How Not To Be A Dick To Your Therapist

If you have a friend who is a therapist, remember they’re your friend first and a therapist second, and they’re not your own personal therapist ever.

Aug 19, 2013 at 3:00pm | Leave a comment

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So, how does that make you feel?

 
Y’all. Relationships can be hard. Building a relationship with anyone can be challenging, and if you decide to start seeing a mental healthcare professional to work on things and stuff and alllllll the feels, that relationship certainly is no exception. It’s like “Hi, stranger! I don’t know anything about you, but let me tell you all my deepest darkest secrets while you get paid to sit there and listen! Cool? Cool.”
 
There’s also the likelihood that, in your search for your personal holy grail therapist, you will encounter some therapists to are dicks to you. Let’s face it: finding a therapist who is a good match for you can feel like searching for a needle in a haystack.
 
Based on my anecdotal experience as both a longtime person-in-therapy and as a practitioner of mental healthcare, coupled with the knowledge I have from my friends and clients in treatment, I think it’s safe to say that there are tons and tons of therapists that just aren’t a great match and then there are plenty who are just plain awful and who should have their licenses revoked. Given all that, I figure that once you do find a therapist who is your best fit, it might be helpful to know how to not be a dick to your therapist.
 
I also acknowledge that some of these points might be challenging to address, especially if you’re going to therapy to work on panic or anxiety stuff, so I’ll say that these are things toward which one might strive when working with a therapist. If you can do it, cool. If not, not as great but also probably not the end of everything ever.
 
1. If you’re running late, let your therapist know.
 
I think this is useful from a number of perspectives namely: schedule management and concern for my client.  
 
a) If I have a few extra minutes to grab some sort of snack or run to a pee break, that’s always good to know, especially in an agency or social services setting where appointments are often back to back and time between clients is scarce.
 
b) Also, if you’re more than 15 minutes late, it can be hard to not worry that something has gone horribly awry. I’m not saying I’m hyperventilating into a paper bag wondering if you’re dead in a ditch, but I care about all of my clients and it’s hard not to worry a bit if someone is really late.
 
I prefer a phone call or an email, but I text my own therapist when I’m running late, and it really depends on the forms of communication that you and your therapist have decided are acceptable. (See #6.)
 
2. If you can’t come to a session at all, let your therapist know.
 
See #1.
 
Also, as with most scheduling things, the earlier, the better. If you get sick the night before, it makes sense that there would be late notice, but if you’re going on vacation, I feel like it’s reasonable for me to get some notice. Another thing to keep in mind is that most private practices have some sort of cancellation policy -- generally, it’s that you must cancel no later than 24 hrs in advance, or else they still have to charge you.
 
In an agency setting, there rarely are those sorts of limits, but the earlier you are able to cancel, the more likely it is that the agency will be able to allot the time to someone else who needs an appointment. So, canceling earlier could help you save some cash monies, and it also helps your therapist keep their schedule up to date in terms of working with their other clients.
 
3. If you decide to stop coming to sessions in general, let your therapist know.
 
Again, see #1, and namely 1b. 
 
(Notice a theme here? You mean to say that therapists want to communicate? Shocker!)
 
Not every therapist is a great match for every person. If you find a better match, that’s awesome! A good therapist isn’t going to be pouty because you’d rather work with someone else or you’d rather not work with someone at all. Chances are a good therapist will also offer to talk with you a bit about your decision to switch, and you don’t have to speak to that if you don’t want to do so. Something like “I’ve chosen to work with someone else who is a better fit for me and I wanted to let you know” or “I’ve chosen to not work with someone at this time” should suffice. I think that a phone call/voicemail would suffice, but if your therapist is OK with texts or emails, either of those would be fine, too.
 
4. If your therapist is totally off, tell her/hir/him.
 
As a therapist, I see my role as a guide who will do my best to help my clients along their paths as they work on their stuff. I walk alongside my clients, reaching out a hand of support when things get gnarly, pointing out potential obstacles, and suggesting alternate paths for consideration when I see those paths. My job is to help my client get to where they’re going and to help them get there in as healthy a way as possible. I have years of training and experience and a lot of innate traits that tend to make me good at being this sort of a guide.
 
However, sometimes, I can misstep. It happens. You, the client, are always going to know yourself better than anyone else. So, if your therapist shares an insight and you’ve talked about it and it still doesn’t quite fit, let your therapist know. A good therapist should know when to leave well enough alone, and try to keep in mind that one insight that isn’t quite on point does not a poor therapist make.
 
Of course, it depends on the severity of the misstep and the frequency of such missteps, but realistically, even the most insightful, best fit therapists make points occasionally that don’t quite hit the nail on the head. 
 
Furthermore, you could potentially be doing yourself a disservice if you let your therapist think that an insight is accurate when it’s definitely not, especially when the trajectory of how therapists structure work with a client is often somewhat dependent on the perceived accuracy of those insights. It might be uncomfortable to disagree with your therapist in the moment (and I know I’ve been there) but ultimately, it end up being better for the work you do together. 
 
Remember: you are the expert on you.
 
5. Recognize that we’re human too, and we make mistakes occasionally.
 
Going off of #4, please give us some benefit of the doubt if we momentarily forget the name of your imaginary childhood friend or how old exactly you were when you first had sexytimes. Yes, it is our job to remember the tiny details, but we’re still human, even if it may seem that we might have a mutant-like ability to remember mass quantities of random details. And, like any human, there might be a slip-up here or there, especially for those of us who choose not to record sessions or to write notes during sessions.
 
Again, this is all to be considered in moderation. If your therapist is constantly forgetting the name of your abusive ex or a loved one who is dead, it might be time to find a new therapist with whom to work. 
 
6. Do your best to understand and accept the boundaries that exist.
 
Most therapists will let you know the best way to contact them in the event that you need to do so. A lot of therapists these days are okay with giving out a professional email address or cell phone number where you could call or text. Chances are pretty good that if your therapist gives you additional contact information aside from an office landline, your therapist will also give you guidelines regarding when and how it is and is not OK to use those modes of contact.
 
If by chance your therapist doesn’t give you these sorts of guidelines, the best option is to ask her/hir/him when you next speak and until then, limit contact between general business hours, i.e., 9 AM to 7 PM, and understand that you might not get an immediate response. That’s not because your therapist secretly hates you, it’s probably because they’re in another session or doing something therapist-y.
 
The exception to this guideline is if you feel you might harm yourself or someone else.
 
In the event that you are having an emergency, mental health or otherwise, please call 911 for help. If you do not feel comfortable calling 911 and you are afraid you might hurt yourself or someone else, please consider calling one of the following hotlines (all available 24 hours a day): the National Suicide Prevention Hotline at 1-800-273-TALK or the National Institute of Mental Health Information Hotline at 1-888-826-9438
 
7. Keep us up to date with your insurance situation.
 
This one is mostly if your therapist is a private practice mental healthcare practitioner.  Insurance can be a tricky one for everyone involved. If there are going to be changes to your insurance situation, e.g., switching between carriers, going from uninsured to insured or vice versa, please please please let us know, even if you don’t have exact details of the change yet.
 
Having the wrong insurance information on file can cause major delays in payment and literally hours of paperwork and time spent on the phone with insurance agents who are often actively trying to reduce the amount of money we receive per claim -- can’t hate on the agents too much though as it’s their job but it’s still crappy for the practitioner who is trying to get reimbursed.
 
If we can anticipate the change, it helps us allot the proper time to work through the insurance transition with you, and it helps us with budget management (which, for young therapists like me who are still paying off massive amounts of student loan debt, is a big fucking deal).
 
Bonus: If you have a friend who is a therapist, remember they’re your friend first and a therapist second, and they’re not your own personal therapist ever.
 
I have had multiple friends say to me more or less verbatim: “I could go to therapy…or I could just talk to you, lol j/k?”
 
My answer is always a pretty firm “…but actually j/k for serious because it’s unethical for me to be your therapist or give you a professional opinion here.”
 
Your therapist is not your friend and your friend is not your therapist. The roles are different, and they are separate. If I’m your friend, there is no way I can separate our personal relationship and my vested interest from a therapeutic relationship, thus rendering any potential therapeutic relationship pretty much useless.
 
I feel like the whole point of talking to a therapist is to talk to someone who knows about mental healthcare and feelings and stuff but who does not have anything at stake and who can be relatively unbiased. Don’t get me wrong, I can still give you some pretty damned good advice based on my knowledge of you and my knowledge of mental healthcare, but I am not going to shrink you, no way, no how. As Faith-in-Buffy’s-body would say, “Because it’s wrong.”
 
Also, knock off the “Only screwed up people become shrinks” and “You’re a therapist? Are you shrinking me right now?” type comments. I really don’t think that more screwed up people become therapists than any other profession, and I also feel that even if someone has a lot of personal issues, that person is still perfectly capable of compartmentalizing those issues and being a decent therapist.  
 
Also, I don’t go around analyzing all the people I know. I have no desire to do so – -it’s ethically inappropriate, and it would be exhausting. Not gonna lie, the analytic therapist-brain does does crop up here and there in my personal life, and I do have to be especially mindful of my brain shifting in analysis mode if I’m talking about deep personal issues with a friend.
 
It’s my responsibility to keep all that shit in check and to remain within the ethical boundaries of my profession (specifically, I am a social worker) and within the general ethical boundaries of friendship to which I ascribe. I don’t shrink my friends. I will tell you my honest truth, but I’m not gonna shrink you.
 
And there you have it. This list is by no means exhaustive, so please feel free to comment away and let me know ones I might have missed. Therapy is definitely not for everyone, but if you choose to pursue the topsy-turvy adventure through your deepest darkest ish, I hope this helps you out!
 
Photo Credit: the wonderful Neil Satterlund