Ask a Therapist: Can I tell my therapist if something isn’t working in sessions?

In Ask a Therapist, our therapists answer questions about therapy, mental health, and healing practices. Today, Margy answers the question: can I tell my therapist if something isn’t working in session? And what if I am upset with my therapist for something they did or said?

Join Margy for Stitching the Wound: Caring for Ourselves in Grief, a workshop for navigating and validating grief emotions, on Sunday, October 26th at 2 pm.

Connect with Margy at Margy@RoomToBreatheChicago.com.

Connect with Ramya at RamyaMK@RoomToBreatheChicago.com.

Interview transcript {edited for clarity}

Ramya (she/her): All right. Awesome. Well, hello, everyone. Welcome back to Ask a Therapist where we pick questions that we often get from clients and don't really know if…you know, our therapists feel the same way or if we're even allowed to ask those questions.

Today we have Margy, a wonderful colleague and friend. And she can introduce herself a little bit and then tell us what question you picked for today.

Margy (she/her): Great. Hi, everyone. I'm Margy. My pronouns are she, hers, and I am a therapist here at Room to Breathe. I work with individual clients and also have a few different grief support groups. And I also do some grief workshops so if you're yeah, if you're ever looking for support with navigating like the loss of someone in your life, death, a difficult transition, feel free to reach out.

And yeah, I'm happy to be here today. Thanks, Ramya, for holding the space. And the question that I picked is something that I'm really eager to talk a little bit about because it comes up a lot. And it's something that brings up a lot of anxiety or other emotions. Often intense emotions for people. And that is, can I tell my therapist if something isn't working in our sessions. And what if I am upset with my therapist for something they did or said?

Ramya: That is huge.

Margy: Huge.

Ramya: Yeah, get us started.

Margy: So the first thing is yes, yes, you absolutely can and should tell your therapist if something isn't working in sessions, like at the end of the day, I think all of us here would say that like - this is your time and space. This is a service that you're paying for whether it's using insurance or paying out of pocket, whatever, like this is a service. And you deserve to have that be the space that you need and want. It is 100% always your right to determine the direction of session and you know how comfortable you're feeling.

And the last thing that I'll say is that it's really normal to try out something with a therapist, maybe not have it go the way that you want. And perhaps that means you find a different therapist or you're liking the rapport you're building with the one you're seeing and so, you know, you want to bring up that feedback - naming that it can be really uncomfortable to bring this into space, to therapy spaces too. So, you know, often that's due to our own people pleasing or conflict avoidance and this, of course, this looks different for every person. That's definitely something I know for me as a human that's come up with my own therapist in the past. You know that like nervousness to bring something up but absolutely I think any therapist would want to hear and would want to support you to make sure you're getting what you need out of session time.

Ramya: Right.

Margy: And building a space where…working then to also build a space where you feel comfortable bringing that into session.

Ramya: Yes. Yeah, I think I'd go one step further and say a therapist that's a good match and where you have a collaborative space with your therapist will be like, “Let's pause, what happened?”

Margy: Yes. Yes.

Ramya: And I mean, like you said, it's bound to happen because we're both human beings in the therapy space.

Margy: Yeah.

Ramya: We're humans. We make mistakes. I know I walk away from sessions sometimes of like, I hope my client got what they needed today because I know that that was not my best work and that's okay because I am a flawed human being that has good days and bad days and….sometimes it does impact our work because sometimes that's just how therapy goes.

Margy: Yeah, 100%. And there's definitely something to be said, like with the question of if you're feeling upset about something, specifically if there was something your therapist did in session that upset you and that's sitting with you. I do think about like - very important to bring that to them.

However, I think it's also a good time to reflect on like, do I feel comfortable bringing this to this person? You know, why or why not? And what could that perhaps also say about the like safety that's been built in the session and the therapeutic rapport and that, you know, like there's so much nuance in that and that can look different for every relationship.

But so important and something that I often think about too is, like as a self-reflective tool, do I feel safe and supported in this therapeutic environment and in this relationship. Do I feel like I can bring all parts of my identities and myself into the therapeutic space? And if those answers are yes, right, then thinking about exploring even with your therapist, bringing it into session, like I'm feeling nervous about giving you this feedback. And that can be something that's also so useful to explore during - together.

Ramya: Yeah.

Margy: It's such an opportunity. I always see those moments as like really great opportunities to be able to both grow and learn in that space together. I know some of that's my approach being a very relational therapist…

Ramya: Sure. Me too. Yeah.

Margy: Yes. But just like really wanting to normalize that there will likely be a time that something happens in session that's not working for you or you get to a rut during sessions or perhaps your therapist did do or say something that upset you and you should absolutely feel empowered to bring that to them.

Ramya: Yeah. I know I've heard from a few clients of like, well, I don't want to say anything because I'm scared I'm going to hurt your feelings and like you're going to drop me as a client. What would you say to clients that maybe feel that way?

Margy: Yeah, and I appreciate you bringing that in because I've also heard that and it comes up and we all have like attachment wounds. We all have also like insecurities and worries because of the ways that when we have perhaps even brought feedback to other people in our life and they had negative reactions to that, we worry about bringing something up to a therapist, especially someone who we've built rapport with. And who we've developed a relationship with as a human. And…you know, what I would say is this once again like, this is at the end of the day like this is a service that the therapist is providing for you. And so it is always…it is important that we're bringing that into the session because if there's something that's bothering you, your therapist is trained to be able to hold that space for you and to be able to honor your emotions and whatever response is coming up for you and then work together to repair that. And… we always say with the attachment framework, right, like ruptures happen with the healthiest of relationships and it's a beautiful opportunity in the therapeutic kind of alliance or the relationship between therapist and client to be able to do that repair together. So I would validate and affirm the nervousness that comes up, so common.

Ramya: Mhmm. Yeah.

Margy: And… like kind of offer that assurance that we as therapists, like that's our responsibility. It's our clinical, you know, like obligation, responsibility to also like support our clients through those situations. And ethically right.

I think the only thing I would add to that that just came to my mind is…I'm trying to think about an example or like…you know, if there's something that isn't - going back to kind of the first question of like telling your therapist if something isn't working. The other piece I did want to offer, throw in here, is let's say there's something that's coming up in session that the therapist perhaps doesn't feel equipped necessarily to support a client through. Like let's give an example that I'm working with a lot, like a death that happens and the therapist doesn't feel for whatever reason, they're either not qualified or they just don't feel like at this time, like they can provide a client the support they need related to grief or to process that, that may be an opportunity to like refer client to another therapist.

And that can happen that also - it's happened with clients of mine where like, this is a very specific area that you're needing support with right now. You know, we did this work together. This might be time for you, for us, to explore finding you a therapist that can offer you that more like specialized support that I don't have like the skill set in or I don't have as much knowledge about. And that also is really common and something that comes up. And there's a lot of feelings that come with that. Especially when you have built a good relationship, but perhaps it's not the therapeutic support that you're needing right now from that person.

Ramya: And what a great way to model and build skills of healthy relationships in and outside the therapy space of what it's like to have conflict and work through that conflict and heal or how to start and end relationships in a healthier way than maybe a lot of us are used to. There's a lot of utility in being able to be genuine and authentic. And bringing our concerns about - I mean, our own lives as clients if we're the client, but also of like this isn't working for me.

Margy: Yes.

Ramya: How many times in our own life have we maybe avoided speaking about how something wasn't working for us because we were worried about what's going to happen after. And that's such a useful life skill and it's almost a secondary gain from being able to talk to your therapist about how to make things better.

Margy: Absolutely. Yeah. And it feels, yeah, I really see it as an opportunity to build yeah, like, you know, trust and and safety also within your self. Like to your point to be able to navigate these difficult, you know, situations and I think that's one of the really beautiful parts that comes out of and really like, you know, a very healing part to our work that comes out of these opportunities.

Ramya: Yeah, totally. Yeah, I know we're reaching the end of our time. Was there anything else that you…wanted to cover that we didn't get to or any last thoughts here before we end for today?

Margy: I don't think so. Just really normalizing this. And just really wanting to empower people to navigate those conversations. And to, you know, like really use this as an opportunity also to like build more rapport with your therapist or, you know, finding a person that's a good fit for you.

Ramya: Yeah, 100%. Well, as always, it's wonderful speaking with you, Margy. We could always go on and on, I feel like, no matter what topic we pick.

Margy: Yes.

Ramya: I do think that we have a coffee chat scheduled for another topic soon. So look forward to Margy and I's conversation about that.

But thank you for joining us today. And thank you, Margy, for bringing such a great and important topic to light today.

Margy: Thanks, Ramya. Have a good rest of your day.

Ramya: You too. Bye.