Psychotherapy is a unique relationship, a kind of connection that is unlike any other kind of relationship a person has in their life. In some ways, it can be more intimate than our most intimate relationships, but it also paradoxically values a vestige of professional distance between therapist and client.
Therapists, alas, are just as human as the clients they see and come with the same human foibles. They have bad habits, as we all do, but some of those habits have the very real potential of interfering with the psychotherapy process and the unique psychotherapy relationship.
So without further ado, here are twelve things you wish your therapist didn’t do — some of which may actually harm the psychotherapeutic relationship.
1. Showing up late for the appointment.
Therapists will usually charge a client for an appointment if they fail to cancel it with less than 24 hours notice. Yet some therapists seem perfectly oblivious to the clock when it comes to showing up on time for appointments. While the occasional lateness may be excused, some therapists seem to be living in another time zone altogether and consistently show up late for their appointments with their clients — anywhere from 5 minutes to even two hours! Chronic lateness is often symptomatic of poor time management skills.
2. Eating in front of the client.
Unless you have enough for everyone, eating and drinking during a psychotherapy appointment is considered ill-mannered. Some therapists offer clients the same access to coffee or water that they themselves enjoy. (If you’re going to drink something in front of a client, make sure you offer your client the same.) Eating while in session — by client or therapist — is never appropriate (it’s therapy, not mealtime). And asking, “Do you mind if I finish my lunch while we get started?” is inappropriate — clients don’t always feel comfortable enough with expressing their true feelings.
3. Yawning or sleeping during session.
Yes, believe it or not, there are therapists who fall asleep during session. And while an occasional yawn is a normal component of our daily functioning, non-stop yawning is usually only interpreted one way by a client — they are boring the therapist. Therapists need to get a good night’s sleep every night, or else they cannot be effective in their job (which requires constant and consistent attention and concentration).
4. Inappropriate disclosures.
Inappropriate disclosures refer to the therapist sharing a bit too much about their own personal difficulties or life. Most therapists are warned about doing too much disclosure in session with their clients, because it’s the client’s therapy, not the therapist’s. Therapists shouldn’t plan their vacations while in session, go on endlessly about their graduate school training or research topics (especially if they were focused on rats), or share how much they enjoy their summer house on the Cape. Therapists should keep personal disclosures limited (even when the client asks).
5. Being impossible to reach by phone or email.
In our ever-more connected world, a therapist who doesn’t return phone calls or an email about an upcoming appointment or insurance question stands out like a sore thumb. While no client expects 24/7 connectivity to their therapist (although some might like it), they do expect timely return calls (or emails if the therapist allows that modality of contact). Waiting a week for a return phone call is simply unprofessional and unacceptable in virtually any profession, including psychotherapy.
6. Distracted by a phone, cell phone, computer or pet.
Therapists will often ask their clients to silence their cell phone before entering session. The policy has to go both ways, or it shows disrespect to the client and their time in session. Therapists should virtually never accept any phone calls while in session (except for true emergencies), and they should turn away from any other distractions, such as a computer screen. In a world that increasingly values inattention and multi-tasking, clients seek refuge from such distractions in the psychotherapist’s office.
7. Expressing racial, sexual, musical, lifestyle and religious preferences.
Although an extension of the “too much disclosure” bad habit, this one deserves its own special mention. Clients generally don’t want to hear about a therapist’s personal preferences when it comes to their sexuality, race, religion or lifestyle. Unless the psychotherapy is specifically targeting one of these areas, these types of disclosures are usually best left alone. While it might be fine to mention something in passing (as long as it’s not offensive), a therapist who spends an entire session discussing favorite musicians or love of a particular religious passage is not likely helping their client.
8. Bringing your pet to the psychotherapy session.
Unless cleared and okayed ahead of time, therapists should not bring their pets to the office. While sometimes therapists see clients in a home office, pets should stay out of the office while they are in session. To the client, a psychotherapy session is a refuge and a place of peace and healing — pets can disturb that peacefulness and calm. Pets are generally not an appropriate part of psychotherapy.
9. Hugging and physical contact.
Physical contact between client and therapist must always be expressly spelled out and okayed by both parties ahead of time. Yes, that includes hugging. Some clients are disturbed by such touching or hugging, and want no part of it (even if it’s something a therapist might typically do). Both therapists and clients should always check ahead of time with the other before attempting any type of physical contact, and respect the other person’s wishes. At no time is a sexual relationship or sexual touching appropriate in the psychotherapy relationship.
10. Inappropriate displays of wealth or dress.
Psychotherapists are first and foremost professionals, and any displays of wealth and style should be discarded in exchange for dressing in an appropriate and modest style. A therapist slathered in expensive jewelry is a put-off to most clients, as are blouses or dresses that show too much skin or cleavage. Too casual of dress can also be a problem. Jeans may suggest too casual an approach to a professional service that the client is paying for.
11. Clock watching.
Nobody likes to feel they are boring to another person. Unfortunately the therapist who hasn’t learned how to tell the time without checking the clock every five minutes is going to be noticed by the client. Most experienced therapists have a good sense of how long a session has gone without having to look at a clock until late in the session. But some therapists seem obsessively compulsive about making note of the time, and the client notices (and internally, they may tell themselves what they’re saying isn’t really important to the therapist).
12. Excessive note-taking.
Progress notes are a standard part of psychotherapy. Many therapists do not take notes during a session because it can be distracting to the process of psychotherapy. They instead rely on their memory to cover the highlights of the session after the session has ended. Some therapists, however, believe they must capture every detail of every session in their notes, and obsessively note-take during sessions. Such constant note-taking is a distraction for most clients, and some may find that the therapist uses the behavior to keep an emotional distance from the client. If note-taking is done during session, it should be done sparingly and discreetly.