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Ten Things a Good Therapist Should be Aware of

Therapy is an unparalleled situation between two people of unequal power which can produce considerable anxiety for the client. Over the years, I have become aware of many things that make me nervous of which my most excellent therapist is not aware – unless I tell her. We’ve discussed these things with much amusement and considerable insight into the unique world perceived by each and every client. Not all clients think in the same way, but chances are each long-term client has their own idiosyncratic way of responding to therapy, the therapist, the room, other clients, the interactions and nuances of other staff and the general therapeutic environment. A good-enough therapist will always respect and respond to her client’s whims and wishes as best she can.

1. Seeing your therapist in an untherapeutic space.

I always arrive half an hour early and park up the street, so I can chill out in the car and listen to the radio, read a book and think about what I need to say. Sometimes, my therapist arrives after me and parks up the street behind my car. On several occasions I have seen her in my rear-view mirror and I’ve slunk down in my seat with my sunglasses on till she’s past. To see her staring longingly into other people’s gardens or stumbling on the uneven pavement with a ham and salad roll in her hand is so out of context I break into a cold sweat and my heart starts thudding rapidly. On one memorable occasion she came out of her office, walked down the street and disappeared around the corner, ten minutes before my appointment time, which immediately put me in touch with my abandonment issues.

2. Therapists’ receptionists and waiting room.

My therapist has some lovely, caring staff in the office she shares with many other different health professionals. However, I’m very conscious of the fact that the same staff have been there for thirteen years, the same amount of time I have been coming to see her. So, after a year long break from therapy once, I got a comment from one of the receptionists, “Hi Sonia, haven’t seen you for a long time.” And I wasn’t sure what my response should be. Perhaps something like, “Yes, well, I’ve stuffed up my life again, so here I am!”

I sit in an area of the waiting room where the receptionist cannot see me and I cannot see my therapist’s door and I always, ALWAYS, have my nose stuck in a book. That way if my therapist comes out of her room, talks to someone else, I can cover my face and pretend I haven’t seen or heard her till she actually calls my name. If I choose to read a magazine briefly then it’s always a non-therapy one. At one stage she had many copies of “Psychotherapy in Australia” fanned out on her waiting room coffee table and much as I was dying to pick one up, that would identify me to other waiting clients and passersby exactly why I was there – so it wasn’t an option.

3. Using the therapist’s bathroom.

I find it anxiety-producing using my therapist’s bathroom. I go before I leave home. I go at the garage around the corner and sometimes I need to go again when I get there. Between five to and five past the hour, not only is there the horror of the corridor meet, but there is also the possibility I may either knock on the bathroom door and she is using it or I come out of the bathroom and there she is. Either way, it would mean silently acknowledging the existence of each other’s bodily functions.

4. Other clients.

I may be in the waiting room and see a crying client come out of her room and logic tells me they have shared an emotional session and that is fine. That is her job. That has little effect on me except for one of empathy for someone in psychic pain. But when I walk through her door, I don’t want to see physical evidence of other clients in the form of someone else’s warm butt-print on my couch, used tissues on the floor, writing on the whiteboard or half-empty glasses of water.

5. Other clients’ presents on display.

Grateful clients occasionally give their therapists presents. My therapist has a small white and gold teddy bear in her room given to her by me. There is another teddy bear, a tartan one that was given to her by another client. Sometimes, when I am with my therapist, my mind wanders and I have fantasies about the white and gold bear strangling the tartan one. Perhaps there is another client out there who dreams of beating up the white and gold teddy bear.

6. Sufficient light and air in the room.

I need to see my therapist’s face. I need to see every line and wrinkle, so I can check out her facial expressions, raised eyebrows and body language clearly; otherwise I might miss something when I’m squinting through the darkness. Aromatherapy candles in a small closed room are atmospheric, but somewhat stuffy.

7. Therapist’s clothing distractions.

A hole in a skirt, a thread hanging down, an unraveling sock or a button undone is really distracting. I hooted with laughter when Desperate Housewife, Bree Van de Kamp was in therapy with her husband and, upon noticing a button missing on the therapist’s shirt, mentally sewed it back on. Oh, how I could relate!

8. Compliments.

Please don’t tell me I look nice when I’m makeup free, my hair is windblown, I’ve put on 20 lbs., I’m wearing a tracksuit and faded t-shirt or if my face is red from crying. It’s not authentic and makes me feel bad rather than good. This can waste many precious minutes of my therapy correcting your perception.

9. Five-minute warning.

My wonderful therapist always gives me five minutes notice the session is ending. That gives me enough time to wrap up my thoughts and say goodbye with decorum. If she suddenly announced, “I have to finish now, Sonia,” and ushered me through the door in the same breath, it would be most disorienting – and irritating.

10. Standing between me and the door.

When therapy is finished and we both stand up to say goodbye, not only does the personal space between us decrease considerably, causing some angst and consternation, I don’t want my therapist between the door and myself. Much as I don’t want to leave, ever – I still need a clear, unimpeded escape route. Just in case! Just in case of what? I’m not sure – just in case! At that point, I can’t get through the front door quick enough and into the relative safety of my car, the same car that’s parked down the street from my therapist’s. My heart rate starts to slow down round about the time I turn the corner and head for home. But it takes another twenty-four hours before the voices of therapy in my head start to recede. Even after thirteen years, therapy can be an inherently exhausting process.

Ten Things a Good Therapist Should be Aware of

Sonia Neale

Sonia Neale was recently awarded the Inaugural Barbara Hocking SANE Australia Fellowship to study and research Borderline Personality Disorder overseas in the USA, Canada, UK and Ireland. Her previous Psych Central blog was called Therapy Unplugged. She is the author of two books, The Bad Mother’s Revenge and Death by Teenager, both published by ABC Books/Harper Collins. She lives in Western Australia, is married with three adult children, has studied psychoanalytic psychotherapy, has a Certificate IV in Mental Health and is studying for a Psychology/Counselling degree. She currently works as a peer support worker in the mental health field.

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APA Reference
Neale, S. (2009). Ten Things a Good Therapist Should be Aware of. Psych Central. Retrieved on July 13, 2020, from


Last updated: 26 Apr 2009
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