Thursday, June 11, 2015

Rules for my clients (and a special one for teenagers)

Photo credit:swong95765
I have rules.

Big ones.

Scary ones.

They’re actually not that scary but I like the look on people’s faces, especially teenagers, when I tell them I have rules.

One of the most important parts of the therapy relationship happens right at the beginning before any counseling is done or healing is facilitated. It is called informed consent.

Informed consent means that you (the client) and me (the psychotherapist) are on the very same page as we enter in to this relationship together.  You will know what I expect from you and how much you will pay for the service I provide. You will know what kind of behavior is ok and what kind is not ok from both of us. You sign a piece of paper indicating that you understand what we’ve discussed and I sign another copy of the same piece of paper and we trade. 

Informed consent has legal and ethical implications and it also represents my desire that you do not enter in to this intimate therapy relationship with me unless you are doing it with intention and awareness.

There are legal rules covered in informed consent and those include confidentiality and its limitations and the fact that sexual intimacy is never appropriate in a professional relationship.

Then there are my rules:

 1.  I expect you to work hard.
I don’t want my clients to waste hard earned money and valuable time coming to therapy so they can say they have a Jewish therapist who has a funny looking hand. I also don’t want my clients to think we’re going to just shoot the breeze. We might do some breeze shooting and we might talk about my hand but when you come to therapy with me I will challenge you. I will say things that might shake your foundation a little or maybe even a lot. Sometimes therapy is fun and sometimes I will challenge you. You always have the option to accept or deny a challenge but if you accept it I expect you to work it hard. Failure is always an option and I won’t try to make you feel guilty if you fail (you are good enough at making yourself feel guilty, I don’t need to do it for you). I will initiate a discussion about it and we’ll talk about it. We’ll talk about what it feels like to fail and succeed and we’ll talk about how to make it work better next time. My challenges are gently strong and I try to push just hard enough to the point of discomfort but not pain. If you feel like I’m pushing too hard then I want you to tell me to stop.

      2. I expect you to tell me when I’m wrong.
When I was a teenager my therapist who is a great guy and a good therapist said something that was so off, all I could do was stare at him. This therapist has a particular affinity for Freud and sometimes he flies that flag big and tall. I had told him about a dream I had which I don’t remember now but was probably pretty mundane and did not include my mother at all. He responded, “Ari, I think this means that you want your mother to                       .[do something really inappropriate]”
I was amazed. I didn’t quite know how to respond but I think I just started laughing and said, "I think you are completely and totally off and you’re a pervert." We had a good therapy relationship and he owned it and apologized. I understand that the therapy relationship needs to build before you will feel comfortable telling me I’m wrong but it’s really important that you do. I am not an expert in you. You are. So if I say something and it feels incorrect for you then it’s important that you let me know. We’ll talk about it and I hope you’ll be patient enough to give me another try because just like my therapist, sometimes I’m wrong too.

3.  I don’t accept “I don’t know” as an answer
This is a special rule I use for teenagers but sometimes for adults as well. In my years of experience as a psychotherapist I have found when I ask a question that needs some thought or causes some discomfort I often get the response, “I don’t know”. This is not true. You probably do know but either the topic makes you uncomfortable or you don’t want to take the energy to think about it. If you say “I don’t know” I will still like you and I won’t get mad at you, I will just ask you again or remind you that “I don’t know” doesn’t work. I challenge you, my client, to instead tell me, “Ari, that question makes me uncomfortable and I don’t want to talk about it.” I will gently thank you and applaud you for being honest with me and for advocating for yourself. The only time I accept the answer “I don’t know” is if I ask a math question because the chances are that I don’t know the answer either.

If you’ve read through these rules and are totally turned off then give me a call anyway. I know some other great therapists you might want to try. However, if when you look through these rules you find yourself getting excited about the possibilities of growing yourself in therapy with me then please drop me a line. I look forward to working with you.

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