How to treat therapy as a "professional" relationship

Hi everyone,

I was just wondering your thoughts on how to treat therapy as a professional relationship.

I know therapy is supposed to be personal. I also know that the therapist is not there to be your friend.

How do you all treat therapy as a professional relationship?

I know I'm not there to agree with everything the therapist says, but I have trouble telling therapists (and psychiatrists) exactly what's on my mind.

It's hard for me to be assertive, too. I recently learned that my therapist talked to my psychiatrist. My psychiatrist said that I was "agreeable." I don't really like that because I don't want to agree with everything my therapist and psychiatrist say. I want to learn to be more assertive. Is there any way you have found to do this?

I think I will insist that I write a list of bullet points for every single session and tell the therapist that I absolutely need to talk about those things every single appointment. Any other ideas would be much appreciated.

Hmm. For me, what comes to mind is how much a dialogue and collaborative effort my therapy was. I went into therapy with the resolve to do whatever it took, walk through whatever fire I needed to walk through, to get beyond the old crap in my life that was constantly invading my present life. Part of my "deal" with myself was that I would be open and straight with my therapist (and myself), even when my previous habit was to stay silent and/or omit relevant things of importance.

That translated to therapy where I was active in the direction of my therapy, where I had no qualms about telling my therapist "no" if something didn't sound right or feel right. They honestly expected that of me, and they respected that I could communicate that to them in a way that was productive and helped THEM with pertinent feedback and direction.

I think this open dynamic I had with my therapists helped me feel on equal footing with them, which is why I never really felt that power disparity some people have problems with in their own therapy. My pdoc was very much they same way - he expected my input, listened, and worked WITH me not AT me.

i Tend to be rather agreeable as well. Pdoc even said that while she loves finally seeing me with a T I have a solid relationship with she would really like to see me get mad at him (so that I would know it was OK to be angry and my relationship with him would survive.
Last week T was telling me a story and he got side tracked and then started venting about something. He was very judgmental about one of the people in the story. So now I am wrestling with the fact that IRL T can be very judgmental and think some really mean things. He wouldn’t do that with me as his client because he knows I need to feel safe and know I will not be judged in order to heal. I also know that there are things in my life right now that if we were friends or some other non-T relationship he would absolutely judge me for. But I also know that even if he did judge me for those things he would still love me as a person.

For me it makes it easier to disagree with him knowing he is human. It’s OK to tell him to stop ringing the damn chime it is too high a pitch and sets my nerves on fire. That I saw him tailgating someone and tailgaters irritate me to no end, what is he in such a damn hurry for? Why did you promise me you would make sure T2 and I were OK but then as soon as I take a break from her to fix things you drop the whole idea??? And, if he saw it he could ask why the hell I let cats on the counter tops and isn’t that dirty? And... we can have conversations and get through it.

(Yes, the cats get on the countertops... Yes, I wash off the countertops before cooking)

My T emailed Pdoc which resulted in major med changes. I was really annoyed at T and I wasn’t going to bring up the fact that I was annoyed with her until she mentioned how I felt about her emailing him. When I told her I was upset she said “yeah I figured you were”

Now I’m just holding back stuff altogether that I don’t feel comfortable sharing with either of them. I know that’s not what I’m supposed to be doing but I legit don’t trust either of them right now. Plus I’ve heard some stuff that they have told me that I won’t share on here but I feel like they are telling me stuff that I have absolutely no business knowing and it could easily turn into a disaster if I were the type of person to talk to people. Especially people who like to blab all over social media.

I don't think agreeable necessarily means what you think it means in this context. Usually when people say someone is agreeable, what is meant is that the person is pleasant and likeable. It means someone is literally agreeing when someone is agreeable to x. And a person can be pleasant and easy to get along with while also being assertive - not saying you don't perhaps have an issue with being submissive, just that your doc is likely not literally talking about your tendency to agree with her. I assume you would not have appreciated had she said you were disagreeable, right? Because that would not have meant you are assertive, but that you are unpleasant to be around.

I think writing down what you want to discuss is a good idea. It's your session, so you should get to use it how you wish.

I agree with susannah in that "agreeable" doesn't necessarily mean someone tends to agree with everything and wants to avoid conflict, I think it more refers to general open-mindedness and flexibility. Likewise, I think assertiveness does not really imply that someone is antagonistic and likes to argue and oppose others, actually more a way of standing up to oneself and resolving conflict that is understand and respectful toward everyone involved (as opposed to an avoidant or aggressive style of dealing with disagreement and conflict). So, I also think agreeable and assertive can be together, and it's definitely a good thing to practice and can come across as a professional attitude.

Did you give permission to your T and psychiatrist to communicate about you? Asking because you phrased it as "I recently learned...". If they didn't have explicit permission, or even if they do but do not discuss things with you openly, I think they are not acting professionally. You definitely have the right to expect that kind of professionalism.

Being disagreeable is under estimated.

re: Agreeableness, it's also one of the "Big 5" personality traits, so your T might have meant it in that sense.

Having a list of things you want to discuss is a good idea, but I don't know if I'd go in expecting each of them to be addressed every time. Sometimes it's good to get into a single topic and see where it leads.

To me, treating therapy as a "professional" relationship is mostly about seeing it as a relationship that has a purpose, which is to help me with my life. Things that don't serve that purpose (like small talk, politeness, people-pleasing, etc.) don't really belong in therapy.

To me, treating therapy as a professional relationship means that I am not there to get the therapist to be my friend or to even "like" me, but to focus on my issues and challenges that come from my experiences in life. The therapist is there as the professionally trained psychologist who know how to effectively guide me to the goals I have set. We are both there together in that hour to work. There are goals, and we focus on them.
There are times I definitely don't agree with the therapist and times she makes incorrect assumptions about what is going on (because I have been unable to articulate stuff). I do my best to tell her when this happens. I am not there to do her bidding. But I am very agreeable!

I am wondering about what is going on for you that prompted you to write your post. You said you want to write a list and focus on those things every single appointment - are you feeling that therapy isn't going in the right direction at the moment? Is it a concern about not staying on topic with the things that most concern you?

My post was prompted by the fact that I don't know what I think sometimes. My therapist also told me stuff that made me feel like I was prevented from quitting somehow and I didn't really appreciate that. I realize that I should probably quit this relationship -- that is why I wrote this post -- I realize that I have gone up on meds when seeing this therapist (even though that is my psychiatrist's territory). I feel more anxious these days. I don't think therapy is going well. I don't know what to do because the last time I tried to quit she convinced me into staying. I am indecisive about most things. I don't know. I don't think therapy is going well, and I want to quit. But then again, she is the professional, so don't I have to defer to her? I have trouble disagreeing with people. I suppose that was my concern with the bit about being "agreeable."

Goodness me, no.

I mean, if you hire a plumber and he tells you he’s going to reroute all your water so it floods your basement and you need to use that water for everything, you’d disagree with him, right? Even if he is the professional.

I know this intellectually, but I can't seem to internalize it.

It's almost as if I have this internal sense that things are going badly, but I don't know whether to trust myself or whether to keep on keeping on with the therapist. And then there's Covid in the background. And there's the extra variable that I'm seeing a psychiatrist, too, and he has been messing with my meds lately.

I’d go with trusting yourself.

Just the way you refer to her as “the therapist” (but it’s “my psychiatrist”) sounds like it is a distant relationship.

If you don't feel like this therapist is helping you, it makes a lot of sense to start looking for a different one. You don't have to defer to her opinion at all.

I would say trust your guts.

Take a therapy break, space out your next appointment(s) and see how you feel. This may enable you to cut ties, if need be.

You get to quit at any time unless under a court order. You don't need to talk to the therapist or get their permission to quit - just call and cancel or don't make another appointment. You do not owe the therapist anything other than payment for the appointment you had.

Oh no - you don't have to defer to anyone. If you don't like how your therapy is going you can leave at any time.
Your T might be a professional, but the only expert on *you* is you.

It is interesting that you want to give her that power to choose what is best for you instead of you deciding for yourself, though.

I would try out another therapist. Many offer a free 15-minute (or longer) consultation (in US at least), so you could get a bit of a sense of one before starting with them. I also found it easier to leave a therapist (ex-T) when I had an appointment already set up with another one. If it's easier for you, you could say you're taking a break--it's up to you whether you mention you're going to see someone else in that time or not.


And your therapist should not be pressuring you to stay with her. It's one thing if she says "I think you would still benefit from therapy with someone" vs. "You need to continue therapy with *me*." If you're concerned about that happening (and succumbing to her pressure), you could wait until the end of the session to tell her. Or you could do so via email or over the phone.

I appreciate the responses.

I realized that this thread was a consequence of me succumbing to my anxiety, somewhat, at least.

I don't think I have a problem with my therapist.

Basically, now I feel stupid for writing this. I don't think she was ever like "therapy with me is a necessity." She wasn't trying to pressure me into sticking with her. I think she just wanted me to see the process through so that I could overcome some problems I have with impulsively quitting stuff.

I should have been more clear in my original post.