NOTE: THIS WAS ORIGINALLY PUBLISHED IN BINAH MAGAZINE'S COLUMN UNMASKING THE MYSTIQUE OF THERAPY

You are paying me, for goodness sakes.

And now that it's clear that you are a customer for my services, same as when you hire a contractor, plumber, teacher, or maid, you expect results. And if not, you voice your complaints. Right? Right.

“Yeah, sure,” you are thinking. “No way am I telling my therapist my complaints about her. I can't. Just can't.”

One year, I attended a LINKS Shabbaton as the therapist-in-residence. For those of you unfamiliar with LINKS, it is an organization that offers support and other services (like weekend Shabbatons) for girls whose parent has died. 

It was a tremendous eye-opener to me to how therapy is viewed by clients.

All day long (and way into the nights), girls approached me with questions about therapy. The most remarkable questions that I fielded over and over again was girls grappling with their own therapeutic experiences, unsure how their therapist was helping them, if their therapist was helping at all, and some complaints about their therapists.

Over and over I told the girls, “Talk to your therapist. Tell her your doubts about therapy. Ask her your questions as to how she works therapy, how therapy is supposed to help. Tell her why your are unhappy with therapy, with her.”

Over and over the girls looked at me in shock and said, “I can't say that! I can't criticize her!”

To me, in seems quite clear.

You called the plumber and the heat is still not coming up? Let him know the problem. The maid left crumbs on the kitchen counter and it's sticky to touch? Show her what needs to be done. Your daughter is failing at math this year even though managed to keep up every year prior? Let the tutor or P3 teacher know her methods don't work for your daughter and must individualize her techniques for her specific needs.

Why is therapy any different?

If a client is paying for therapy, she must see results. If she doesn't, she must discuss it with her therapist. That's all. Nothing more, nothing less is expected of any service given and paid for.

After that Shabbos, I have tried to examine this phenomenon of a client's fear to demand accountability, transparency, and open, honest communication about the therapeutic process itself in order to empower clients to take charge of their therapy and for therapists to engage clients in this process which will decrease drop-out rates and increase client success.

As a therapist, I have been greatly influenced by the works of Dr. Irwin Yalom who has written many books unmasking the mystique of therapy. Perhaps that is why I entered my own practice with a forwardness in which in the first session, I ask my clients, “Do you have any questions about therapy? About my credentials? How I work as a therapist?”

I ask, “Once you start therapy, how will you know I am doing my job, that therapy is working?”

Along the road of the therapeutic relationship, I will often ask, “What criticism do you have about therapy? What is not working for you? What do you think I should be doing differently to help you? What is not helpful to you in therapy?”

I am not afraid of the answers because their ability to speak to me will foster a greater commitment to therapy and deeper therapeutic relationship that will enable them to achieve the goals for which they entered therapy to begin with.

I will say, “It seems like you are wondering why you came to therapy. Maybe you think you came to the wrong therapist. Possibly you are in middle of deciding to change therapists who can do a better job.” And when the client looks surprised that I am reading her mind, I will say, “Do you want to talk about it?”

The client will ask me why she should bother talking about the things bothering her about me or therapy in general if she can just change therapists and avoid the hassle.

I explain.

“Maybe I truly am not the right fit for,” I will say. “Maybe another therapist will do a better job, or your personalities will mesh better, or her therapeutic orientation or style is more attuned to your needs. Maybe. So examining these aspects of what is wrong here will help you find the therapist you need without wasting more energy by starting again and again and again.”

sometimes, that will make sense to them.

Sometimes, they need to hear more. Because most of the time, they do not want to change therapists, they just want me to change, to be better, to help them more. Because they are feeling anxious and upset and don't like feeling this way and want me to help them change and fast. And faster. So they want me to explain more.

So I will ask them what bothers them about me.

One client will say, “You talk too much. Be quiet so I can think.”

One will say, “You allow too many silences in the room and they make me uncomfortable. I need you to fill the silences with words.”

When I hear these criticisms, I think about what they are saying. If there is merit to what they say, and realize I am remiss in some way, I address it directly. If I know that the issue lies with the client, as in the need to be able to hear in therapy what they have come to hear; or the inability to sit with silence and with introspection is indicative of a deeper problem, then this gives me the opportunity to open dialogue with them.

I celebrate my client's ability to criticize me, to ask me what I am doing to earn the hard-earned money they give me. And I continuously seek to explain the process of therapy. Sometimes, I will say, “If you have such-and-such anxiety, you can save yourself a lot of money by just buying such-and-such book. You don't need to see me for that.” Or, I will say, “I don't think you need to see me so often. You are doing fine. What if we begin talking about termination?”

I like to help them speak about things they find difficult to say.

Even, “I think I have helped you as much as I am able to. Do you think you want to move on to another therapist?”

Their relief is palpable.

They worry they may hurt my feelings; they worry that I may get insulted.

Clients do not realize that therapists are more committed to doing their job than nursing hurts and wounds in the office. We do not get insulted when a client tells us that we are lousy at what we do. We use that information to help the client understand how they are disappointed in us, in their parents, in their spouses, and how to improve expectations and relationships by taking responsibility for their actions, for their health.

We do not get affronted when our clients choose to leave us to see a different therapist; we want to help them find the right one that will be the right shaliach to improve their life.

As intimate the therapeutic relationship appears, a good therapist thinks first and foremost of the client. And part of that is not only allowing freedom of speech in the therapy office, but inviting it, embracing it. Through that dialogue, the client is empowered—and sometimes, sometimes, the therapist learns something new, too.

My book, Therapy, Shmerapy, can be found in bookstores or online