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Stood Up by Your Therapist

What if your therapist flakes?

Sound familiar to you?

2:51 - I took that blogger's advice and showed up 10 minutes early to collect my thoughts and decide what I'd like to talk about. What happened this week? What do I want and how do I feel? What have I noticed about myself this week?

3:00 - That little stir of anxiety rises as I watch the door....and holds.

3:02 - This is normal, nothing to get worked up about.

3:05 - Did she forget? Is she alright? This is a little annoying. What was it I wanted to talk about today?

3:11 - 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?!

3:17 - Oh crap. This is ridiculous. Where the hell is she? If she's in a crisis with another client, I'll understand, but damn it, I've got stuff to talk about too. If it's a personal crisis that would be horrible, but what can I do about it? How long should I wait? If she blew me off, well, that's a whole different story. She knows my issues, she knows how important consistency is for me. Doesn't she care? Is this some sort of cruel test? Do I want to be in treatment with someone who does that?

3:22 - I'm going, peace out. Leave an angry/confused voicemail. Stew. Worry. Wait for the (hopefully) apologetic and concerned phone call. Why does this bother me so much? The topic for the next session is set. She'll want to talk about this, but I don't know if I will.

A number of factors can lead to getting stood up. The therapist forgot to write down the session time. The schedule changed and her brain didn't adjust. She misunderstood or miscommunicated the session time. She got stuck in traffic/another meeting/a personal situation/etc. Maybe you wrote down the wrong time. She double-booked the session and since she judged you to be more resilient, you got bumped. Alien abduction.

Each of these is more likely than what you're tempted to tell yourself: She doesn't care about you, she's testing you, she's avoiding you, you're not worth remembering. If you have a decent, ethical therapist, those just aren't likely reasons. If you're curious, and you probably are, ask. You can say or ask anything in therapy, and this is no exception.

As someone who has played both roles in a therapy stand-up, I know how disappointing this feels. Therapy is about the relationship and communication, and when the therapist no-shows, the client is left with neither. It makes for a bad day or even a bad week. For both parties. And for clients who struggle with issues of loss, rejection, or abandonment (and that's a large percentage), this hurts even more. Therapy becomes a cause of the distress, or at least a contributor, rather than a source of healing. Pain: 1, Supportive, healing relationship: 0.

But there's a silver lining to this dark cloud, a substantial one at that. Once the sting subsides, you may want to consider this:

  • The client gets a glimpse of the humanity of the therapist. Whether it was a schedule mix-up, a miscommunication, or a total brain fart, you now see that your therapist is human with flaws just like everyone else. Both clients and therapists can perpetuate the myth that therapists don't make mistakes. When a client is stood up, we have the scary and enlightening realization that the pedestal was a mirage.
  • It's an opportunity to confront the therapist. It's one thing to talk about being forgotten 20 years ago by someone who is no longer a part of your life. It's another to deal with it with your caregiver, here, now, in the moment. A therapist worth his or her salt will own up to the dis, take their lumps non-defensively and go about the business of caring for their client — which is a new and corrective experience for many people. The client gets a chance to tell the person who hurt them exactly how they feel, in vivid detail, work through forgiveness and move forward. This sort of exchange doesn't happen enough in life.
  • It's a chance to deal directly with all those abandonment feelings. Along with the relational piece above, this might open the door to working through the internal ghosts of abandonments past. How does it feel? Why does it feel this way? Is this familiar or a rarity in your life? Do you tend to blame yourself or attribute pure evil to the other? Needless to say, these are some of the most painful, cut-to-the-core feelings we ever experience, but working through them can be tremendously liberating. Maybe this will ease the pain:
  • Free session! I don't know that this is common practice, but the policy I'm familiar with is not to charge for the next session (nor the miss, of course). I say if you pay for your no-shows, she should "pay" for hers too. Tough love.

While being stood up gives us the opportunity to confront deeper issues of loss and abandonment, it's still one of my least favorite therapy experiences. It's not supposed to happen, but then again, neither are many other tragedies. Maybe you can salvage some of that hour. After waiting the 20 minutes or so, maybe you could use the rest of your hour meditating, walking, or reading. Better yet, you could journal about your experience while it's still fresh. This way you get some reflection time and have prime material for the next session. If therapy is a time to learn more about yourself, being stood up is a chance to learn how you respond to rejection. Exploring these feelings provides some consolation, and perhaps all is not lost.