I decided to fire my therapist, Aaron, after a year. My goals were to be more focused and productive at work and in my personal life. I didn’t have much interest in addressing formative experiences. I wanted to deal with the constant rejection faced by a freelance writer and a single male without anxiety and self-doubt hampering my ability to rebound. It was like I wanted to debug a program. But Aaron kept bringing the conversation back to my upbringing, and I left thinking, “Well, when I came in, I wasn’t ruminating about the time my dad smacked me to the ground for bicycling after curfew, but I am now. Thanks, Aaron!”
As I started seeing other therapists, I began to realize that it felt a lot like dating. Sometimes, things feel wrong—or ridiculous—from the first meeting. Sometimes, the relationship starts out great but erodes over time or lingers for years without inertia, or you call it off for small, Seinfeld-y reasons. And sometimes, there are abuses of trust that leave only one course of action.
Often clients don't feel empowered to determine if a therapeutic relationship isn’t right, or to end it after deeming it a dud because of the inherent power dynamic of the client-therapist relationship. You’re going to this tranquil office with a framed Monet print once a week because your thoughts are muddled and their view on your behavior is more informed and rational than your own, right? Who are you to say their approach isn’t right?
“The hard part for most people is trusting oneself and finding the strength to [end the relationship],” says Jude Treder-Wolff, a therapist and New York State-approved provider of continuing education for others in her field. She says she has “treated many people who should have fired a prior therapist but did not feel empowered to do that or assumed they were the reason things were not working.”
Therapists aren't always inclined to end things either. “Therapists like to believe they are good and that they can help practically anyone,” says Israel Kalman, a psychologist who often gives seminars to therapists on how to help clients with specialized traumatic experiences like bullying and oppression.
“This may prevent them from recognizing they are not right for a particular client.” However, there are signs a client should find another couch to occupy each week. These are a few of them.
Your Therapist Gives Practical Advice, As Opposed to Helping You Navigate Your Feelings
Brianna Snyder Deyette first saw a therapist for body image issues while an undergrad at Westfield State University in Massachusetts. “I was down on my bod and down on my freckle face and I was living with a bunch of hot college chicks who all had boyfriends and I was fucking this guy who didn't like me,” says Deyette, now a marketing specialist in Upstate New York.
The therapist at the student counseling center was not much older than Deyette. Her suggestion? Start hanging out with people closer to her level of physical attractiveness—or “make uglier friends,” as Deyette puts it. She was so flabbergasted, she didn’t go back. The next therapist she saw suggested she join Weight Watchers.
This tendency to offer practical suggestions as opposed to talking through feelings and thoughts is a common rookie mistake, says Treder-Wolff. “Giving advice gives therapists a boost,” she says. “They want to be able to say, ‘I fixed it!’” This has the pitfall of starting arguments if the client doesn’t like the advice. (Deyette was fond of her thin, attractive friends.)
A more advanced therapist “wants a person to engage with their own strength and creative capacities,” Treder-Wolff says. When a client comes to their own realization about behaviors or attitudes, through guidance, that tends to lead to a steadier commitment and greater resolve.
Deyette says that, after a few years, she found a therapist who clicked with her and who readjusted her outlook to make her happier. “He didn't all-out campaign for me to be a fat activist or something,” she says, “but he did suggest that some people are just happy being fat.”
Your Therapist Lacks Cultural Competence
J.R. Heller, a writer and English professor near Kalamazoo, Michigan, says she and her husband sought the help of a marriage counselor shortly after their wedding. Some of their issues stemmed from their upbringings: He was raised in a family where the husband/father made the major decisions and was allowed angry outbursts, uncommented upon, and he saw this as normal. Her family was calmer and more gender-equitable and democratic.
Their first marriage counselor “was very nice and tried earnestly to be helpful,” Heller says. But he turned them off when he said that her husband was “from a type-one Jewish family” and she “from a type-two Jewish family.” Heller considered this condescending—and still doesn’t quite know what he meant by that. “Jewish families come from all over the world, are different sizes and have different histories, [so] I cannot imagine why [he thought] only two types of Jewish families could exist,” she says. Also, she didn’t think their issues had much to do with Judaism.
They decided to see another therapist. R. Ruth Linden, president of the San Francisco-based healthcare navigation agency Tree of Life Health Advocates, says that a decent therapist should show “cultural competence,” an ability to work with people of different backgrounds without falling into condescendence or simplification. Linden says she likes the term “cultural humility,” which implies a capacity to learn and listen when presented with concerns that might be foreign to the therapist’s own background.
“A therapist who lacks cultural competence or cultural humility might trivialize a client of color’s fear of being stopped by the police by saying, ‘Oh, I think your exaggerating the risk,’” Linden says. While whatever trait causes a therapist to say such things can be unlearned, it’s not the client’s job to get their therapist “woke.” These kinds of micro aggressions show “disrespect by undermining a client’s self-confidence and trust,” Linden says. “No client should ever tolerate this sort of behavior from a healthcare provider.”
Your Therapist Seems Motivated by Money
Kevin Ryan, a communications specialist for a Kentucky health network, saw a therapist for post-traumatic stress issues after he was robbed in downtown Louisville. Over eight months, the therapist was successful in helping Ryan readjust—which, Ryan says, eventually threatened the man’s bottom line.
“[He] wouldn't let me back away from once-a-week appointments when I no longer experienced symptoms of PTSD,” says Ryan. “He insisted that we meet once a week, and the relationship got uncomfortable. I was a steady source of income, and I had to fire him.”
Chris Rock once said, “There ain’t no money in the cure. The money’s in the medicine. That’s how you get paid, on the comeback.” That could also be a motivator for some less scrupulous therapists. “The dread of losing out financially can be an unconscious motivation to continue working with a client they aren’t helping,” Kalman says.
However, like any self-employed professional, therapists in private practice should accept income fluctuation as part of the job, Treder-Wolff says, and patients shouldn’t feel obligated to stabilize their cash stream.
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Your Relationship With Your Therapist Just Feels Languid
By the time I stopped seeing him, an appointment with Aaron occupied the same place in my life as a Sunday stock-up trip to Shop ‘N Save or a visit to the laundromat (but with more recollections of gym class beatings). It was just an unpleasant thing I had to do. Still, I was hesitant to cut him loose, because he was nice enough and therapy was supposed to be unpleasant. Wasn’t it? This is not sufficient reasoning, Linden says. “If therapy isn’t working for you, then it is time to leave, even if you can’t put your finger on what’s not right.” She adds that it’s enough if you “don’t feel connected or bonded or maybe you don’t feel supported.” Treder-Wolff says that signs that a relationship has soured include: going over the same things in a circular fashion, failing to create or meet goals, excessive arguing, and missing appointments.
This kind of malaise is often not enough for the therapist to suggest an end to the relationship. “Unfortunately, many therapy relationships drag on endlessly,” Kalman says. “This is to the benefit of the therapist, who needs to have enough clients to make a living, so they have nothing to lose as long as the client keeps coming, but may not be beneficial to the client.”
If you aren’t feeling comforted, excited, or motivated by your therapist, it’s probably best to move on, and Kalman says to cut out if this happens early. “If you feel you are getting no benefit after six or seven sessions, you are not likely to feel you are getting any benefit after ten or 20 sessions either.”
Your Therapist Tries to Be Your Friend or Lover
Just like any profession, therapists are guided by a code of conduct. Sometimes, they can break the code in ways that seem innocent or inadvertent.
Confidentiality is a big one. This is pretty straightforward: A therapist can’t tell anyone (in almost all circumstances) you’re seeing them. Linden says a mental health professional she knows flubbed that one recently by sending a mass email to her patients, which disclosed their email addresses to one another.
The one that presents the greatest obstacle is “multiple roles.” The American Psychological Association (APA) defines this as “when a psychologist is in a professional role with a person” and “at the same time is in another role with the same person.” It also extends to family or close friends of the client.
Basically, this means a client should have no place in a therapist’s life other than as a client. They shouldn’t be friends, in the traditional sense. They shouldn’t hang out. “This includes sharing specialized knowledge,” Treder-Wolff says. Therapists shouldn’t ask accountant clients about self-employment tax filing tips or contractors about kitchen remodeling.
This might seem like friendly chit-chat, but getting anything from a client, even if intangible, might suggest a preference for them above other clients. Treder-Wolff says she once refused Broadway tickets from a client who couldn’t use them. “Her husband worked in tourism,” she recalls. “They were really good seats.” And sexual overtures to clients are not only a fireable offense, but grounds for a complaint to the APA, which controls the licensing boards for therapists. These kinds of violations can creep up slowly and do significant harm.
In 2014, Teena Touch, a marketing and branding freelancer in New York City, quit drinking. She sought a therapist who specialized in addiction and LGBT relationships (Touch is a lesbian) to help her with that, her childhood trauma, and her pattern of throwing herself into relationships. “She helped me become emotionally stable,” Touch says. “I was incapable of calming myself down." But over time, the therapist's demeanor became friendlier—she sent text reminders of appointments that included “Peanuts” references. (Touch is a big fan of Charles Schulz.) On Touch’s birthday, she came into her session and her therapist was wearing a paper party hat and surprised her with a cake. At first, Touch chalked it up to a bond that was close, even for a long-term client and therapist.
But the therapist knew to straddle boundaries: She began repositioning herself during sessions, taking a chair closer to Touch, though she had sat across the room in their previous sessions.. At one point, she sat on the ottoman in front of Touch and complimented her eyes—during a session. (Touch never asked if her therapist was gay or bi, but assumed she was.)
The therapist never made inappropriate physical contact with her. It was like she was signaling for Touch to cross that line. It was tempting. The woman was beautiful and smart, and they shared a deep emotional bond. But Touch knew it was this kind of exercise in sexual abandonment that caused her trouble before she was in therapy. It was like the 2014-era version of her therapist had taught her to resist the 2016 version of that same woman.
Eventually, Touch told her therapist she noticed the advances and they made her uncomfortable. “She completely denied it,” Touch says, and over the next four sessions, they tried to unpack why Touch thought the therapist was coming on to her. It felt like gas lighting.
Touch called to say she wasn’t coming back. The therapist sent several pleading text messages, all under the auspices of a therapist saying her client needed her help. Touch felt devastated. “I was walking around trying to process it for weeks,” she says. “I have intimacy issues. When the most emotionally intimate person in your life betrays you, it’s hard to trust people.” She quit dating and therapy for a while.
When I relayed this story to Kalman, he said, “The situation you are referring to is certainly an obvious sign of malpractice.” Touch considered filing a report with the APA, but didn’t. “I believe in karma and I think she will get hers in time,” she says.
Now, the main issue she’s addressing with her new therapist, an older “hippie-dippie” male, she says, is her previous therapist's violation of trust.
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