Should You Ask Your Therapist How They're Doing?

Does COVID-19 change how therapists and clients talk to each other?

Posted Mar 27, 2020

“I know I’m not supposed to ask about your personal life,” said Judy*, who had been in therapy with me for a couple of years before COVID-19 hit the scene, “But I’m worried. And I really want to know how you’re doing.” 

“I think you’re about the same age as my parents,” said Matt*, who had only been in therapy for a few months before the virus became a pandemic. “I worry about them. They’re part of the baby-boomer generation that’s in denial about the dangers. And I’m wondering if you’re doing the same thing.”

“I think I hear your husband moving around in the background,” said Trina*, whose own child was playing at her feet. “I’m worried that he can hear what we’re talking about.”

I’ve heard variations on that theme in session after session over the past weeks. And, in numerous discussions with other therapists, I’ve heard the other side of this coin. Some therapists are touched by their clients’ concern. Others are unsure how—or even whether—to answer. At the same time, both clients and therapists are learning new things about each other, ranging from what the inside of their homes look like to how comfortable they are with the technology we’re all using to keep in touch and keep working. 

It seems to me that there are two separate but connected issues here. One is theoretical. The other is simply human. 

On the one hand is the question of whether or not clients should ask personal questions and whether or not their therapists should answer them. The traditional Freudian answer to that question is that clients can ask, but therapists should not answer. For Freud and his followers, a therapist should be a blank screen onto which all of a client’s inner struggles and beliefs are projected. Knowing personal information about a therapist interferes with that blank screen. 

Of course, today with the Internet, there is little hope of a therapist remaining a truly blank screen. But even before the existence of the Internet, therapists like Dr. Eda Goldstein, who was at that time dean of the School of Social Work at New York University, wrote that clients know much more about their therapists than either of them realizes. There are all sorts of silent communications, from how a therapist decorates the office to what kind of clothes they wear and how they act that are providing information all the time. 

Dr. Stephen Mitchell, the founder of a contemporary psychoanalytic school of thought called Relational Psychoanalysis, believed that the traditional Freudian so-called “neutral” non-response was actually not neutral at all. He likened it to being at a party and being asked to dance. Saying nothing is not being neutral, he said. In fact, it often feels like a rejection. But if a therapist accepts the metaphorical invitation to dance—that is, a client's interested or concerned question about the therapist's personal life—by genuinely considering and responding, the therapist and client together can begin to wonder why they’re dancing this particular "dance"—that is, why that particular question is meaningful. And the subsequent possible connection to relational dynamics that a person brings into therapy is where therapeutic work can begin. 

But today, in the time of COVID-19, there’s another issue at play. Dr. Ghislaine Boulanger, author of the powerful book Wounded by Reality, which explores the impact of trauma that occurs when we’re adults, has also studied and written about what happens when a therapist and a client share the same life trauma, like a hurricane, cyclone, war—or, in today's situation, a pandemic. She tells us that in times of shared trauma, there will be some lifting of traditional boundaries and even some shifting of roles, not only between therapist and client, but between spouses, friends, teachers, parents and children, and so on. 

A recent article in The New Yorker captured one role reversal that I have heard a great deal about in the days of the pandemic—adult children who are angry at their older parents for not taking the COVID-19 threat seriously enough and refusing to take mandatory precautions. 

In this day of general anxiety and genuine concern about physical health, I particularly think it’s understandable that clients want to know how their therapists are doing. We are in a relationship, after all, and knowing that a person who’s important to you is okay is not only normal, but healthy. 

In this time of crisis, when therapists and clients are both facing the same trauma, boundaries are of necessity a little more flexible than usual. Because most sessions are being held by phone or video, and because of the need to stay in our homes, therapists and clients are getting glimpses into one another’s personal lives—sounds and images of children, pets, parents, and partners or spouses sometimes come through the line. We see parts of one another’s space. The timing of sessions may be slightly off because of problems with internet connections or finding privacy. We hear snippets of one another's lives—a child talking, a partner accidentally intruding, a pet wanting attention.

So go ahead and ask the question, if you want to. However, it’s also important—and okay—not to ask, if you’d rather not or if you’re genuinely not interested or don’t want to bring a personal component into the work. You have every right to protect your own boundaries, not just during this pandemic, but at all times. 

But therapists also have a right to protect their personal space. And not all therapists are comfortable discussing their personal lives. Further, some therapists believe that a therapist’s personality and personal life have nothing to do with the work.  

So you shouldn’t take it personally if your therapist doesn’t answer your question. It’s not about you; it’s about them, their personal style, their approach to the work, and the way they understand the therapeutic process. 

That said, if your therapist does answer your question, they should give you a simple, clear answer without spilling their worries or burdening you with their problems. Therapists are human, and we are worried right now as well. But you and your therapist have a job to do together, which is to focus on your needs and your dynamics in this particular session. If your therapist does seem to be having trouble coming back to the work, after you have expressed whatever sympathy you genuinely feel, you have every right to ask them to return to the task the two of you have agreed on—your therapy. This is not unfeeling on your part. It is part of the therapeutic process, and for most therapists, is part of the therapeutic work. 

It of course is not usually a client’s job to set boundaries, but again, we’re living in somewhat altered times, and boundaries and roles are not always as clear cut as they are in normal times. 

123rfstock photo #71369220 agenturfotografin
Source: 123rfstock photo #71369220 agenturfotografin

It’s okay to enjoy hearing about your therapist as a real person. And in fact, that might offer some insight into you—for example, if you were a “parentified child,” who often played the role of parent to the adults in your life, you might be slipping into the same role with your therapist. Even setting boundaries with your therapist might feel somewhat familiar. If that’s the case, you might want to point that out to your therapist and ask for some guidance about how to get out of this familiar role reversal with them.  

But you can also say that you feel badly bringing the discussion back to yourself but that you have some things that you had wanted to discuss in this session. You can ask if they’re too worried to be able to continue your session and, if so, you can let them know that you would rather wait until they can focus with you on the issues you’d like to deal with. You can even ask if they have someone they are talking to about these things.  

All of these questions should get your therapist back on track. But on those rare occasions that it doesn’t, you might have to be the "adult" in the situation and tell them that you feel that their needs are interfering with the work, and that you’d like them to get some help dealing with those needs before continuing the session. Again, in some cases, this dynamic might reflect a pattern in your life—for example, do you often take care of other people at the expense of your own well-being? If getting your therapist back on track feels like a familiar pattern from your life, it's grist for the therapeutic mill—once you're back on track! 

The point here is that it’s okay for you to ask (but only if you want), and for your therapist to answer (if they feel comfortable doing so), the question of how they’re doing during this time of shared trauma. While some therapists will see that as a momentary step away from the therapeutic work, others of us will see it as part of the work itself. In either case, neither the question nor the answer should de-rail the therapy. 

*names and identifying info changed to protect privacy

copyright@fdbarth2020

References

Aron, L. (1991). The Patient's Experience of the Analyst's Subjectivity. Psychoanalytic Dialogues, 1(1):29-51.

Boulanger, G. Wounded by Reality 

Hoffman, I.Z. (1983), The patient as interpreter of the analyst's experience. Contemporary Psychoanalysis, 19: 389-422.