Psyched in San Francisco: When Your Good Therapist Turns “Bad”

So, you’ve been in therapy for a while. Perhaps a crisis brought you in initially, and you and your therapist spent the first weeks or months talking about the crisis. She (or he, but I’ll use she because I happen to be one) listened empathically and helped you work through the complicated feelings stirred up by the crisis. Her presence was comforting as you revisited the events that caused you pain or anger, and she made comments that made you feel heard and understood. You gradually felt you could trust her with your vulnerable feelings, and you’ve made a commitment to continue in therapy and explore some of the issues that came up as a result of the crisis. You are beginning a journey together that may last months or even years, as you discover patterns of thinking, behaving, and feeling that are familiar but which are getting in the way of your desire to live a full and satisfying life.

One day you’re in session and you’re telling her about something that happened at work that upset you. You’re fired up as you describe how your boss reprimanded you in front of your co-workers and you felt you just had to stand there and take it. Your therapist, who normally makes you feel safe and want to keep talking, says something that seems, well, off. It feels like she’s not getting why this experience was so upsetting. It feels like an abrupt turn of events, like suddenly your therapist is not on your side. How can she not understand how you feel? You start to feel anxious and withdraw, but you don’t say anything. You find yourself in familiar territory, a place you’ve been before: “No one understands me, and it’s foolish of me to even try to get anyone to understand me. I just end up feeling ashamed and embarrassed for having revealed myself. It’s better to keep my feelings to myself.” Your therapist, who until now has seemed like the one person you can trust to understand and validate your vulnerable feelings, has suddenly turned into someone who’s just like everyone else: insensitive, clueless, and not interested in understanding your pain.

You spend the rest of the session trying to regain your stability. Perhaps you stop talking about the incident at work and move on to something that feels less charged, and safer. Perhaps you keep talking about the incident at work but you check out emotionally so you don’t have to deal with what seems to be an intolerable turn of events. You trusted someone, and she let you down. It’s hard to remember that just minutes ago you were feeling safe and open, and the person sitting across from you seemed warm, engaged, and attuned to your feelings. You may not even be aware that the shift occurred, because it’s so automatic. Your therapist may comment on the sudden change of subject or notice you became quiet. She may even draw a parallel between the story you are telling about the incident at work and what is happening between the two of you right now. But you don’t want to risk telling her that you’re hurt or angry, and that you don’t trust her. After all, she let you down. Why open yourself up to another failure of understanding by telling her your true feelings?

This kind of thing happens in therapy all the time, as it does in “real” life. We desperately want to feel understood and cared for, but the people in our lives don’t always “get” what we’re trying to communicate. For some people, this is a dominant aspect of their relational experience. They grew up in a family where their parents weren’t interested in their deeper emotional experience, or couldn’t tolerate it when their kids cried or got angry or frustrated. They didn’t know how to respond when their kids came to them with problems they were having in school or with friends. Or, perhaps there was a situation in the family that distracted the parents from attending to their children, such as marital problems or a chronically ill child or spouse. Sometimes divorce puts kids in a position where they feel they have to “be good” so as not to upset their parents any more than they already are, and they learn not to burden their parents with their fears, hurts, or other emotional needs. In any case, the child is left feeling that expression of needs and personal thoughts or feelings is dangerous because they will get some kind of adverse response. Some kids will “act out” and exhibit aggressive behavior as an indirect way of expressing their anger and frustration about feeling misunderstood or dismissed; others will internalize their feelings and act as though nothing is wrong. Either way, these kids learn that the world is unresponsive to their needs so they better find another way of dealing with them.

Just like people in “real life,” your therapist is occasionally going to let you down. It may feel like she doesn’t “get” you, or she’s late for your session, or she wants to raise your fee even though you think she knows you are strapped for cash. It can be something even more subtle, like a facial expression that seems unwelcoming or judgmental, or a tone in her voice that triggers your distrust. It can be something that feels so wounding that you want to stop coming, and perhaps you entertain the idea of canceling your next session because you are so upset. If enough of these incidents go by without some resolution, you may feel so distrustful that you feel you need to stop therapy altogether.

These “empathic failures” are actually a great opportunity to heal your childhood wounds by talking about them, rather than withdrawing. Even when the breach seems minor taken out of context (“I shouldn’t be mad at her for being late this once, she’s usually on time. I don’t want to make waves or hurt her feelings, even though I’m upset”), it feels like a big deal because, sometimes without even realizing it, you expect to be disappointed or hurt by other people, and the incident that happened in your therapy is just another piece of evidence to support that belief. However, by talking about your feelings with your therapist, you have the opportunity to experience a familiar situation but with a different outcome. The need to keep your feelings to yourself is a protective strategy to prevent further emotional pain. There is also a dread to repeat this behavior because although your experience tells you the outcome will be painful, there’s a part of you that longs to express your feelings.

This is where the curative factor of the therapeutic relationship can really be tangibly felt: you take the risk of telling your therapist that something she said or did was hurtful to you, and she actually makes an effort to understand you. She encourages you to share your thoughts and feelings about the incident as much as you can, and demonstrates that she cares that she was the cause of your pain, even if she didn’t mean to upset you. You discover you can talk freely about your feelings and something good happens. Instead of feeling shamed or dismissed, you feel heard and understood. You begin to see that there conflict can be talked about and resolved without you collapsing or the other person retaliating, as you have always believed would happen.

Your therapist is a real person in whom you place your trust, or try to. She will let you down from time to time, and hopefully not often. Practicing dealing with breaches of trust in therapy helps you develop the courage and skills required to deal with the breaches of trust that are inevitable in everyday life. As you get better at this, you can experience more intimacy with the people in your life because you no longer have to withdraw or accommodate when a conflict arises.

Carol Gould is a master therapist who trains other therapists. She has had a private practice in Noe Valley since 1995, working with individual adults and couples. Her work is informed by Self Psychology, Relational psychoanalytic theory, Control Mastery Theory, and Intersubjectivity Theory. She has been trained in John Gottman's couples therapy model and Emotionally Focused Therapy. You can learn more about her work or schedule appointments by contacting Carol at; 415-826-5435 via her website.