I have had a number of people contact me to start therapy, and in the process also ask me how they should know when it’s time to switch therapists. I often work with people who have been in therapy in the past, who are now seeking to go deeper or reach places they weren’t able to in their previous therapies. So, this is a common question.
Negative feelings towards one’s therapist are common, and often necessary in the process.
It can’t be overstated enough how complicated of an issue changing therapists really is. What makes this so complicated is understanding the greater picture of what’s triggering the urge to leave. Is it something the therapist is specifically doing, or not doing? Is a pattern in your life being re-enacted with the therapist (a very common phenomenon that can actually enhance the treatment when explored)? Is a dynamic coming up that’s triggering past emotional states that could actually be useful to understand in the treatment? Is old trauma being projected onto the therapy (very common, but also hard in the moment to be able to tell the difference between the old trauma and the current situation when triggered)? Are you wanting to leave the therapist for actually not being a good therapist, or is it more about the difficulty of facing the difficult or negative emotions within an overall good treatment? And so on.
There are so many dynamic enactments and emotional states that move through the relationship between the two people in the treatment (you and the therapist). It can be difficult to pinpoint in a triggered moment when something old is showing up in the present and is now ready for the attention it’s always needed, versus when something is actually happening in the present situation with your therapist that you really need to change away from.
How does a person determine when the therapist is problematic, versus when the difficult, up-and-down emotions (not only consciously, but also unconsciously) of an otherwise positive or helpful treatment are triggering a desire to step back or leave?
In trying to come up with a rule of thumb to answer this question, I would say when the therapist consistently (on a regular basis) and obviously impedes forward movement of the process of the treatment, then it’s time for a conversation, and possibly a change. Keep in mind that negative emotions can still be present in a forward-moving treatment. But if it feels like the therapist is having a direct hand in consistently impeding your treatment, this is a problem.
Here are some points to consider:
- Therapist leaning on Client — if there’s a pattern of your therapist using you for emotional support, such as talking about or turning the focus to their own issues at length, bringing in their own relationship or family problems, and seeming to vent to you, this could be an issue. Sure, therapists are human and have lives, however, your therapy isn’t the place for the therapist’s life issues to be sorted out. It’s one thing if a therapist discloses pieces of their lives in the service of your treatment, but it’s another thing if there is a repeated pattern of the therapist venting or sorting out their lives in your therapy.
- Sexual Boundary violations — If the therapist makes sexual advances, this is an ethical violation, and comes with many consequences to the treatment.
- General Boundary Violations — Other non-sexual boundary crossings need to be considered. For example, if the therapist suggests meeting outside of the office for coffee, or to socialize in ways not related to the therapy. However, even this isn’t automatically an “issue” (some therapists do experiential therapy that may extend beyond the office). The main question here is: what’s the reason for this request? Is this in service of your therapy, or is this a need of the therapist to make the relationship more personal and casual, even if not overtly sexual. Other general boundary violations could be things such as the therapist advising you on things that are outside of their realm of expertise, or asking you for advice based on your job or area of expertise, or advising you on how you “should” live, or dress, and so on.
- Therapist is Chronically Unfocused — This isn’t as simple as looking tired. This refers to more clear lack of focus. For example, if the therapist answers their phone (aside from emergencies), responds to texts, listens to messages during sessions, gets up repeatedly, and in other ways interrupts the sessions to deal with other things. Of course, at times things come up that require urgent attention, and it’s good to not base this on one occurrence. But if it seems constant, this can compromise and disrupt your treatment, and you may not be getting a level of attunement and care needed.
- Therapist is Unreliable — If your therapist is often significantly late, canceling sessions last minute, or canceling for several weeks at a time without notice, or is otherwise preoccupied in a way that impacts your ability to have your therapy, then this is an issue.
- Feeling consistently unheard or unsafe in the room — if you are attempting to bring up issues with your therapist and the therapist continuously defends themselves, or otherwise makes you feel insignificant and unheard, this can be troubling. Even if there is a therapeutic lesson to be had, if your therapist is consistently shutting you down when you’re trying to open up and trust them with your vulnerability and emotions, this can shut down the treatment.
Advocating for your needs and moving forward
Keep in mind, therapy is a human process. Emotions can come up between both people in the room. Some flexibility of humanness is recommended (aside from obvious violations). But if negative patterns develop to the point where it’s getting in the way of having a treatment that makes sense for you, then it should be brought to the therapist’s attention so it can be addressed directly (even just opening the conversation of things you’re not feeling good about can be a positive benefit to you and your treatment). If you continue to feel unsafe, unheard, or otherwise at odds with the therapist after attempting to work through this together, then a change to another therapist and new therapy may be necessary. If you are looking to start therapy, contact me today to discuss your situation.
