Why Does My Therapist Ask Me to Talk about Our Relationship?

Exploring the therapeutic relationship can be illuminating.

Posted Nov 19, 2019

By Lisa Wallner Samstag, Ph.D.

Africa Studio/Shutterstock
Source: Africa Studio/Shutterstock

Many people come to psychotherapy for problems with personal relationships. In certain types of talk therapy, an intense relationship develops between a patient and therapist and these interactions often take center stage. Exploring this therapeutic relationship helps unlock patterns that may be causing trouble with important relationships outside the consulting room.

Transference

“Transference” is the term used to describe the patient’s feelings for the therapist that have been “transferred” from childhood caregivers onto the therapist. Transference feelings can be very powerful and can include love, hate, suspicion, and deep trust. Analyzing the transference is an important aspect of psychodynamic therapy and can illuminate a great deal about the patient’s relationship patterns.

Relationship patterns  

Starting from birth, children develop interactions that increase the likelihood of adapting to their particular caregivers. For example, when an infant is hungry, she cries. If her mother does not respond, she cries louder as she instinctively tries to figure out what will bring food and nurturance. Over time, a child learns what works to feel safe and satisfied. Such experiences lay the groundwork for future relationships, including with a therapist. What worked in childhood, however, doesn’t necessarily work in adulthood.

One reason a therapist may ask how you feel about them is to untangle these two aspects of the therapeutic relationship: what part of the experience between you and the therapist is related to old familial patterns unconsciously carried forward, and what part is about the conscious, in-the-moment interaction with a new person?  When old patterns play out with your therapist, it can be an opportunity to learn something about yourself.

Focusing on the relationship with your therapist

From this perspective, the relationship with the therapist serves as a laboratory where expectations, reactions, wishes, fears, and disappointments are explored in a safe, supportive manner. It is important to feel you can tell your therapist anything, although for some people, this may be difficult to do. It is also important that you and your therapist are on the same page in terms of therapeutic goals and tasks, or the specific ways you work together to achieve those goals. How these treatment goals and tasks get negotiated is a good place to start examining the relationship with your therapist.  

Agreement between a patient and therapist on treatment goals and tasks is a part of the therapeutic relationship known as the “working alliance” and it operates in tandem with the transference, described above. Importantly, it is not enough to simply like your therapist: you must try to trust them to help you make the specific changes you need to make. Do you need a therapist who will challenge you to be more assertive with others, or one who will respond in an emotionally supportive fashion to your attempts to be vulnerable? 

Misunderstandings between you and your therapist 

In therapy, as in any important relationship, there will be inevitable misunderstandings and disappointments, often exquisitely subtle in nature. These moments are called “misattunements” or alliance “ruptures,” and they are critical opportunities to explore misunderstandings between the two of you.

For example, perhaps you took a risk telling your therapist you canceled a session in order to go to a concert, and in response, your therapist seemed annoyed. You withdraw into silence, concerned that it was not OK to assert yourself in this way. Psychotherapists trained in working within the therapeutic relationship are genuinely curious about your reactions to them and, in this case, might ask what you were experiencing in that silence. 

Focusing on the therapeutic exchange can initiate a deeper exploration of relational patterns. It is important that therapists acknowledge their role in any rupture event, that is, being annoyed or appreciating that they seemed annoyed to the patient, as in the previous example. Often the first attempts to work through a rupture will unintentionally stimulate more ruptures. Exploration of these new experiences in the context of well-developed patterns is hard work and takes lots of practice with your therapist.

How to work with a therapist on your relationship

  • Reflect on how you negotiate the goals and tasks of therapy. For example, do you agree to what the therapist suggests as a way of working together because you truly believe this will help you to make important changes in your relationships, or is compliance and deference to others part of a problematic pattern for you? 
  • Be explicit about treatment goals. This will help in reaching an agreement about what the two of you are working towards.
  • Discuss the ways of working towards your goals that the therapist suggests, including focusing on your relationship with them. The therapist should show that they are willing to be flexible.
  • Accept occasional ruptures as opportunities to work through misunderstandings with your therapist and learn about yourself. Growth might include testing out how it is to disagree with your therapist and discovering how they support you. 

You may find, in the midst of resolving a rupture and trying out new relationship skills, that you do the same thing with your therapist that got you into trouble in other relationships. Working through ruptures takes time and practice with your therapist so don’t be surprised if you find yourself falling back on familiar patterns. 

No reason to give up, however. This way of working in therapy always involves trial and error and nobody gets it perfectly right the first time.

Dr. Lisa Wallner Samstag is professor of psychology and director of psychotherapy research at Long Island University, Brooklyn Campus. She conducts research on the therapeutic relationship and teaches Alliance-Focused Training skills to psychotherapists.