In Therapy

A user's guide to psychotherapy

Stood Up by Your Therapist

3:11pm - How lame. What does this say about her? About me? About our relationship? This is taking a serious chunk out of my time, now I might not get my whole session. This is inconsiderate! Unprofessional! I pay for this time! Did I do something wrong?! Read More

Who doesn't know the

Who doesn't know the therapist is human with flaws? Mostly therapists perpetuate this myth, not the clients. I generally think a therapist is doing the best they can if they can come off less crazy than the client for the full appointment time. And some can't even manage that.

I kind of agree with this

I kind of agree with this statement. I never thought my therapist was perfect to begin with but you psychologists seem to think that what I think of you.

It really is unprofessional to miss an appointment or consistently be late to an appointment. I switch therapists when this has happened.


My therapist forgot me once. I showed up and her door was locked. At first I was really upset that she forgot, but then I was worried and couldn't stop thinking maybe she'd been in an accident or something.

She left an apologetic voicemail later and I let her sweat it out for a couple of hours. Then she sent a follow up text message, so I texted her back telling her it was ok. And yes, my next session was free.

Free session

Free session works. I had this happen with me and my therapist. He made up that session for free, and didn't charge for the next one, either.

I was pathetically grateful. He said that's just what a professional should do, that nothing was more important than his remembering all his appointments, and that everything else is just words.

Unforgettable professionalism. Talk about modeling behavior!

My therapist forgot once

My theapist forgot my appoinmtemt one time, because she had accidentally scheduled something else. I felt like she didn't care, and I called her, and I discovered that I was totally wrong. She really felt bad. My next session was free. She also knows that I can't afford therapy for my OCD, so she only charges me $5 per hour. She always goes out of her way to help me, so when she runs late I never worry now. She is very caring therapist.

A friend of mine, is an Academy Award nominated filmmaker, and he is doing a documentary film on my life with OCD. I have discovered that when I go caving and backpacking my OCD is 99% gone. It's a wonderful break from my OCD. Here is the link to our 5-minute promotional video at Kickstarter.

"Many other tragedies" link =

"Many other tragedies" link = LOL.

Tragedies Link

Hilarious! I usually click on the links and this was way too funny!

middle aged men on the block

There are, of course, many tragedies I could have mentioned, but this one seemed to fit. Someone's got to say something about it - I consider it my civic duty.

A good test of progress

A few weeks ago my therapist had to cancel my session due to an emergency. She tried to reach me about an hour before the appointment but, due to technical difficulties, I didn't get the message until I was a block away from her office.

This ended up being something of a good thing for me. I had told her a few weeks earlier that I was beginning to feel I was getting close to the end of therapy (we left that discussion on hold). For this particular week when she had to cancel at the last minute, I had a big emotional issue that had arisen a few days earlier. And when I realized at the last minute that there would be no therapy that week, my thought was, oh well, it can wait. No anxiety, no worries, etc. I actually felt pretty good. So that missed appointment ended up being a good test for me of the progress I have made and that I was handling my life pretty well on my own. I'm still in therapy, but spending a lot of time thinking, how much longer?

I really appreciate hearing

I really appreciate hearing that the idea of accountability for therapists exists, too, and it's just not for clients. I'm sure I'm not alone in that I put a lot of genuine effort and thought into therapy and to show up emotionally ready to be open, vulnerable, honest...and to be shut down, is hard. It's a good experience to go through, but it's nice to know the understand does go both ways at that therapists understand this.

Thanks :)

Thanks for the linkage Ryan and, as always, for the inspiration :)


Hello, I would like to

I would like to unsubscribe from this RSS Feed.
Thanks, Dino R.

When are you going to post something else???

Just curious...

Fear not

I've got a few things cooking, almost ready to serve. Is there anything in particular you'd like me to pontificate upon, Emilie?

Why, yes. I have done a lot

Why, yes. I have done a lot of looking around for literature on eye contact during therapy and have consistently come up empty-handed. Specifically, I'm interested in the power of eye contact between a psychotherapist and his or her client for example in moments of silence or perhaps in the moments after a particularly big disclosure made by the client. Who looks away first? I'd be interested in any thoughts you would have on that topic generally, in addition to those on the other dishes you're currently preparing.


I just wanted to second this

I just wanted to second this as I've too looked for information about eye contact and have come up empty as well.

I take the chance to say that

I take the chance to say that it would be very useful for me -and perhaps for others- to read something about choosing psychotherapy or psychoanalysis. Apart from practical reasons e.g. cost, time, available experts in the area, which are the creteria for someone to chose one or the other? I have read that in some cases only psychoanalysis can cure while in others psychotherapy is the one and only way. Of course a good therapist/analyst would suggest the treatment he thinks is best for you but it might be useful for some people to have a clue before they knock the door of a therapist or an analyst.

The last three minutes...

Dr. Howes, you've written about Last Minute Bombs, and it was a great post. But maybe you could do a blog post on the last three minutes of the session? What is the therapist thinking during this crucial time? What happens if the patient is in the middle of something big? What if a LMB is dropped? Should patients have a clock they can look at, too? How do you tend to wrap up? Is there anything more frustrating than the therapist saying, without any warning, "We have to stop?" (Well, the New York Jets, but let's not go there.)

Anyway, if it interested you and you wanted to tackle this subject in the future, it would be interesting to many, I think.


I generally think a therapist is doing the best they can if they can come off less crazy than the client for the full appointment time. And some can't even manage that.A few weeks ago my therapist had to cancel my session due to an emergency. She tried to reach me about an hour before the appointment but, due to technical difficulties, I didn't get the message until I was a block away from her office.

Stood Up By Your Therapist

If a therapist is committed in practising his/her expertise, he/she will never come late and let the client wait. He/she should meet up the client in accordance to the time they planned or set prior to the appointment.

Thank you

Thank you so much for this post! As a therapist who recently missed an appointment with a client, I can attest that there is probably no worse feeling for a therapist short of a client harming him/herself. It had nothing to do with how much I care about the client and everything to do with a health condition I have that affects my memory at times. Still, I feel awful about it and reading your honest post has been helpful as to the reparation I might try making beyond apologizing and helping both me and the client grow through this unfortunate experience.

She's consistently late

The VERY FIRST session i had with my therapist, we started 15 minutes late. I was already anxious beginning this process, but now i think i'm in the wrong place. Do i knock on her closed door? do i yell,"hey, crazy dude's here!" I just sat. She never apologized.

She consistently starts therapy late, but what upsets me most is she ends it RIGHT ON TIME on the dot, so to not affect HER business. I feel cheated, i feel like i'm not valued, and i feel like she's just there to take mine and my insurances' money.

One session, she made me wait another 15 minutes before therapy started, and she was in with another client and theyh were laughing and having a great time. I wish i had walked out on her and if she called i would tell her i had already been there but thought i came at an unscheduled time. She did apologize (the only time she did).

I think i will bring this up soon in therapy, as this is somethign that has been growing as resentment. Feeling unvalued, feeling like she's just in it for the money (well of course she is, but it shouldnt' all be about that), and feeling cheated.

Say it

It's okay to confront your therapist on stuff like this. The sooner the better. Take a look at this for more:

Best wishes!

- Ryan

This just happened to me

Yesterday, i had a session at 11:00, showed up 10 minutes early b/c i try to get my mind right. Her office door is opened, the lights are off, and at 11:10, i go in and notice her laptop and ipod (she plays music a lot before our session) are all gone. I left a note on her desk,"Sorry i missed you." a few minutes after i leave, she leaves a voice mail on my phone "sorry i just got here 5 minutes after 11:00 i had to take care of something that caused me to be late. Sorry i was a "FEW MINUTES LATE"" I actually was on my way back to her office when i received the voice message, i ended up getting there aroudn 11:20 and finnishign the session. I had went back to check my schedule to see if i had come at an unscheduled time. When i got to her office, she was very brusk with me, arms folded most of the time, and acted like it was my fault for not waiting around a little longer.

I saw her true colors right then and there, she was perturbed with me and annoyed by me the entire session, and it was weird. I nearly fired her. The one thing that stands out is that she deliberately lied about when she arrived, because if she had arrived at 11:05, i was still there until 11:10 and know better. She did apologize in her voice mail, but she was very annoyed becuase i didnt wait around for her. She tends to be late very often, but i thought she was testing me or didn't care.

I'm very thankful for this experiennce becuase i'm no longer obsessing over her, i see her as a human, i no longer have a crush over her, and i'm over her. Anyways...there you have it.

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


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