So what is your definition of a difficult client?

I don't know how it could corrupt therapy but it could possibly stand in the way of progress.

If s client is there to work on improving something in their life (whatever the goal is, improve their marriage or finances or parenting their kids better) but can't even concentrate on anything because all they want is to get into therapist's pants.

That doesn't make clients difficult though or warrants termination unless they start harassing and intimating Ts or demand unreasonable favors from them. Still it's important that t addresses it in the most kind of manners and doesn't simply call a client "difficult" and call it quits. That's not professional

I really do think that clients should not be concerned with any perceived difficulty or not. To me, it is the therapist's problem. If they can't handle clients who don't fit neatly into their boxes, then the therapist should consider a different profession. Why the need to label and shame people for what happens at a therapist's office? I don't see how it helps anyone.

Sometimes, it's not just behaviors. My T told me once that I always come to my appts., I'm always on time, I work w/in the guidelines of therapy, etc. (I forget the rest). Anyway, I think difficult clients, IMO, would be those who don't seem to want to try to get to the bottom of what's going on w/them, always verbally abusing the T, physically attacking the T, not paying on time, not coming to appts. on time, missing appts. w/o notice, making the T "drag" things out of the client. There are probably more small things, but those are the biggies for me.

I think that it is ridiculous to expect people who are having difficulties in their lives to not sometimes be difficult. I think Ts should be prepared to deal with many of the behaviors described as difficult in this thread. They get paid over $100 per hour, at least in this area. Sometimes even $200 an hour. For that kind of money, they should be doing a difficult job!

I do think that sitting outside t's house, following t, charging into sessions with other clients, making threats, calling repeatedly after getting voice mail would all be intolerable.

I would say someone who doesn't bring anything to the session. Someone who doesn't say anything to the therapist.

I think each client and each therapist is so different that there isn't a "one size fits all" way of defining what difficult means. And, I think it can be fluid; changing all the time.

That being said, I do believe I can be a challenging client. I also think challenging and difficult are two different things. I am challenging because I have a lot of issues that need to be worked on. I am also quite entrenched in behaviors at this point in time. I am also not consistently medically stable. Because I am in a labile place, we have to focus on life-threatening issues first which mean that we can't always work on what we actually need to. I struggle with shutting down, dissociating, and acting out. While that doesn't make me a bad person, it does make therapy more difficult. I do have a tendency to whine and to say no. A lot. But, as soon as we work past the initial feelings that come up, I am compliant. She recognizes it is fear that causes me to behave that way and she just stays firm and consistent. As she continues to be consistent with me, some of that behavior has dissipated. My fear of abandonment and not understanding attachment is also challenging. But, that's all part of the reason I am in therapy and is not difficult, but something we will continually need to process and work through. I would say the most challenging thing about me is that I struggle with having behaviors even in her presence. So, there is a lot of work done just to keep me safe in the moment. I used to think I was "bad," but my T has been consistent in just telling me that I'm okay and not doing anything wrong. She is reassuring and understands that my actions are not intentional and are just a way of communicating. She redirects me, I try, and we move forward. She probably deserves a medal, but she doesn't let on and I appreciate that. Especially since I have been told I'm difficult and a handful before...

A previous therapist would constantly punish me for being who I am. If I was needy, there was always a derogatory statement and an action. For example, she offered text support. I did not abuse this! But, because I communicated the fact that I was dealing with attachment and some neediness surrounding a particular situation, she took it away. The situation, by the way, was the fact that she cancelled about every other week. I didn't feel safe and would ask for reassurance only to be told I was wrong for having any sort of feeling. She would also tell me that she couldn't understand why I wouldn't accept everything she said. If I was expressing shame over trauma and she said it wasn't my fault, she would become angry and resentful if I still stated I had shame around the situation. She would analyze me and tell me what I was feeling and then become frustrated if I corrected her or tried to explain. It got to where I felt I had no insight and that I was actually not able to process events, thoughts, or emotions logically or rationally. She said I was difficult for not getting well on her timeline. If someone else experienced X, why couldn't I? She refused to acknowledge my dissociative disorder and would put me down for having it. Or, rather, for not having it or whatever it was she believed. My behavior was always the issue and she would solely see the behavior and shut down versus working with me to understand it. She thought I was defiant and a brat. And, she would offer consequences for everything. In the end, she detached and then I terminated to begin working with someone else. I was her definition of difficult and I began to take that on. While I am sure I have my moments, overall, I want to get well and do the work - it just takes me some time. In the end, it was likely she who was difficult.

Everyone is different. Every day is different. Difficult to me would be someone who was only there due to being forced to be; someone who had no internal motivation to work on things. And, even then, I would only say that person was difficult if there had been significant time that passed with no shift in motivation or desire for help. Not paying, insistence that the therapist provide services that were unethical, and serious threats of harm or violence would be my other concerns. Having feelings, acting on thoughts and emotion, and questioning things are challenges, but don't mean that someone is undeserving of understanding, patience, and help. And, what's difficult to one may be an enticing challenge to another. Everything is variable.

I'd say people who are difficult (in general or/and in therapy) are in therapy for a reason. Maybe for those exact reason! Because they are difficult! So dismissing them or labeling is just not going to help anything!

What came to my mind is my mom. She is a 'difficult' client.

I think her biggest thing is lack of responsibility.
She has her own t for 20 years now, and it works for her. Great!

But, when i was younger i invited her to a t apt to help our communication. My t taped the conversation between us and played it back to her. His point was to show that she was disregarding my emotions. And the only way he could get her to understand that, was to show her herself.
She yelled at him and walked out.

She was a difficult client.

Were good now tho. She finally embraced her lack of responsibility to an extent. We can atleast have a conversation and visit without yelling. Its all good now. . It has taken 15 years tho. Her personal t must be doing something right.

I think a lot of what is being described here is either what the person is doing in therapy in the first place OR because the person does not know what is supposed to be happening or what is meant by therapy. If those guys would do a better job of explaining how the whole thing worked, I think it would go smoother.

In my opinion people are most likely behaving same way in therapy as they do everywhere else. I can't imagine too many reasonably well adjusted people would all of a sudden become very difficult in sessions.

I tend to believe ( and based on my observations of people in various situations, circumstances and geographical locations) that people tend to behave very similarly regardless where they are at (some differences of course like more constrained in professional environment etc). IMHO

Me.

I am afraid of therapist, doctors, and similar. I am very easy to talk with outside therapy but horrible when I talk to my psychotherapist.

Makes sense. I understand. Good point. Well I certainly don't talk to my boss exact same way I talk to my best friend (although I still maintain similar style etc). I kind of meant general disposition and behavior but I do understand your point

I know of many people who behave quite differently depending upon what environment they are in. Perhaps it is because lgbt people often have to hide in plain sight. Perhaps not as much now, but it was pretty common when I first came out in the late 70s.

In my experience most therapists would consider a client difficult who dares to question therapy orthodoxies and assumptions, who does not defer to the therapist's presumed authority or expertise, and who thinks critically and independently. Most of the therapists I have seen would likely be completely undone by such a client. The last one actually was.

Exactly my experience. Interaction became difficult, real fast. Everything had held together on the slender thread of my subordination to them. Then I saw another example when someone who was a therapist, not mine, high handedly tried to give me unrequested life lessons. Amazing how Queen Bee her behavior was.

I agree that a lot of them seem to just want clients to submit /comply/ not question much or disagree (I base this on my professional work where I read their notes and question them)

My T doesn't believe in difficult clients. I asked her once what a difficult client would be. She told me a couple of things but it wasn't on the clients end, it was things that would be difficult for her (her own triggers, counter-transference, etc) but she never places blame or anything on the client. She doesn't think anyone is difficult.

I agree with you. Complying with their recommendations is a difficult and tricky situation. Yesterday I came across an issue with my boys T. My youngest has an issue answering calls or texts with his father via his phone and prefers to use mine. I have to encourage him to call or text him when his father contacts him. His T is very much aware of this scenario. However his father wants him to communicate using his phone and now his T is pushing this as well. She said that she tried comprising with his father in meeting my son half way as to ease up on the length of time for a call back. Now my sons T wants my son to use his phone. She told him that if he didn't then she wouldn't speak to his father and intervene when he wants her to do so. I was in session with him and he just looked at me and stared. All she said then was that she didn't know how to help him and how to go from there. However there are other bigger issues to address but she's stuck on this and wants him to comply in order to pacify his father. I'm still not sure how to go about this. So is my son at 11 years old considered a difficult patient?

This wasn't true in my case. Therapists were authority figures who tightly controlled the circumstances, rules and used a procedure they never explained. Unlike a boss who oversaw my specific job performance or a teacher who imparted knowledge, the therapists' (illusion of ) jurisdiction and judgment was over the entirety of my life, being and personality. I never felt so ineffectual, subordinate and powerless. I was far more tentative, deferential and reverential with therapists than with others. Once I realized that therapy left me far more despairing than when I came, the co-therapists petulantly needed their old worshiper back, and viewed me--difficult.

This might have been my personality, but under extreme manipulation.

I think some of the issues that are commonly cited as constituting difficulty -- neediness, drama, resistance, reticence, frequent emailing -- can actually be to the therapist's advantage. These things either prolong therapy, providing them with ongoing income, or make them feel needed and important. Being triggered into childlike neediness, being so destabilized that you can't stop emailing or obsessing, or having an expensive session wasted because you are too uncomfortable to speak or be open... these are difficulties FOR THE CLIENT.

"people are most likely behaving same way in therapy as they do everywhere else. I can't imagine too many reasonably well adjusted people would all of a sudden become very difficult in sessions. "

Would this not also then be true for the therapist?

I can say from experience it is traumatizing. It's also deceitful and irrational. Therapy provokes those feelings and the therapist encourages their expression. If the therapist then says -- those feelings are wrong, you're terminated -- that's crazy. In that scenario the client is doing their job (as it were) and the therapist is being difficult.

Yes it certainly would be.

Reasonable and decent person is very unlikely become a difficult, obnoxious or especially abusive therapist. If it's a wrong profession for them they would be smart enough to change professions. I am fairly confident that horrid therapists, described on this forum, are difficult human beings in other situations

In retrospect, I wish I'd been much more "difficult." My therapists gave me some ridiculous instructions about handling family which I obediently followed. The results were so disastrous and the fallout lasted the remainder of my parents' lifetimes. But worse, I was going against my own intuition, since I knew my family far better than the therapist did.

In another case, I became so swept in self-examination and magical thinking I was essentially in a meditation psychosis and lost valuable friends who rightly believed I was going crazy. I bet my therapists loved my compliance though.

I don't think not blindly following therapists' suggestions (or anyone else's for that matter) makes one difficult. I don't think obediently following everything to the book is the goal of therapy at all. One could have their own ideas how to live their lives yet not be difficult. I never think that speaking ones mind is the same as being difficult. Do therapists told you that you must follow their instructions?