Out On The Couch
Relationships between therapists and clients can involve vulnerability. Exploring topics related to identity is delicate work. Both client and therapist may be impacted by their education, knowledge, and preconceptions. Moreover, therapy often requires discomfort. None of this is news but: but managing conflict while centering your client’s experiences takes skill and experience.
Affirmative therapy requires vulnerability on the part of both client and therapist, and making errors is inevitable. The harm that can come from those errors can impact the client-therapist relationship and the client’s treatment. Harm can occur in myriad ways and for countless reasons. In this post, we focus on how therapists can address their own errors and accept critique. Therapists need to tolerate their emotions in a conflict, and center a client’s experience to help the relationship move forward. Additionally there may be an opportunity to explore similar conflicts the client may have experienced outside therapy. This can lead to emotionally corrective experiences, and changes in the way the client manages conflict.
You Will Make Mistakes
Let’s start with what you know but probably don’t want to hear. You’re going to make mistakes that may cause harm to your clients. Unless you are brand new to therapy, you have almost certainly done so. In many cases, responding to these errors may have changed how you work. It’s also possible that you are totally unaware of injuries and slights your client hasn’t made you aware of. While we can strive to cause as little harm as possible, it is an inevitable part of any vulnerable relationship. In therapy, where you are likely choosing to dig into tender areas instead of avoiding them, it is also an invitation for conflict. Learning how to repair these moments of rupture will impact your relationship with the client you harmed, as well as other clients throughout your career.
Making a Mistake Isn’t a Measure of Your Value
Let’s start with an overview. Making errors, particularly about someone’s identity, personhood, or how they move through the world, doesn’t feel good: for the person who mis-stepped, or the person who experienced it. We all know that doing harm to someone tends to make both parties feel bad: but for very different reasons.
In many cases, at the core of making mistakes is the sense that one is a Bad Person®. Getting stuck in that feeling makes it harder to move forward and heal the harm. It can be easier to just throw one’s hands up. Try to remember that this error doesn’t define you as a therapist or as a person, It is an important step to ensure that you don’t react in frustration or shame. Additionally, leaning into your own support systems in these moments is essential.
Education is Key
You may consider yourself to be an ally to LGBTQIA+ people (for example), but if you haven’t been trained on how to work with queer clients (or in some cases, you have had training that perpetuated harmful stereotypes), getting more education may be key to your internal work.
Not having enough or proper training on topics of identity can result in shame and expectation of judgment, even before you’ve made an error that may cause harm. Focusing on this can run the risk of making everything about you rather than the harm you caused; however, increasing your education on how to be a more affirming therapist can help you to understand the errors you made and prevent them in the future.
An important note to remember, though: identity is complex. No class is going to teach you the essential truth of a marginalized identity. Further, a client’s own history informs their relationship to their identity. Knowing your client’s specific vulnerabilities and being aware of the working alliance between you is information too! After a conflict is resolved, there’s an opportunity to make meaning and help your client increase their own awareness and communication skills.
How to Manage Conflict When You Recognize a Misstep
One of the most challenging moments is recognizing that you have made a mistake that is likely to cause harm. The balance here requires that you recognize the possibility of harm (and the possibility that even if your client was harmed, they may not wish to discuss it), without making the discussion about you.
First off: don’t ignore it if your client doesn’t say anything. If you notice immediately while speaking, correct yourself, and consider finding the right time to explore further. Is tending to the rupture, or sticking with the client’s material more essential? They may need some time on their own to understand how they were impacted and talk about it later.
Don’t forget: your goal isn’t to make you feel better about making a mistake or to make another person not “have the wrong idea about you”, but to repair or maintain trust and to address any harm done by your words or actions.
Finally: don’t force your client to discuss it if they do not want to, especially if it came out of the blue. However, if relevant to their treatment, you may suggest it is discussed again at a later session, after they have had time to think about it more. Make sure your client knows you are available to come back to the moment if and when they want to.
What to Do When You are Approached by a Client About Harm
It’s worth noting that in many cases, a client sharing an injury that you caused can be an excellent sign that despite having caused harm, you have created a relationship in which they feel safe bringing this up with you. It may show that the client is invested in the work that they are doing with you and also want to repair the damage.
Remember: it’s not about you. In many cases you, like the client, may need to step back and reflect or do more research before talking more about the harm. However: don’t expect your client to provide you with resources for learning. It is the client’s responsibility to explain their own positionality and perspective, but not to speak to what you as a therapist should have done or should do in the future. Make sure you have your own supportive and reflective spaces to continue your own work.
Conflict and rupture in a therapeutic relationship is likely inevitable and is certainly one of the most difficult elements of therapy, but it doesn’t have to be a source of shame or additional trauma. Responding affirmatively, making meaning of the client’s experience, and creating a safe and nonjudgmental environment throughout conflicts are key to repairing your relationship with your client.
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