“But You’re a Therapist!”

It can be weird being open and vulnerable with others as a person who also happens to be a therapist. People are sometimes very surprised to hear that their therapist friends also, believe it or not, struggle to understand their partners, get petty or irritated, feel abandoned, lash out at people, avoid flossing or exercising or initiating difficult conversations, or feel judgmental. For example.

I’ve been hearing the refrain “But you’re a therapist!” since—actually—before I even technically became a therapist. (Back then it was, “But you’re going to be a therapist!” Yes, and? You’re apparently going to be a millionaire or a bestselling author one day, and yet.) I even see therapists themselves throwing this at other therapists in some of the Facebook groups I’m in. That, combined with actually becoming a therapist and hearing a lot about how other people think, has given me a lot of opportunities to reflect on what causes people to say this.

People seem to be of two minds about therapists. Either we are fully self-actualized human beings who float through the world with the gravity-defying force of our own impeccable coping skills and preternatural ability to sense others’ thoughts and intentions; or we’re all “crazy” and “broken” and got into this field either to wallow in our misery along with our clients, exploit those clients, or use them to somehow fix our own unusually severe mental issues.

Obviously, I highly dislike both of these stereotypes (though the latter is of course more offensive and ableist). The reality is that most people will experience some sort of significant mental distress at some point in their lives, therapists included, and experiencing it early in one’s life can be a motivating factor when it comes to choosing a career path.

But I think there’s more going on here than just stereotypes about particular professions, and I think it reflects a common misunderstanding of how therapy works. Continue reading ““But You’re a Therapist!””

“But You’re a Therapist!”
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Setting Boundaries With Your Therapist

It’s a rare relationship that doesn’t require any boundary setting, and the therapeutic relationship is no exception.

Setting boundaries is something many people find difficult for all sorts of reasons–fear of rejection, uncertainty over whether or not your desired boundaries are legitimate (spoiler alert: they are), a history of getting bad reactions from people when setting boundaries with them, and so on.

It’s especially difficult to set boundaries with people you perceive as having more power than you, whether they actually do or not. Therapists are often perceived as having power over their clients because of their expertise and authority, and because it can feel like your therapist is holding your mental wellbeing in their hands. Sometimes that power is more tangible–for instance, in cases where counseling is mandated or when the client needs their therapist to sign off on or approve something. And sometimes that power is compounded by structural factors, like when a client of color works with a white therapist or a queer client works with a straight therapist.

Although these power differentials are real and have consequences, it might be helpful to reframe the client-therapist relationship slightly. Namely: you, as a client, are employing your therapist. Your therapist works for you. Most likely, either you or your insurance company (or both) are paying this therapist, not the other way around. If your therapist isn’t helping you, or is doing something that you find harmful, you have a right to let them know and to expect them to fix the problem. You can fire a therapist who is failing to help you just as you can fire anyone else you hired for some task or service that wasn’t done to your satisfaction.

Some therapists may reject this framing because it feels too consumer-y, or because they worry that this will cause clients to leave them. But I would argue that we shouldn’t be using social norms to trap clients in therapeutic relationships that aren’t working for them, and also, this framing is directed more at clients than at therapists, because I think it will help them feel a greater sense of control over their therapy.

How to know when you need to set a boundary

Therapy can be uncomfortable sometimes. But it should be uncomfortable in ways that mesh with your goals. For instance, if your goal is to learn how to ride a motorcycle, but you’re scared of riding motorcycles, you’re going to be rather uncomfortable. That’s normal and okay. However, if your goal is to learn how to drive a car, and someone is pressuring you to ride a motorcycle instead, that’s not a normal and okay sort of discomfort.

If your goal is to form healthier, more stable relationships with others, you might be uncomfortable when your therapist notes that you seem to assume negative things about people without evidence. You may disagree with your therapist’s observation, at least at first. You may even be right. You may think, “How dare they tell me I assume the worst of people!” But that discomfort is part of the process. Even if your therapist’s observation turns out to be wrong, both of you have gained from this. You’ve gained greater understanding of you. But if your therapist’s observation turns out to be right, then you’ve especially gained.

On the other hand, if your goal is to form healthier, more stable relationships with others, and your therapist suggests that maybe it would help if you accepted Jesus into your life, the discomfort you may feel (at least if you don’t already believe in Jesus) is not part of the process. You and your therapist are at cross purposes. You have already decided that Jesus is not for you.

Not all examples of boundary-crossing are that obvious, however. Many people who go to therapy to deal with trauma report that therapists ask them invasive questions about the trauma, questions that they’re not ready to answer before more trust is built or before they work through things a little more. However, some therapists were trained that they should push for details about traumatic events because talking it all through in detail helps people heal. This theory has since been complicated quite a bit.

Even if sharing all the details of a traumatic event necessarily helped people heal, though, it is crucial that therapists understand that just because the therapy office should be a space where clients feel comfortable sharing anything, that doesn’t mean it automatically is. It can be triggering for survivors of trauma to reveal intimate details about what they went through to someone who is still basically a stranger to them. It’s perfectly legitimate for them to shut down certain avenues of questioning and to expect therapists to respect that boundary until they are ready to shift it.

Setting a boundary vs. firing

When do you ask a therapist to stop doing something that isn’t ok with you, and when do you simply stop seeing them? In most cases, the answer probably depends on what happens when you try to set a boundary. If your therapist refuses to respect your boundary or argues with it, it might be a good idea to find a different one.

(Note, though, that they might agree to respect your boundary but still ask you questions about the boundary itself. While this can feel uncomfortable, I think that’s usually that better kind of uncomfortable–your therapist needs to understand you and your boundaries in order to be able to help you, and it may also help you to process your reasons for needing the boundary.

For instance, when a client says that they can’t talk about something [yet], I won’t push them to talk about it. Instead, I might say, “How do you feel when you imagine telling me about this?” or “What happened last time you tried to talk about this with someone?” That yields a lot more information than “I really think you should tell me,” and is more compassionate.)

Another way to tell whether to boundary-set or leave is this: think about what it would take for this situation to be okay. For instance, suppose your therapist mentions that attending church might be a helpful way for you to cope with depression because that’s what helped the therapist. This makes you feel really uncomfortable and you don’t want to hear anything else about the supposed benefits of religious observance from your therapist. Imagine you say, “Please don’t mention religion to me anymore; I’m not religious and am absolutely not interested in attending church or hearing anything else about church.” Imagine your therapist responds, “Okay, absolutely. I won’t mention it again.” Does this feel okay to you? Are you okay continuing to open up to someone who might believe that you’d do better if you went to church (but doesn’t say so out loud), or are you still uncomfortable?

If you continue to feel uncomfortable no matter how well the therapist responds to your boundary-setting, then you might need to find a new therapist. The strength of the relationship between a client and therapist is the best predictor of the effectiveness of the therapy, so if you can’t trust or feel comfortable with your therapist, they’re unlikely to be able to help you.

Scripts for setting boundaries

In many ways, setting boundaries with a therapist doesn’t work much differently from setting boundaries with other people. Just as I might ask my friends not to talk about weight loss around me, I might ask my therapist not to mention weight loss in therapy. Just as I might ask a partner not to ask me about [topic], I might ask a therapist not to ask me about [topic].

One difference, though, is that it might be really useful in therapeutic boundary-setting to explain why you’re setting that boundary. With other people in our lives, that’s not always necessary and may be too scary/risky–I don’t want to disclose my history of disordered eating every time I ask someone not to talk about weight loss with me. Your boundaries are your boundaries whether your reason for them is one that others would consider “legitimate” or not. (All boundaries are legitimate.)

But a therapy situation, telling your therapist why you need this boundary gives them useful information that will allow them to help you better. If you say “please don’t mention weight loss because I have a history of harmful behaviors around that,” they might know what else not to mention, or what to ask for permission before mentioning. Knowing that you have a history of harmful weight loss behaviors helps them understand your psychological history and know what to look out for in the future.

Here are some specific examples of ways you can set boundaries with a therapist:

“Please do not ask me about my weight or dietary habits. It’s a trigger for me because of past issues with disordered eating.”

“Actually, I didn’t ask for advice. Please either ask me before you give advice, or wait for me to ask for it myself.”

“The issue I came here to work on was my depression, not my relationship with my parents. Let’s keep our discussion focused on my depression as it’s affecting me right now, because that’s what’s causing the most problems for me right now.”

“I’m not ready to talk about the stuff that happened with my brother when I was little. You can ask me again in a few weeks and I’ll let you know if I’m able to talk about it then.”

“My identity as an atheist is not the reason I’m struggling with depression. If you continue to suggest that my mental illness is caused by atheism, I won’t feel comfortable coming here anymore.”

“I do not believe in karma, Zodiac signs, or any other superstitions. Please stop bringing them up in our sessions and stick with what can be tested scientifically.”

“I need you to stop suggesting that it’s my fault that I’m being bullied. Even if there were some truth to that, it feels like you’re putting all the blame on me and it’s preventing me from opening up to you about things.”

It may feel somehow manipulative to tell a therapist that you won’t tell them things or come back to therapy if they don’t respect your boundaries, but it’s also true. You can’t effectively work with a therapist you can’t trust, and they need to know that.

Also, while I certainly don’t think you should be intentionally mean, don’t worry about the therapist’s feelings. It’s our job to worry about our feelings, and your job to be as direct and open with us as you can be.

When setting boundaries is a challenge

As I mentioned, most people find boundary-setting difficult, especially in situations where they feel that they have less power than the other person. If you’re finding it so difficult to set boundaries with a therapist that you’re unable to speak up about it at all, here are some suggestions:

  1. Practice first. You can practice in front of a mirror, alone in the dark, with a friend–whatever works for you. If you’re practicing with a friend, you can tell them a little about your therapist and what they’ve been doing that’s problematic so that they can roleplay as the therapist. Make sure to be clear with your friend about what you want them to do in the roleplay–for some people, roleplaying “worst case scenarios” (for instance, your therapist arguing with you and refusing to respect your boundary) can be useful because it allows them to prepare; for others, it might just be really anxiety-provoking.
  2. Write it down and bring it to session. If you don’t feel like you can come up with the right words on the spot, write them down and bring them to therapy with you so you can read them or at least refer to them. It might sound weird, but you won’t be the first person who’s done it. Many therapists actually encourage clients to do things like this, because anything that helps facilitate communication in therapy is probably a good thing.
  3. Write it down and email it. Although we often hear about the virtues of Real Face-To-Face Communication, I’d say two things here: 1) text-based communication is also a real and legitimate way to discuss difficult things, and 2) the perfect is the enemy of the good. If you are so uncomfortable bringing something up with your therapist in a session that you’re not going to bring it up at all, try doing the next best thing, which is emailing them. That way, you’ll have ample time to think about what to say and run it by trusted people if you want to. Know that your therapist may respond by asking you to bring this up with them in the next session, so you’ll probably still need to discuss it with them in person, but that initial email can help open the floodgates.
  4. Be transparent with your therapist. You can say something like, “Setting boundaries is really hard for me, so I’m having trouble finding the words for what I’m trying to say,” or “I’m really uncomfortable with something you said in the last session, but I’m scared of bringing it up.” A good therapist will know how to guide you through this and help you speak up.
  5. Don’t worry about bringing things up days or weeks after the fact. You don’t have to have a perfect, firm, concise boundary-setting comeback right away. It’s totally normal in therapy to bring up things that happened a few sessions back. It’s never too late to make sure that therapy is meeting your needs.

Conclusion

Sometimes all people need to hear to be able to set boundaries with their therapists is that they have the right to. Always remember that. Your therapist works for you. Your therapist has expertise, yes, but they are not the expert on you individually. You know way more about yourself and the boundaries you need than any therapist can ever know.

It is true that some of the boundaries you may set may delay your growth or recovery, or make it more difficult for your therapist to understand what’s going on with you. However, what delays your growth or recovery even more is feeling unable to trust your therapist or connect with them. A boundary isn’t a permanent brick wall. It’s a fence. Two people can stand and chat from opposite sides of a fence, and over time, you can choose to build a gate in the fence and open it up, or close it again.

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Setting Boundaries With Your Therapist

[blogathon] Shit People Say To Future Therapists

Today’s my blogathon for the Secular Student Alliance! I’ll be posting every hour starting now until 6 PM central. Don’t forget to donate! To start, you get a rant!

Sometimes I wish I’d kept my career plans a big secret. Maybe if I had, I wouldn’t constantly be having conversations that go like this:

Me: “Wow, I just don’t understand this person.”

Them: “You don’t understand a person?! But you’re going to be a therapist! How can you be a therapist if you don’t understand people?!”

Me: “Sometimes I just don’t have the energy to listen to someone talking about their problems.”

Them: “But you’re going to be a therapist! How could you run out of energy to listen to people talking about their problems?”

Me: “Huh, I really don’t know what you should do in this situation.”

Them: “But you’re going to be a therapist! How could you not be able to give me advice?!”

I understand why people sometimes feel compelled to say these things. I think they stem largely from a misunderstanding of what therapists do and also from what therapists are like as people.

Firstly and most glaringly, these comments are amiss because, clearly, I am not yet a therapist. I have many years of training to go. So the fact that I have not yet developed certain skills that I will need is not, in and of itself, cause for alarm. Either I will develop them over the course of my training, or I will fail to develop them and I will realize that I need to pursue a different career (I have a few backups). But I doubt that that’s the case.

For now, I am trained in just a few specific things: active listening, conflict resolution, sexual health, referring callers to mental health resources, and a suicide prevention protocol known as QPR. That’s it.

I don’t think people realize that while there probably is a certain “type” (or more) of person who becomes a therapist, we’re not born being able to do these skills. We develop them through training and experience. Nobody would ever demand that an undergraduate in a premed track be able to diagnose them with diabetes or cancer. Why should I be able to fix someone else’s emotional troubles?

Second, I think people have this view of therapists as calm, self-assured, eternally tolerant saints who always understand everyone and never feel frustrated with anyone and never tire of listening to painful and difficult things. The reason people have this view is probably 1) this is how good therapists typically behave in therapy sessions, and 2) this is how therapists are typically portrayed in the media, even though there are many styles of therapy that don’t look like this at all. Some are even confrontational!

But that’s not really how it is. Therapists get bored. Therapists get annoyed. Therapists get frustrated. They get overwhelmed and exhausted from listening to people. If they are good at what they do, they don’t show this in therapy–like a good dancer doesn’t show the pain they feel, or a good salesperson keeps smiling and being enthusiastic. Sometimes people doing their jobs have to act in ways other than how they feel. This is normal.

But for therapists, it’s especially important to be mindful of these feelings in oneself rather than trying to tamp them down, because otherwise they can affect how the therapist treats their client. In traditional psychoanalysis, this is called “countertransference,” and while psychoanalysis is quite outdated, the term is still used by respected therapists like Irvin Yalom.

So, personally, if a therapist told me that they neeever get bored or frustrated or annoyed with their clients, that would be a red flag. Nobody that I’ve ever met is such a saint. I would probably conclude that this person is either trying to make themselves look good, or–worse–that they’re not very aware of the negative emotions they sometimes experience during their work.

Of course, I might be wrong. Maybe some people really are like that.

Another misconception is that therapists “just get” people or “just know” the solutions to their problems. This is also false. While therapists are probably more perceptive than the general population, that only really helps when it comes to understanding how a person is feeling, not why they feel that way or what might be the best way for them to change how they feel, as there’s no one-size-fits-all approach to this.

That understanding, if it ever happens, happens after a period of time during which the therapist has gotten to know their client, learned a lot about their background, and started to discern their patterns of thinking. That thing you see in the movies where a therapist “just knows” what’s wrong with you after ten minutes? Nope.

It’s also worth pointing out–as callous as it may seem–that once I become a therapist I will be doing this for money. I will expect to be paid for doing it. When I’m not at work, doing work for free will seem like…not the best use of my time. While I’m sure that I’ll always enjoy listening to my friends talk things out and try to help them feel better, being expected to do so just because I happen to be a therapist is unfair.

I will not be the same person with my friends and family as I am with my clients. This is normal and okay, and it’s the case for basically anyone who has a job that involves working with people. If you want to avoid needlessly annoying and frustrating your friends in the helping professions, try not to expect them to essentially work for free and to act saintly and perfect while doing it.

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[blogathon] Shit People Say To Future Therapists