therapyAs an advice columnist, I frequently receive letters from people who say they are writing to
me because they’ve quit their therapy. They give many reasons: They don’t like the therapist. They feel their therapist doesn’t like them. They feel misunderstood or blamed. They are unhappy with progress. They don’t think the therapist can handle their issues. They’ve reached the conclusion that the therapist thinks they are hopeless. They think that because they aren’t getting along with this therapist, all therapy is useless.

What worries me most about these letters is not that they’ve quit (there are lots of good reasons for ending treatment) but that they never talked to their therapists about their concerns. They just stopped going. By handling their dissatisfaction in this way, it’s very possible they deprived themselves of a great opportunity to move their therapy forward.

You and your therapist are limited in your work together by what you choose to share. It’s like starting to make a pizza for dinner during a blizzard. Unless you are willing to brave the storm to go to the store, you can only make the pizza with what’s in the fridge. If there aren’t enough ingredients or it comes out half-baked, you’ll wonder why you bothered. Even if it’s kind of interesting, if it isn’t what you had it mind, you’ll be disappointed. You may decide to eat it anyway despite being dissatisfied or you may just throw the whole thing out. You may conclude you’re a lousy cook or that pizza is a terrible food — when the problem was in what went into making it in the first place.

The same is true of therapy. To move toward your personal goals, you have to pull out whatever is in your emotional and mental “fridge.” That means sharing your feelings, your doubts, your fears, your satisfactions and dissatisfactions — whatever is going on in your mind and heart. You may have to even go out into what feels like a risky mental blizzard, having faith that you and the therapist can keep you safe in the storm. If you don’t share your thoughts and feelings, you and your therapist are left trying to help you make sense of your life without all the necessary ingredients. It simply doesn’t work. The “pizza” (the therapeutic progress) you make together will be disappointing. Sadly, you may decide you are both terrible cooks and give up trying.

Yes, I know, it’s difficult to talk about things you’d rather not talk about. It’s frightening to bring up issues that you have buried for years. You may be ashamed of something you did or didn’t do. You may worry that your therapist will judge you harshly. You may be so anxious, upset, depressed or uptight that even thinking about talking about whatever you’re avoiding talking about is exhausting. But they are all necessary ingredients in the process.

Your observations and opinions about the therapist are also in your mental “fridge.” They too need to be put on the worktable. You may be right in your judgment that the therapist is tired or preoccupied or just doesn’t “get” you. It’s certainly possible that the therapist doesn’t have the wisdom to help you with your particular problem or has personal biases that get in the way. But it’s also possible that you have misinterpreted her comments or behaviors due to your own filters or assumptions or fears. It’s possible that you’ve signaled your therapist that you are too fragile to get down to work as yet, so she is holding back, too.

There are two predictable results to holding back any negative issues about your therapist and therapy: You may end up just hanging out with your therapist once a week to get emotionally stroked instead of working on the hard stuff. That inclination is perfectly normal. Difficult issues are difficult for a reason. They are so difficult that they are probably the reason you came into therapy in the first place. But hiding challenging issues behind the ketchup in your emotional fridge will only preserve them (or give them a chance to grow even hairier and scarier).

Or, you might decide to quit because you feel you can get the same thing for free from your hairstylist or bartender. That’s also understandable. When people don’t get what they need from a relationship, they often break up and look elsewhere. But breaking up from your therapist may be another way to avoid understanding why you are blocked or your part in what is keeping it that way. Closing the fridge door doesn’t change what’s in there.

Fortunately, there is another option for getting unstuck in therapy besides “hang out” or quit. You can decide to push through the block. Doing so can change the relationship between the cooks (you and your therapist) and alter the recipe (the ingredients and the process) for making changes in your life.

If you think the problem is that you aren’t clicking with your therapist, the block may be a metaphor for what happens in other relationships in your life. Perhaps you’ve never figured out how to have a difficult conversation with someone you perceive to be an authority. Maybe the therapist reminds you of someone else in your life who disappoints you. Perhaps you have learned to keep some things to yourself because you’ve had disastrous experiences in the past when you’ve tried to be honest about your feelings or opinions. The only way you’ll find out what’s getting in your way in your relationship to your therapist is to start talking about it. The conversation may lead to new insights about how you function in other relationships as well as to understanding new and more helpful ways to interact with others.

If you make your best effort to change the relationship so it works for you and you still get nowhere, maybe you are correct that you need to hire another cook (therapist). But please don’t do that without discussing it. Navigating how you leave is another opportunity for growth.

If, however, you are comfortable with the therapist but you’re scared to talk about the hard stuff (that icky stuff in the back of our metaphorical “fridge”), you need to dig down to find the courage to bring it into the open. It’s those hard parts of your life, the parts that you find upsetting and perhaps shameful or angry-making, that will lead you and your therapist to the place where you have the most opportunity to grow. Once the therapist has been given a glimpse into what’s in the back of your “fridge,” she has a better idea about how to help you. Once you see that the therapist handles what’s back there with compassion and wisdom and offers some guidance about what to do next, you will feel more willing to stay for the next, and probably much more helpful, round.

As much as I sometimes wish that I could relieve my clients of their distress on my own, I know full well that it takes both of us to cook up a satisfying outcome. If you are even thinking about quitting, devote at least one session to talking it over. When you pull out all your “stuff,” you may give both you and your therapist enough ingredients to work with to relieve your pain and to develop new and more satisfying life choices. In the process of confronting whatever you think is getting in the way of a successful working relationship, you may also discover how to improve other relationships and avoid repeating past mistakes. It’s worth one hour more to give it that chance. If you still don’t see improvement, you can leave knowing that you did your best.

If you do decide to leave the therapist but are still in pain, I hope you won’t quit therapy just because that particular relationship didn’t work for you. That would be like never eating pizza again because you didn’t get what you wanted that time you tried to make one. Like all people, therapists have different personalities and skills. You may just need to find the one that cooks well with you.

Therapy image provided by Shutterstock.