing the scars.
You're not a magician.
Mildred: No, and I don't want to! And let me tell you why.
Because things like trauma, these are devastating, very horrible life experiences that people go through that they shouldn't, and unfortunately, they do. And even within the experience of their trauma, there's opportunities to grow and to learn about themselves and their strengths. And through their suffrage, really being able to see how they're survivors, not victims, but survivors. And without those life experiences, we don't get that.
There's a book Man's Search for Life by Viktor Frankl. And he talks about it beautifully. It's a very popular book, small pocket sized type of book written in many languages, including in Spanish.
Viktor Frankl is a psychotherapist himself in the era of the Holocaust. He was a Jewish psychotherapist, psychoanalyst in the Freudian era. But he talks about how we grow and we flourish from suffrage.
So why would I want to take that away from somebody?
Paulette: That's a huge perspective shift for most people. So instead of being defined by your trauma or your scars or the things that have happened to you, you get to use them as a jumping off point for your strength.
Mildred: Absolutely. That's really the stance that I've been working off of.
I learned very early on about myself as a therapist that I want to look at people's strengths. I want to help people find their light. I want people to feel empowered. Really focusing on their personal strengths and looking at their suffrage. Yes, grieving it, processing all those emotions that come with it, as well as looking at it from the stance of, and so how do we grow from here?How do you want to view yourself and what can you take away from that experience?
You get to define yourself, not by this trauma, but however you want. So giving them autonomy in that as well.
To recap the tips that Dra. Ortiz gave for starting the therapeutic process, if you’re seeking therapy be prepared to answer these questions:
What do you want to work on?
What do you want to gain out of therapy?
When you're done with therapy, what are the tools you want to leave with?
When vetting a therapist, consider the following:
Are you concerned with their gender?
Should they speak a specific language besides English?
Do you want someone with your same spiritual values?
Do you need someone with an LGTBQIA+ background?
How comfortable, how safe do you feel when you're meeting with this person?
If culture is something that is important, being able to talk about certain traditions, then make that clear.
Therapists aren’t psychic so if there's something specific that you're looking for in the therapeutic relationship, it's your responsibility to communicate that to them. And don’t be afraid to ask if they think they can help you with your issues.
Stay tuned for next time when Dra. Ortiz will provide the script for breaking up with a therapist.
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