Psychotherapy is a unique relationship, a kind of connection that is unlike any other kind of relationship a person has in their life. In some ways, it can be more intimate than our most intimate relationships, but it also paradoxically values a vestige of professional distance between therapist and client.
Therapists, alas, are just as human as the clients they see and come with the same human foibles. They have bad habits, as we all do, but some of those habits have the very real potential of interfering with the psychotherapy process and the unique psychotherapy relationship.
So without further ado, here are twelve things you wish your therapist didn’t do — some of which may actually harm the psychotherapeutic relationship.
1. Showing up late for the appointment.
Therapists will usually charge a client for an appointment if they fail to cancel it with less than 24 hours notice. Yet some therapists seem perfectly oblivious to the clock when it comes to showing up on time for appointments. While the occasional lateness may be excused, some therapists seem to be living in another time zone altogether and consistently show up late for their appointments with their clients — anywhere from 5 minutes to even two hours! Chronic lateness is often symptomatic of poor time management skills.
2. Eating in front of the client.
Unless you have enough for everyone, eating and drinking during a psychotherapy appointment is considered ill-mannered. Some therapists offer clients the same access to coffee or water that they themselves enjoy. (If you’re going to drink something in front of a client, make sure you offer your client the same.) Eating while in session — by client or therapist — is never appropriate (it’s therapy, not mealtime). And asking, “Do you mind if I finish my lunch while we get started?” is inappropriate — clients don’t always feel comfortable enough with expressing their true feelings.
3. Yawning or sleeping during session.
Yes, believe it or not, there are therapists who fall asleep during session. And while an occasional yawn is a normal component of our daily functioning, non-stop yawning is usually only interpreted one way by a client — they are boring the therapist. Therapists need to get a good night’s sleep every night, or else they cannot be effective in their job (which requires constant and consistent attention and concentration).
4. Inappropriate disclosures.
Inappropriate disclosures refer to the therapist sharing a bit too much about their own personal difficulties or life. Most therapists are warned about doing too much disclosure in session with their clients, because it’s the client’s therapy, not the therapist’s. Therapists shouldn’t plan their vacations while in session, go on endlessly about their graduate school training or research topics (especially if they were focused on rats), or share how much they enjoy their summer house on the Cape. Therapists should keep personal disclosures limited (even when the client asks).
5. Being impossible to reach by phone or email.
In our ever-more connected world, a therapist who doesn’t return phone calls or an email about an upcoming appointment or insurance question stands out like a sore thumb. While no client expects 24/7 connectivity to their therapist (although some might like it), they do expect timely return calls (or emails if the therapist allows that modality of contact). Waiting a week for a return phone call is simply unprofessional and unacceptable in virtually any profession, including psychotherapy.
6. Distracted by a phone, cell phone, computer or pet.
Therapists will often ask their clients to silence their cell phone before entering session. The policy has to go both ways, or it shows disrespect to the client and their time in session. Therapists should virtually never accept any phone calls while in session (except for true emergencies), and they should turn away from any other distractions, such as a computer screen. In a world that increasingly values inattention and multi-tasking, clients seek refuge from such distractions in the psychotherapist’s office.
7. Expressing racial, sexual, musical, lifestyle and religious preferences.
Although an extension of the “too much disclosure” bad habit, this one deserves its own special mention. Clients generally don’t want to hear about a therapist’s personal preferences when it comes to their sexuality, race, religion or lifestyle. Unless the psychotherapy is specifically targeting one of these areas, these types of disclosures are usually best left alone. While it might be fine to mention something in passing (as long as it’s not offensive), a therapist who spends an entire session discussing favorite musicians or love of a particular religious passage is not likely helping their client.
8. Bringing your pet to the psychotherapy session.
Unless cleared and okayed ahead of time, therapists should not bring their pets to the office. While sometimes therapists see clients in a home office, pets should stay out of the office while they are in session. To the client, a psychotherapy session is a refuge and a place of peace and healing — pets can disturb that peacefulness and calm. Pets are generally not an appropriate part of psychotherapy.
9. Hugging and physical contact.
Physical contact between client and therapist must always be expressly spelled out and okayed by both parties ahead of time. Yes, that includes hugging. Some clients are disturbed by such touching or hugging, and want no part of it (even if it’s something a therapist might typically do). Both therapists and clients should always check ahead of time with the other before attempting any type of physical contact, and respect the other person’s wishes. At no time is a sexual relationship or sexual touching appropriate in the psychotherapy relationship.
10. Inappropriate displays of wealth or dress.
Psychotherapists are first and foremost professionals, and any displays of wealth and style should be discarded in exchange for dressing in an appropriate and modest style. A therapist slathered in expensive jewelry is a put-off to most clients, as are blouses or dresses that show too much skin or cleavage. Too casual of dress can also be a problem. Jeans may suggest too casual an approach to a professional service that the client is paying for.
11. Clock watching.
Nobody likes to feel they are boring to another person. Unfortunately the therapist who hasn’t learned how to tell the time without checking the clock every five minutes is going to be noticed by the client. Most experienced therapists have a good sense of how long a session has gone without having to look at a clock until late in the session. But some therapists seem obsessively compulsive about making note of the time, and the client notices (and internally, they may tell themselves what they’re saying isn’t really important to the therapist).
12. Excessive note-taking.
Progress notes are a standard part of psychotherapy. Many therapists do not take notes during a session because it can be distracting to the process of psychotherapy. They instead rely on their memory to cover the highlights of the session after the session has ended. Some therapists, however, believe they must capture every detail of every session in their notes, and obsessively note-take during sessions. Such constant note-taking is a distraction for most clients, and some may find that the therapist uses the behavior to keep an emotional distance from the client. If note-taking is done during session, it should be done sparingly and discreetly.
222 comments
7 good habits of effective therapists
1. The therapist does their own psych work, attends therapy, and gets consultation! Very important!
2. The therapist is consistently on time for appointments
Client’s do understand that “life happens” and occasional misses are acceptable. My boss expects me awake and in work on time except for emergencies, I expect you to be awake and on time, except for emergencies since I am paying you!
3. The therapist eats on his own time not on the client’s time…it’s just rude to do so.
4. If you the therapist take insurance please don’t complain about the paperwork involved or act as if you are doing clients a favor by filing it
…many clients come to you because you are in their provider directory and do not know where else to look, not because they heard you were an exceptional therapist.
5.The therapist maintains integrity when it comes to billing. (Many people can now check their insurance statements online. Make sure you are billed accurately and report inconsistencies to your insurance company)
6. The therapist keeps the office reasonably clean and uncluttered.
Please, we are there to clear our heads not to stare at dusty piles of psych journals and books you haven’t read. If you have a home office your son’s pot plants and bong really shouldn’t be within viewing range of the client… not impressive! (yes, I did witness this!)
7. Therapist can take responsibility and is accountable for his/her own behavior
… many therapists go with the line of thinking that “it’s always about the client”, and their behavior is beyond reproach… ie…a therapist that treats a client in a disrespectful manner is likely to trigger issues of certain client’s background, but the therapist is also responsible for treating a client with respect.
For a couple of years I saw a therapist and we worked hard to eliminate fears and build confidence. I had been through a lot and he was good at getting me to work on my issues over time. I did very well through these sessions.
Then, one day, out of the blue, after seeing him for several years, he left a message on my answering machine saying he was terminating me immediately.
Why? He went on to say that he had told me he would NOT deal with insurance. I had just turned 65 and was on Medicare and Medicare had contacted him asking about his credentials. He would bill me and I would send his bills to first my insurer only and then when I went on Medicare to Medicare who would pass it along to my secondary insurer. Medicare and the secondary insurer paid the therapist and I paid the balance due. Even when Medicare said I did not need to pay for an individual session, this guy billed me. He terminated because he had to deal with insurers.
Shocked I called his office but he never returned my call.I sent him a letter. No response. Medicare then investigated him and it turned out he owed me $1400 which he paid.
I wanted to report him to somebody and researched various organizations including the licensing division in my state. I tried to report him to them but in order to investigate I would have to sign a statement allowing investigators to research my personal file. Not a good idea I decided.
So this guy is still practicing and who knows what harm he has caused other people. There ought to be stricter licensing of psychologists – maybe that would help.
I see a psychiatrist every six months for med checks. I like him a lot, but he is not good at talk therapy. Over the years I’ve come to realize that if you need/want to spill your guts and get emotional support, etc, then see a Licensed Clinical Social Worker or other Therapist. Psychiatrist are notoriously involved in prescribing meds, mostly because they are the only ones who are legally able to do so. I have seen a great “talk” therapist to deal with ongoing issues. Some people don’t get the distinction – and it might just be my perception. What does every one else think?
Hi Therapy Friend
I’m happy to hear you got paid back!
I encourage you to go back and deal with the Licensing Division in your state.They need to see your record to determine that therapy sessions in fact took place and when, and if other “rules of the therapy game” were followed. They are not looking specifically at your mental history although it is there. It has nothing to do with your insurance case.
You were also “improperly terminated” as a client and (pressumably)sent away without a referral… this goes against the ethics policies of most mental health professions (if not all)
I’m sad to hear of another perosn who was hurt by a therapist but it’s time to practice what you worked on with that therapist to “eliminate fear and build confidence”…let the scenario serve as your practice ground. Sounding off here is just making noise and complaining if one refuses to really do anything to help themself in the real world.
These posts are both appalling, and educational. I have been a practicing Marriage and Family Therapist in California for thirty years, and I can’t believe the incompetence and lack of boundaries in the therapists described. My education taught me what to do. My clinical internships taught me about working with patients, and I have a consultant to keep me honest. I feel that the patient should not be expected to know what they are supposed to do. That is just crazy making. I am there for the patient, to guide, and educate if necessary, and above all to listen to what they want, and why and how they hurt. It is our job to be “patient,” and to wait on them, not to expect them to live up to our expectations. And each patient is different. If we are bored, then we need to check on what is going on, not be critical.
Right now, I am very grateful for my teachers!
I’m glad you replied. I went to a LMFT for a couple reasons. I was seeking support and individual therapy. some of what I was going thru was quite challenging. I maintained a positive attitude for a while. It became tough after excessive self disclosure. He was practicing close to 25 yrs, but still hadn’t figured out not to talk about his stuff. I felt like I had “brain screw from him.I couldn’t think of what to say whle wondering what he was trying to do. He complimented me more than necessary & it sounded quite fake. He also tried to hide his tendency to think in an oversexed way. Wow. Than he sat close to me & freaked me out. A very odd therapist.
I’m sorry so many of you have had such negative experiences. I would encourage you to say something to the therapist as difficult as that may sound. I know that I’ve been guilty of running late, drinking a beverage and in emergency low blood sugar cases eating something so that I could concentrate better. I try to stay away from asking the How do you Feel about that question but there is a reason why that question is asked. As cliche as it sounds being able to name feelings is a form of exposure and those that have difficulty articulating and sitting with their feelings are more likley to have psychosomatic issues. I don’t know how it is for other therapists but I’m certainly not in it for the money. 7 years of education, the cost of insurance, continuing education, health insurance, being on-call 24 hours a day and the cost of licensure and I’ll be lucky if I clear 35,000 this year. The unpredictable nature of the work and who will show to their appointments sometimes makes it difficult to work in proper breaks. Maybe these are excuses. Most therapists are very caring but they are not all knowing and what offends some does not offend others. So please speak up and let us know.
I had a therapist, she was in her 50’s, and she was a knowns professionist.
Once she fell asleep in front of me, she just closed her eyes.
it was 18.30, not 23.00.
I have minor issues and I can understand i’m not thrilling, but still I felt it like a lack of respect, and her bill was sky-high.
In add, her way of approaching things was letting me talk,talk, talk.
Not answering at my questions, not helping me with any kind of suggestion, or directions.
When I was trying to see where my therapy was headed, she never said anything to me.
I spent 3 years talking, talking and never having anything back from her.
This summer I faced a kin’s illness which made me really tremble and in front of it it was obvious her session were just too easy going and unable to help me.
Looking back, I wondered if I got better just cause I grew up and life changed me or if she really did something on me.
I found another therapist, a young male, probably not out from college from more than 4 years, but is just better:
maybe cause of first time passion, he’s always on time, he’s gentle, he listens really and he always is careful to show me the path I decide to do with him.
I pay him way less to do quiet hours in his study which is just deliciously quiet and good scented.
Sometimes change’s good.
RE: Crys
“….young male…first time passion…he’s gentle, he listens really and he always is careful to show me the path I decide to do with him….do quiet hours….deliciously quiet and good scented.”
wow. your choice of words reveals quite a bit i think! Using words like passion, gentle, delicious and “good scented”(?) to describe your therapist? Hmmmmm…..
my therapist was going to lose her home,and i gave her loans so she wouldn’t lose it,if my husband finds out i will be beat up,but i don’t think she cares
oh i forgot to say she is now with a 70 year old client.boyfriend girlfriend thing,sick
I am very pleased to say that my therapist, who has helped me tremendously, and whom I’ve been seeing, off and on, for several years, has never done any one of these things.
ONCE, in all those sessions, I was in crisis, and the only early opening he had was during his lunch break, which he told me over the phone before I came in. He asked me if I minded him eating his sandwich during the session. I said no, of course not. I think he took about two bites of the sandwich during the entire hour.
THERE ARE GOOD THERAPISTS OUT THERE. IF YOU DON’T LIKE THE ONE YOU’RE SEEING, TRY ANOTHER
I’m not a therapist, just a very experienced RN–who, by the way, lives on the EC. The absolutely best therapist (and most helpful by far) to me has done the following:
Brought her very well-behaved little, miniature Yorkee to work with her. Now, I have no dog phobias, and I am huge dog lover. But after she “introduced,” I really didn’t know he was there. BTW, he was totally adorable.
Secondly, she has used a few (not extensively elaborated on) examples from her own life and experience in order to be helpful. I am also a teacher, and I know the value of relating to help guide the other person/s in understanding. You just have to be carefuly not to make the session about the example or about yourself or something else as a therapist. You must focus on the client and staying relevant.
Dear God in heaven, absolutely never has she yawned or fallen asleep. She completely understands and relates the vital importance of active listening.
NOw, and here is where some may part ways–but you must understand that a client knows this going in–prior to intake or any sessions. . .her practice is in a group of Christian therapists. Guess what? Sometimes she prays with me and her clients, and honestly, it is awesome.
Finally, any hugs have always followed a reguest if it is “OK” to give each other an understanding, supportive, platonic hug. Sheez. All things must be put in context. As professionals in this field, I would think that would understood–not at all suggesting that indeed it is not–that’s just a sort of colloquial way many communicate on the EC. It’s a matter of fact style, not meant at all to seem condescending.
But I have always sort of expected a more general lack of well, perhaps “rigidity” among therapists. I mean I agree with the person that is talking about appropriate lines and boundaries.
Finally, I like the way my therapist has dressed–well, professional, but not too “business-like.” She’s really a good balance of things.
My only probable is that she moved, and now it’s quite a bit further to get to her office–darn it. She really helped me with some huge issues, and w/o her guidance (and yes, I also believe prayers), I would be stuck in something tragic–still suppressing, repressing, and blaming myself for things that happened to me as a child.
I can honestly say that I believe (know in my soul) that God used this therapist to help me grow in a greater understanding of things and experience this immense sense of total freedom.
LIke I said, I only wish she lived closer. She is one of these persons that is not only well-educated, she just naturally has certain gifts and abilities that make her quite excellent at what she does. As nurse-professional and teacher, I can say that one can be very well-eduated, but that does not mean one is particulary gifted to do something for which they have been educated.
Just some perspectives from one in the “peanut gallery.”
Thanks
Please pardon any typicing or other errors. I’m under the time “gun.”
I went to a male therapist in private practice for over a year. He flirted with me all the time and I ended up knowing more about him than he ever got to know about me. I really thought that he loved me because of all the things he told me and I thought I was special to him. He told me so many things that I won’t even post. The truth is he is a very lonely person who feeds off his clients attention. His self-disclosures were intentional to create this relationship and the reason I know that is he was very professional at first. I feel that all therapists should be supervised no matter where they practice home etc. I still miss him to this day because my love for him was real and unconditional. I became the mother he never had. I doubt this person will ever have any close relationships outside of therapy. What I did learn was that we are all the same in the end. People looking for love, understanding, warmth, nuturing and caring. The only problem is sometimes the client ends up realizing the therapist is more damaged than they ever could be and wants to help them because they do care.
Maggie, that person was way unprofessional and inappropriate. I am wondering what made you keeping going to him all that time. I’d have been out the door.
I am sorry you went through that.
Makes me appreciate the therapist I wrote about all the more. God bless her.
I feel there is a certain element of the “Stockholm Syndrome” happening to a particular subgroup of clients – ones with emotional lability and abandonment issues.
Sometimes these clients know their therapy is not progressing in an ethical, legal, procedural, moral, logical or even intuitive manner.
Yet they are drawn back again and again to that particular therapist because they make them feel good about themselves through countertransference, self-discloure and compliments.
Would anyone care to back me up on this or propose an alternative theory.
I am a psychology student who is thinking of using this scenario for my undergraduate thesis.
wow, i never thought most of these behaviors existed in therapists. I didn’t realize until this moment, reading the article and the many comments, how freaking lucky I am when it comes to therapists. I am going to give my therapist on Thursday, a sincere thank you for being a great person and great therapist. Can’t imagine being able to work on healing myself if she would do any of these behaviors.
I wish therapists would try and sort out their own issues before committing their lives to helping others with issues they can’t possibly give honest counsel on.
Ultimately, more than anything in the world I want to heal myself, to love myself, to love others, and for everyone to be able to work on healing themselves. I wish the best to all here, in therapy and out of it.
I am totally appalled by this list. Call me naive, or call me someone who has the good sense to not see a therapist twice who would do any of these things!
I feel sorry for anyone who had to deal with an unprofessional/abusive therapist, but I hope they would care enough about themselves to get out of the negative situation.
(Eating during session is totally fine with me—my therapist is amazing, and sometimes pulls 5 hour in a row sessions…it’s totally necessary for her to function!)
Eating during a session is NOT fine with me. Therapists get 5-15 minutes between clients which is enough time to eat a couple of sandwiches, make a couple of phone calls or have a toilet break. My therapist does eight in a row some days and professionally honours all of her clients. When I am the last client of the day I am amazed she is still not only awake but mindful and vibrant at the same time. This has been a consistent pattern of hers since 1996.
My therapist has never eaten in front of me, only drinks tea or coffee with my permission but not before offering me one as well, doesn’t bring distracting pets into her office, has the phone turned onto silent, ditto computer and closes the window if it gets noisy outside. I have her full, undivided attention and she has only once yawned in front of me and that was when she had a cold.
Most therapists do the right thing by their clients. This sort of blog will always attract people who are not happy with rather than the majority who are satisfied with their therapist and their therapy.
I think there may be a vastly skewed representation of disgruntled readers posting here because of the nature of the original blog. The proportion of people who are unhappy tend to be drawn more to posting negative comments. I believe that in the real world the percentage would be much less. I could be wrong of course.
Stranger than Fiction at 10:58 pm on March 20th, 2009 wrote:
I feel there is a certain element of the “Stockholm Syndrome†happening to a particular subgroup of clients – ones with emotional lability and abandonment issues.
Sometimes these clients know their therapy is not progressing in an ethical, legal, procedural, moral, logical or even intuitive manner.
Yet they are drawn back again and again to that particular therapist because they make them feel good about themselves through countertransference, self-discloure and compliments.
Would anyone care to back me up on this or propose an alternative theory.
I am a psychology student who is thinking of using this scenario for my undergraduate thesis.
Hi STF… I changed my ID to Maggie09 as there is a second maggie posting as well.
I concur with your statement and would like to talk you about it. Is there a way for us to talk/email away from this blog…I don’t feel this is the place for it…way too long.
Essentially though, when one grows up in a dysfunctional environment, then attracts during the course of their life the same types of people who feel “like family”, they will also attract therapists who share the same characteristics. In my experience with one therapist the unethical things that happened “felt normal”…until I woke up.
You may want to read up on “repetition compulsion”. I have a wonderful therapist now who explained all of this for me. Some say it’s an efforet to heal the original hurtful circumstances. Thank the heavens for sending her into my life!
Hi Maggie09,
My email address is [email protected]
Would love to hear from you.
Listen up, folks, Miastella is right – the demands for paperwork are extensive in private settings, too. We are in a hospital-based clinic and have to gather volumes of information by the end of the first session – hence the reams of paperwork that clients are asked to fill out, most of it very personal, before the first session. The information has to be correct because it goes into the electronic record and cannot be altered once it has been “processed”(I think clients should scream bloody murder about electronic records for therapy, but that’s another topic.) Then the insurance companies demand another set of information. If we therapists fail to gather this information, our clinic can be cited with violations, or the insurance company can deny a client’s claim. The client literally gets no time to explain his/her needs, and it’s all because the regulatory bodies and insurance companies insist on these practices. If a client survives the first few sessions that require a large number of irrelevant questions, they can get what they came for – until 90 days later when almost the entire process has to be repeated.
Now we are told that we must collaborate with physicians (hence the electronic record). If an MD calls, we are to drop everything, including the client in the office, and take the call.
Perhaps knowing the backstory of the demands on the therapist can help put some of these annoyances into perspective.
Regulatory bodies and insurance companies certainly don’t listen to us therapists; even the APA gets nowhere with them. Clients have to speak up and insist that quality of care requires that therapists have more flexibility to respond to the needs of their clients, not the “needs” of the regulators and corporations!
I am lucky to have a terrific therapist now. She does none of the things on the list, but if she ever found it necessary to eat or take notes, I know she’d ask me if it were ok first, and she’d have a good reason. Her boundaries are very good and I have never felt that she was trying to fit me into some preconceived idea of me and my condition.
I have to say that I have been in therapy on and off for the past 4 decades and I have had therapists who have done all the things on the list. Luckily, I guess I’ve had enough experience and gained enough confidence to stick up for myself and make sure my needs get met.
That’s not easy or even possible for many new patients. It requires that you know what you need, and it helps if you have good experiences with which to compare the bad ones, and you know what is helpful to you. I only know that I have read a lot; I have compared notes with other patients in support groups, and I’ve done a lot of self-examination to get to the place I’m in now. I’m sorry to hear about all the bad experiences. There are terrific therapists out there too.
I am a therapist (clinical psychologist) who works primarily with children and families. I found this article and the comments very interesting and even enlightening. I always enjoy and appreciate having the opportunity to hear things openly from clients’ perspectives.
I do have one question that I would like to bounce off of everyone: I do one of the behaviors indicated here and would like to get a sense of whether people think this is wrong. I’m a type 1 (insulin-dependent) diabetic. My clients and their parents are aware of this. I tell them primarily so that if I do start to have an insulin reaction during a session, I can explain to them quickly why I need to eat candy or glucose tablets. That probably happens about once every two or three months. In those situations, I’ll say to my client something along the lines of “you know how I told you I’m a diabetic?” Well, my blood sugar is dipping and I need to have some sugar. Is that ok?” No one has ever expressed any misgivings about me doing that or seemed bothered by me eating at those times.
But I welcome any feedback.
Dr Mateja
In your circumstance I don’t think there are any clients who would object. What is being talked about is the eating of a meal in front a client. Some therpists with poor boundaries will not, or do not, schedule a meal break for themselves and think it’s just fine to eat while in session.
If you do need to eat candy and take care of your needs I do suggest you also offer a piece to the client. More so for the benefit of the client and yourself… If you have an attack…wouldn’t it be a better idea to stop the session and reschedule the client as your system needs to return to homeostasis? If your reading your own bodies signals that something is off balance…taking care of your needs and then feeling when balance is returning…how much focus are you really giving your client at the time?
I think there are a lot of therapists who truly love what they do and want to help their clients. As a client, when my therapist is not perfect…she’s a few minutes late, or she forgot something I thought was important but probably only barely mentioned it once, then I get to see that she is human just like me. When I first saw my therapist and I thought she was this perfect person it was intimidating. Now I am not talking about a therapist making a big mistake that really harms the client, but sometimes we can learn something from these little things that just make them more human. Just my thoughts.
@Michelle- The question of “How does that make you feel?” has gotten a bad wrap for years, mostly because people don’t understand why we therapists ask it. I can understand how it feels generic to you, but we ask questions like that because we genuinely want to know how you reacted to a particular situation!
Often I will hear clients describe a particular scenario, and while I know that I personally would have felt disgusted/angry/guilty in response, I can’t make the assumption that my client feels the same way. When I ask, “How did that make you feel?” it’s because my client hasn’t said what his/her emotion was, is giving me lots of details but avoiding the emotional aspects, or telling me what his/her friends’ reactions were but lacking insight into his/her own reactions. Sometimes it’s not so obvious, as you say, and a question like “How did that make you feel?” will be greeted by a stunned look and “Hmm, I’m not sure,” or “I don’t know.”
We ask questions like that to keep the focus on the client. It helps both of us understand how he/she is working inside and can be informational for the both of us.
So therapists should explain why they ask it, and why they do and say other things, instead of (and no, I am not saying this is all therapists) assuming they are the expert and performing their little hocus-pocus on the client without treating the client like an equal and an adult enough to tell them what is going on!
I think most of these should really go without saying. I found the worst habits of therapists were:
failing to see things from my perspective
not offering sympathy
not being flexible about the kind of treatment offered
telling me the conclusions instead of letting me work it out for myself.
Its simple, when I go to therapy I want to talk about my emotions to someone who cares about me, to feel like they are on my side. I want them to ask the right “guiding” questions so I can eventually work out my own solution and put that into action. Sounds basic but I’ve had such a hard job getting anything like that from some therapists!
I didn’t even know that people had issues like these. I am lucky that I don’t have issues with my T.
I place the profession of “Psychotherapist”, in general, in the same category as “Lawyers” and in some cases, “Doctors”. There are others that fit into this general category. What is the the tie that binds them?
They all have a vested financial interest in non-resolution. In other words, they all will make more money the longer the “problem” persist.
I have been to a “therapist(s)” and, though I don’t blame them for the issues I’ve had, I do accuse them of NOT offering possible valid solutions.
To be in the profession, I think, takes a person of extreme moral and ethic fiber to do their job without thinking about how to make the next payment on their upcoming hawaiian cruise they plan to take in September.
My comment to my fellow psychiatrists would be: why not give your bills to your patients and let them file? As long as you are up front about it. Also, I wouldn’t get too upset about patients regressing, whining about the how do you feel question, wanting a perfect pill, expecting you to read their minds and fix their problems for them immediately, etc. If they had wonderful childhood they wouldn’t act this way. But then they wouldn’t need THERAPY. These behaviors are called *transference*.
I can’t tell you HOW many times #1 has rung true for me.
I would not like it if my t had a insulin reaction in session, I would then feel like I was having to take care of them, I have hypoglycemia and know that I can fade out very fast and need assistance in coming around…besides my brain always gets foggy first…
#13: A therapist who sets herself up as powerful and in control of the session through obvious and covert means. Obvious: telling you why you feel as you do before obtaining sufficient background on you or placing you in a ‘shoebox’ labeled as xyz and identifying all your symptoms as from that ‘xyz shoebox. Covert: sitting in the ‘big chair’ which is higher than any other chair in the room and using a ‘professorial’ tone of voice. I tested my current therapist several years ago by sitting in her ‘big chair’. She was very open to the switch and we had a good discussion of the power dynamics involved. Needless to say, she is still my therapist.
My therapist is absolutely wonderful. He genuinely cares and empathizes without coming on too strong or making it uncomfortable. He made it clear from day one that he was coming from another location and will most likely always be 5-10 minutes late but always makes sure I get the extra time at the end. The only time he tells of his personal life is if the subject matter relates to my particular problem. Too bad their aren’t more therapists out there like him. Previously I had seen a social worker a few times for a family members terminal illness and all she wanted to do was talk about her favorite restaurants..needless to say I got the hell out of there.
Lola…it’s great that you really like this therapist but think about this…
Why don’t you and your therapist make your appointment time 15 minutes later so he’s “on time” and you’re not waiting? It’s not extra time your getting at “the end” but the time you are paying for.
Unless of course you both just enjoy the dynamic.
Regarding the “how does it make you feel” question, you would be surprised how often you either can’t tell how a client is feeling, or assume they feel one way only to find out otherwise.
For example:
Therapist: it must have hurt you when Shelly broke up with you.
Client: Not really. I was eagerly waiting for it to happen.
Just there the therapist has lost credibility with the client and made themselves look foolish. It’s better to ask how a client feels than assume. On the other hand, if it bothers the client, he/she is free to ask their therapist to stop asking this question.
13 should be attacking the client. One colleague of mine bombards his clients with “why did you do that”, “you know that was wrong”, ect. He should have been a police interrogator, not a counselor.
Dictating the client’s feelings actually goes all the way back to Freud, when you think about it. Read some critical interpretations of how he handled the “Dora case” and you’ll find that his refusal to accept input from his clients and dogmatic rejection of any opinions on their emotions other than his own was absolutely stunning. In a nutshell–
Dora: “So this friend of my parents’ who’s like thirty years my senior sexually harassed me and now I find out that my father is screwing the friend’s wife.”
Freud: “Obviously, you liked being harassed by the family friend, and I think you two should get married!”
Number 10 is the worst!
My previous counselor talked about how wealthy he was all the time! His expensive canes and how he wins money gambling! It was atrocious to say the least.
Glad I found this great thread. I recently found a therapist around my own 45-50-year-old range, with whom I feel quite comfortable so far. He’s always on time, dresses up but neatly, and interacts with me very professionally, yet he seems warm, sensitive and empathetic. I am also bugged by therapists who are overly sterile- or clinical-acting, who make you feel like a complete lab specimen.. When one prior therapist of mine did that, I felt put off and uncomfortable.
I will agree that I always find it hard not to wince when the end-of-session arrives. Often I feel like a goof being in the middle of some important statement or profound thought — only to have my therapist remind me our time’s up.. He’s good though and will try to quickly get in a “We have to stop in a moment, but…” segue a good minute or two before. But then you get rushed right out the door, and sometimes your thoughts are like wounds that were opened and then not properly closed up.. Sometimes I find ME checking the clock to try to out-session-end him! These little things can make therapy seem to me like “advice prostitution” sometimes — but overall it’s quite valuable and self-affirming to me.
I like professionalism mixed with an easygoing nature — but I would not want a therapist to only be a drive-through prescription refiller for me, nor someone who acts like my best friend — which they never are and should never be or feel like, IMHO.
I happen to know that my therapist changed careers (she was an Account Executive in the ad agency world), has been divorced (her husband was very controlling) and is a Buddhist. All of this plus her habit of giving me books to read (that I have no time to read) instead of giving me insights that would actually help are making me want to dump her. My husband has finally agreed to go in with me but now I’m not sure I want to. She’s trying to push me to a psychiatrist and I don’t want any part of that. I’m depressed, I have some issues but I don’t need to be medicated for the rest of my life. She’s also inconsistent in when she can see me. I’m happier when I’m not in her office. How do you spot a good therapist and what are the warning signs that one is kind of a fake, like she is?
I’ve been attending therapy since I was 6 years old, and have been to at least 10 different ones. All of which have always asked the same question at least 20 times in an hour session, “and how does that make you feel?”. Honestly, the first time it’s fine, but after the 3rd or 4th time you begin to answer the questions more hostilly and eventually lunge at them with a fountain-pen-spear. So, what I was trying to state is that you forgot the asking of “how does that make you feel?”.
-Alex
Wow. I have been sooo fortunate with my therapists! The first was an intern – a delightful lady with a pleasant (almost musical) voice and a charming accent. She would drink hot tea in some sessions, always asking did I want some. I didn’t care that she drank her tea during session… there were just bigger issues in my life.
She moved away and referred me to a male therapist. For about the first 6 months I was bound and determined to hate him. He has a well honed “therapist stare” (as it was called in a much earlier post) and I felt as if he could see the very stains on my soul. Now, I absolutely adore him. We have a friendship, but on a professional level. I trust him completely. Sometimes he has a bottle of water, but not usually. If he is expecting a phone call he warns me at the beginning of the session (ie when family was ill, or when there was unexpected road construction blocking the normal route to his office).
His stomach has growled. He has yawned. He has sneezed. I don’t have him on a ‘little god’ pedestal, so they don’t bother me.
Sometimes if my appt is right after his staff meeting he runs a little late – a quick apology and we move on. I guess we have just developed a relationship that is based on more than “perfection”.
He asks ‘how do you feel about that?” … but because I trust him so much, I know he genuinely wants to know. How else would he find out my true feelings if he didn’t ask????
I admire the therapists (etc) who set out to truly help hurting hearts find healing… it isn’t a glamorous or thankful job, but I would think in its successes there is a multitude of rewards.
I must not be like most people because I really don’t want my therapist to be uptight! Some of the examples are no brainers (common sense) but the others, I believe, get in the way of the therapist being themselves. Also, for me, some of the examples listed would make me feel more comfortable not less. I don’t believe every therapist can be everything to everybody but as long as the therapist stays true to themselves and doesn’t try to be something they are not the people they do mesh with will have a much more positive therapy process.
Each person has a story and their experiences (good , bad , or ugly ) are a reflection of what *Another person experiences or has experienced ,providing them with insight and helping them cope with issues , that aren’t very hard to deal with , what im trying to say is that its very important to recognise these emotions and let them float and manifest into an enlightening learning experience that in turn paves way to a healthier and happier future.
i,ve read every post-took me 3 hrs. as i like to reflect on them to see if there is one that fits my situation. i have DID and the process of knowing the altar and learning of the memory can take a day or weeks for me. But the one thing i get comically annoined with is the part where he says, “Next session we’ll process the memory.” just to give me a heads up. i finally asked him if there was a better word for “process”? i grew up ona farm and when fall came around so did the “beef”. my job was to “process” the hamburger! When I told him this story, he laughed loud and long!! He said he would try to find a proper synonym, but he can’t break an old habit. Yet, every now and then, when he says we would be processing a memory, i shoot back with, “…will it be from the rump roast part or sirloin mixed with a bit of fat…!” After almost 11 yrs., we still have fun with the process of processing!!
Therapist re-wrote my family history and had me believeing mom was the cause of all my problems and I should cut her and anyone else who disagreed with me out of my life. And I did do that accusing them of all sorts of crap. Then I woke up one day reading online stories of bad therapy and how the drugs affected thinking and emotions. I had a lot of relationship repairing to do, including the husband and kids I walked out on, and one step at a time I am taking my life back without drugs or a shrink.
I am a therapist. I agree these 12 habits are poor. However, one expection maybe talking about yourself. Self-disclousre can be beneficial to a client. Sharing how you may have handled a common situation the client has can help. Sometimes it is relieving to a client to know their experiences and feelings can be common and they arne’t the only ones etc. However, if the session revovles around the therapist talking about themselves not good.
In defense of therapists people can project so much on to a therapist about their own preconceived notions about what the therapist is suppose to look like, say, dress like, what their office is suppose to be like etc. If you don’t match these ideas clients can project their anger, disappointment, pleasure, annoyance, etc on to the therapist before the therapist even has a chance to attempt to work with the patient. Sometimes I can immediately just upon a greeting sense whether I am what they think I should be positive or negative. If it doesnt match their expectations then its over before it starts. I do addicitons counseling in addition to individual and couples. I have actually had clients assume from the beginning once they realize I also do addictions that I can’t help them because I am that type of counselor and they are probably in the wrong place. Thus, just having a addicitons credential is a stigma. At times I can feel I am being judged unfairly and sets a tone that can make it difficult as a client has already made quick judgements. So I say give us a break too! We are just trying to help even if we don’t match some idea in someones mind about what we are suppose to be like before we get a chance to see if we can be helpful.
By the same token, some forms of self-disclosure are fairly revealing, like a therapist I knew who gradually revealed through tidbits of information just what a complete dysfunctional psycho she really was, much more disturbed than any of her clients. It’s important for a client to know if the therapist is, in fact, the really sick one in the room.
This was a good list. I caught my therapist glancing at the clock a few times, and she tended to be late a lot–sometimes by 10, 15, or 20 minutes, which wasn’t good for me since I saw her on my lunch break. I will say that she brought her dog Eli with her and I actually found that calmed me down a bit: He was adorable and seemed to like me a lot. I no longer see her, but I did adopt my own dog, partly because of the effect I noticed he had on me. Because I have to see him every day and his needing to be walked forces me out of bed every morning, Oliver’s presence in my life is more therapeutic than the therapy!
Right ON! Wow, I’ve been waiting almost 20 YEARS to read this!!!
I even suggested light-heartedly once that my Therapist’s Grocery list was looking kind of extensive, even for ME!
He had no sense of Humor at all! Ever.
:o)
At the beginning of a session I noticed my therapist had a Cornell coffee cup on her desk. I kiddingly asked if she was trying to hold her superior education over my head. Suddenly she looked like a deer caught in headlights. I looked over to where she was staring and I saw her Bachelor’s and Master’s degrees hanging on the wall next to me — right over my head.