In Therapy

A user's guide to psychotherapy

Seven Mistakes Therapy Clients Make

How to sabotage your therapy

Is your coffee trying to tell us something today?
Just clearing off my desktop before I return to other pressing tasks. We’ve already discussed 21 tips to help clients get the most out of their therapy and 10 tips to recharge therapy, but what should clients avoid?

Equal time here. I read the riot act to therapists a couple weeks ago, pointing out several ways they sabotage their career and hasten burnout. Clients, now it’s your turn. I’m both, I can do that. Without further ado, let’s fire up the satire: Want a brief, disappointing stint in psychotherapy? No problem. Follow these seven simple rules.

Rush to Choose: Pick a therapist based only on your insurance plan, the proximity to your work/home, or someone your cousin saw once. It’s well known that effective therapy is all about the quality of the therapeutic relationship, but many people hastily enter into a time-wasting debacle instead. People who spend time checking a therapist’s credentials and areas of expertise, as well as test-driving a few to see who they feel they can trust have a better chance of finding a good fit. (more here)

Don’t Ask: Asking direct questions can be uncomfortable. Why invite this discomfort by asking your therapist about her therapeutic approach, her expectations of you, and how she feels about your work together? When she uses jargon you don’t understand or develops a theory you don’t follow, why rock the boat by asking for clarification? Why ask the tough questions when you can sit and wonder in isolation, trial-and-erroring your way through this spendy venture? Besides, your mind reading abilities are flawless, right? (more here)

Lie/Withhold/Downplay/Avoid/Obfuscate: To totally derail therapy, present false material and spend the session looking for meaningless answers. Dodge questions about what’s really on your mind or in your heart. Tell yourself you won’t talk about it unless the therapist asks exactly the right question. Your issues won’t improve just because you’re in therapy. In order to see results you need to talk about what’s going on and not wait for your therapist to drag it out of you. (more here)

Communicate through hints, riddles, gestures, or tokens: Rather than talking about your warm feelings, try to sneak in a hug. Instead of expressing your anger with your therapist, show up 20 minutes late every time. Lead your therapist down mysterious rabbit trails by speaking in riddles. Leave a symbolic gift without explanation and make him guess what it means. You could always talk directly about it for a few minutes, but where’s the fun in that? We call this the “talking cure” because we choose to make words our commodity, not the many substitutes for direct communication. You may still end up giving the gift or hug, just talk about it first. 

Triangulate: Did your therapist say something you don’t agree with, don’t understand, or don’t want to accept? Instead of asking about it, just run it past all your friends and family to get their opinion, starting with “My therapist said _____, what do you think that means?” Then bring the results of your survey to the next session and spend the hour talking about what everyone else thinks. Why have that awkward, direct talk when you can divert the objections to your friends and family? (more here)

Compartmentalize: When you leave the session, leave the whole relationship, train of thought, and the feelings behind. Don’t implement any changes between sessions, don’t think about what you’d like to talk about next time. Start each session like you’ve never been there before. Real progress requires that clients integrate what they’re learning into the rest of their life.

Vanish: When you don't want to be in therapy anymore, goals achieved or not, just disappear. End a session with a Last Minute Bomb or a voicemail or just vanish. Why take the time to wrap up loose ends, air your grievances, summarize your work, grieve the ending, make an aftercare plan, and have one good, clean goodbye in life? The satisfied customers take the time, at least a session, often more, to have a good ending. Sudden departures are like walking out of a movie 15 minutes before it ends. No resolution, no closure, no goodbye. (more here and here)

I realize this is an incomplete list. A few other obvious self-imposed obstacles include sex with the therapist (a definite no-no), the infamous “yes, but” dismissive tool, the silence/wall-of-words communication barrier, and the self-explanatory “be late/cut back sessions” maneuvers. And I’m certain many others are out there, perhaps you will share in the comments section.

** Of course, this is satire; I note this because not everyone is familiar with the literary device. I understand that most people come to therapy to get help and not to waste their time and money. This piece shows the many ways clients can subvert the effectiveness of their therapy, whether they realize it or not. If you think I’m picking on clients, I assure you, I’ve spent more time in therapy than most and these infractions are informed by both personal and professional experience. I also know that it’s the job of my profession to teach clients how to avoid these pitfalls, a job we fail to do most of the time.

If only there was some sort of national movement aimed at educating people about all aspects of therapy.......

If you want to get the most out of your therapy, do the opposite of the points listed above: choose your therapist carefully, ask questions, be honest, talk about it first, be direct, integrate therapy into your life, and plan on having a satisfying goodbye. That doesn't guarantee success, but it’s a good start. Read the 21 Tips for more ideas.

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Interested in more self-sabotaging behavior? Come waste your time on my website or like my facebook page. But definitely don’t join National Psychotherapy Day, that’s a movement that will change you and the world for the better.

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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