In a recent interview in the Wall Street Journal, psychotherapist and licensed marriage and family therapist Paul Hokemeyer admitted that his mind often wanders when his patients are talking.
“Frequently. Most of the time it wanders back to the session I had with the last patient and what I should have done differently,” said Hokemeyer, who sees patients in New York and Colorado as well as Skyping across country. “It can also wander if the patient is avoiding connecting and filling the time with superfluous details. I’ll start to think about the dry cleaning or what I can have for dinner.”
He explained that is often a sign that he and the client don’t have a good connection and that he “will refer a patient out if I don’t feel we have a good connection.” He also said he is judgmental while in session.
“I’m constantly judging. It is my job. This notion of unconditional positive regard is a fantasy,” Hokemeyer said. “Yes, I need to accept the patient for who they are, but to pretend that I won’t bring my humanness to the equation is unrealistic.”
It is unrealistic to imagine anyone can leave their “humanness” at the door when they are working, but is judgment part of humanness? I always thought of therapy as fluid. There was no judgment or final decision on my status or how I was going to be treated. I saw my therapist as a perceiver, taking in information and refraining from any hard and fast judgements about me.
I’ve brought my trauma, anxiety, and depression to therapy. I’ve seen three different therapists, and I never felt that they weren’t listening to me. I’m accustomed to stories of my childhood abuse causing my therapist to be speechless, wide-eyed, head-shaking. I fit in anecdotes about my battle with my self-destructive worry and get a chuckle from the therapist sometimes. I find those reactions humanize the therapist and make me feel understood and connected. But reading Hokemeyer’s interview made me a little nervous.
Wouldn’t fear of judgment make some people avoid therapy? After all, aren’t we all sensitive to how others perceive us?
In a 2008 article, 10 Common Reasons to Lie to Your Therapist, John Grohol, PsyD, listed “My therapist will judge me” as the number three reason why a patient would lie to their therapist.
“I caught a lot of flak for suggesting that therapists somehow were above judging their clients,” Grohol said. “Perhaps I was lost in my idealistic world of therapy professionals, but I still believe that good professionals try not to judge their clients. The fact is, judgment does happen, and sometimes therapists don’t always handle their judgmental attitudes or beliefs in a positive, therapeutic manner.”
I don’t know if judgment would make me lie to my therapist, but it definitely would make me consider leaving treatment.
Judgment is predominantly why I was too afraid to attend group therapy for nearly a decade. My anxiety told me that other members of the group would think I was weird, weak, immature, or even disgusting. And yet that’s not how I felt about any of them. Now that I’m in group, members seem to be largely supportive and relatable — not judgmental. Hopefully the same thing goes for most therapists.
The only way to deal with my now-tainted view that I’m being judged by my therapist is imagining that she thinks I’m pretty great. That in and of itself is a challenge for me. My self-esteem is a work in progress and it’s hard for me to avoid harshly judging myself. I’m sure it has also become more important that my therapist laughs at my jokes.
But the one thing I can always hang my hat on, and so can anyone in treatment, is that I’m doing the right thing. I saw a problem, I sought support, I’m self-improving and healing. No matter how I’m judged for anything by anyone, really putting in the time and compassion to care for myself is righteous.
What’s your reaction to the Hokemeyer interview? Have you ever felt judged by a therapist and, if so, how do you deal?
Judgmental person photo available from Shutterstock