How often do you contact your therapist? How much is too much?

I see T once a week, with no contact between sessions. I've never asked his policy, but I believe he would be there for me if I really needed him. Once when he was going out of the country for 10 days, I guess I looked a little anxious, but he said that he would have his phone with him and there was also email. So at least for me, any contact between sessions would be in an emergency only.

I'm glad we don't do email because it's so open to interpretation...too easy to read meaning that isn't there. In the few emails we've exchanged, he writes short, brief sentences that are to the point. It's too easy to read those as him being brusque, or maybe he's annoyed, etc etc etc. I have enough trouble trying to comprehend his true meaning when we're in person and I can see his body language, hear his tone of voice, see his facial expressions!

And I agree with other posters who've said that no contact forces them to deal with things themselves. I know I CAN contact T if I really need to, but I just keep putting that off. One day at a time...

I see T once a week. I started writing regular emails this year (several months into therapy), tends to be at least a couple a week.. Sometimes I struggle to verbalise in session.. or I'll have thoughts in between, and I find it helpful to communicate in written form.. my T has encouraged me to write, but has been clear she won't always be able to respond - so I don't expect replies, but am glad she often does. I think it helps me keep the connection between sessions (or 'rescue' it, in my mind, if I've not felt I've been able to really connect IN session ) and I feel like it's helping me progress. I'm less inclined to call. I think I've only requested to speak to her the one time.. Email feels less intrusive, as I feel she's free to ignore it if she wants, lol..

I see T once a week and probably 50% of the time, send one email a week, depending on how intense the session was, or what we are working on. Sometimes its to emails something for the next session I find difficult to say out loud. If I am in crisis, I will call him during the week, but that's rare - probably only happened a dozen times in the six years I've been seeing him.

Intermittent reinforcement is very powerful and it seems intuitive that something so powerful would increase the anxiety and insecurity when the client doesn't get the awaited response. But having been through this, and working it through in my own therapy where I was allowed to initiate contact through email whenever I wanted, with the understanding that my therapist would not respond every time I asked him to, I found that intermittent reinforcement was actually what I needed in order to form a secure attachment to my therapist. It did drive me nuts for awhile because I had to learn that he wasn't abandoning me if I didn't get the response I wanted or thought I needed, but that's because the relationship itself had activated my attachment needs. The relationship itself activated all the insecurity and anxiety of my childhood relationships, and I had to go through that very painful period in order to learn how to trust my therapist and believe that he hadn't abandoned me every time he was unavailable when I needed him. If he hadn't allowed or responded to any contact between sessions at all, I would have continued my pattern of avoiding asking for support because the message I would have been given was that no one will be there. But if he had responded every time I asked him, I wouldn't have learned that the relationship was still intact and he was still there for me if he couldn't or didn't respond. Either way, I could not have learned to trust him and feel secure.

It's actually very similar to the way that babies and toddlers develop secure attachment. Babies and toddlers are intermittently reinforced when they cry because it is humanly impossible for a parent to respond 100% of the time, and a secure attachment isn't dependent upon getting a response every time a child cries. A secure attachment develops when the parent provides an overall environment of safety, consistency, predictability, and nurturing, enabling the child to learn that she isn't being abandoned when her parents can't or don't respond every time she cries. The child needs to learn that parents and other caregivers are "good enough" and that the relationship still exists despite its imperfections and human limitations. A child who is never allowed to learn that she isn't being abandoned when she doesn't get the response she wanted does not feel secure in relationships because she hasn't learned how to cope with her own feelings and needs in the absence of a response from someone when she wants one, and it is inevitable that people will disappoint her. Behavioral researchers and CBT therapists have known for quite awhile that too much availability and reassurance actually increase insecurity and anxiety because they teach the child (and the therapy client) that she is incapable of handling discomfort and disappointment, and that she must have someone else relieve those uncomfortable feelings for her.

This has been my experience also, especially the part I bolded. I was just about to type something very similar. My previous two therapists did not encourage any between session contact, so I never learned to trust them, and I never felt that they were really there for me. I'm too used to handling everything on my own, and I needed to know that I could reach out and ask for support. I needed to know that I could safely share my thoughts in an email without having to edit the thing to death to make it more acceptable. I needed to see that asking for support is okay. I also needed my T to show me that no responding to something is okay and does not mean that you're mad at the person or abandoning them, or need to apologize.

So, for some people, limited or no contact between sessions may be the best approach, but for others, it's nearly vital to building that trust and relationship. I don't think I really started trusting my T until she started strongly encouraging and even flat out asking me to email or call her.

I see T twice a week for 3 hr sessions, & inbetween we email/ text a bit. T doesnt mind. She usually doesnt have time to email back but does read them all. We are also working on a project together so sometimes she calls/ emails/ texts about that.

Love this post. It makes so much sense. Thanks.

I feel the same way. I can email or call T at anytime ( have cell phone # but am saving that for a MAJOR issue) but I try not to. I also perceive myself as too needy and pushing boundaries. I am always told that I am neither and that is why I have been free access.

Don't worry your T always has a client like me blowing up there email 24/7 making you guys look awesome.

I do agree with all of this.. I however, think that there are different phases, or seasons in thearpy. I think that every good T will work towards getting their clients to a sulf-sufficent way.. They(the client) learn new coping skills, learn how to having and deal with emotions, restructure wrong thought patterns, etc. However, I think order for that to happen their needs to be some amount of attatchment.. Some people's attatchment will seem more extreme than others. However, it will be the right amount for them and for their T. So, for some that means no contact in between sessions, once a week sessions, once a month sessions, e-mails or not.. I think that as long as they are working towards the getting better part, and don't stay where they are at.. Then it is all good

When you say you didn't trust your T, what do you mean? What were you afraid she would do? Did you think she would break confidentially or something?

I have trusted my pdocs and T from the first session, was able to open up from the first session, so it's hard for me to understand. The only thing I needed to be able to trust is the promise of confidentiality, which is obviously there from the beginning.

I've been a little concerned about confidentiality, but, usually once I ask for and receive confirmation on that, it's not an issue. I trust that a T's professional standards include confidentiality.

No, my issues with trust are on trusting that it is safe to discuss things with my T, that I won't be judged or made fun of or yelled at or dismissed. It's more of trusting that the relationship is one in which I am safe to share the issues I need to discuss.

I'm so very used to censoring everything I say or write...making sure that I'm not going to upset the person I'm talking to, that I'm projecting the "correct" image, that I'm managing to stay mostly unnoticed. I had to feel that it was safe with my T to be authentic, to be noticed, to not censor every word and action. For me, that kind of trust could really only be built with lots of different kind of contact...not just one hour a week.

After an abandonment of my former p/doc T, my new one encourages me to email because I have a hard time making myself call him. I guess I feel like at least he can check his email when he is ready rather than have him have to answer the phone and have to deal with the issue right then and there. He doesn't have a secretary and answers his own phone unless he is in session. He reassures me he is still there and it really helps reduce the anxiety. Usually I work at doing it only once a week unless something big happens.

it depends on how my week is going. I used to text inbetween my weekly sessions if I was struggling. Sometimes I don't contact between sessions at all. A while back, I started looking for reasons to connect in between sessions so I would text just to tell her I was having trouble..eventually I realized that I was getting angry at her because I was not able to get what I need in the context of a text or phone call and therefore I made myself stop and now I only contact her if I need an appointment change or something like that.

I didn't originally post this, but I feel very much the same way as Blessed Rhiannon. For me, I have LOTS of trust issues - afraid that when I open up and show the real me to someone that they will find it so repulsive and run away OR I will inevitably do something wrong or fail in close relationships. This has to do w/ my parents, them judging me, not taking care of my needs, not providing a safe space to be me or share my feelings. This has been reinforced by a few damaging relationships, including one with a previous T.

I totally agree with this. Therapy relationships, like any relationships, are not static and have phases. In the last phase I learned to completely trust, not question my T (if she would leave me, for example) and this only worked through lots of contact and reinforcement. She would always return calls back--which were never like talking to a friend, but anxiety attacks, etc.--and we were generally in contact via email almost everyday (calls maybe a couple of times per month for about 15 minutes). Now, we're shifting into more independence for me and less contact between sessions and it's working, but this wouldn't have been possible if she didn't first provide the secure attachment. Part of my issues with this stem from spending the first 6 months of my life in the hospital, therefore, nursery, few people holding me/attending to my crying, difficulty forming an attachment with my mom (who worried that I would die), etc.

This is an excellent post! I didn't learn what I bolded from my parents and therefore am now, at the age of 36, learning this from my T--it's a slow, long process and I'm blessed to have someone so patient to reparent me and teach me to parent myself.

this is an interesting post.
I had different therapist in the past, all from the mental health public system, so hospital base, free service. They all had different approach and different boundaries for contact between session. One was no contact at all, i left a few phone messages to cancel or change appointment. One was only crisis phone call, 10 minutes max. Another therapist let me only email but there was no reply to any of them. If email were "not nice" I had to explain myself at session...

I am hoping to start therapy in a few month with a private therapist, which I will be paying. I am wondering how it will/can be different with between contact session if I am "paying" for a service.

I've only had private therapists and I can say that each one has different rules. One would charge me for anything more than 10 minuteso on the phone, another limits calls to 15 minutes as a rule and doesn't chare, yet another would talk occasionally for as much as 45 minutes and charge nothing, and another wouldn't ever call me. Each one has allowed email and again, different rules for responding from never responding to responding to most emails. Truly, this is a personal preference by the T.