Jeff Guenther on May 19, 2019
In the most recent episode of my podcast Say More About That, I interview Nani, a therapist who talks about her experience of going to therapy. It’s a fascinating story with twists and turns and everyone should listen. Nani talks about a time where she felt incredibly betrayed by her therapist even though her therapist was appropriately operating under our ethical guidelines. You’ll need to listen to the episode to hear the bizarre story but it got me reflecting on how bonkers it is to be a therapist. Being a therapist myself, I’ve always known that therapeutic relationships were very strange and kind of unnatural. It makes perfect sense that there are laws and ethical guidelines that keep our relationships with clients safe. But these rules and therapeutic norms create relationships that can feel totally abnormal and kinda messed up when compared to typical relationships.
Here are 8 things that occur in a therapeutic relationship that would probably end or destroy any other relationship.
This one is inspired by the episode with Nani. But let’s say you’re seeing Mary, a client who is single and in the dating scene. Eventually Mary meets a man named Barry and falls in love. The relationship is deep, but it’s also complicated and brings up a lot of insecurities that Mary needs to work through in therapy. The romantic relationship lasts for years and Barry is the main topic of conversation in counseling. Now, let’s say Barry has been one of your clients for many years, even before you started seeing Mary. And Barry has decided not to tell Mary that he’s been seeing you for therapy. But Barry knows that Mary sees you as her therapist because Mary talks to him all the time about what you say in session. Well, as Mary’s therapist you can’t tell her that you’re talking to Barry too. Even though you know Mary would experience this as a huge betrayal. Essentially, you have to lie through omission and keep your therapeutic relationship with Barry a secret. Probably knowing full well that Mary will eventually find out and there will be a major rupture.
How messed up and ridiculous is that? If you had a friend in real life who was talking to your partner behind your back while you were spilling your guts to them, you might feel pretty upset when you found out they had a secret relationship the whole time. If you assumed your friend had zero connection with your partner, and your friend led you to believe that, and then it was revealed that they were lying to you, then you’d probably feel really angry and betrayed.
But ethically and due to confidentiality, a therapist couldn’t reveal the relationship and because of this rule it makes this scenario a little bonkers. Being a therapist is so weird!
As therapists we have been told over and over that you can’t acknowledge people in public. I get it. Confidentiality. I 100% agree with this rule. However, it’s hard to suppress the urge to acknowledge a client when I see them out in the world.
Not too long ago I was in the airport trying to quickly take my shoes off and empty my pockets as I was going through security. A client was in the line next to me just watching me frantically trying to put all my stuff on the conveyor belt. They were making a face of compassion as they watched me struggle. I looked up, saw a friendly face, waived and laughed at them, and then felt shame and guilt wash over me a split second later after I realized I should not be acknowledging them.
In the next session I had to process how they felt when I waived at them at the airport because that must have been strange for them to see me outside the office. And even weirder that I broke confidentiality by acknowledging their presence without their permission. Being a therapist is so weird!
Hands down the shittiest and most unfortunate rule is that you can’t accept gifts from clients. I get it! I get it! It throws off the balance of the relationship, clients shouldn’t feel the need to bring gifts, there is probably some sorta meaning behind the gift that we have to unpack, yada yada yada. I understand the rule. But how awkward is it to tell a client that you can’t accept their Starbucks gift card? Or that you can’t accept a piece of art they’ve worked on for you? Imagine doing this in a normal relationship and how hurt and confused your friend would be if you didn’t accept their gift with open arms and gratitude.
I’m not perfect. I’ve accepted some gifts before. And I know that it can sometimes be very healing for the client if I accept their gifts. But even if you do accept it, you then have to process the gift giving and it makes the gesture fall a bit flat. Being a therapist is so weird!
Ask any of my friends, I am the best advice giver. Always have been, always will be. Especially when it comes to starting and growing a business. But unfortunately for my clients, they are deprived of one of my truly wonderful gifts. No matter how much I want to do it, as a therapist, I’m not allowed to give advice. What if that advice was actually wrong for them? Or what if they didn’t take it and then they felt guilty for not following my advice? It creates all sorts of weirdness. The worst part is that clients straight up ask for my advice. And then I have do some bullshit cliche therapy crap and say something like, “It sounds like you just want me to tell you what to do. Let’s talk about why you might be apprehensive about making this decision on your own.” Ugh! I hate myself every time I say something like that and if a client stood up and walked out the door after I said that I would totally understand. Being a therapist is so weird!
Similar to the point above, if a client asks me something like, “what was your relationship like with your mother when you were a kid?” Which by the way is totally reasonable since I’m asking the same question of them, I would probably have to respond in some other therapist cliche that is deserving of a major eye roll. I might say, “I’m interested in knowing where that question is coming from. Is it important for you to know about my relationship with my mother?” How annoying would it be to get that response as a client? And what if a friend responded to you that way? I would probably question the friendship based on how avoidant that response is. Being a therapist is so weird!
I wonder if this is more of a me thing and not really felt widely by other therapists. But the relationship with a client always feels completely unbalanced to me. First of all, there is a power differential in the room. The power is thrown off for a host of reasons. And I’m not sure power can ever be balanced. And of course, I’m not the one disclosing a bunch of emotionally honest and vulnerable stuff. The client is being really brave and courageous while I’m sitting back in my protective little chair encouraging them to tell me their deepest darkest secrets. Can you imagine having a relationship like this that is completely unbalanced outside of your office? It wouldn’t survive! And it shouldn’t survive. Being a therapist is so weird!
I understand that as a therapist I am giving the client my time and expertise. I get that I provide a valuable service and I should be paid for it. But have you ever had to end therapy with someone because they just couldn’t afford it anymore? Oh my God! That experience is horrible. It’s horrible for the client and it’s horrible for the therapist. The client feels attached to you, feels like you’re their secure base, that you’re the only one who really understands and accepts them. And then you have to tell them they can’t see you anymore because they have no money due to losing their job. It’s a crushing feeling. If a friend came to me in that situation, I would want to be more connected and supportive. I would be a bad friend if I didn’t do that. But as a therapist I have to show them the door and that can be quite traumatic sometimes. Being a therapist is so weird!
I gotta say, I have an amazing realtor. If anyone is buying a house in Portland and needs a kick-ass realtor then you should contact Laurie Gilmer. She’ll take care of you really well. Let her know I sent you! Unfortunately for my clients, they’ll never get this recommendation and they’ll suffer because of it. It makes a ton of sense why I can’t give them Laurie’s number. They might have a bad experience with her and then that’ll mess with our therapeutic relationship. Trust me, that won’t happen with Laurie! But I can’t take the chance. So instead my clients have to work with some second rate realtor that will inevitably cause even more stress in their lives. I could have saved them a ton of worry and anxiety with Laurie. But that’s not gonna happen. Being a therapist is so weird!
I created a therapist directory that I think is better than Psychology Today. It’s inclusive, progressive, beautiful and we donate 10% of our revenue to organizations like Planned Parenthood and the Trevor Project. But the only way this revolutionary therapist directory can steal the throne from Psychology Today is for therapists like you to sign up. Every therapist that signs up today will get their first 6 months on us. After that, subscriptions start at $20 a month. And you can cancel any time. Me and my team have worked really hard on this directory and we couldn’t be more proud. At the very least you should check out our search page and see all our modern filters. The search filters have all been influenced by what clients say is important when looking for a therapist.
And even if you don’t want to sign up for a directory profile right now, check out my new podcast Say More About That. I’m working hard at helping therapists understand what our clients want out of therapy and I’m helping potential clients learn more about what therapy really is so that they can feel empowered to reach out to a counselor.
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Jeff Guenther, LPC, is a therapist in Portland, OR. He has been in private practice since 2005. Jeff is the creator and owner of Portland Therapy Center, a highly ranked therapist directory. Jeff, and his team, have launched a new progressive therapist directory, TherapyDen.