Difficulties in the Therapeutic Relationship

Now I’m going to discuss some of the things that can be suggestive of poor therapy, but which sometimes can be worked through. This isn’t a complete list — I am sure you can add lots more things.

Dual relationships. What this means is having a therapeutic relationship and also another, separate kind of relationship with the same client. Licensing boards and professional organizations are moving more and more toward banning all double relationships. Canada is looser about this, maybe because so much of Canada is rural.

Banning dual relationships is probably a good idea because it is hard to keep your client’s well-being in mind when you are simultaneously relating in another way. Certainly therapists should not have another financial relationship with their clients on the side. This means no hiring the client to paint your house or do your books, no trading lobsters for appointments, no accepting gifts. If a client wants to give a gift, it should have no monetary value – a hand-made card or a poem is fine.

In small isolated communities, it’s almost impossible to avoid dual relationships. People are spread out and there is only one therapist, one carpenter, one doctor, and so on, for miles. If a dual relationship is the only alternative to no therapy at all, it should be discussed at the beginning and some plan should be put in place to avoid pitfalls. Sometimes that’s all that is needed to set boundaries and make for a good working relationship.

There’s another circumstance that I don’t know very much about, and that’s ministers, priests, or rabbis who are also counselors. I don’t know how the different denominations ensure that the two roles stay separate. If you are considering working with a religious counselor, it would a good idea to ask about this.

Poor boundaries. The therapist asks for your help in personal matters, leans on you for comfort, or tries to be so giving that you end up being taken care of in inappropriate ways. The therapist is neither your savior nor your child – a therapist is a reliable, trustworthy coach who meets you where you are and always keeps your best interest at heart.

Flakiness. The therapist is consistently late, forgets appointments, often calls at the last minute to cancel or reschedule, or doesn’t return keep phone appointments in a crisis. Or messes up the bookkeeping. Or forgets important facts about you. Forgets to tell you about vacations. Once or twice is forgivable, but a lot? You need consistency, not chaos.

Over-stepping their knowledge. The therapist says he or she has expertise which he or she doesn’t. I’m not only talking about padding a resume; I’m talking about giving medical or legal advice or diagnosing somebody (like your parents) who they have never met. A therapist should be honest enough and confident enough to admit to not knowing something or not being qualified on a particular subject.

Suddenly changing the ground rules. Sometimes changes do need to be made, but they should be thoroughly discussed ahead of time. It’s not helpful to change the fee with no warning or to state that there will no longer be phone calls in a crisis. If you feel that the rug has been pulled out from underneath you, it will take a lot of time to rebuild your relationship.

You can see how any of these issues, if poorly handled, could prevent trust from forming in the beginning of the relationship or mess things up in the middle of therapy. You relationship with your therapist is the basis for therapy and it should be treated thoughtfully and respectfully at all times.


14 thoughts on “Difficulties in the Therapeutic Relationship

  1. PS And when I was reading this post earl;ier, I couldn’t help think it sounded familiar…. that’s because it is, I already read and commented last week 🙄

  2. I have a great Therapist in many ways and while I’m willing to work through little hiccups and analyse what they represent in my past, cancelling appointments at the last minute and yesterday they forgot to inform me of the cancellation at all, is starting to wear on my patience. This was cancellation number 6 in about 6mths. If they cushioned the blow or even pretended to care about my inconvenience, I might feel better, but it looks like I just need to suck it up and if I don’t, then it’s my problem. Enjoyed your post, Jean, it comes just at the right time

    1. It’s your therapist’s problem, whether he/she knows it or not. Probably all other clients are subjected to this. Have you spoken about it? If so, what response did you get?

      There may be some old issues being stirred up, but even so, this kind of treatment is engendering a lot of anger etc. How would you feel if a dentist cancelled a quarter of your appointments? Or one day a quarter of the street cars did not run? Maybe this T is so good in other respects that you are willing to put up with this and then you have to suck it up. But you shouldn’t have to.

      1. Trouble is, it’s NHS, we don’t pay in the UK for treatment, although we would be better off if we did because we pay extremely high taxes and National Insurance Contributions to cover the cost.

        It’s a service and I have followed all the right things; talked about how it effects me, asked for assurances it is only a one off, asked for them to give me more notice of cancellations rather than text me 3hrs before my appointment. I’ve looked at how it affects me and what it represents in my past (being ignored and disregarded). But it evidently makes little difference. Only this time was worse because they forgot to call me to cancel gggrrrr

        Sorry to babble. I was just trying to write a post about it, but it feels so emotive. These people are a team of professional Psychotherapists, Psychologists and Psychiatrists. I don’t need to educate them on how this can impact on a clients therapeutic journey. Like the narcissistic parents, it seems I need to just suck it up or leave. It’s infuriating, but I can do little else but carry on talking and listening to my Therapists apologies and validation. That doesn’t cut it anymore.

        1. Ah, and you get assigned somebody I bet. Maybe it’s the system and they can’t help it. Like a last minute all-staff meeting is called? Bureaucracies suck

  3. This makes me think that your writings can be compiled into a good book. In general, these are very good and reasonable advices, there are complexities and shortcomings in real human life, but they can be dealt with. I’d like to comment only on two very specific moments.

    You said that a psychologist should only do deprogramming and not try to become a savior. He should be doing his specific job, but the actual situation with quitting the cult is more complicated and bigger than this. Like I’m always saying, programming is an integral part of the occult way of life, which is a global thing. Cultist stuff trigger warning for the next. So, a therapist talks how harmful was that the father raped the client, then, the said client goes back to her upper class elitist family, there is a gang for satanic practices lurks nearby, she does her job on the stock market to run the agenda, then goes to meditate and do astral projection to rise her energies, then may be watch some occult inspired movie and the cult doesn’t really care about that therapy session. That’s why deprogramming have been rare and not very productive. Deprogramming should take its course as rebuilding a personality, but it should accompany a change of life from life causing programming to life with healthy personality. Deprogramming should come as an integral part of it. A therapist may help in some things, but it also is a path for many people to share.

    Another tricky issue is with religion. Yes, therapy and spirituality should be kept separately. But programming always has the Occult and the other religious stuff involved. I’m trying to keep deprogramming only about a personality and abilities, so a client could deal with the rest personally. Spirituality needs a separate different talk and a person forms his beliefs there. Both are important. They should not be mixed, but both should be available for a person to seek full own life. Perhaps, a good priest can do both things, if he is not from the cult. The Occult controls priesthoods tightly, religion is the foundation of any power.

      1. Oh, Mark, a book is soooo much work! And then it has to be marketed, which is not something I would enjoy. But thank you for the kind words about the material that is posted on this blog.

        A good therapist will deal with all aspects of the client’s life. That’s different from trying to be the client’s savior. It’s not appropriate to give clients money, to take them into one’s house, to try and satisfy their every need. Only babies can have all their needs satisfied, and they quickly grow into complex beings who should start developing independence in some areas.

        It seems like you agree with me that therapy and spiritual growth should be kept separate if at all possible. However, as I said, I don’t know enough about the way ministers, rabbis, etc who are also therapists handle the situation, so I can’t say anything intelligent about the issue.

        1. You can just compile your articles with some systematization. For convenience of your internet readers.
          My question remains, because in what life with its aspects therapists support survivors? It is often becomes psychological support in going from the cult to the street. Therapists must work their part within the mentioned change of life for the survivors, whatever they do. Besides therapy, there must be a complex of substantial basis, support and embodiment for this life to change in practice. This is our duty as humanists to give social environment for life without the cult and with normal living humanity.

  4. I don’t know what to do My therapist is leaving for two weeks. I understand she needs a break but for the first time ever I am feeling stuff. She started using the word torture on Friday and I just started talking to her about it and it’s making me fucking crazy. Now she is leaving. Now what the fuck am I supposed to do? I’m Stephanie by the way. I’m fifteen years old.

    Sent from my iPhone


    1. Dear Stephanie:

      Terrible timing! But I am sure you can get through this.

      Can you ask her to give you something little, like a pebble or a tiny toy, to remind you of her? Can you write or make something to give her when she gets back? These things would help keep the connection strong.

      Make a list of things that would help. Maybe a calendar, so you can cross off the pages until she gets back. (This is funny — one therapist gave a child she was working with a strip of 14 pieces of toilet paper, so the kid could rip off one every day and see how the strip got shorter.) You are very smart and creative and found ways to get through the abuse and you can get creative in finding ways to soothe yourself while she is away.

      Write here whenever you want and ask for support, k?

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