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Cliff Hangers & Therapy Don’t Mix

732128_72168845*No matter what happens during a session, whether or not you resolve an issue, as the end of the session approaches, your therapist should “check in” with you and make sure you are feeling okay.

He may ask you to summarize your session by talking about your progress, discussing the accomplishments you made during the session, or exploring what you have achieved over the course of therapy so far. He may also summarize the session himself. He may also give you homework, highlighting some skills that you can work on before your next session.

I like to give my patients a lot of homework–I want them to have really solid techniques at their fingertips to help them deal with both internal and external problems.

It is important that each session end on a positive, hopeful note. Above all, your therapist shouldn’t allow the session to end if you are experiencing any extremely negative feelings or thoughts which might cause you to have a crisis. Cliff-hangers and therapy DO NOT MIX.

If you are overwhelmingly upset, he should refer you to get a crisis evaluation even if it means calling 911 for assistance. If he has another patient waiting to see him while you are experiencing a crisis, he should step out into the waiting room and ask the other patient if he would mind waiting or rescheduling.

If when you leave you are still upset (though hopefully your feelings will be manageable), your therapist should ask you to call him later or offer to call you.

I want to stress that ending a therapy session when you are in distress should be the rare exception rather than the rule.

Pay attention to this red flag: Unfortunately there are therapists who are working out their own problems during their patients’ therapy sessions.

Some feel that they must “control” their patients. One of the easiest, most passive ways to do this is for them to allow a sensitive, vulnerable patient to leave feeling badly. These therapists believe that a conflicted patient is more likely to return to therapy, and keep coming back for an extended time in order to try and get rid of his bad feelings.

Sometimes these therapists, either consciously or subconsciously actually trigger the patient’s bad feelings to keep him dependent and coming back for more therapy!

Since these kinds of therapists obviously aren’t the kinds of therapists who would teach their patients how to handle triggers in the first place, their patients are very vulnerable to this kind of manipulation.

I want to stress that this is not common.

Still, I have heard of this occurring. Other therapists, including my staff members, have told me that their patients have shared these kinds of stories. Sadly, I’ve had a couple of patients over the years tell me stories like these, too.

On the rare occasion, perhaps a time or two over the course of therapy, you might feel more down after a therapy session that when you went in.

For some people, it’s possible there will be no noticeable change at all during one or more sessions. But at least these clients don’t feel much worse at the end of a session.

If you consistently feel worse after a therapy session than before, you may consider telling your therapist. Your therapist should address this problem in a proactive way, helping you find ways to leave therapy in a more positive mood.

*Parts of this post were excerpted from Therapy Revolution: Find Help, Get Better, and Move On.

 

 

Cliff Hangers & Therapy Don’t Mix


Richard Zwolinski, LMHC, CASAC & C.R. Zwolinski

Richard Zwolinski, LMHC, CASAC is the author of Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money and is licensed in addiction and psychotherapy with over 25 years experience as well as a consultant to organizations and companies in the fields of mental health and addiction. He is the executive director of an outpatient behavioral health program. Learn more about Richard here.


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APA Reference
& C.R. Zwolinski, R. (2014). Cliff Hangers & Therapy Don’t Mix. Psych Central. Retrieved on November 12, 2019, from https://blogs.psychcentral.com/therapy-soup/2014/08/cliff-hangers-therapy-dont-mix/

 

Last updated: 3 Aug 2014
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