, Newburyport, MA

October 18, 2013

Health and Well-Being: Choose a therapist wisely

Health and Well-Being
Dr. Jim Manganiello

---- — Readers often ask me about how to choose a therapist wisely. The decision to go into therapy is an important one. Ideally, it should be based on some clear understanding of what we need and what kind of psychotherapy we are getting involved in.

Psychology is a broad field with many different theories about the nature of personality. Each psychological theory is partially true in that it puts forth accurate views about particular aspects of human psychology. A problem usually arises when any one school of thought tries to present itself as having accounted for all that is true about psychological experience.

Any approach to psychotherapy is based on one or more psychological theories. The question that underlies a psychological theory and the visions of therapy that it generates is: What is a human being?

Before going into therapy, we should have some sense of how our potential therapist answers this question both as a person and as a professional practicing a particular style of therapy.

The question is an important one because the answer can greatly determine what our experience in therapy will be. If we present a symptom of depression or anxiety to two different therapists, for example, we could get vastly different views about our discomfort depending on how each therapist consciously or unconsciously defines the nature of human beings.

Some therapists regard depression or anxiety as a symptom based on brain dysfunction. They focus almost exclusively on treating depression with medication. The question — What is a human being? — is answered in terms of some abstract norms that suggest that “normal” is symptom-free functioning. Depression is understood as being a brain disorder that’s highly resistant to change on its own. Medication is thought of as an agent that reduces symptoms and relieves suffering. Indeed, medication is sometimes necessary to a person’s well-being, especially in challenging transitions, but, too often, medication is prescribed when it’s not needed.

In contrast to a view that understands a personality on the basis of where it has been in the past is another position that emphasizes the question — Where is it going? If a tree by a barn in a field is bent and twisted, the “where has it been” view would understand the tree’s “symptoms” as having been caused by events early in that tree’s life. Such events need to be seen and their damage healed. Another view would see the tree’s bends and twists as efforts to position itself in order to get its needed supply of sunlight and nutrients that may be blocked by the position of the barn. The question what is a tree is answered by making reference to a fully healthy tree of that species. That is, the tree is going or heading toward becoming everything it has the potential to become.

In fact, both views need to be integrated for best results. For some therapists, a human being is a project on its way to becoming all that is possible for a human being to be. In this view, each of us has a powerful, though subtle, force operating within us that pulls us toward our deepest possibilities. But in truth, deep work is needed to clear the way for this growth. The past must be dealt with. We can’t wax a dirty floor and expect it to shine for long.

Depression and anxiety can be seen, not as symptoms of illness, but, rather, as symbols of understandings that are begging to come about. Our conditioned personality may be pushing us in a direction that is in opposition to where we are being pulled by the deeper force within us. This conflict typically involves turmoil and hard, but inspired, inner work. Dealing with our past wounds and real feelings is essential if we are to truly move forward and grow into all that we can be. Deep therapy is not a walk in the park. You must be willing and able to do the work to become free.

It is rumored that Carl Jung, one of the greatest psychologists of our time, was prone to express his condolences to patients who came to sessions with a happy and satisfied conditioned personality. He assured them that he would stand by them during such a dangerous and unproductive time. When these same patients came to therapy anxiety-ridden and depressed, he would congratulate them on their good fortune in being in a condition where the soul’s work could be deeply done.

Before going into therapy, we should ask ourselves what we really want and why. Sometimes, these questions can be explored during the initial stages of work. In any case, we would always be well-advised to have a clear sense of how our therapist has considered the question — What is a human being? She or he will see us and treat us accordingly.


Dr. Jim Manganiello is a clinical psychologist and diplomate-level medical psychotherapist based in Groveland and West Boxford. He is also an author and teacher focusing on stress, personal growth, meditation and “inner fitness.” His book “Unshakable Certainty” is available on Amazon. Email him at or visit