When does a therapist’s relatability stop being therapeutically helpful and start taking up space that belongs to the client?

Over the past year I have begun working with an increasing number of people who were coming out of treatment with another therapist. Sometimes the change happened at the therapist’s end (therapist moved, had a change in schedule, etc.) other times the change happened at the patient’s end (felt like there wasn’t a good connection, felt like therapy was no longer progressing etc.). But there is a common pattern I’m seeing emerge in the therapeutic relationship my clients are describing. More clients seem to be describing previous experiences as feeling more like casual conversations than structured therapeutic work. Some described spending a significant time hearing about their therapist’s life, relationships, problems, or opinions. Others described feeling like they were providing advice or emotional support to their therapist! Several did not seem to recognize that anything was wrong until they began their work with me and experienced a different kind of therapeutic relationship. I wanted to share my thoughts on this phenomenon. 

Let’s start by examining the difference between a therapeutic relationship and a friendship. Therapy is a relationship, but it isn’t reciprocal. I don’t want to suggest that therapy should be cold, distant, overly formal, or impersonal. There is no doubt that the quality of the therapeutic relationship is the single strongest predictor of a positive treatment outcome. Decades of empirical data demonstrate that a collaborative bond, often measured as the therapeutic alliance, is foundational to psychological healing. The definitive, large-scale empirical backing for this statement comes from a deep-dive analysis requested by the American Psychological Association (APA) Division 29 (Society for the Advancement of Psychotherapy)[i]

I pride myself on the connection I make with most of my clients. I don’t think there is any doubt in their mind that I not only care about their well-being, but that I genuinely enjoy working with them. However, my job is to hold the clinical framework, to maintain boundaries, and to keep YOUR needs at the center of our work, no matter what may be going on with me. This time is for YOU! A particularly important nuance here is not whether a therapist should conversationally talk or self-disclose or not; it’s what purpose those conversations and self-disclosures serve. In my sessions, I may spend several minutes talking about your cute outfit, a new haircut, checking out a picture you want to share with me, or even sharing a story about my dogs that I know you will relate to. With self-disclosures, I may share something more personal by first asking if you are open to hearing something personal about myself and then sharing with the intention of validating your experience, strengthening the relationship, helping you feel more understood or less alone, or to help reach a therapeutic goal. (I must emphasis, when a therapist uses a more personal self-disclosure, it should not be significantly deep, traumatic, or immediate- i.e. “I have also struggled with this kind of imposter syndrome”. “I lost my grandfather when I was your age”. “Here’s what worked for me when I was in grad school, does that feel like it could be helpful for you as well?”  not, “my husband is cheating on me too”). I will never ask you to respond to this disclosure or even continue the discussion about my own experience, I shift right back to the importance of you and ensure that you see why the disclosure was used at that moment. These kinds of disclosures help create a human connection that is essential without detracting from the therapeutic work or place me at the center of your time or attention. 

Excessive self-disclosures shift the focus away from the client and our time is already very limited. If a therapist shares personal struggles, the client may feel pressure to empathize, offer advice, reassure the therapist, or avoid discussing something that might upset them. This can be particularly counterproductive for clients who already struggle with people-pleasing behaviors or parentification issues. 

A therapist spending excessive time talking about themselves or engaging in more casual conversation may not outwardly be recognizable as poor quality therapy. As demonstrated by some of my clients who really enjoyed their therapist; walking out of the room feeling cared for, entertained, and comforted feels nice, but it doesn’t always lend itself to therapeutic progress. A strong connection is meaningful but not a replacement for challenging maladaptive patterns, engendering insight and awareness, and psychoeducation on tools for personal growth.   

Finally, I want to address the difference between feeling better and making progress. I warn clients at the start of treatment that therapy is hard, and sometimes you might leave feeling a little uncomfortable, uncertain, or emotionally triggered. This isn’t bad, it means you’re doing the work and allowing yourself to face difficult things. You have to go through it to get through it as the saying goes. I am often told by my clients, “That was a hard session. I went home and cried. But then I felt better. I needed to work through that.” Laughing together, venting, and feeling understood are not inherently bad; and we will do all of that. But it has its place and there has to be more than that alone. A strong therapeutic relationship should make that hard work and growth possible, not detract from it. 

I share this information not to put down the work of other practitioners in the field, but to help you if you are questioning "is this is what therapy is supposed to look like?" By building rapport for a strong therapeutic connection while still maintaining professional boundaries in our session I hope to allow you to feel supported, heard, and understood. To leave room for your feelings alone. A space where you don’t have to worry or care for anyone else; guilt free. To feel encouraged to make your own decisions; even if that means disagreeing with me and the fact that this isn’t a reciprocal “friendship” allows you to do just that!

  [i] Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.