If you are a former therapy client or patient you may likely have built a deep, intimate relationship with your therapist.  Clients tell us their innermost challenges, dreams and aspirations.  Then, they move on.  Have you ever wondered why your therapist hasn't called to see how you have been? Often, therapists would love to know more about the developmental trajectory of former clients. We are, of course, human. We care about our clients, think about them and hope for the best for them.

The therapist-client relationship is one of great importance and meaning, and we spend years helping clients develop themselves only to eventually lose contact. But in the course of our work we developed intimate, meaningful relationships and delved deeply into their personal worlds. Admittedly, for many therapists it can be difficult to completely disconnect from these individuals and families.

What can possibly be the problem with a short text or phone call once a year? On the other hand, can a call actually benefit the client? While some clients may be touched when a therapist reaches out, others might actually find it offensive or painful. One thing I have learned in the course of my career is that there are few rules that are absolute. When it comes to reaching out to follow up with a client after transition, each situation requires consideration  of several variables before the therapist can come to a decision. In psychotherapy in particular, care must be taken that the therapist be mindful and honest that his or her own needs to ‘feel good’ are not the motive behind the decision to reach out. If they are, the client can sometimes get  hurt.

Let’s explore the following examples. Yochie came for therapy at an extremely vulnerable period in his life. He had great regrets over certain choices that he had made that seriously impacted him and the people around him. In the course of his work Yochie relived some significant traumatic memories from his childhood  and experienced deep shame and embarrassment. He knew that he had to be brave and face them in order to improve his functioning, and courageously dug them up in the therapy room.

During a period of around seven months, Yochie also experienced periods of distress and panic throughout the day, sometimes having psychosomatic symptoms; at other times, he would ask for an extra session or call for support. While I knew pain was inevitable, I felt sad for Yochie that he was tormented by the flooding of these memories and previously repressed feelings. My compassion for him helped me to be patient and present throughout the process, never rushing him to move on. Being so attuned also created a deep and intimate safety for him, perhaps something that he had nowhere else in the world, and it connected us on a level that only pain can produce. Tears were shed for months until Yochie began to feel some relief.

A year after transition, I debated reaching out to him. Would Yochie appreciate a call? Was he perhaps even waiting for me to call or hurt that I hadn’t reached out yet to see how he was doing? Or would all the anguish Yochie had suffered during our tenure trigger so much shame that he would not be able to face me?

Ruchie, on the other hand, came to therapy to “work out some stuff.” She was impulsive and often tripped up socially because she spoke before she thought. Ruchie grew up in a happy-go-lucky home where inhibitions were not considered a virtue. Chessed was commonplace in her home, which had an “open-house policy”; the neighborhood seemed to converge there as one family. Her husband, however, appreciated boundaries, and she came to me with the goal of becoming more refined. Ruchie talked about how unnatural it felt to inhibit herself and how fun it was to be spontaneous and say whatever came to mind. She and her husband talked these issues through and did well learning to be more mutually sensitive and understanding.

Ruchie was fun and not the overthinker type, and reaching out to “check in” with her would be a no-brainer. But for some reason I didn’t feel as inclined to check in with her, probably because our relationship was more superficial. Upon reflection, the same lack of depth in our relationship that would make it appropriate for me to reach out was precisely why I did not feel a great interest to do so. But in her case, the risk of doing so would have been low.

In Avi’s case I felt more like a father figure who kind of re-raised him after years of neglect. His profile made it almost natural to reach out and check in on his well-being, just as he had shared so much of his personal day-to-day affairs while he was in therapy. Avi’s healing came predominantly from my intense interest in listening to him figure himself out, something that was deeply lacking in his formative years. While we spent most of our time exploring his options in life and empowering him to make independent decisions, we explored little about any deep, dark pain. Our work focused primarily on personal development in areas that others would have gotten from more present primary caregivers. In Avi’s case it felt almost natural to call and say hi, and I was pretty sure he would appreciate it.

Therapists always need to exercise caution with regard to crossing the boundary between meeting our own needs and meeting our clients’ needs. When reaching out to a client, a therapist should be asking themselves, at the very least, the following questions:

  1. What is compelling me to call? Is it my need to find out that I did a good job?
  2. How will it affect the client? Will they feel ashamed, invaded, or grateful?
  3. How will I react if they say they are doing poorly?

All that being said, if your therapist reaches out to you, he or she probably just cares.

Moshe Norman, is a popular Licensed Clinical Social Worker with a private practice in Lakewood, NJ. Moshe is a New Jersey certified supervisor and is the founder and clinical director of Transcend Counseling and Quality Families, LLC. Moshe is the host of the popular "Mondays With Moshe" weekly webinar for mental health professionals He can be reached at 732-806-1399 or by email at mnorman@njqualityfamilies.com . 

 

Pull quotes:

  1. Care must be taken that the therapist be mindful and honest that his or her own needs are not the motive behind the decision to reach out
  2. Would all the anguish Yochie suffered during our tenure trigger so much shame that he would not be able to face me?