Creating a positive therapeutic alliance is very important in determining the success of therapy. In episode 316, I received a question from a listener who, having started therapy, has found themselves curbing their true thoughts and feelings due to their therapist becoming frustrated and angry. In this post, I offer my thoughts and share how you can approach this situation.
I have no idea if you’ll remember this, but nearly a year ago I sent an email that you answered on the pod asking about when to take my own suicidality seriously.
Since then, I have started therapy and it’s helped me process a lot, though some days are still harder than others. I’ve been with one therapist and we have a good therapeutic relationship. The main issue I’m having, though, that I wasn’t really expecting is that on the harder days, when my suicidality is really bad and the thoughts are really active, it seems that my therapist gets frustrated and sometimes even angry with me.
She raises her voice more, she pushes me a lot harder than I’m comfortable with, and her comments feel much more critical. During one particular session, for example, she kept asking what was stopping me from just jumping out the window right then and there, and I ended up having to call the suicide hotline later that day.
My question is, how do I address this with her? I feel like I now have to work around her feelings and tone down when I’m feeling suicidal so as not to upset her. I don’t want to find another therapist, but it’s making me feel more guilty to know I’m burdening her like this. Sometimes it even contributes to the suicidal thoughts where I think that even my therapist would be better off if I weren’t here to take up her time.
I’m sorry this is long, and thank you in advance if you answer it. I really appreciate everything you do with the podcast and your books!
I do remember! I’m glad to see that you’re still here. Thanks for writing in again. I’m proud of you for starting therapy and beginning the journey of really digging into this stuff. I think what you are writing in about is really valid.
A lot of people have to get over the hump of people pleasing in therapy. Where they are worried about inconveniencing their therapist or being too difficult. This can sometimes lead to people minimizing their problems or lying to their therapist so that they feel like they are doing a good job. I can imagine there is definitely a risk of that here. You have already had concerns and questions about your own symptoms, so for you to get the impression that you are doing something wrong by struggling could easily lead to worries in therapy. There are a couple of terms called transference and countertransference that occur in therapy. Transference is basically when you project feelings about someone else from your life onto your therapist. Countertransference is when the therapist has feelings elicited in them by your behavior. For instance, a lot of older therapists find that they experience a lot of parental countertransference toward their younger clients that they have been with for a while. There could be a bit of countertransference that is coloring your therapist’s reactions to you. However, that is something that the therapist has the responsibility of recognizing and working through. This can be on their own with their own therapist and it can also be something that is called out and worked on within the context of therapy. For example, in therapy, I have literally said things like, “You know, I sometimes feel a pull toward nurturing feelings toward you. My instinct is to jump in and solve your problems rather than letting you work things out. Does that sound familiar? I wonder if that’s a pattern you’ve had with anyone else in your life.” So that’s one possibility.
The other is that they are just legitimately getting frustrated and having a hard time masking it. We are human as therapists and sometimes we have a bad day, or we are agitated because of other clients, life stuff etc. It may have come out the wrong way and your therapist may have left that session hoping for a do over. They could also be totally unaware that they tend to get more forceful with you when you have a hard time. If they are trying to give you tough love, I would say that’s not appropriate in a situation like this. I can’t help but wonder what I would have seen from an external perspective if I was a fly on a wall. Like there is a HUGE difference between saying “well what’s stopping you from just jumping out the window?” in a mocking sort of way and earnestly asking about what is keeping you safe from that sort of action. The latter, I do often when assessing suicidality. The other is really not an appropriate intervention. So, some of this comes down to what exactly is happening. My perspective and advice would vary depending on that.
If you are comfortable, I think that you could definitely be honest and bring this up with her. That could present a good opportunity to get real and do some processing in session. Again, I don’t think she should be egging you on when it comes to suicidality. So if she’s doing that, you don’t need to necessarily have as much grace here. That’s an issue. If you were to bring it up, I would say something like, “I’m not sure what your experience of sessions has been, but I’ve been getting the feeling that I’m irritating you or upsetting you when I’m struggling. It’s like when I am suicidal, you get frustrated with me. I’m not sure if that’s how you feel, but the last time when you asked what’s keeping me from jumping out of the window, that felt harsh.” That’s a hard thing to do probably. It takes some courage to be so open and honest in therapy like that. But it would be a massive step for you and possibly a massive step for the course of your therapy.
Overall, I want to reassure you that this is not on you. You aren’t doing anything wrong. You aren’t in therapy to be perfect. You are in therapy to get help with the struggles you are having. Of course, you have a responsibility to show up and do your side of the work, but this is the whole reason you reached out for help. I know this is playing into one of your fears about being a burden to others, but to be honest as a therapist this is our f**king job. If your therapist is not capable of handling this type of issue, they need to find someone else that would be more appropriate for you to work with. If we are indeed just seeing the therapist not handling things well, I want to reassure you that it’s not you and not all therapists are like this. There are plenty that are more competent in working with the kind of struggles you are living with.
You can listen to this on Episode 316 of the podcast!
Thank you for the great question!
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