Just my ramblings gathered from dealing with 8 shrinks over the course of 20 years, so take my advice or leave it.
says you: Hasn't she said she's 25 (and a half)1) Write. A LOT.
says me: I know... but that's what it is...
Writing helps you express things that are too embarrassing to tell your therapist in person. This has rarely been an issue this time around, but it still is sometimes, even after 3 years. Sometimes you may finally see an opening to discussing something you haven't ever been able to tell anyone. See #2. Make sure they read it before your session. Once they know, they know. You might as well talk about it.2) Find a therapist who is email savvy.
See the other post for another reason why writing is good. Writing just helps you express things period. You might feel put on the spot during a session, or like if you sit there going uuuuummm... for too long you're wasting both of your time and your money. Sometimes it just takes awhile for thoughts to form. Writing gives you that time. Write some, take a break, delete it, write some more. Take a 2 day break and go back to it if that's what you need. Or write it all at once in one sitting if your mind is on the ball. Things definitely come out of my head more eloquently and cohesively on this blog then they ever do coming straight out of my mouth.
There is no way I would ever see a therapist that didn't have a work email and/or wasn't into checking email at least twice a week. I never realized how beneficial writing was to me until I started blogging. What was horribly frustrating for me was printing things out and spending the first 15mins of each session twiddling my thumbs while she read something she could have read on Saturday or at 1:30 that afternoon.3) Availability by text is optional.
I would never fault a therapist for setting that boundary. In fact, I know lots of doctors that have work emails, but I don't have any doctors or know of any friends who have doctors or therapists who welcome text access.4) If you don't like to write, try art. Or, even better, do both.
My current one does. I find it much more convenient to reschedule by text then to call, wait for her to check office voicemail, call back, miss her call, etc... It also frees me from being tied to my computer like I am with other doctors. That, and well, I get answers MUCH QUICKER. It's also the most convenient way to say "AAARRRGH! The stupid cab hasn't shown up yet," When it's 2:55 and my appt is 3.
PLUS, if, for example, I am extremely irritable on Thursday, but am fine by my appointment 5 days later, the chances are I'll have decided there are much more important things to talk about in the 1hr I have. Maybe there is, but maybe this is important. The jury is still out on whether or not this makes me codependent, but I'd rather mention it right when I am irritable then not at all.
I like to do art when I'm extremely anxious. Others I know like to do art because not only are things too painful to talk about, they're too painful to write about. However you can get it out is a good way to get it out.5) If you leave your therapist's office feeling like you want to punch a wall, and you didn't feel that way when you went in, find another therapist.
If you're really into art, try an art therapist. Just because someone is a board certified art therapist (has the letters ATR-BC after their name), doesn't mean you can get money back from your insurance company for your time with them. To do that the person has to have ATR-BC after their name, but additionally has to have one of the following groups of letters as well: LCSW-C, PhD, PsyD, LPC, LCPC, DSW. That means they have separate additional training in psychotherapy. I don't agree that this is necessary, but it's the way it is.
It's obviously more challenging to have a therapist review your art work in advance, but it isn't necessary like it is with writing. Reviewing art should be a dyadic process. There's too much complexity to art to gain a true understanding without asking questions.
By the way, if you go to someone who has one of those 6 groups of letters after their names, but is missing the ATR-BC, you're not really doing art therapy, you're just playing with crayons in a therapist's office. To find an art therapist check the link above, or in Maryland try the Maryland Art Therapy Association.
If they try to twist things around and convince you that you're the problem, not them, definitely find another therapist. If you believe them and schedule another appointment and then get home and go "what have I done?" Call back immediately, tell them you just remembered something you forgot, and you'll have to call back to reschedule. Then find somebody else and forget that person. Don't call back.6) If that happens, DO NOT pick a new therapist out of a book. Ask someone or someones that you trust for a recommendation.
If you've been to a lot of therapists in the past, (I mean, this is my 8th) you know what you want and what you don't want. My main criteria is that when I ask a therapist a direct question they actually answer it. "What do you think?" is not an answer. "I can't say right now. I need more information," IS an answer.7) If you walk into your therapist's office feeling like you want to punch a wall and you think their assessment is completely off the mark, I encourage you to argue with them.
Don't be afraid to ask the therapist what their approach is and to tell them what you like and don't like on the phone before meeting them AND during the first session. I was told by the 'what do you think' people that answering questions "isn't therapeutically appropriate," so I found someone who agrees with me that this is bull.
If they insist on keeping you in the little box they created and are unwilling to explore other possibilities that coincidentally have that same specific common symptom, consider getting a new therapist. See #6 (unless they won you over and you now, truthfully, agree with them).8) If for some reason you find you can't look your therapist in the eye, don't. Fidget.
However, if they agree with your assessment right off the bat, keep them and smile to yourself for being an insightful genius.
This was never a conscious issue with me, but I spent years in therapy fidgeting. Even the bad therapists don't mind. The good ones will have something to fidget with. I'd take my necklace off and play with it. Or, since I've had long enough hair, I always have a pony tail holder on my left wrist. I've broken quite a few pony tail holders in therapy. Those ones that are glued will eventually snap if you play with them enough. Or I'd take my hair down and put it back up. Repeatedly. For awhile I brought in theraputty.
I don't know when I stopped fidgeting. It's not something I was conscious about either, for awhile. When finally I realized it was one of the times went "WOW she's good!"
Any suggestions on what guys can fidget with? Maybe borrow your girl/friend's pony tail holder? I once gave one to a platonic friend (who is bald BTW) and it made all the difference to him.