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5 Ways to Give Your Therapist Feedback Rather Than ‘Ghosting’ Them

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As a therapist who often engages in mental health advocacy on social media, my timelines are usually a constant stream of articles and blog posts related to mental health. Recently, a think piece on client-therapist compatibility caught my attention, as I had been contemplating whether my own therapist and I were working well together. I couldn’t have come across a more discouraging resource! For almost every problem listed, the proposed solution was to drop out of therapy, or “ghost” — but without first making an earnest attempt at broaching the problematic concern. This misguided advice unsettled me for a couple of reasons.

First, I know it’s a privilege to abruptly quit therapy on a whim, under the assumption that a better therapist will be easily affordable and readily available. I’ve witnessed this reality while working at community health agencies, where long waitlists are a given, and clients are designated to therapists by availability, not preference or specialty. Secondly, I’ve observed that clients who ghost are typically those who need support most of all, yet have the fewest options and are the least experienced with therapy. I always wish they had realized I wouldn’t have taken their departure personally, and that I would’ve assisted them with a referral.

In many cases of ghosting, dropping out of therapy could’ve been a last resort, but it’s all too common for people to feel intimidated or ill-equipped to advocate for themselves. Maybe if our K-12 schools would offer a mental health curriculum to demystify therapy, more people would feel empowered and informed enough to voice concerns. A savvy understanding of therapy would especially benefit people who have limited options for therapists. Knowing how to offer feedback about awkward, disappointing or uncomfortable moments in therapy, instead of ghosting to avoid confrontation, can save therapy-goers money, time, health and stability. I’m writing because I know many of us must figure out this skill through trial-and-error.

This guide picks up where others left off. It addresses common issues that precipitate ghosting, while also debunking the number one belief that drives conflict avoidance: that honesty might get judged harshly or pathologized. Self-advocacy is key to reaping the benefits of therapy. When we reframe “confrontation” as self-advocacy, we’re less likely to let anything deter us from arranging our healing how we need it.

1. Consenting to lead.

I once considered ghosting a therapist who would set the agenda for each session without my consent or input. As we got comfortably seated and checked in, they had a habit of minimizing red flags — like my recurrent reports of debilitating fatigue — then segueing to childhood trauma, their interest and specialty. Steering the conversation in a different direction seemed like a power struggle because I didn’t know that I could. On the whole, they weren’t a bad match, and I sometimes wonder what we could’ve accomplished had I spoken up. Lesson: You can grab the mic.

2. Identifying needs.

It’s perfectly fine to seek therapy just because things don’t feel right, without having a clue as to what issues need addressing. If all you know is that you’ve been much better before, that’s OK. Therapists can help you figure it all out. That said, be mindful of deferring too much to a therapist’s interpretation of your circumstances or life narrative. The consequence might be that your therapist deems an issue problematic, while you may not desire to change it, or may disagree altogether. It’s important to remember that a therapist’s assessment or perception of your situation is professional, but also subjective. Ultimately, you know yourself best, and you should have the final say on the overarching focus or purpose of your therapy journey. Lesson: You’re the expert of yourself and your story.

3. Specifying goals.

The real work finally begins when you and your therapist specify a few goals and steps to achieving them. This stage of implementing life changes is why most people seek out therapy, and yet, it can still prompt ghosting when therapists set goals for you. The consequence is that you’re not fully invested in the target outcome, which can make pushing past stagnation feel like an obligation or punishment, and being held accountable feel like pressure. Someone with a conflict-avoidant disposition might find it easier to bail in this situation, rather than propose readjusting a goalpost to suit their limitations or readiness. Lesson: For accountability to feel supportive, not pushy, your honest input is needed when setting goals and sharing updates.

4. Staying engaged.

To make long-lasting, sustained change, we need lots of opportunities to practice new habits and skills. This is where therapy activities and homework are useful. An intuitive, strengths-based therapist will understand that your interests and traits are important factors in the likelihood that you’ll engage with these tasks diligently. Yet, there are also therapists who lazily assign everyone the same generic cognitive behavioral therapy (CBT) worksheets, and whose insistence that you try watercolor painting seems more bossy than enthusiastic. And so you ghost, right? No. You just need to convey that facilitating your growth in ways that stimulate you requires purposeful, personalized content selection. Lesson: Early on, give pointers on how you prefer to de-stress, learn, practice new skills and process emotionally, and follow up with firm feedback.

5. Addressing oppression.

You’d think there’d be a consensus among therapists that mental health disparities are linked to oppressive structural forces that sanction institutional barriers, economic exploitation, social stigma and targeted violence toward certain groups. Yet, a social justice pedagogy isn’t central to every counselor training program. Some therapists won’t know how to apply an anti-oppressive framework to your concerns, or to the dynamic and interactions between the two of you.

When confronted with a therapist’s unconscious biases or blindspots of privilege, put them in the hot seat. Ask them what they’re committed to (un)learning in order to empower you. It’s imperative to stress that the American Counseling Association Code of Ethics prohibits decontextualizing your wellness or identity-related concerns from sociopolitical conditions that impact the collective welfare of communities to which you belong. If, after honest self-assessment, they deem themselves ill-equipped to do so, they’re required to refer you. I delve more into anti-oppressive therapy, in Therapists for Women of Color and Queer People: How to Find One and 52 Mental Health Resources for Disabled People, POC, LGBTQ Folks and More.

Lesson: Anti-oppressive therapy necessitates a therapist who genuinely empowers your identity development and pursuit of political liberation. Not every therapist has that capacity, but you’re certainly entitled to it.

In all of these scenarios, remember that staying present through the tensions that arise can be both a matter of resourcefulness and an act of self-love.

Photo via Nicholas Githiri at Nappy.co.

Originally published: October 31, 2019
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