When It’s Not Working Out With Your Therapist
When you know something isn’t working, how do you approach the conversation so you get what you need?
You’re feeling stuck. Maybe you don’t know what it is, but you KNOW something isn’t working. It seems like your therapist is just not getting you.
You’ve heard of just “not clicking,” but maybe this goes beyond that. Is it not the right fit? Or is it a bit more complex than that? Did something happen that turned you off?
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Now, I’m a therapist, so I’m talking about this kind of thing happening with your therapist. You can replace “therapist” with anyone – psychiatrist, dietitian, doctor, and so on – but we’re going to be zeroing in on the therapist-client relationship today.
Whatever it is, and whomever it is… this is your episode to help you figure out what to do and how to get through it… even when it feels terrifying.
When It Feels Terrifying
I get it: the idea of approaching this conversation can feel terrifying.
But here’s the thing: you can’t expect anyone to read your mind. Your therapist can’t read your mind, and you can’t read your therapist’s mind. 🤷🏻♀️
So unless you talk about something, the other person won’t know what’s bothering you. It’s so important to turn everything into words… so this entire conversation is going to center around how you can put words to your experience, even when it feels terrifying.
Because honestly? You owe it to yourself to talk about it.
Otherwise, you’re completely wasting your time and energy. What are you doing in therapy if you’re not willing to talk about what’s not working? You owe it to yourself to be honest.
When You’re Afraid of Confrontation
I get WHY it’s terrifying… it’s confrontation. And who in the world ENJOYS confrontation?
But maybe we can actually start there. Meaning, instead of saying something like, “This isn’t really working, and here’s why…” you can start one step before that.
✅ Example: “I have something I want to talk about. I feel kind of anxious about talking about it. It feels a little difficult to have a conversation about this.”
And then, you and your therapist can have a conversation about exactly WHAT is difficult about having that conversation. Because chances are… this isn’t the only kind of situation like it that’s difficult.
If this kind of confrontation with your therapist is hard for you, then confrontation is probably hard for you with everybody else. Right? 🙃
So when we have these (or any difficult) conversations, it’s not just about pushing you to say something that’s uncomfortable. It’s about trying to understand WHAT’S uncomfortable about this, and so then we can shed light on this general pattern – because the discomfort you’re feeling likely isn’t exclusive to this situation alone.
You and your therapist can then explore what makes it feel uncomfortable.
✅ Example: “I’m uncomfortable with this conversation because I’m afraid you’ll get angry with me.”
And then we can explore what happens when you’re afraid someone will get angry with you during a confrontation. What are you actually afraid of? Do you feel like they’re going to hurt you in some capacity? Even if you don’t actually believe it in the moment, what is your fear?
When we can answer that, that is going to shed light on what is likely a pattern. It can also help you get over the hump to actually talk about why your therapist isn’t working for you.
Communicating With Words vs. Actions
It’s so important for you as the client to explain exactly what you feel like isn’t working. Now, this doesn’t mean you have to be able to pinpoint the EXACT issue – but just the best way you can.
And I do believe that one of the biggest differences – if not THE difference – between excellent therapy and mediocre therapy is the ability to engage in these types of conversations.
Now, that obviously goes two ways. It’s not just the therapist or just the client who needs to talk about it… it needs to be BOTH.
Are you as the client able to tolerate the discomfort of talking about this? Do you ignore it and pretend it’s not happening? Do you act out and use your actions to communicate?
Example: you reschedule sessions, cancel, don’t show up, arrive late, don’t respond to emails from your therapist…
Or are you the kind of person who TALKS about it?
Now, I think the biggest difference between communicating verbally and communicating via your actions is a certain level of respect vs. aggression (obviously, this is easier said than done).
Acting out – meaning, using your actions to communicate – is called passive aggression for a reason. It’s aggressive.
If you use your words, though, you have the capacity to actually have a conversation about it and explore it, as opposed to just dumping it on the other person. And this, of course, applies across the board to all your relationships, not just your relationship with your therapist.
Your Therapist’s Responsibility
The flip side is, does your therapist have the capacity to talk this entire thing through?
Let’s be real. We’re all humans here. We know that therapy is a place where we can say anything.
But the therapist on the other side of that is a person. And if you as the client explain what isn’t working, it’s very possible that if you phrase your words a specific way – in a judgmental or critical way – that it will be perceived in that way. And when anyone receives criticism that’s not constructive, it’s pretty natural to respond defensively and angrily.
Disclaimer: I am NOT condoning defensive reactions from any providers, AT ALL. Just want to make that clear.
What I AM saying is that if you’re able to put your words out there and this person is able to react in a way where they can put aside their defenses to hear you out… then you have found your unicorn 🦄
It is really important for your therapist to be able to engage respectfully and curiously in these kinds of conversations with you, no matter how they go. Even if she feels insulted or hurt or angry.
Beautiful Debate
If you are devoted to truly figuring this out, if you think about what’s the most likely way we can have a conversation that’s curious rather than judgmental, you have a higher probability of coming out of this conversation with more information, rather than butting heads.
Let’s think about any kind of disagreement. If you have a respectful disagreement, what you have is a beautiful debate. You might come to an agreement or decide to respectfully disagree.
Either way, at the end of the conversation, you get somewhere.
But if you think about the other way disagreements can go – when arguments escalate, they call each other names, they get angry at each other – there is no openness to hear the other person.
I think if we apply this dynamic to someone’s relationship with their therapist, I think we can figure out a way for you as the client to get what you need if you bring this up in a way that’s open.
Example: “I really want to have this conversation. Maybe I don’t know how to say it, maybe I’m using the wrong words, maybe I’m actually being mean… but I really want to have this conversation.”
Whereas if you come in pointing fingers, saying, “This isn’t working, I’m paying all this money and you’re not fixing me,” and so on… then the other person might not be inclined to help.
Now, they’re your therapist. They WILL help you. But circling back… you as the client have a responsibility to bring this up as assertively as you possibly can and your therapist has the responsibility to respond with curiosity.
If You DON’T Bring It Up…
Your emotions don’t just go away. They ALWAYS come out somehow.
And if you don’t bring up how you’re feeling, they might come out in passive aggressive actions… and it’s likely your therapist will notice.
Let’s just say you are canceling, not showing up, and so on. Your therapist has a responsibility to bring it up.
I, as the therapist, could say, “You were pretty late today, and you were also late last week. The week before you canceled, and then you didn’t respond to an email. Something’s going on, and I really think you’re trying to tell me something.”
Or, I might ease in by saying, “I noticed it was a little hard for you to get to session today. Is everything okay?” This gives you the opportunity to talk about it, or provide excuses (which might actually be valid). And then I might say, “I noticed this happened before, and I guess I’m just wondering about that.”
Notice a difference in your response to the two?
This easing in to the conversation is for me to tell you that I’m noticing your behavior and I’m curious about it. I might say, “I’m noticing that this is a pattern, and that usually means you feel a certain way about something. I’m wondering if you’re feeling a certain way about therapy, and I wanted to give us the opportunity to talk about it.”
All of these are ways to open up conversation verbally in the most gentle way, so we can actually get somewhere. Because if I DID say it in a more pushy way, you would be headed for the door… and rightfully so.
It’s all about how you say it!
Why This Matters
If it’s just not working with a therapist, dietitian, or whoever, it’s obviously really important to talk about it. Because if it’s not working, seriously, what are we doing here?
But more than that, the interpersonal relationship between you and your therapist is going to provide so much information about how you relate to other people.
And if you ignore it – if you ignore that there is some sort of communication happening between you – you are ignoring a large piece of your work and your healing journey.
We can talk about your eating disorder all day, and how restricting leads to bingeing, and so on (obviously, that’s SO important)... but if we don’t talk about your relationship with your therapist and your relationships in general, we almost didn’t do anything.
And I know that sounds pretty harsh, but if we’re trying to figure out:
The root of your eating disorder
Coping skills
Why do you do what you do
Why does your body react in certain ways
Why you turn to bingeing or restricting or excercise
All, if not most, of that can be addressed by what is actually happening in the therapy room.
When you get angry, do you snap? Do you get defensive? Do you shut down? Do you have the capacity to discuss these things with your therapist?
Otherwise, we are in pursuit of intellectually understanding your relationship with food and others instead of practically experiencing and changing it.
The interpersonal dynamic between you and your therapist is the key to your recovery and healing journey.
I really hope that you use this post to arm yourself for a conversation with your therapist. And I hope you take it one step further – this goes so much further than talking about something that isn’t working. You can use it with anyone when someone has angered or upset you. This is going to be your golden ticket to where you need to go.
Tweetable Quotes
“The interpersonal dynamic between you and your therapist is the key to your recovery, your healing journey, to really getting anywhere that you need and want to go.” – Rachelle Heinemann
“Honestly, you owe it to yourself to talk about it. Otherwise, you’re wasting your time and energy.” – Rachelle Heinemann
“Let’s think about any sort of disagreement. If there’s respectful disagreement, then what you have is a beautiful debate.” – Rachelle Heinemann
More From Rachelle
Hey there! I’m Rachelle, the host of the Understanding Disordered Eating Podcast. As a Licensed Mental Health Counselor, I work with clients to make sense of life’s messy emotional experiences.
I believe in the power of deep work and its positive impact on your life in the long term. Learn more about how we can work together here.
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