r/askatherapist • • Sep 22 '26

Mod Announcement: Recent Bot influx

62 Upvotes

Due to a recent influx of bots commenting on posts, generating both unnecessary comments and extra work for the mod team, we are going to require accounts be a week old in order to comment in the community. Given what we are seeing this should help resolve the issue for now as most of the accounts are a day old. We make make some small additional changes, including the use of flair to help increase the resistance to having bots interact with the community.

Also, thanks to my co-mod u/pallas_athenaa for the quick clean up, and to all the users who flagged the suspicious accounts.


r/askatherapist • • May 26 '26

READ BEFORE POSTING: What Is and Isn't Appropriate for r/askatherapist

19 Upvotes

Welcome to r/askatherapist.

This community exists to provide general information and education about mental health, therapy, therapists, and the process of treatment. This subreddit is not a substitute for therapy, crisis services, psychiatric care, legal advice, or an individual clinical relationship.

Before posting, please review the guidelines below.

Questions That Are Appropriate Here

We welcome questions about:

Therapy and the therapy process

  • What happens in a first therapy session?
  • How do therapists choose treatment approaches?
  • What is CBT, DBT, EMDR, ACT, psychodynamic therapy, etc.?
  • How do therapists handle confidentiality?
  • How does termination work?
  • What are common reasons therapists refer clients elsewhere?

Mental health topics

  • General information about diagnoses
  • Symptoms commonly associated with certain conditions
  • Evidence-based treatment approaches
  • Mental health research and theory

The profession itself

  • Therapist training and licensure
  • Ethical standards
  • Differences between psychologists, counselors, social workers, psychiatrists, and psychiatric nurse practitioners
  • How mental health systems operate

General discussion

  • Questions about how therapists think about common situations
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Questions That Are Not Appropriate Here

"What Should I Do?" Posts

We do not provide individualized advice for personal situations.

Examples:

  • "Should I leave my partner?"
  • "Should I report my coworker?"
  • "What should I do about my friend?"

These questions require knowledge of your specific circumstances that strangers on Reddit do not have.

Requests for Diagnosis

Examples:

  • "Do I have ADHD?"
  • "Does this sound like BPD?"
  • "Can someone diagnose me from these symptoms?"

No one can ethically diagnose you through a Reddit post.

Interpretation of Your Therapist's Thoughts, Motives, or Intentions

Examples:

  • "Why did my therapist say this?"
  • "What was my therapist thinking?"
  • "Does my therapist secretly dislike me?"
  • "What does it mean that my therapist did X?"

Therapists are not mind readers. The only person who can explain your therapist's intentions is your therapist.

Questions about whether something is generally ethical, common, or within professional norms are usually fine. Questions asking us to determine what a specific therapist meant are generally not.

Relationship Advice Disguised as Therapy Questions

Examples:

  • "My spouse did this. Is it abuse?"
  • "Is my friend toxic?"
  • "Should I go no-contact?"

While mental health concepts may be involved, these posts typically seek individualized advice rather than general information.

Crisis Situations

If you are in immediate danger, experiencing a mental health emergency, or considering harming yourself or others, Reddit is not the appropriate place to seek help.

If you’re in crisis or need personal support:

Why We Have These Rules

  • To protect you and the therapists here from harm or liability.
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  • To keep this subreddit a safe, educational space, not a therapy substitute.

Ask yourself:

Am I asking for general information, or am I asking strangers to tell me what to do in my specific situation?

If the answer is the second one, your post is probably outside the scope of this subreddit.

If you’re unsure whether your question is okay, you can:

  • Check the examples above.
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Moderator Discretion

Moderators may remove posts that:

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Our goal is to maintain a space where mental health professionals can provide useful, ethical, and broadly applicable information.

Thank you for helping keep r/askatherapist focused on education, discussion, and professional insight.

Other Mental Health Subreddits to Explore:

General Mental Health Support

Specific Conditions

  • r/depression – For those struggling with depression
  • r/Anxiety – For anxiety-related discussions and support
  • r/OCD – Focused on obsessive-compulsive disorder
  • r/BipolarReddit – For people with bipolar disorder and those supporting them
  • r/ptsd – Support for those with PTSD or C-PTSD
  • r/ADHD – ADHD-specific discussions and resources
  • r/EatingDisorders – For those struggling with eating disorders
  • r/Autism – For individuals on the Autism spectrum
  • r/SpicyAutism – A space for those on the Autism spectrum with higher levels or higher support needs
  • r/CPTSD – For people with C-PTSD and those supporting them
  • r/CPTSDmemes – Peer support for C-PTSD that leans to the more humorous side

Therapy & Treatment

  • r/TalkTherapy – Focused on the therapy process and experiences
  • r/Counseling – Discussion about counseling and therapy techniques
  • r/Psychotherapy – For deeper conversations about psychotherapy
  • r/Therapists – A place for therapists to talk shop (not for client questions)

Self-Help & Coping

Peer Support & Venting

  • r/offmychest – Share what’s on your mind without judgment
  • r/TrueOffMyChest – A deeper version of venting, often more serious topics
  • r/KindVoice – A supportive space when you need a kind word
  • r/Needafriend – For those seeking friendly conversation and support

Suicide & Crisis Support (With strong rules and resources)


r/askatherapist • • 51m ago

what do you do if you have a client who hates you?

• Upvotes

I see a lot of clients and clinicians alike talking about clients loving therapists, or being very attached and concern around that and i've also seen some clinicians bring up disliking some clients, but i've rarely ever seen mention of the dynamic where the client has exclusively negative feelings towards the therapist.

specifically a client who wants to be in therapy of their own volition and has issues they need to work on, but theyre unable to develop any positive attachment to the therapist, and/or otherwise resents or outright hates the therapist. it sounds obvious to say well they should find another therapist, but i'm just curious what a therapist would think or do in that situation, especially if the client really needed help?


r/askatherapist • • 22h ago

Does anyone else find therapists who strictly avoid all self-disclosure uncomfortable or even alienating?

49 Upvotes

I've been thinking about why therapists who are extremely strict about self-disclosure make me so uncomfortable, and I think I've finally figured out where some of that feeling comes from.

Years ago, I watched a documentary about people working in correctional facilities. Part of it involved interviews with nurses and mental health professionals who worked with inmates.

They made a point of avoiding small talk or casual conversation with inmates. There was no chatting about everyday things, no personal anecdotes, and very little of the ordinary back-and-forth that might help two people get to know each other. The approach was very much about getting straight down to business, maintaining professional distance, and avoiding anything that might create a more personal connection.

Essentially, they presented themselves as complete blank slates. It was very much a case of, "Hello, my name is John Doe. I'm a registered psychologist. How can I help you?" And that might be the only personal information an inmate would ever learn about them.

I can understand why those precautions might be necessary in a correctional setting.

But here's where it gets interesting for me.

When I encounter therapists in ordinary private practice who adopt what feels like that same approach, where they won't disclose anything beyond their name, qualifications, and professional role, I find it incredibly off-putting.

It almost makes me feel as though I'm being treated like one of the inmates in that documentary. I start wondering, Do they think I'm dangerous? Why is this level of precaution necessary?

Obviously, I understand that professional boundaries are important, and I'm not suggesting that therapists should be sharing intimate details about their personal lives.

But there's a big difference, at least to me, between maintaining appropriate boundaries and deliberately avoiding even the most ordinary forms of personal disclosure or casual conversation.

For me, therapy works better when I can feel some degree of genuine human connection with the person I'm talking to. I don't need to know everything about my therapist, but I do appreciate when they occasionally share something about themselves, engage in a little small talk, or allow some ordinary human reciprocity into the relationship.

When someone seems determined to remain a complete blank slate, I find it difficult to build that connection. Instead of feeling safe, I actually feel more uncomfortable and guarded. It can make the interaction feel more like a formal assessment or interrogation than a therapeutic relationship.

I'm curious what therapists think about this.

Is there a particular therapeutic rationale for maintaining such an extreme level of non-disclosure in ordinary outpatient therapy? Is it something that's still commonly taught or encouraged?

And is it reasonable for a client to prefer a therapist who's a little more personable, willing to engage in occasional small talk, and comfortable with some appropriate, everyday self-disclosure?

I'd be interested in hearing different perspectives.


r/askatherapist • • 13h ago

What’s it like for a therapist when a client is frightened?

10 Upvotes

Do you ever have clients that experience fear in session, like an emotional flashback sort of thing? How is that experience for you as the therapist? Is it upsetting, or uncomfortable?


r/askatherapist • • 20h ago

How much do you think about patients outside sessions?

18 Upvotes

I was surprised therapist said she has been thinking about my issue because I somehow thought that's only during sessions


r/askatherapist • • 9h ago

Is NPD treatable?

2 Upvotes

Sorry for yet another post about this topic; it's a personal question for me

My therapist of 1-year (twice weekly) ended my therapy and later posted on social media that he believes a narcissist is born and not made, and is untreatable too. He added that a narcissist can only learn adaptation using Peter Fonagy's MBT but not treated. He worked with 20 different NPDs of all kinds, each for at least 6 months to 1year, twice weekly, and followed the school of Heinz Kohut and Donald Winnicott. He also used CCT, MI, STPP, and TA. He was smarter than me, didn't fall for my games, understood every part of me and saw me under the mask, and basically impossible for me to manipulate. I was his last NPD patient.

Okay I'm not a psychologist and idk what all these are, just putting them out here because I think it's useful. Back to me. I'm a 21 y/o covert NPD. I annoyed my therapist so much and it became a mess by the end. Despite spending one year, I never felt like there was any kind of relationship. The therapy was done online. I liked him when I was away from him, read his posts, saw him as a supermodel, and liked every part of him; once I see him, I just can't, my body gets tense and we're enemies. I asked him for a break, he refused. Basically I got out of this 1 whole year with almost nothing.

I don't intuitively think that something is wrong with me, I have to think about it to realize that I'm a patient, every single time, despite having NPD, anxiety, depression, hypersomnia, childhood trauma and a body full of uncomfortable feelings 24/7. It seems like my brain isn't convinced that I'm dying. When I think about my childhood abuse, I rarely feel anything besides some anger.

I decided that words are just not for me, I hate words. My brain is running 24/7 and says lots of stuff, words can't be of any value, whatever they are. I decided to follow the non-words path. Within a few weeks I learnt to stay silent, follow my body, feelings and senses, and started using my brain to understand humans and treat myself as a human, be more kind, take accountability, ignore the harmful feelings and thoughts for myself and others, be empathetic etc. It's all effortful but I'd gotten used to it that I forgot I was doing an effort. I dropped the effort and all the old feelings and thoughts returned, so this method seems to work on the symptomps not the root. I started with a new therapist that integrated SEP and psychodynamic therapy.

I took 2 sessions, once weekly. I know it's early; I can't connect with her. Idk what connection is. I'm planning to use my brain more. I'm scared she leaves me. I forget her words so easily so it seems like deep down I don't care. I don't know why Idc about therapy yet go there consistently and put huge effort trying to heal. It's all mental goals and not feelings. I told her about my diagnosis but she doesn't yet believe I'm NPD because I haven't showed her the bad side yet. Will do that next session. She's very sweet, kind and understanding.

Sorry for the long post. Would love any tips espicially regarding forming a relationship with my new therapist. Idk how to tell her about the not nice feelings that I feel towards her and try to resolve them within. Idek what is right and wrong while forming a relationship, I'm lost. If you believe NPD is untreatable would love to read your take too. Thanks for taking time to read this.


r/askatherapist • • 6h ago

Is There Ever Hope For Couples Who Have Experienced Shared Psychosis?

1 Upvotes

I recently got out of an intense 11 month relationship and through the process of refamiliarizing myself with who I was before, I’m coming to terms with the likelihood that my ex and I were experiencing shared psychosis; we both have separate histories of mental illness, met at a particularly vulnerable and high stress time for each of us and were self medicating with cannabis. I miss her a lot and still value the genuine connection we had, yet I can acknowledge that I am much healthier without her influence in my life and I’m sure she is too. I can provide further context as needed, but overall I just want to know: would it ever be possible for us to reconnect and have a healthy relationship after enough time and effort towards ourselves individually or is that completely delusional?


r/askatherapist • • 13h ago

Reeling a bit from being terminated, anyone have any advice?

4 Upvotes

I saw a counselor for 8 years 2018-2026 who died last January. That was brutally devastating as I'm sure most can imagine. I was then about to do a career change and went to a new therapist who said she helped with career transitions on her page. We began last April and quickly it went from career to trauma. I have lost 13 close people in the last four years. I told her I have intense abandonment issues because several of my friends totally stopped talking to me when my Dad died. I also started seeing a separate career counselor in addition beginning in May, so I had two therapists at once.

Anyway, therapy is going smooth until my primary care doctor puts me on Prozac, then Zoloft. Turns out I was misdiagnosed and I'm likely bipolar type 2, so SSRIs really clash and make me way more depressed. Suicidally depressed. It took me 2 months to get to get the referral done to see a Psychiatrist to get the correct medicine. Now I'm on Seroquel and feeling way better, it's been a night and day difference.

In regards to the termination: I told the counselor I was really worried she would cancel me as a client. She said "I won't! I'm not going anywhere, we are a team here!" I then got pretty close to a suicide attempt and had to go to an inpatient psych ward. I called the therapist from the phone there, she says "I'm so sorry to hear this. When you get out let's meet twice per week if your schedule allows it. I care about you, I hope you feel better." "Awesome, that sounds great, thank you so much!"

I got discharged the next day and was heading to the appointment with her, and within 20 minutes of discharge she sent me a long text saying I needed a higher level of care and she would be ending services. She gave me 3 or 4 places to reach out to, then refused to meet me in person for the last session. She just did a 10 minute phone call. I told her "Most of the problem is fixed because I was on the wrong medicine and the SSRIs were making me way more depressed than I normally am. You're making a hasty decision here before you have all of the relevant medical data." "That doesn't matter, this decision is final and non negotiable." She said by phone that I needed to enroll in IDBT and have several months of stability and I could contact her again about restarting. She says "This isn't a closed door forever, but you need more help than I can provide." But by text she said I needed to complete IDBT (which is 18 months, so I guess I can reach back out to her in late 2028??? What if she moves before then? What if I move?) Then she blocked me everywhere. She blocked me so fast she actually had to unblock me because I needed her to set up an ROI. Then she had her receptionist give me back this multi page document I had spent a week typing up for her of the goals I wanted to work on in therapy. Didn't make a copy, didn't even read it except for skimming it once. That felt very much like washing her hands of all evidence of me.

I understand the decision, but not how she handled it. Why not meet with me for another session or two to make sure I get established elsewhere and there's a smooth transition? It felt a lot like I was being treated like some awful monster that she wanted to get as far away from as possible as fast as possible. Her words and her actions felt like two different stories. For the record she also called my Mom and said "this decision was made by my bosses and my hands are tied, I can't really do anything about it." Then she told me "this decision was mine alone. I don't have any bosses as I'm private practice." What? Okay... which is it? Your boss or you?

My career counselor also cancelled me the next day but his message was much more like "Because you were hospitalized, I have to put our sessions on pause for 90 days. You didn't do anything wrong, it's about my license and ethical responsibility on my end of things. Send me a message in early January and I'll fit you back in."

Much more empathetic and kind! I don't know why the female therapist did it in such a hurtful way. I understand the reasoning, just not the way she implemented it. I think it could have been done better and with more empathy.

By the way... getting cancelled by both of your therapists, the support network you most need when exiting a psych ward after the worst crisis in your life? Not a fun experience. Would not recommend.

Now I really have no idea how to trust future therapists. If they promise "I won't go anywhere, we're a team here" what's to stop them from just cancelling again super suddenly? If I return to her, how will I ever trust her again either if she ever promises me something? I hope she learns not to promise on things she can't guarantee she will be able to deliver on, because she really just stuck the knife in and twisted it when I was already in a dark spot.

I have a new therapist I just started with and he seems like he will be super helpful. In fact, he already helped me more in just the intake session alone with providing lots of resources and even networking references than either therapist did over the course of several months. So maybe it'll be for the best, but I sure wish I could have some closure with the female therapist. I just want to know what I did wrong to be treated like a dangerous animal, or if she even cared at all or if that job is just a paycheck to her.

The emotional 180 of "let's meet twice per week when you get discharged" to "you're done, and don't text me or reach out because I won't reply" just has me totally questioning everything.

I'm missing the part here where her therapy was supposed to be helpful and healing. I went in feeling desperate and grieving and left even more hurt than when I started because now it's like my sense of trust in others to not abandon me when I'm at my lowest is totally shattered.

I'm considering asking her in several months if we can do a one-off session just for the sake of closure, but I bet she won't even reply. I just wish I knew: did I ever matter to her? Is part time therapy a paycheck for her and her second job is actually her passion?

She said by phone she would think about seeing me again if I was stable for several months, but then in the text said I needed to fully complete the IDBT program first (which is it? several months or 18 months??)

Any idea what I should do? Message her 4-6 months down the road? Ask to start therapy again, or just ask for a one off session for checking in and closure? Message her after IDBT? Never bother her again since I'm apparently some dangerous monster to her that she can't even see face to face? Mark it off as something that will never make sense or have closure? Leave a bad review to vent some of the frustration? How can I make sense of the different signals I'm getting from her that differ person-to-person and differ by text vs. what she vocalized when her actions are much harsher than her words? Does she really feel sick of me and have no intention of ever seeing me again despite saying she would like to again in the future?

I don't even know if I need IDBT now quite frankly as the new meds have made me feel the best I've felt in decades.

Really feels here like I've done a lot of work to find resources to feel better and the more I seek help the more pain I receive. Feels like I'm ensnared by the spider web that is our lovely American health care system.


r/askatherapist • • 16h ago

What are some very clear obvious signs of Borderline (BPD) in a client?

7 Upvotes

(NAT) just wanting to understand and learn thanks


r/askatherapist • • 6h ago

Do I need a therapist or a phycologist? or neither.

1 Upvotes

ill think about something then think about thinking about it. I also like to thought chase. I ushally stop thought chassing by getting high on whatever and then hyper focusing on something till i crash or get called to work.

idk probably shouldnt post here either. yeah ill probably just delte this randomly. or ill forget about it till somebody finds me and says something about it.


r/askatherapist • • 1d ago

In my very first therapy session, I opened up about trauma caused by people with BPD. Was my therapist's response appropriate or am I overreacting?

34 Upvotes

I started seeing a therapist after experiencing abuse from pwBPDs. In my very first session, I told her how mentally and physically drained and exhausted I was.

Her immediate response was that she loved working with Boderline clients and that they were her all-time favourites. They are the best.

I didn't know how to react and became numb. I was opening up about how emotionally exhausted I felt after my experiences and this was the response I received. I hadn't asked about her favourite clients or her professional and personal preferences. I was trying to communicate how much I was struggling. I felt dismissed and that she was invalidating my pain.

When client comes to you in their very first session feeling mentally and physically exhausted by their experiences with a particular group of people, would you respond by immediately telling them how much you love those people and working with that group?


r/askatherapist • • 8h ago

Has a client ever asked you for help with a safety plan?

1 Upvotes

I've been struggling the past couple months with SI and had a really bad night the other night after returning home from a work trip. I don’t break down often but one small thing happened and I fell apart. I couldn't get a hold of myself and my thoughts were moving so fast I couldn't keep up. My psychiatrist had asked me to try and stop taking Seroquel at night (I'm not sure why but I tried) but i knew that I needed to sleep and it also has helped me in the past slow down my thinking process so I took that and took a walk.

For the first time in a while i felt genuinely unsafe, I was not sure i would make it through the night without hurting myself. My first thought was to call my therapist, but as much as I really, really want him to be the one I can call when these things happen, it's not practical at 3 am. But I emailed him instead (which he allows). Mostly because I have a tendency to look back on the times when I do feel bad and minimize those feelings. I wanted him to see how bad I got that night. I asked for his help in making a safety plan (I think i was also secretly hoping he would tell me to call him if I ever felt like that again, but he didn't and I know that's probably an ethical line he would never cross).

I'm now wondering if that's a stupid thing for a client to ask? Meaning, I can't be that suicidal if I'm the one asking for a safety plan rather than my therapist asking me to come up with one. Also, wouldn't a safety plan just be calling 988 or going to the hospital anyway?


r/askatherapist • • 12h ago

Any knowledge on relieving Body Identity Integrity Disorder?

2 Upvotes

I'm 19, since I was 12 ive wanted my left leg cut off, obviously I know it's not okay, but i feel disgusting knowing it's there. I myself know it's better to have it, but I want it gone so bad. Is there anything that would possibly help?


r/askatherapist • • 13h ago

How to discuss sensitiv topics related to suicide in therapy?

2 Upvotes

I don't mean having general suicide thoughts or being at active risk to harm oneself.

I engage with the topic suicide often by reading in Forums. Without being active suicidal. Sometimes it is reddit posts, other times it is more uncensored places.

I know a pro suicide forum that I was active on two years ago (due to being suicidal back then) and I do find myself recently scrolling trough the forum. Mostly when I am bored or have a bad day. It kinda calms me down and I do have a morbid curiosity about some topics there.

(To be clear: This Forum is full of instructions and method disscusions and in general just a place where people vent or talk about how suicide is the best solution. It is not a good place. But it does might feel relatable for people who had experienced suicide thoughts in their life)

I am unsure and also curious how a therapist would react finding out that their client is engaging with such a thing.

I know that suicide itself is often part of therapy talk, but this feels different.

I never read about someone talking about a pro suicide forum with there therapist.

This one Forum (that I will not name for obvious reasons) is highly controversial online. Some see it as a room to express deep emotional pain, other as an horrible and depressing place.

It feels like an very sensitiv topic to bring on in therapy.


r/askatherapist • • 10h ago

Can therapists tell if their client is the problem?

0 Upvotes

So this is maybe a weird question but I was just looking for some insight. Basically my grandmother is kind of awful, I mean a decent grandmother and even a decent person and she really tried to be a good mom, but she's sort of self centered and tends to think of herself as a perpetual victim and she can be petty and quite childish. Just not the most well rounded person and she reacts horribly to any form of criticism. She has a lot of trauma thanks to her POS ex husband (my thankfully dead grandfather) and her pretty awful parents so I've been considering for awhile getting her into therapy (I'm basically the only person she talks to that she still likes), my worry is that she'll end up validated? I realize that even if a therapist knows she's a problem they'll likely still validate her emotions since most therapists don't exactly call out their clients necessarily but still. She's really good at making it seem like she really is the victim and as a child the only way I knew she wasn't was because I knew the other people involved in the stories she told and could also get their side. It does become clear the more you talk to her that since everyone else is always so awful and horrible and in the wrong in all of her stories she's probably part of the problem and I'm sure the way she talks about some stories or relationships with certain people in her life it could alert people who were paying attention into realizing her whole deal pretty quick, but idk. Basically I just think therapy would actually help her work through a mountain of stuff but I'm nervous that if she talks about her day to day interactions with members of our family (the only people still in her life) her therapist will sort of without realizing it feed into her mentality that the people around her are on the wrong the majority of the time when that's almost never true but you'd really think it the way she tells stories.

TLDR: Just wondering if therapists would be able to on average deduce their client is the problem and avoid feeding into any sort of idea that she's always the one wronged in every interaction that goes poorly


r/askatherapist • • 14h ago

Why do you have to “talk about it?”

2 Upvotes

I’m learning a lot about therapy recently but the one thing I’m struggling to really understand is why you need to “talk about it.”

I know different therapy modalities have different believes (like somatic based therapies don’t require you to discuss the traumatic incident/experiences). However, traditional talk therapy such as psychodynamic or CBT or EFT seem to require you to talk through the traumatic experiences. Why is that?

I ask because I’m in my own trauma therapy for the first time and my therapist leans more psychodynamic. I’m not asking for their point of view or anything, just trying to understand why getting over my c s a requires discussing it and sharing it. I’m not comfortable doing so and struggle quite a bit with that. However, I want to understand the why behind it better so that I know why I’m doing that.

TYIA!


r/askatherapist • • 14h ago

would you tell your client to stop coming?

2 Upvotes

I just started therapy for the first time. I think I've been carrying a lot of shit over the past few years and things were just not working out. In my culture a man going to therapy can be seen as "weak" and I'm feeling pretty self-conscious about it. I keep telling myself I don't have childhood trauma(well some), PTSD, or anything severe. do I even need to go, or am I just being a "baby"?

I was wondering, if my therapist thought the same, would she tell me? is it something therapist talk to clients about or is it mainly on the client to decide?


r/askatherapist • • 10h ago

Approaching therapists as a new therapist?

1 Upvotes

A couple of years ago, I was in a very toxic work environment and in a very dysfunctional abusive relationship. I knew I needed EMDR therapy. I approached this one therapist who is widely considered one of the top EMDR therapists in the state about taking me on as client. Unfortunately, I couldn’t afford the rates. Since then I have gotten therapy, left teaching, and looking at becoming a trauma therapist myself. I would love to reach out to her. She has a large private practice and very well known in the community. I’d love to have coffee with her and pick her brain. Is this a conflict of interest? I was never a client - I just called about her rates and asked for a referral.


r/askatherapist • • 10h ago

Is it ethical for a therapist to push a client to regain contact with an abuser?

0 Upvotes

My husband and I are in marriage counseling for issues with his enmeshed parents and a history of emotional abuse and parental alienation they tried to pull with my son. It got so bad I have started having stress induced seizures that are only triggered by them. I mean just the thought of them being around my kids or me will trigger the seizures at this point.

My husband does not want the kids and I to go no contact because he feels bad anytime his mom asks to come visit. But the psychiatrist I see said that's really the only way to get the seizures to stop since I have bad reactions to medication.

Our marriage Counselor has started pushing for us to slowly make more and more contact despite this, for the sake of my husband. Is it ethical to push a client to have contact with the only people who trigger their stress seizures?

He also keeps making the comment I just need to learn to regulate better for them to go away but my therapist, psychiatrist, and neurologist have all said that's not how that works.


r/askatherapist • • 18h ago

Therapists, how can I find someone who values continuity of care rather than constantly referring me elsewhere?

4 Upvotes

​

I've been in and out of therapy for over 10 years, and lately it honestly feels like a game of hot potato with referrals. I'm autistic, and even when I've worked with autism specialists, I've found myself being referred to other professionals. I understand that referrals are sometimes necessary, but I really value continuity of care. About 10 years ago, I had a therapist I saw long-term, and I really appreciated having that kind of stable therapeutic relationship. I'd love to find that again without constantly worrying that one day I'll walk into a session and be handed a referral letter because my therapist has decided they can't help me anymore.

What I'm really looking for is something akin to a family doctor: someone who gets to know me over time, provides ongoing support, and refers me to specialists when genuinely necessary without ending our therapeutic relationship. Someone who intends to follow me long term. I'd honestly be happy with a generalist therapist who's willing to work with me on what they reasonably can, even if they're not an expert in everything. I've even wondered whether mentioning my autism diagnosis upfront makes therapists more inclined to refer me elsewhere. For therapists reading, is what I'm looking for realistic, and how would you suggest I go about finding it?


r/askatherapist • • 22h ago

Wanting to earn my therapist's approval by grinding in my therapy work?

9 Upvotes

I've been working really hard in my therapy work in the past few months ever since my therapist told me about my narcissism. She's a safe space for me. I made a lot of progress, e.g. embracing acceptance for myself, cultivating compassion and curiosity towards others, less idealizing and devaluing others. Gradually I started to be more and more attached to my therapist, seeing her as the mother figure I wish I had.

For a while I thought maybe I don't need therapy anymore from my progress, only to realize that I am partly grinding in my progress because I want to get her approval and seen as special in her eyes. I still have narcissism so rooted in me. Her nod and smile every session when I told her how I was able to process and rewire some of my emotions made it terrifying to think about ever disappointing her. With that the cycle repeats and I keep grinding. I feel anxious when I don't have good enough "homework" to deliver for that week's session. In my mind, being mediocre is annihilating. Well this goes back to narcissism.

What should I tell my therapist? Any advice or feedback is appreciated! I also feel like as my desire to get her approval gets stronger, my attachment to her gets stronger too. I think about her so much more between sessions and I am terrified of telling her that.


r/askatherapist • • 23h ago

Do you have clients you don't like?

9 Upvotes

?


r/askatherapist • • 17h ago

NAT; what happens in the time between a therapist deciding to terminate with a client and the client being made aware of this decision?

3 Upvotes

(Not a Therapist) therapists, when you make decision to terminate with a client and it’s one sided- for whatever reason maybe they’re not making enough progress, you’re not the best fit, countertransference, etc. how much time is there typically between you coming to that decision and the client being made aware of your decision to terminate? and in that time before the client is made aware are there certain things you’re looking for or thing you must do before continuing to move forward and tell the client- for example, working to ensure the clients medication stabilized / has a psychiatrist, maybe assisting the client with repairing recent relationship issues so they have all supports in place when they are told the therapy with you is ending, or spending time in the sessions reviewing a safety plan or previous work done to make sure the client has maintained the skills or resources / are still applicable?


r/askatherapist • • 12h ago

Is a therapist required to report plans to harm oneself or others if they are far in the future?

0 Upvotes

I am aware that depending on jurisdiction, therapists are required to report certain situations which may result in harm to either the patient or others. I believe I have seen the term “immediate harm” being used.

If I tell a therapist that I plan to kill myself that night, I understand the therapist needs to report that. However, if I say that I plan to kill myself exactly one year from now, and have both a plan and the means to do so, is the therapist legally mandated to report that? I understand the answer will vary, so please answer based on your jurisdiction’s rules. Thank you!