Matthew Cuddeback, LCSW

Sometimes your relationship with your therapist can feel one-sided. This is, in part by design, and appropriate, and in part it is an unintended consequence of the therapist-client relationship. This balance can be different for each client and therapist, and the bottom line is that the focus should be completely on the client’s well being. However, it is natural to have some questions about your therapist and your relationship with them. Some of the following are how a therapist should act (though not all therapists may do so) and other aspects are concrete rules for the profession. Below are a few common questions people have and my answers to them that may help you understand your therapist better:

  • Does My Therapist Talk About Me? First, it is not okay for your therapist to use any identifying information about you when discussing your case. Second, they may discuss your case with their supervisor for assistance working through difficulties or complications. Your therapist may possibly mention something to a co-worker but it is via non-identifiable means and is usually something along the lines of sharing feelings after a hard session or they felt empathy for something you experienced. There are unfortunate exceptions but appropriate therapists do not gossip or say negative things about you after you leave. We are here to help and have no interest in saying anything to anyone you would not want us to.
  • Do They Actually Care About Me? Yes. We do this work because we genuinely want to see you do well and feel better. We have developed ways to cope with and compartmentalize certain aspects of our work so we don’t get too emotionally involved, so it may not always be obvious, but we do in fact care about you.
  • Does My Therapist Get Annoyed With Me Because Of What I am Discussing? No, we don’t, we may at times feel disappointed that something did or didn’t happen for you. This is never disappointment with you but rather that we wish things had worked better. We do not get annoyed with you because you are asking a lot of questions, or aren’t doing something that you think we want you to do. We are here to encourage and help understand when things don’t go the way you would want. We may slip and feel frustrated of course, but a good therapist quickly becomes aware and corrects this to ensure you are treated with an unconditional positive regard.
  • Why Does My Therapist Sometimes Not Say Anything? Silence can be very useful. Sometimes it is important to let silence sit and not try to fill quiet moments with something that is not useful. Further, we often want you to guide the session, and it can often be useful to sit in a moment and take in what had been said or discussed.
  • Can My Therapist Really Handle What I Want To Say? Yes. We have been trained and have experience with many very difficult areas and topics. It is rare to bring something to your therapist they have not heard in some form, and even if you do, they are trained to be able to manage it and manage their own response. You should never be in a situation where you feel you are having to take care of your therapist.
  • Is My Therapist Just Making It Up As They Go? No. Your therapist uses specific models designed for your specific areas of difficulty. However, there are times when we let sessions drift to other topics that may need to be addressed or to build rapport.
  • Is It Okay To Ask My Therapist Personal Questions? Yes. However, they may not feel it is something that is pertinent to the situation or feel it is too personal. It is always ok to ask though.
  • What Will My Therapist Do If I Tell Them I Am Suicidal? This can be a tricky topic. The bottom line is that if your therapist believes you are in danger, they will discuss with you the possible need to go to the hospital. However, you can and should bring up thoughts of suicide and discuss them. Ideally you are able to come up with plans to address these feelings and both you and your therapist feel you are safe. The key difference is if you are at risk of harm at the time of the discussion you may need to go to the hospital.

The focus when in therapy should always be on you as the client, but that does not mean you cannot ask questions. There is nothing wrong with wanting to know more about the process and these questions are always fair game. If you want to, it is also okay to ask your therapist for information about themselves. Not all therapists feel comfortable sharing personal information, but it can at times be helpful to the relationship to talk about ourselves. However, your therapist may choose not to discuss if they deem that it is not pertinent to your care. The therapeutic relationship you have with your therapist is a key component to your mental health, as such it is not inappropriate to explore it a bit more.