Although not all that common, psychotherapists sometimes fall asleep in session. Probably more common in traditional psychoanalysis (where the psychoanalyst is sitting behind and out of view of the patient), it far harder to do in more modern, time-limited psychotherapies where each session is more of an active, working period between therapist and client.
What is one to do when one is confronted with a sleeping therapist?
Stephen Metcalf, writing in New York magazine, set to find out by going back and talking to his prior four therapists, all of whom had fallen asleep on him. Was it him or them?
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This is amusing for me actually, because my therapist began to drop off during my appointment this past Monday. He hasn’t done it before to me, but admits he has sometimes done it to others. I forgave him. He apologized to me and explained that he didn’t get very much sleep the night before which makes dealing with his MS more difficult – it really takes a lot out of him when he doesn’t sleep. But at least he acknowkedged it and that is worth something to me.
On the other hand I had a therapist many years before who was 20 minutes late for my evening appointment because he fell asleep in his office. The receptionist tried to call him but he didn’t answer – she finally knocked on his door. This made me angry that he was so late because it dug a huge chunk out of my hour and I was also feeling suicidal – so his falling asleep made me feel less than important and just fed my issues.
I’ve almost drifted off in client sessions. I always feel absolutely horrible. It’s usually more about the heat in the office and the volume/tone of the client’s voice then it is about their content, plus of course how much sleep I’ve been getting etc…
It goes in the same category as a sleeping airline pilot or a sleeping surgeon. Even one time is one time too many. What if the patient just made the most important revelation of the therapy, and what he heard in response was, “Zzzz-zzz?”
I once fell asleep on a patient. To this day I feel terrible. I remember dropping off while daydreaming about ‘not falling asleep’. The best I recommend to other therapists is to take a short nap before seeing a person who usually speaks quietly.
My therapist has his days where while he never actually konked out, he has struggled not to. He gets quiet and still and his eyes start to roll back in his head. When it happened, a part of me was horrified, part angry, part amused and part sympathetic. For a long time I didn’t know what to do. I liked him too much to quit therapy however it inhibited feeling like he would be available to me when/if I finally reached my long repressed emotions. After doing some reading about sleepy therapists and becoming more aware of myself, I realized he became sleepy whenever I started drifting out of the present moment (disassociating). If I stayed present he stayed alert and responsive. It made me much become more aware of when I disassociated and how to reground myself. I also talked to him about it which was incredibly difficult for me to do but was a great exercise in learning to assert myself appropriately. He was responsive to my feedback and seemed honestly unaware that he was even doing it.
Before I had this experience I would have said if your therapist nods off, get a new therapist. However now I would give different advice. If otherwise you like your therapist use it as an opportunity to examine yourself and to work on your relationship skills. You may still determine you need a new therapist but its also possible you’ll gain some valuable information about yourself and yourself in relationships! I used to experience conflict as relationship ending, now I find it actually enhances relationships. My most meaningful experiences with my therapist have involved ruptures and repairs in our relationship.
I’m a therapist who has certainly struggled at times with sleepiness in sessions, but never, thank goodness, with actually falling asleep. That said, I certainly get fidgety when sleepy and may get up to pour a cup of coffee or water or get something to eat if I feel that might help–I’d rather be awake and discussing my patient’s feelings about my fidgetiness than asleep and woken up by my rightfully upset patient.
I found Judy’s response above really wise and grounded–and I want to validate that if a therapist cannot listen and discuss their treatment mistakes/failures/imperfections (whatever they may be), then indeed it’s time to move on to a new therapist.
My therapist dozed off once a many years ago. He didn’t seem to realize he had done this and I was too unassertive to mention it. Sadly, it just confirmed my feelings of worthlessness. That was my first clue that I should have moved on. Unfortunately, I stayed for another two years but I never forgot that moment.
Judy’s comments are well thought through…Basically if you have a good person and this is an anomaly, cut some slack – but speak up. Once when I was learning
to swim as an adult, the teacher told the group something that stuck – we owned the obligation to be prepared, which meant getting enough rest and eating well to be fully present and energetic. If a professional has ongoing problems with staying alert and present — and this is everything that therapy is about – they must address this. As a patient, one cannot know if the therapist had a bad night, personal crisis, is ADD, has a substance abuse problem or a separate medical problem which is interfering with ability to work.
That said, I did have one therapist in early days who was so totally “non-directive” that it was impossible to tell what was going on. NOT being assertive back then, and this being my first experience in psychotherapy, I stayed much longer than I should have. Perhaps he wasn’t a black hole, he was napping? In other words, most patients won’t have a clue as to what’s going on, and I am afraid many therapists will simply sit the hour as if they were providing a service…
My husband is a therapist. He is a totally compassionate and engaged therapist, and on the rare occasion that he has come home and told me that he *almost* fell asleep, he is basically horrified with himself. He makes every effort to get to bed early, he meditates, he exercises and eats right, but the bio rythms do get you – just like pilots and surgeons. We have been intending to get him a sleep study, but have deferred due to expense, but we do have to get it done. He has told me when he has had 7 or 8 clients in a row (5 minutes in between, and not much time for the bathroom), you can get exhausted (and his day starts early – testing, reports, clients start around 12-1 and then go to 7, 8. It’s a long day of strong concentration. I can only imagine. He tells me how much better his day goes when he can get even a half hour break in the middle. Hard to do though, when end of day is the ideal time slot for people and families.
My husband has a sense of humor. If my therapist fell asleep, I’d sit quietly till he woke up. Then I might try humor (I know you must be more tired than normal, as it’s hard for you to stay with me…if you want to reduce your fee today, we’ll call it even – then smile). My husband would do it. If it happened more than once…I’d find a different time slot first, then if it still happened, another therapist. It’s true that some clients can be dry and not wildly interesting, but you deserve the full attention and awareness of your therapist. And maybe, they should get to bed earlier!
PS – the sleep study is because he might have a bit of sleep apnea…
I am one of those embarrassed therapists who developed sleep apnea. Fortunately, my clients woke me and were very understanding. After getting a cpap machine for the apnea, I never fall asleep, but I will drift in my thinking, and use that to see were the client is or if I need to look at that thinking. I hate that stereotypic Freudian interpretation that everything is about what is “wrong” with the patient. Sometimes, the therapist is off base, and we need to look at that. By the way, I’m a Jungian trained therapist, who still uses a consultant after 30 years in private practice-just to keep me honest.
I used to have a therapist where I regularly got the 3pm slot. He fell asleep every. time. And that wasn’t even the worst part of my experience there>_<
I can think of nothing more disrespectful than a therapist falling asleep in session. However, just as disrespectful was the therapist I caught playing solitaire during our session. I saw the reflection of her game in the window behind her. I immediately went out to the front desk and informed them of her actions. I refused to pay for the session, and I “fired” her that day and began to see a different therapist at a different clinic.
I had a psychologist who was nodding off in a session. I asked him if I was keeping him up. It startled him into alertness. It never happened again.
Hi,
My therapist didn’t nod off yesterday but was sleepy. He has trouble forming his sentences and then just throws out random therapy words. His timing was off.
What do you do if it is true your client is boring? Sigh, not that he would say it. I just need to go by his actions, his cancellations, his lateness, etc.
Sigh.
My son’s therapist has repeatedly fallen asleep but I didn’t know that. My son’s responsibility is not to be more self aware or any of the other “kindly”(really senseless to me) ideas here- he is there for help. IF the therapist needs help, he can pay my son for the session- who has been in agony over what to do. We are terminating and the therapist thinks we are harming the relationship between him and my son because we haven’t told him why- except my son has progressed and no longer needs these sessions. I would tell him the truth but my SO says no.
It is an obvious and understandable tendency.Although one must encourage a relaxing atmosphere, one needs to have certain tools if one is susceptible to this. Xtra minty gum,a fan,a tazer….whatever works…..As both patient and therapist it is understandable due to the very nature of therapy and the feelings it induces….it is draining,relieving,boring(to both sides),traumatic- it’s no wonder…