5-Uncomfortable Conversations to Have With Your Therapist

5-Uncomfortable Conversations to Have With Your Therapist

In therapy, if the client-therapist relationship is strong, it is much more likely that therapy will be successful and that the client will reach their goals. In fact, it may be the most influential factor in creating successful outcomes other than the overall skill and competence of the therapist themself. As a result, graduate school professors and clinical supervisors spend an extraordinary amount of time training therapists in creating relationships that are conducive to psychotherapy. Moreover, one of the most powerful tools for treatment is the client and therapist relationship itself. It is often the case that a strong therapeutic alliance (the clinical word for such a relationship) is in of itself, sufficient for a client’s healing.

Not only that, but the client and therapist relationship can be used as a way to better understand and help clients by having intentional and often difficult conversations about the relationship itself. A good therapist will find a way to initiate such conversations with the client when necessary. This process can be accelerated and will create even better results if the client actively notices and participates in this process as well. In light of this, here are five uncomfortable conversations to have with your therapist:

1.  Any negative reactions or relationship problems you may have with your therapist

We often think of our therapist as a “neutral” or “objective” perspective with whom we have an exclusively professional relationship. We may want to be polite, and may see any points of contention with them as irrelevant or unimportant due to the professional nature of the relationship. This is not true. Although therapists have more objectivity than most people in a client’s life, the client-therapist relationship is still very personal and intimate. Even though therapists have a desire to remain objective, they also simultaneously invest themselves fully into the therapy relationship in order to create an authentic relationship with their client- the type which is most conducive to therapy and healing. This can come at the cost of some of the therapist’s “objectivity” by its very nature. Thus, it is only natural that conflicts, disagreements or discomforts may arise. In the spirit of maintaining a strong relationship, it is important that they be addressed.

Clients also bring their own ways of relating to others, coping with uncomfortable feelings, and dealing with relationship difficulties into the therapist-client relationships. As previously mentioned, therapists are trained in dealing with this. Any therapist worth their salt will welcome any concerns clients may have within the therapist-client relationship and see it as part of the treatment. When we address problems in the “here-and-now” relationship of the therapist and client, we are utilizing one of the best opportunities to gain insight into underlying relationship dynamics which cause problems for the client. Ideally, the therapist will help the client recognize how they contribute to the conflict and help relate that back to how this may contribute to other relationships in their life outside of therapy in a compassionate way. As previously mentioned, a therapist can never be completely “objective,” and therapists make mistakes. Knowing this, a good therapist will also reflect on how they contributed to the disagreement and own their part in it.

The insight and strategies gained by working through issues in the client-therapist relationship can help clients learn to work through issues in other relationships as well. A strong argument can be made that this way of gaining insight is even more effective than most other tools therapists have because it teaches through present-moment experience instead of just through giving hypothetical solutions/skills or processing feelings from something that happened in the past.  This present moment experience has the additional benefit of disconfirming unhelpful fears of beliefs that the client may have about themselves or about relationships.

For example, let’s say a client comes in with the following belief: “I should never stand up for myself because if I do, it will always lead to rejection.” This might play out in the therapy relationship in the form of aversion to talking about conflict. And if conflict did come up, the client might experience immense fear and shame. However, having the experience of a therapist willing to listen to and respect their concerns and work with them to resolve the conflict in a way that works for both parties can be a powerful tool for disconfirming this belief because it teaches through experience. This, in turn, would result in decreased shame and fear, and an increased likelihood that the client will directly face conflict when necessary and stand up for themselves in their daily lives. This same process can be used as a treatment for a large variety of relationship difficulties.

It’s also important to note that even if there are no big problems in the therapist-client relationship, even addressing small issues can foster progress.

Examples of “small” issues can include but are not limited to:

-  The therapist talking about themselves too much, thus wasting time which could be spent on treatment

- Disagreeing with a therapist’s diagnosis, interpretation of a problem, or solution

-  A therapist’s unprofessional behavior such as frequently being late to the session

- Mild feelings of anger or discomfort with the therapist. They may occur for any reason. There is no reason that’s “off-limits”

- Feeling like the therapist is insisting that you do a particular behavior or solution to a problem, even if it’s not something you want to do

-  Feeling as though treatment is not progressing or that you’re needing something the therapist has not given you so far

- Feeling hurt by the therapist. Even if you don’t know why or the reason seems “stupid” (resolving conflicts like these can actually yield some of the greatest insight and progress).

Any conflicts or unmet needs in the relationship are relevant. The point is that the process of resolving conflict can in of itself, be part of the treatment in a way that is more effective than most other interventions. Thus, it does not matter how big or small the issue is.

I also want to clarify that I do am not suggesting that you intentionally find conflict with your therapist in order to progress the treatment. I am only suggesting that it is wise to be intentional and do your best to find the courage to bring up any discomfort, big or small which organically arises within the relationship.

2.  Treatment is not working

There are times when a client might feel “stuck” in treatment, coming to therapy for many weeks in a row and feeling that there is little if no progress.

The truth is that progress in therapy is not linear. Sometimes going through a period of being stuck is an important part of the treatment. In fact, treatment can sometimes even feel worse before it gets better. It is not uncommon for clients and therapists to struggle for many weeks or months with seemingly no progress, but to finally experience a “breakthrough” all in one session. Having said that, there are times when there is legitimately no progress and that for one reason or another, the therapy is not working.

Letting your therapist know about your concerns is important because your therapist will be able to collaborate with you in better understanding if this feeling stuck is a normal part of the treatment, or if it really is a sign that the therapy is not working. Your therapist can also help guide you in finding resolution, whether this means switching things up within the therapy so that you can better get your needs met, referring you to higher levels of care, or just referring you to a different therapist with whom you have a better fit.

3.  Conversations about Sex

Sex is another extremely uncomfortable topic in our culture. Clients often leave their sex lives out of their narratives in therapy either because they believe it is irrelevant to therapy and/or they are too embarrassed to talk about it.

It is important to talk about sex because our experience of sex can be relevant to many aspects of our psychology including but not limited to: how we see ourselves, how we see others, how we relate to others, how we cope with uncomfortable feelings, how we experience pleasure, what it means to us to be in relationship with someone.

Talking about sex is especially relevant when we experience sexual dysfunctions. There are certainly cases of sexual dysfunction which are a result of biological problems. But if those have already been ruled out by a doctor, there is a good chance that there is an underlying psychological or relational difficulty manifesting itself in the form of sexual issues.

4.  Feelings of Attraction Toward Your Therapist

A therapist cannot have any relationship with a client outside of the therapy room- especially a romantic relationship of any type. Doing so would be a serious ethical and legal violation on the part of the therapist, and would cause great harm to the client.

Having said that, having feelings of attraction toward your therapist is very natural. Disclosing such feelings, exploring them, and working with them without acting on them can be extremely useful for treatment. People whom we are attracted to trigger unconscious material, insecurities, and other uncomfortable parts of ourselves in ways that few other experiences do. This is part of the reason why we often feel so insecure when we first meet someone we are attracted to.  For more information on attraction and how it relates to us as individuals, see this article.

Much like working through conflicts in the here and now can progress treatment, working through and understanding the roots of attraction and the meaning we make of it can serve the same purpose.

5.  Needing a different therapist

A good therapist will understand that sometimes, the client-therapist relationship is not a good fit. It is unfortunate when it happens, but it is also a simple fact of life. Not every two individuals mesh well together and that is okay. As previously mentioned, the strength of the relationship between client and therapist is one of the most important (if not the most important) factors which lead to successful outcomes. Therefore, if there is ever a time that a client feels that this therapist is not a good fit for any reason, it is important that it is brought up to the therapist. If this happens, a good therapist will be happy to help you find someone who is a better fit.

***Written for Meridian Counseling by: Simeon Simov, AMFT Associate Marriage and Family Therapist (117648)

INTERESTED IN WORKING WITH SIMEON?

Contact information:

Phone: (323)723-2674

Email: simeon@meridian-counseling.com

Website: therapywithsimeon.com

Supervised by: Sandra Kushnir, LMFT (992