To err is human...

Eventually every therapist will make a mistake -- forget something important, be late, forget to return a call -- something. It will happen because it must, because we are human and part of the therapeutic process is learning to accept both one's own and the other's humanness. Some patients will stubbornly hold on to demands for perfection and not forgive even the most minor slips. As the therapist, I have to be willing to stay with it and apologize for the mistake and listen to the patient's hurt and anger while also trying to help them see that life has gone on, that the relationship is not over and that there is room for forgiveness. This isn't always easy, though with practice, over the years, it does get less anxiety provoking to listen to and deal with a patient's anger.

As a therapist, I cannot act out any hurt or anger caused by the patient. This means that the patient can say what happened and that the effect was that she was hurt or inconvenienced or whatever. And trust that there will not be retaliation.

The most frequent situation that I encounter is a patient forgetting the check or bouncing a check. Often that patient expects that I will be angry or disappointed or make her feel bad for her mistake.  I calmly tell her that the bounced check must be replaced and include whatever fee my bank charges., Or I tell him to please mail a check to me that day after the session. I might also express curiosity about what might have led to this behavior -- how it reflects some unspoken feelings about our work or might reflect a recurring destructive pattern.

We build trust by showing up, listening, being willing to receive the  patient's feelings, even the ugly ones. By being willing to not act out. And by reflecting on our own behavior and willing to acknowledge mistakes.

And the patient's responsibility? To show up and be willing to talk, not just about the things that are comfortable, but also the things which are dark or ugly or scary or angry.

If both therapist and patient are willing, these things can be worked through. Sometimes no amount of mea culpas will appease some patients and they leave -- usually they have been ready to leave since starting, and/or they have a history of being failed by therapists and have no insight into their role in the process.

© Cheryl Fuller, 2018. All  rights reserved.