What would you like to tell a T reading PC?

Today I thought about how many silent Ts read our forum on PC.
They never say a word... but I am sure they consider what is posted.
I know I would if I were a T. So I thought "Why not make a post where we clients can offer a bit of advice for those T's?"

My two cents:

1) If you are going to never hug a client, let them know up front that it is a boundary so they don't go through a year of bonding while thinking 'One day my T will give me a hug I really need!'

2) State your email rules clearly at the first appointment. Is it ok for the client to email you, but they should not expect a reply? If it is ok for them to write, will you even read it?

1. Have a plan. Make sure questions relate to the plan in some way and for some purpose
2. Tell client what the plan is so client can see the connection.
3. Explain how therapy works so client will know what to do and what to expect the t to do. Be concrete about this.

Hello T's,
What are you writing on that legal pad about me? When I ask, you tell me about what you are writing, but my paranoia makes me fear that you are writing about things I didn't realize I had shared, and that I am not ready to deal with yet.
Bluemountains

If your personality is talkative, you might think it's okay to bend that advice that is so common for helpers, to be quiet and listen. It's probably okay to bend it sometimes to help people feel more comfortable, but for God sakes at least shut up and listen sometimes.

I would tell a T to please read our posts carefully and learn from us. Learn what is helpful and what is not helpful in therapy. Examine carefully your own methods and try to determine if you need to make changes. Be sure you never forget that many or maybe most of your clients are in a lot of pain but may not show or share that with you easily. Be very sensitive and adjust your techniques if your client is not showing improvement. Above all, be attuned to your client and do whatever is necessary that they are sure to feel that attunement.

Another note to the t's out there-please do not ever let us down by forgetting and appointment or another form of communication you promised us. I feel so sad for the brokenhearted people on PC when their therapists let them down.
Bluemountains

Yes. Don't 'over-promise and under-deliver' - one of the basic rules of customer service. Makes the customer/client feel like crap - as witnessed here rather frequently on PC, unfortunately.

That you probably did say some things at our first appointment that you want to stand by, which you call your rules or the boundaries or whatever.

But when I showed up, well, I was just a wee bit stressed and I may not remember those things. So do more than say..."we discussed that" in your soothing voice, come right out and be direct about it. it's fine for you to repeat the "frame" now in no uncertain terms, because I sure as hell don't remember the specifics from the time I showed up and practically blacked out.

You have to realize you have the power in the relationship. When you set the limits, and then backtrack on your part of the committment, it leaves the client in shambles. We have learned over the years, others are not trustworthy and that we aren't worthy. When we finally land in your office, willing to be vulnerable, it is damaging that you can suddenly change the rules and yank your part of the original committment. It's re-traumatizing.

Listen to your client. When they come in and say "This is what I need" and it's within your ability, your ethics, your style to do it - stop denying it. Client's are the expert in their own life, it would be helpful to actually hear what they're saying.

Control your mood. Speaking for myself - I come from a place where love and comfort and attention is easily taken away, and given here and there. When you are constantly "warm/cold" and we don't know what we're walking into, it reminds us of our past.

Remember most of the time you are dealing with PEOPLE who have had a very hard past, experience suffering, and are looking to you to cope appropriately. Do not cause more harm.

I wish I knew just how emotional and awful I would feel after sessions at times.

And please please please see through my "I'm good *huge smile*" and my "I'm fine to drive home" afterwards. And maybe even understand I'm scared to tell you about my sui thoughts because I don't want to be thought of as unstable and needing to be hospitalized.

Know how much sometimes we hang on your every word looking for comfort when we reach out, if you don't provide it ( email , return phone call etc. ) let's us know why, especially if you are trying to teach us something.

I think I would tell the Ts out there that we really do care about them as people even though we know and respect the boundaries of the relationship.

Those times when I seem the most composed, and I tell you that I am ok and I don't provide any details, odds are, I am so far from ok.
Please, push me, find out what is going on that is good, that way, when I feel like crap, but am afraid to tell you, you'll know (even though usually, you can see right through the mask anyway)

I really you guys here on PC! Your words to the Ts secretly reading PC are just blowing me away with your honesty!

1) Immediately after a client shares a deep, shameful secret, after over a year of therapy, is probably not the best time to tell that client you are shutting down your practice. That feels so much like abandonment!

2) Telling a client to try and track a behavior they are ashamed of, without providing any kind of framework is not helpful. Never asking about that behavior again is hurtful.

3) That first session - there's a very good chance the client retained almost nothing about what was discussed. If there are boundaries that were discussed in that session, it might be a good idea to either offer a written version, or address them again at a later point.

4) When I say I'm fine, and then don't elaborate and don't engage, PLEASE, PLEASE dig deeper...I'm so far from fine at that point! (thanks to my current T for doing this!!!!)

Dont lump every patient in the same hole. The way BPD comes out in me can be worlds apart from the next person.

Oh, and not all persons with a BPD are manipulative scum.

Find more creative ways of validating your clients's feelings without repeating the same stuff back. "It must be tough that <insert same stuff here>" or "It must be really awful that <insert same stuff>" or "I know that <same stuff> hurts" or "I know that you've been struggling with <same stuff>." After a while, it just becomes annoying as your responses are obviously artificial.

Don't rearrange your office EVER.

You are not allowed to take more than one extended vacation a year.

If at all possible, have a setup where clients don't come into contact with each other.

Please don't loose your patience with us. If these sessions are frustrating for you because we wont open up and share, imagine how hard it is for us when we know what we want to share, can think of nothing else and just can't bring ourselves to spill our guts.

I would say...

Thank you.

Sigh....if I am going to tell you something important to me, can you please remember it? It is somewhat troubling to be asked a question that I already answered.

Do not ever look sleepy, never fall asleep when a patient is talking, if you cant have energy to listen, then have the sense to be honest and reschedule.

Sigh, if you suggest a medication, once or twice at the most is sufficient. But if I tell you I cant handle the sexual side effects (constant and no release) you don't have to suggest trying that same medication 8 more times. It is a clear indication that your not really listening.

Open Eyes

omg

more words to make the message long enough

(just the thought of that makes me nervous. lol.. but... anyways..)

1. if you make promises, or give your word on something, don't break it.
2. don't go into the profession for the paycheck.
3. don't say one thing, then do another... it gives mixed messages and only causes more problems... (such as that you'll call at a certain day, and then the person sits around diligently watching the phone, and then gives up after midnight roles around for the next day, when they never get the call.)
4. Even if you might not believe a client, give them a chance to prove to you that they are being truthful.

Don't worry, there are no T's secretly reading here, they are all at home pacing the floor, wondering how not to offend their clients. Having read all the replies here I think T's are better off turning into soft cuddly toys where you can press a button and they say exactly what you want them to say.

Love and hugs to you.

It is not a bad idea for them to wonder about this. But they really do not have to pace the floor - all they really would need to do is admit when they make a mistake and apologize sincerely without blaming the client.

All T. reading this...remember to check in with your clients. Realize that you may trigger your clients and before you know it ...they may be gone from the room (dissociating) and you are wasting your time when you just keep talking...cause we do not hear any of it.