Therapy Watch: Fighting Words

Emotions can run high in therapy sessions, but disagreements don't have to escalate into brawls. We asked members of Psychology Today's Therapy Directory (psychologytoday.com) about how they deal with provocation.

Silence Is Golden

"I try to contain myself and say nothing for a while. If it is clear that my patient is forcing the heat, I will reflect back their behavior with something like 'I wonder if you are trying to provoke me.' The point is to respond to the aggression but try to direct awareness to what is motivating it." —Gibbs A. Williams New York, N.Y.

Putting a Foot Down

"It's important, especially as a female, to hold my ground and not allow the client to bully. I have worked with some narcissistic men who are rude and continually interrupt. Therapy is railroaded if the client takes over or is allowed to throw zingers in the room without processing this dynamic." —Ann Pultz Kramer Temecula, Calif.

Let It Sink In

"If someone disagrees with an interpretation, I will usually let it go, because chances are on some level they heard me. I really think some patients are trying to see if the therapist will respond rationally rather than emotionally." —Anne Rettenberg New York, N.Y.

Take a Time Out

"I dim the lights and deftly move them to traditional psychoanalysis where they can simply talk, or argue, with themselves. That works. If it didn't, then I'd simply say, 'Why don't we continue in the next session?' Ending the session would give the client a chance to self-reflect and save face, and give me a chance to define my boundaries." —Madhu Sameer Fresno, Calif.

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