Does my therapist care about me?

heartWhen I was in my late teens I began seeing a counselor because I was depressed. I was taking a full load of undergrad classes at OSU and working 40 hours a week and living by myself without roommates or family for the first time ever. My weekly visits to Barbara (my therapist) quickly became the center of my schedule. I’d drag myself to work and school, grind my way through my day, all the while focused on that bright spot, once a week, when I would sit in her office and feel safe.

I loved Barbara even when I didn’t love therapy, which was hard and often painful. I didn’t always leave her office feeling better. There were days I left feeling raw and fragile, my face swollen with tears. I started scheduling my work so I had the day off on therapy days so I could come home, curl up in bed and sleep away my emotional exhaustion. I could feel myself growing stronger and straighter but it was hard going.

I think I saw Barbara for about a year, maybe a little more, maybe a little less. I saw her weekly and then I saw her every other week and then we agreed I didn’t need to see her anymore at all. But for the time I was in her care, I felt very dependent on her and I wondered how it was for her because she may have been the person I centered my weeks around but I was just a client on her schedule.

I wanted her to call me up to have coffee. I wanted her to like me best of all of her clients. I wanted her to lean in one day and whisper, “My sessions with you are my favorite!” And I was free to want that as much as I liked because I knew it would never happen. It was a little like Lisa Simpson’s copies of Non-Threatening Boys Magazine; a celebrity crush, all safe and worry-free. I knew I could tell her anything and she’d have to like me — or at least pretend to like me — because it was her job.

But I always wondered if she cared about me for myself and not just as a name in her appointment book.

Now I know because I have my own appointment book (well, iCal calendar — same difference) and I can tell you that yes indeed, Barbara cared about me and your therapist cares about you. But we care within the boundaries our profession sets for us and those boundaries are what allow us to serve you. It’s not like caring for a friend or family member because it has specific limits and in other ways it is limitless. The space we hold together in the counseling relationship is full of unconditional positive regard (loving acceptance of all you are), which is harder to maintain in real life relationships. In that way the counseling relationship is boundless. On the other hand, I would never call a client up and say, “I’ve been thinking of you; let’s have coffee on Thursday.”

I remember when my son was very small and I heard about a preschool teacher who made space in her evenings to think about every single one of her students for a moment, hold the thought of each child close and then let it go. This is a little bit like how it is with clients. Before work, I review my schedule and mentally and emotionally prepare for the specific clients I will see that day. Each night, before I leave my office, I review them (usually as I write up case notes) and then on the way home, I give myself permission to stop thinking about them by the time I arrive home. This is because it’s easy to worry about a client going through a particularly tough time and worrying does neither of us any good. When I do catch myself feeling anxious about a specific client, I take a page from the preschool teacher and give myself permission to sit with my thoughts for a discrete time. This helps me come to my sessions fresh and focused instead of wrung out and worried.

So this love and caring I have for my clients — and that Barbara had for me — is not the love and caring I fantasized about when I was in therapy (there are no intimate coffees, there were no confessions of favoritism from Barbara) but it is good and solid and dependable.

Comments 6

  1. I always appreciate the way you articulate the inner workings of the work we do. This really resonates with me from the perspective of a client who knows she is cared for, and from a therapist who definitely cares about her clients. Thanks for writing this!

  2. Pingback: Therapy – a few thoughts | Life In a Bind

  3. I can’t tell you how much I appreciate this post, as this is an area I struggle with so very much. And it’s reassuring to know that this is the way that therapists feel about their clients. But it’s one thing knowing it (on paper) and feeling it (in session, and out of it). I am confident my ex-therapist cared about me. But I don’t feel cared for by my current therapist. My gut tells me (or at least my ‘wishful’ thinking tells me!) that I should ‘feel it’ as well as ‘know it’. But exactly _how_ can or should a therapist convey ‘caring’ to a client? Presumably not by actually telling them they care about them – or does this sometimes happen? I guess there is such a difference in terms of how much therapists are happy to disclose, it’s probably a nonsensical question, but I guess I was just interested in your thoughts!

    1. Post

      Life in a Bind, I was thinking about you on Friday and about how I’d answer this post. I think every therapist has to figure out which boundaries work for them and then figure that out again with every client. I think that some therapists tell some clients that they care for them (sometimes) and some of us work to convey it in other ways. That said, I feel concerned that you don’t feel cared for by your current therapist and I’m wondering if this is something you would feel comfortable with bringing up in session? Because I think that could be a really valuable session. I would certainly appreciate it if one of my clients brought that up if that was her concern! I hope you’re able to and I hope it helps move your therapy forward.

  4. Thank you so much for the reply. I really wish I was with a therapist who would ‘up-front’ tell me – I feel I need ‘directness’ and to hear things clearly! Having said that, I agree it could be a really valuable session. if I were able to raise the fact I don’t feel cared for. I have tried to bring it up – one of my big problems generally, is being able to communicate clearly how I feel. So I have been vague about it, or indirect about it, and asked in general terms about ‘caring in therapy’, rather than asking about _her_ caring about _me_. And other issues always seem to overtake us. But I am determined to tackle it soon -I have to, before I can make a decision about whether to try and move on to someone else. Thank you again for your really helpful comments, and for your blog in general!

  5. Hi Dawn, I just wanted to say that I took your advice and finally managed to raise my concerns with my therapist. It took a few sessions to go through it all, but I feel like it’s made a real difference. We talked about my concerns about the fact that she doesn’t talk that much, and about how I don’t feel cared for or understood. I finally feel like I’ve turned a corner, and I’m no longer thinking of finding another therapist. I still find it hard to maintain a constant view of her, and I alternate between feeling sessions are great, and feeling they are disappointing, and I do still sometimes revert to feeling uncared for. But I feel as though I have a more solid foundation, and for the first time since I started sessions with her, I feel as though I’m not in this alone. It made such an impact, I wrote a post about it: http://lifeinabind.wordpress.com/2014/06/13/the-new-therapy-from-house-to-home/ . Thank you again, so much, for taking the time to reply to my comment, and for your advice!

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