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Page Contents: When a psychotherapist’s comments in psychotherapy feel demeaning.                    


Yes, I am in love with my psychotherapist, so maybe my perceptions are biased or delusional, but at the same time I feel violated and disrespected and that I am being driven to secondary insanity.
A few months ago, when he told me that he was leaving on vacation, I mentioned how difficult it is when he is gone. He replied, “You should just come to
[...]. It’s not a bad idea.” The following week during the same scenario he replied, “You should just come with me. We could spend some time, you know, talking about [expletive deleted]” No, he didn’t mean what he was saying, but the lightness of these comments felt demeaning. . . . We spend large portions of our sessions in casual conversation, sometimes up to half. Once, when I stated we had wasted to much of our session he replied, “That’s what happens when you have relationships that only last one hour a week.” A few weeks ago after we had spent fifty minutes visiting I asked how much time we had left and he answered, “Ten minutes. Why? Did you want to talk about things?” He says that he thinks psychotherapy should be personal, and that feelings of closeness and caring are to be expected. After working as a nurse aid for the past ten years, I understand the importance of respecting feelings that my patients have for me, and the importance of preventing confusion around those feelings—and I’m just a dumb bed-maker. As I stated at the beginning, maybe my infatuation is clouding my vision, but this behavior seems to resemble that of the annoying guys who follow me around the grocery store asking me if I have a boyfriend and what my phone number is. Maybe I’m just confused. I understand that rules regarding boundaries in psychotherapy are open to a wide range of interpretations, but are there any circumstances under which this behaviour would be considered normal?

Are there any circumstances under which this behaviour would be considered normal? Yes. In a grocery store.

Psychotherapy, however, is different from shopping for groceries—or seduction.

One basic tenet of psychoanalysis and psychodynamic psychotherapy asserts that, until we have reached a relatively deep state of psychological awareness, unresolved emotional conflicts from childhood will unconsciously motivate all the interpersonal interactions we have in the present. So, yes, even though your feelings for your psychotherapist are genuine, they still derive from unresolved feelings from your past, most likely about your father. Your psychotherapist could give you all the comfort of casual conversation and light comments in the world, but it would never be enough, and it would never heal your inner pain. Why? Because you really yearn for your father’s comfort which, as a result of all his emotional failures, you never received. And in that frustrated yearning you feel tremendous hurt and anger.

Your task, then, is to keep looking at the present with an eye to the past. You have to come to terms with your father’s failures. You need to look at them honestly—without shame or malice—and see clearly how much you were hurt and how much that hurt still lives within you, in all things, to this day.

Once you start this task, honestly, in small bits here and there, you can begin the broader effects of healing: to give to others the comfort that you never received as a child.

But you need a psychotherapist who can guide you competently into this process. Now, if your psychotherapist said the things you say he said, in exactly the way you say he said them, then his casualness misses the point about true psychotherapy. He could be taking his own unconscious frustrations and cynicism out on you.

It often happens, however, that a psychotherapist might seem to be making idle conversation when really he is “poking around” looking for unconscious clues to the client’s experiences. In medicine, when a physician examines your body with a stethoscope, this is called auscultation (from the Latin auscultare, to listen), and in a similar way a psychotherapist will be listening for significant hints of the unconscious in the casual things you say.

Also, when a psychotherapist points out an unpleasant aspect of a client’s behavior, the client can become confused and upset and can even project his or her own feelings of anger onto the psychotherapist; thus the client will end up believing that the psychotherapist is angry and purposely saying hurtful things. This is transference in its most destructive aspects.

For the client, though, it can sometimes be almost impossible to tell whether feelings about the psychotherapy are based in transference or whether they are based in genuinely inappropriate behavior of the psychotherapist. Thus the psychotherapist’s entire demeanor must be considered. If the psychotherapist is always professional and considerate, then a client’s feelings of being dismissed are likely transference reactions. But if, even in a joking way, the psychotherapist ever suggests something unethical—such as going on vacation with him—or if he never links seemingly idle chit-chat in one part of a session to a later psychodynamic interpretation, then it’s time for the client to beware.


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Raymond Lloyd Richmond, Ph.D.
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