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Professional Relationship

Review of Jung vs. Freud in A Dangerous Method

by John M. Grohol, Psy.D. 2/9/2024

Review of Jung vs. Freud in A Dangerous Method A Dangerous Method, the new David Cronenberg movie — based upon the 2002 Christopher Hampton stage play entitled, The Talking Cure, (which in turn was based on the 1993 non-fiction book by John Kerr, A Most Dangerous Method) — is not only about the relationships you see on the screen between Carl Jung, Sigmund Freud and Sabina Spielrein, but a breathtaking metaphor for Freud’s depiction of the mind.

A successful effort on a multitude of layers, the movie offers us a rollercoaster ride in a car filled with a motley group of historical characters in psychology and psychoanalysis. The movie depicts the life of Jung and Freud’s relationship from the time they first met in 1907 until their professional relationship collapses in 1913 — a short 6 years. I saw a screening of the movie earlier this month.

But it would be wrong to characterize this as a story only about Jung and Freud’s relationship. Instead, it’s a larger-than-life tale about the first days of psychoanalysis and Jung’s career, set against the backdrop of pre-war Europe, artfully relayed on many different levels.

2/9/2024 15 comments

My Therapist Won’t Stop Yawning in Session

by John M. Grohol, Psy.D. 11/18/2023

By John M. Grohol, Psy.D.

My Therapist Wont Stop Yawning in Session Psychotherapy is often described as an art as much as it is a science. The professional relationship between a therapist and their client can be a tricky one. Especially when it comes to bad habits of either the therapist or the client.

One of these bad habits is especially frustrating to clients — a therapist’s constant yawns during session. People often read into a yawn far more than what is usually meant — or not meant — by the behavior.

Part of the problem is yawning itself — we don’t really know why people yawn in the first place. So a person often will assume the worst — “I’m boring him with what I’m talking about.”

But that’s often not the case.

11/18/2023 34 comments

What Are Doctors Doing on Facebook?

by John M. Grohol, Psy.D. 9/10/2023

By John M. Grohol, Psy.D.

What Are Doctors Doing on Facebook? In a survey of 405 postgraduate trainee doctors (residents and fellows) from France, researchers examined how doctors are using Facebook — not only for themselves, but also in their interactions with patients.

Facebook, if you’ve been sleeping for the past year and didn’t notice TIME magazine just named Mark Zuckerberg — Facebook’s CEO and founder — Person of the Year, is the world’s largest social networking site. It allows you to connect with other acquaintances (they use the term “friends,” but this is a ridiculous use of the word since most people’s Facebook connections are not traditional friends) easily, online.

Perhaps too easily. The relationship between doctor and patient (or therapist and client) isn’t one based upon friendship. It’s a professional relationship with boundaries. Apparently, though, some doctors aren’t aware of those boundaries — at least according to this survey.

9/10/2023 11 comments

Exchanging Gifts With Your Therapist

by John M. Grohol, Psy.D. 9/3/2023

By John M. Grohol, Psy.D.

Exchanging Gifts With Your Therapist It’s that time of the year again — the time where gift-giving is a part of many people’s holiday rituals. While we don’t think twice about buying little gifts for close friends and family, sometimes it gives us pause to consider giving a gift to our therapist. Here’s a relationship with a professional that we see once a week, and yet it is a professional relationship (even if it doesn’t always feel that way).

What should you do? Should you exchange a little gift with your therapist?

Of course, before you do anything, you and your therapist should talk about exchanging gifts (especially if you don’t know your therapist’s policy). Some therapists are okay with it — as long as the gifts are small — while others have a strict, “No gifts” policy. In either case, it’s good to know — and respect — your therapist’s policy when it comes to gifting. So if you feel in the mood and don’t know what your psychotherapist’s policy is when it comes to exchanging gifts, please ask them during your next session.

9/3/2023 14 comments

10 Secrets Your Therapist Won’t Tell You

by John M. Grohol, Psy.D. 1/21/2023

By John M. Grohol, Psy.D.

10 Secrets Your Therapist Won't Tell You Psychotherapists are a unique profession in the world because they are paid to listen and help people improve aspects of their lives or combat a mental health issue that’s affecting them. But there’s some stuff that goes on in the therapy office that you should know about before you decide to take the plunge (or if you’ve already taken it, well, better late than never!). Here’s a few…

1. I honestly don’t know whether I can help you or not.

Most therapists honestly believe they can help most people with most problems. However, until you get in there and start working with a therapist, a therapist can’t really predict whether they’ll be able to help you or not. Most therapists believe they can help anyone who comes to them with a specific problem they’re trained or experienced to handle. However, every single individual is unique and there are few reliable predictors of any given therapist’s success with any given client.

2. I’m not your friend, but I want you to open up to me anyway.

As I’ve written about previously, the therapeutic relationship is not a natural one. Nowhere else in our lives do we have this kind of professional relationship that demands openness, honesty and intimacy (not of the sexual kind). Without those components, your therapy isn’t likely to be as beneficial. It feels like a close friendship sometimes, but it isn’t.

3. If you ask to see your chart, I’ll probably give you a hard time about it.

Despite the rights of patients to be able to view and have a copy of their own medical records and data, most mental health professionals still resist attempts for a patient to view their own mental health chart. They’ll ask you why you’d like to see it. They may hem and haw a bit, and ask that you pay for copies of it rather than just look at the chart itself while in the office. Your chart likely contains little eye-opening information, as it’s probably just full of short progress notes that describe very generally your progress in therapy from week to week.

4. I’m not supposed to give you advice, but I will anyway.

The first thing a young therapist in training learns is that psychotherapy is, Do not give advice to your clients. “If a person needs advice, they should talk to a friend,” one of my professors said in class. And yet, most therapists end up doling out advice as though their client’s lives depended upon it. Even cognitive-behavioral therapists will give advice, disguising it in the form of “homework” — “Why don’t you try keeping a journal of your irrational thoughts?” It’s a successful strategy for most to try, but it’s still advice.

5. This is probably going to hurt, but I may not tell you that up-front.

Most medical professionals rarely are up-front about the extent of how painful an operation or procedure is going to be. Why would they be? The more painful you hear it is, the more you tense up, become anxious, and the more it does end up hurting. (Ah, the joys of the mind-body connection!) The same is true of good therapy. Good psychotherapy requires you to make changes in your life — in your thinking, in your behavior, and how you interact with the world around you. This isn’t easy, and it usually takes most people a lot of hard work, effort and energy. And if you start digging around in your past (as some, but not all, therapies do), you may find it very painful indeed.

6. My graduate degree probably doesn’t matter much; neither does where I graduated from.

There’s little research to demonstrate that one degree will produce better patient outcomes than another. A “patient outcome” is you feeling better, faster. Because, after all, time itself does indeed heal most wounds. As long as the mental health professional has a Master’s or better in education, it’s likely they will all be equally just as helpful. There’s no evidence to support the idea that a graduate degree from one psychology program is better than another, or that a Ph.D. is better than a Psy.D. for your feeling better, sooner. Find a therapist that you feel comfortable in working with. As long as they are licensed (or registered) and paid for by your health insurance, you’re good to go.

7. If I’m pushing a particular brand of medication, you can likely thank a pharmaceutical company.

You can’t throw a Google keyword without hitting a blog that talks about how various pharmaceutical companies have influenced physicians’ prescribing practices (including psychiatrists’) over the past few decades. Pharmaceutical companies, for instance, love to give doctors free samples of their newest and most expensive medications. Doctors then prescribe these to their patients, who get the free samples as a starter. But the free samples aren’t forever, and then the patient (or their insurance company) winds up paying an arm and a leg for the medication when an older, less expensive medication will work usually just as well.

8. I work for you, but battle your insurance company to get paid.

Yes, you pay your $10 or $20 co-pay to see a therapist, but the majority of their fee will often come from your insurance company. And what your therapist will rarely tell you is how much work it can take to actually get themselves paid from your insurance company. There’s not a lot you can do to help this process along, but it can be a time-consuming and frustrating process — especially in the past when patients would bump up against their maximum-allowed sessions for the year. Or the insurance company denies payment for a certain diagnosis. It’s a mess, and many therapists end up spending more of their time on paperwork for reimbursement than they’d like. Although most therapists won’t admit it (or may not even be aware of it), if your insurance company is giving them a hard time, it may impact their relationship with you.

9. I will give you a diagnosis whether you need one or not.

Nobody likes to admit this, but without a diagnosis, the therapist won’t get paid by your insurance company. And it can’t just be any diagnosis (despite the mental health parity law passed last year). It has to be a “covered” disorder. Which means that if you come in with something that isn’t quite clinical depression, your therapist may diagnose you with it anyway, just so they can get reimbursed. (That’s one of the many reasons why you shouldn’t put too much faith into your diagnosis in the first place.)

10. I love my job, but hate the long hours, client’s often-slow progress, and the difficulty in being understood as a profession.

Like most people, a therapist isn’t always going to be in love with their jobs. There are a lot of daily frustrations a therapist faces, including those mentioned above. Unless the therapist is well-established and successful, many therapists work 10 hour days, or up to 6 days a week. Sometimes clients aren’t committed to the process of changing as much as they say they are, which can be frustrating. And many people still believe that therapists listen to you talk about your dreams as you lay on a couch. It’s hard to be respected as a profession (psychiatrists are often looked down upon by their physician peers), and everyone believes that it’s one of the easiest professions in the world that just about anyone could do (“You just sit there and listen to people’s problems all day?! Sign me up!”).

1/21/2023 154 comments

When You Disclose Too Much in Therapy

by John M. Grohol, Psy.D. 10/22/2022

By John M. Grohol, Psy.D.

A normal part of the psychotherapy process is something therapists call “disclosure.” This is simply your telling the therapist your thoughts, feelings, and experiences, which is a normal process of most types of psychotherapy. Sometimes, though, we have thoughts or feelings which are very near and dear to our hearts, or feelings or experiences that we are deeply embarrassed about. When we share such experiences or feelings in therapy, we might feel like we have “disclosed too much.” And once you let the cat out of the proverbial bag, it’s hard to know how to continue on in the therapeutic relationship.

Disclosing “too much,” however, is not that uncommon an experience. The psychotherapy relationship is an odd one, the kind of relationship that you don’t find elsewhere in everyday life. It’s intimate like your close relationships with a romantic partner, but also professional, like the relationship you might have with your accountant or lawyer. Therapists, in fact, emphasize the professional aspect of the relationship and its professional boundaries. But in what other kind of professional relationship do you talk about everything that makes us uniquely human — our emotions, our thoughts, our reactions to others?

In that context, it’s no wonder that sometimes when we’re in therapy, we cross over that imaginary line we’ve drawn in our minds, and talk about a subject we hadn’t meant to bring up. The very situation we’re in draws out such experiences, in fact, actively encourages us to speak about them. Even when we’re not ready to.

The first instinct many people have after they’ve said more than they wanted to in therapy is to try and take it back, to “undo” what was said. A good therapist who is truly listening to you might realize you’ve just made a greater disclosure than you intended, and will help you process why you feel the way you do. You may, for instance, immediately ask to end the session, or give some other sign that something just happened that has made you feel very uncomfortable.

Try to resist the temptation to “take it back.” Instead, think about why you’re feeling so anxious about having it “out there” in your session and having your therapist now know this piece of information. Talk about the anxiety to your therapist and hopefully they will help you work through the anxiety you’re feeling, which may help dissipate it (or at least reduce it).

A second common instinct about overdisclosure is to try and minimize the meaning or weight of what was said. Resist this temptation, too. This is our selves trying to protect our self-esteem and ego, often simply trying to minimize the embarrassment. If you dismiss the importance or meaning of what was said, you may convince your therapist, who will never broach the topic again. While this insulates you from the embarrassment you felt in the short term, in the long term it may hurt your ability to talk about this or related important issues.

Plus, you’ve learned you can “pull one over” on your therapist and have him or her be none the wiser. If you can do it once, you can do it in the future anytime any type of topic comes up that makes you the least bit uncomfortable or anxious to talk about. Psychotherapy is about change, and nearly all change in life involves some anxiety and uncomfortableness. If you’ve discovered a way to prevent that, you may have also discovered a way to successfully sabotage your own therapy.

A third instinct is to grit your teeth and bear it through your current therapy session, and then never go back to your therapist. Some people actually do this. Or they’ll return the following week and never speak of it again. When the therapist brings it up, they’ll dismiss it out-of-hand as though someone else said it, or it happened to someone else.

This is nothing more than running away from the problem. And while it may work in the short term, it’s not the best way to handle an uncomfortable situation long-term. People certainly use it as a coping strategy, but then it means they miss out on anything in life the moment it becomes a little too much for them to take. They simply walk away.

Disclosing too much in therapy can be uncomfortable as heck. But it can also open the door to delving into deeper issues, or things that you just needed to talk about but couldn’t figure out a way of bringing them up. While immediately, you may feel overwhelming feelings of embarrassment or having said too much, usually with a good night’s sleep and talking about the disclosure itself with your therapist, you can move past those initial, automatic negative feelings.

The key to moving beyond too much disclosure in therapy is to stay in therapy and to talk about the disclosure itself with your therapist. Directly and upfront, as soon as possible. Even if it’s not in the same session, maybe you need a week to regroup and find some peace with it. These might sound like impossible, Herculean tasks, but in most cases, doing so will result in a better and healthier therapeutic outcome for you.

10/22/2022 31 comments