Therapists do not eye the clock only to avoid disrupting their schedules. They also monitor it for therapeutic reasons. Without the counselor’s awareness of a rising emotional temperature within the person he is trying to help, his client can fall into a trap.
It is best if the weightiest issues are brought into the discussion well before the conversation must cease. Psychologists should remember the individual’s history and the concerns that have been in play within his recent past. Absent that knowledge, inadvertent damage to the treatment process and the client’s trust in him are possible.
The clinician needs a sense of how much intensity and additional raw emotion might tip the patient over. Unexpected feelings evoked late in the 50-minute hour may leave him vulnerable. Moreover, the client might wonder why his time with the therapist upsets him. Rage, anguish, sleeplessness, or sadness may cause him to question why departure from the office leaves him with an open wound.
None of the above suggests that a therapist will never extend the appointment duration or plan to meet more often. Even so, sometimes it is useful for the psychologist and patient to discuss how to approach tender issues. There are major differences among clients in developing the strength to delve into them.
Therapy can be like a dance, and at its best, the partners move together as if choreographed, not out of sync. The same is true of pairs out in the world, whether they are friends or lovers. Unless they have plenty of time to handle a heavy conversation, the wise refrain from talking about such things late in the day.
Be mindful of the time and who you are with. We all forget the passing minutes on occasion.
None of us wants to begin or end things on the wrong foot. The solution is not to be found in a shoe store or a podiatrist’s office either.
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The image is called Red Staff by Rudolf Bauer, 1937. It comes from Wikiart.org/
That’s something I’d have not considered, but I appreciate that therapists are thinking about… it’s not just about the emotions during the session, but those that linger once it’s concluded. Beautiful.
Thank you, Erin. There are several insights that grow out of training and experience. One example is that some clients will not remember our conversation from one week to another. Sometimes they dissociate in the time between meetings. Their “forgetting” is informative to the counselor and very often becomes a topic of discussion in session.
I am going through cognitive processing therapy right now for long-term PTSD. I have seen my great therapist weekly for 2 years due to a generous offering by my insurance. As difficult as are some of the things we talk about, I still always try to have at least a 3 minute funny for both of us at the end. Either something I saw in the news or silly occurrence in my life. You made a great essay about “door knobbing” your therapist, as one of mine called it 🙂 I even like to tell mine when time’s up just to turn the tables. 🙂
Very clever, Harry! Yes, clients have been known to talk about something important (like their decision to terminate) in the last few minutes — as you say, with their hand on the door (metaphorically speaking) as they are about to leave.
Glad to hear you have made a good connection with your therapist. Humor is a blessing in such relationships. Continued good luck in your treatment, Harry.
Finding the right times for those heavy conversations in my personal life is always the hardest part for me, Dr. Stein. I keep pushing them away—and then I find that time has passed without any discussion of the painful subject.
You have lots of company in the kind of avoidance you describe, Lori. I’m betting you will find your way out of this. You’ve just made a first step by what you’ve offered here. Thanks much for your comment. Wishing you every good fortune.
Thank you, Dr. Stein.
I’ve wondered about that, I imagine a therapist doesn’t want to have a patient open up too much or too quickly as it can do damage and leave a patient in turmoil in between appointments.
You have offered a major insight, Tamara. Indeed, a therapist needs to be careful lest some patients say to much too soon. The pain of revealing a trauma they likely haven’t opened up before often leaves them in a bad place once the initial session is over. They feel over exposed and vulnerable, to the point of deciding not to return to treatment. Thanks, Tamara.
great advice for all of life – ‘doorknob confessions’ must fall in this category as something to try to avoid. i find it interesting that people sometimes wait until the absolute last second, on their way out, to reveal something they’ve been wanting to say. maybe it needed to be said but they didn’t have the courage, or felt shame, or didn’t really want to talk about it yet? it’s hard to be on the receiving end of it, as it catches one off guard with no time to address it.
An astute observation, Beth. It is exactly as you describe it. The revelations might include sexual attraction to the therapist, being in love with him, ending treatment, expressing anger, etc. Thanks, as usual, for adding something worthwhile and insightful to the discussion.
Ah….love the imagery of therapy being akin to dancing. So true on so many levels…and this made me smile, with deep, deep recognition about the importance of honoring body clocks and energy patterns when important topics loom in one’s personal life:
“Unless they have plenty of time to handle a heavy conversation, the wise refrain from talking about such things late in the day.”
Thank you, wise Dr. Stein! 💝
Relationships of all kinds run into a variety of bumps. I recall a young woman who instinctively preferred being physically near to others. She was fixed up for a date with a fellow who instinctively wanted space.
Whenever he moved away she tried to move closer. He ended up walking on the street, while she remained moving on the sidewalk. Thanks for helping me to recall this.
Thank you for your thoughtful essay. 😉
Much appreciated, Vicki.
Dr. Stein, your article brought to mind a conversation with a male friend that did not end well for the reasons you mention. It was our first and last meeting (date?) over dinner.
I imagine we all have stories about timing and conversation choices, the latter in terms of the topics chosen, timing, and the emotion they carry. Whoever the fellow was, he missed out on a lovely human being. Thanks, Rosaliene.
🙂 <3