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Talking About Therapy

Air Date: 10/24/10 Dr. Rebecca Jankovich, PhD can be reached at 322-1839.9-2-10 Talking about TherapyHow much should you, or must you, talk about your own therapy with a partner, or if you're a kid, with your parent? How much do you ask someone you love how their work in therapy is going? Therapy is such a peculiar process. You pay money to talk with a complete stranger about your most private thoughts and feelings; they're not supposed to tell you what to do or what decisions to make, but isn't that kind of what you're there for? To figure out who you are, what you really want and then try to have the courage to make life choices that allow you to be your best self? If your mate is in therapy, you walk a delicate balance between being interested in what they're discovering and not being prying or controlling. Not an easy balance to strike, especially if you're unhappy in the relationship or you're worried about your partner's emotional health. One way to walk this tightrope is to tell your partner the truth: you want to be supportive and you'd love to know what they're talking about, and at the same time, you understand therapy requires the safety of privacy and you don't want to pry or try to direct what issues are addressed. So, the two of you more or less negotiate how this dance will go between you; maybe you acknowledge there was a therapy session by just asking, "how did it go with Dr. so and so?," and then your partner tells you as little or as much as they want to reveal. If you try to dig and find out if they really told the truth about how much they're drinking, how depressed they are or how verbally abusive they can be, you're likely to get shut out. With kids, it's tricky as well. Ethically, the parent has the right to know what their child tells the therapist and they have the right to read the clinical record of what goes on in therapy. Practically, if the therapist tells the parents everything the child tells them, you can imagine the child isn't likely to tell them any of the difficult material that they should actually be talking about. Little kids don't mind as much if their parents know their secrets; adolescents are vehement that their parents not know what's really going on. Each therapist has a way of navigating their ethical responsibilities with getting a kid to actually talk with them. Typically, the therapist explains to the parents and the child how privacy works in their practice; often the therapist keeps the child's secrets unless the secret is dangerous to the health or safety of the child. With small children, the therapist usually tells the parents specifically what the child is working on in therapy and how the parents can help the child at home. With teenagers, the therapist usually works it out with the teen, what to tell the parents, and the therapist tells the parents so the teen hears what they say, helping the teen build trust in the therapist. All bets are off if the child or teen is in danger the therapist does whatever they must to protect the young person's safety. Don't grill your teenagers about what they talked about in therapy; the interrogation is likely to backfire with your teen clamming up or not talking about the juicy stuff with the therapist. If you're concerned you don't see any progress, ask for a meeting with your teen's therapist. The parents of the teens I see are usually worried their charming kid has conned me into thinking everything is fine when it isn't. We can surely be conned, so it's good to have parents in the feedback loop to provide the therapist with the bad information the teen might be leaving out. Some therapists welcome voice mail messages or emails to give them a heads up as to what's gone wrong in time since they last saw the child. Of course, most mates want to try to direct the issues that are addressed in therapy because they believe they know the most pressing issues by virtue of living with this person and they don't totally trust their partner to tell the therapist the bad stuff. Of course, most mates are curious how their partner is portraying them in therapy, and want to make sure the therapist knows their side of what goes wrong. And as I've said, therapists CAN be conned. Each therapist has their own way of working this out. Some are adamant that the partner not contact them or have anything to do with their client's therapy. Others will meet with the partner just to get their take on things; sometimes they'll have a few sessions with the partners together so the client knows what was discussed and exactly what the therapist said. Others allow for voice mail or email messages for the partner to voice their concerns. As the partner, ask your mate how they feel about you meeting their therapist, and tell them why: you want the therapist to know what you're like, you want them to consider your perspective in what's not working. And if your partner says it's OK, ask them to talk with their therapist about it. The key here is to show interest in your partner or child's therapy without asking too many questions, or telling them what they should really be discussing with their therapist. People resist being told what to do and especially when they're trying to figure themselves out, looking at feelings and thoughts that make them feel weird or uncomfortable. Don't be part of what makes them feel bad, when you're really trying to be part of the solution.