In Therapy

A User's Guide to Psychotherapy

Ryan Howes, Ph.D. is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California. See full bio

September 2, 2008, Self-Help

Comments on "The Last Minute Bomb in Therapy"

The Last Minute Bomb in Therapy

By Ryan Howes, Ph.D. on September 2, 2008 in In Therapy

With only one minute remaining, the client discloses something huge. How to understand, manage and prevent Last Minute Bombs (LMBs). Read More

Dr. Howes: I am sure you are

Submitted by John L. on September 6, 2008 - 9:31pm.

Dr. Howes:

I am sure you are a cool therapist and maybe I might move to California to see you if I don't find someone in Bozeman soon.

I have lived in Bozeman my whole life--I play with a punk/art band. So my lifestyle is pretty chaotic but my old man is famous and has a lotta money so I have seen probably 15 shrinks since I been 16.

There are so many clueless therapists who want to do whatever they can to keep the conversation within their range of emotional comfort or their particular little therapeutic approach that they all but sh*t the couch when I start talking about what has been happening to me. Granted my life is not normal but of all the shrinks I have seen I gotta say they screw sessions up more often than I do. They talk about what they want me to be, they talk about their kids, honestly I had one talk about their mistress who had cellulite.

So, I guess my question is how can a patient tell a fucked up shrink when they are making it hard to talk about what I need to talk about. My guess is that 80% of LMB's come from FUS (F'd Upped Shrinks). Has psychology ever thought about having a panic button for patients to hit when the shrinks just are blowing it? Or is it just me?

Johnny

Dr. Howes: I am sure you are... - John L.

Submitted by Urs on September 18, 2008 - 7:31am.

Hi John,

Have you tried to challenge your Therapist on the issue of self-disclosure? Throughout my own therapy sessions I found that, whenever there was something which didn't "sit right" with me, I would bring it up. This helped both, the Therapist for his own process, and me because I could actually concentrate on my issues rather than having created a new issue (Therapist and client relationship) to deal with.

As for LMB's ... The first time I challenged my Therapist was a LMB and looking back, it was me trying to build up the courage as well as resistance having to deal with this. At a later stage I realised that my time with the Therapist was/is valuable (Time and Money) and it was/is mainly my time and money,... and the Therapists job.
The therapist needs to work with the client on the reason to why LMB happen, which is usually a deeper level to dealing with LMB itself. (This needs to be dealt with as well.)

On the end of the day, if you were unhappy with customer service in say the retail industry, you would say something, wouldn't you? It's not really that different with Therapy.

It might also be worth while choosing a different orientated therapist. Different orientated Therapist use different levels of self-disclosure.

Good luck with your punk/ art band and I hope you find a Therapist which is right for you soon.

Urs

LMB

Submitted by Sue on September 17, 2008 - 4:25pm.

I did an LMB recently because I wasn't sure how to bring it out in the session. It's like I am thinking I got to tell him what I am thinking but like there was fear/anxiety in me. The I realized the session was almost over and if I didn't bring it out in the open now it might be harder next time I see him in 3 weeks and during those 3 weeks I would beat myself up for not bringing it up at the last session.

Sue

Eep! I think I'm guilty of this one

Submitted by Elle on February 3, 2009 - 2:15am.

I set up a therapy session recently, and am the indrawn type. I didn't know exactly why I was there, so I think my therapist got used to asking me general questions about what we'd talked about before- which was nothing close to the reason I wanted a session (existential crisis, of all things). Since this was the third time I tried to explain how I felt to someone, and the first two times just drew blanks from who I talked to, this third one that didn't even reach what I wanted to talk about was... a little depressing. I felt very alone.
And near the end of the session a completely different issue ended up arising, which almost caused me to miss a train. Oops...

great post

Submitted by BTC on February 23, 2009 - 8:08am.

Dr Howes,

This is a really interesting post. I agree that issues of time management (on both sides?) can lead to LMB. I also think there is a difference between LMB and last-minute-insight and this is an area of confusion for therapists. Perhaps what might seem like an LMB to a therapist could be something previously hidden in the unconscious of the client, particularly where its not a significant fact ie "I quit my job" but rather a more abstract concept or discovery that is food for thought and needs to be carried through to the next session, rather than a cliff-hanger that needs to be avoided.

But this thinking is formed by personal experience so I could be completely wrong!

BTC