In Therapy

A user's guide to psychotherapy

What If Your Therapist "Hates" You?

Mailbag: Adversity in the therapy office

It squeaks, too
Ah, the mailbag. The place where people help me write about things they want to know instead of the hash I’ve been slinging. Fine by me, you help keep me on my toes.

For this installment, I received a short and sweet email that I know some folks can relate to. Once again, we have a disguised and distorted letter from an unidentifiable and possibly fictional reader:

“I think my therapist hates me. I’ve tried talking about it, he swears he doesn’t. Do you have another perspective?”

Yikes. Hated by a therapist? Hated? Everyone talks about the importance of the therapeutic relationship for a positive outcome. A good relationship can help activate a lot of healthy change. But hatred? What will that produce? 

These concerns aren’t uncommon. You reveal a big secret and you’re afraid the therapist now thinks less of you. Your phone call isn’t returned, and you think your therapist is avoiding you. You give a compliment and get a lukewarm response, and it feels like a punch in the gut. You make eye contact and find indifference instead of warmth. Or you seek help but perceive judgement or harsh words in return. It’s a horrible feeling.

To be fair, therapists don’t often hate their clients. For starters, we chose to enter the helping profession because we want to facilitate positive change in people’s lives. We choose this field because we’ve been there ourselves, or we have a strong desire to understand the human condition and lend a hand, or both. We spent years of our lives and several digits of student loans to learn to understand people’s pain, the unproductive patterns they fall into, and the defenses they've clung to.

On top of that, most of us (I wish it was all of us) have gone to our own therapy to help us discern between our issues and the issues clients raise. When we have a response in a therapy session we should be able to understand whether this is about our baggage or our client’s. Most concerns raised by a client should be understood, empathized with, and not taken personally. Unfortunately, this isn’t always the case. Which brings me to this declaration:

Therapists, if you “hate” your client(s), or even dislike one or more of them, it’s time for some soul searching. In fact, I encourage all therapists reading this to take a look at their caseload to find which clients (if any) stir the most negative feelings. Then make an honest appraisal of whether or not you are able to help them reach their goals. If you do harbor negativity, what are you doing to deal with it? Therapists are people too, and even our training in empathy and theories of personality don’t prevent the occasional sour response.

Clients may remind you of people or situations from your past that stir negative feelings. Maybe you identify with your client’s problem so much that you resent them as much as your own hangup. Or maybe you’re experiencing a level of burnout that is tainting all your therapy relationships. It’s easy to imagine how negative feelings can compromise the quality of your work with clients, either by committing vital errors or omitting useful insights.

This article by Dr. Michael Blumenfield points out helpful ways to engage these challenges, including referring out, consultation, and seeking your own therapy. I’ll add to this hanging up your notepad. If you can’t find compassion for the people who seek your counsel, maybe this profession isn’t for you.

I could say plenty more to therapists, but this blog is a client’s guide to therapy so I’ll turn my focus back to empowering them.

What can you do if you believe your therapist hates you? In short, leave or stay. Maybe you’re absolutely right and bailing is the best move, or maybe this is an opportunity for your own growth. Here are a few thoughts to consider when making this decision:

What’s the data? Let’s start with the facts. What makes you think your therapist hates you? Is it his words, a look, the way he clears his throat, his tendency to be late? Take a look at the actual data you have and think about what it means. How would you perceive the same behavior from someone else? Could his questions or mannerisms be a way to show concern or a personality quirk, or is it criticism? Are his signals clearly pointing to rejection? We all read into things, let’s be clear about the actual data first.

Is this familiar? Where else in your life have you felt this way? Is this the first relationship where you’ve felt this kind of negativity? Is it possible that you’re seeing mom’s critique when your therapist is giving a harmless comment? Could this be an opportunity to tackle some issues from your past? If you can identify this fear of rejection and name it as such, it could help you get manage the feelings. Changing your conversation from “You hate me” to “I’m getting that feeling that you hate me again” makes it a topic you consider together rather than an absolute truth.

Is it relevant to your issue? Let’s take two scenarios where you might feel animosity. Suppose you’re seeing an older female therapist to 1. address your fear of flying, or 2. to resolve issues involving a negative older female figure in your life. In scenario #1, the negativity isn’t relevant to your issues, so it's just getting in the way. You can see how scenario #2 might more easily trigger a sensitivity to criticism and rejection from an older female, and may even have the potential to be of more help—if the issues can be addressed and resolved, you’ll have one experience of healing a relationship with an older female, which may have implications elsewhere.

Can you talk about it? Fictional Reader has tried to talk this over in therapy, but many people don’t. If you think your therapist hates you, I’d say this is the only thing worth talking about until you leave or resolve the issue. Any other advice, insights, or comfort you receive from the therapist will be tainted if the relationship is troubled, so you might as well dive into this first. How do you bring it up? I’d start with the data, then how it makes you feel: “When I talk about my boyfriend I think you’re looking at me with disgust, and then I feel afraid that you hate me. Can we talk about this?” It may be a difficult discussion to raise, but a mature therapist should be able to respond constructively. And if they can’t...

Why stay? Assuming your therapist does have strong negative feelings toward you, or she isn’t able to process your feelings, why stick around? You are the consumer of services, if you aren’t getting what you want, you have every right to speak up and/or take your business elsewhere. Are you afraid to leave? Do you question how you’re reading the signals? Are you avoiding the confrontation? If you’re truly floundering in the office of a negative or unhelpful therapist, leaving may be the best way to take care of yourself.

In therapy, you’re opening up your life to a stranger, hoping your concerns will be accepted and understood. When you instead perceive judgement and scorn, the safe space of therapy becomes treacherous. Sometimes this perception is more about your issues and can help unlock helpful insights, but the trick is finding out when staying is worthwhile. Words are your best means to evaluate this negativity, or at least give you a clearer view of what’s going on.

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Come find acceptance and understanding at my website or Facebook page.

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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