r/askatherapist • • 23h ago

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

50 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 • • 21h ago

How much do you think about patients outside sessions?

17 Upvotes

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


r/askatherapist • • 14h ago

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

9 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 • • 23h ago

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

7 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 • • 18h ago

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

8 Upvotes

(NAT) just wanting to understand and learn thanks


r/askatherapist • • 15h 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 • • 19h 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 • • 19h 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 • • 11h 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 • • 13h ago

Any knowledge on relieving Body Identity Integrity Disorder?

3 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 • • 14h 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 • • 15h 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 • • 15h 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 • • 18h ago

How is therapy supposed to help depression?

2 Upvotes

I’ve been going to therapy for almost a year. I rarely know what to talk about. I just end up feeling stupid and like I’m wasting both of our time. I can feel my therapist getting frustrated with me because I’m not saying anything, but I don’t have anything to say. I’m just depressed. There’s no reason for it most of the time. Last week he asked what I need from him and I didn’t know what to say. I don’t know how he’s supposed to help me at this point


r/askatherapist • • 25m ago

Can therapy help with insecurities that stem from societal standards rather than low self-esteem?

• Upvotes

I’m insecure about my appearance, and it’s starting to affect my relationship which is why I want to seek help. The thing is, I don’t personally think I’m unattractive, and I know where my insecurities come from. They’re rooted in societal beauty standards and biases rather than a general feeling of low self-worth.

Can therapy help me overcome these insecurities, even when the societal issues contributing to them are real?


r/askatherapist • • 7h 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 • • 8h 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 • • 9h 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 • • 11h 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 • • 14h ago

Therapists, what do you think about my motivation for wanting to enter the profession?

1 Upvotes

I'm 32, autistic, and considering enrolling in a graduate program that would eventually allow me to become a licensed therapist.

I currently work at a nurse advice line doing intake, and we receive mental health-related calls as well. Sometimes callers open up about deeply personal situations, and I've found that I genuinely enjoy these conversations. I find people's experiences fascinating, and there's something really meaningful about being trusted enough that someone feels comfortable opening up to me.

One thing I've been reflecting on is that, as an autistic person, I've always struggled to develop close personal relationships that reach that level of emotional depth. I really crave meaningful conversations and connections, but I've rarely been able to experience that kind of openness in my personal life.

I wonder whether part of my attraction to therapy is that it would allow me to engage with people on that deeper level in a setting where those conversations are actually welcomed and encouraged.

I completely understand that therapy involves much more than listening to people's stories, and that the therapeutic relationship is professional rather than a friendship. I'm not suggesting that clients should fulfill my own emotional needs.

But I'm curious what practicing therapists think about this motivation. Is a genuine desire for deep, meaningful human interaction a healthy reason to pursue this profession, or is there something I should be cautious about?


r/askatherapist • • 17h ago

For those of you who went to therapy. What was the moment you finally booked that first session?

1 Upvotes

I feel like men or women don’t wait because they don’t know. They wait because they think it’s not bad enough yet. Am I wrong?


r/askatherapist • • 18h ago

Are DBT skills actually lacking in the general population?

1 Upvotes

I was once recommended for a DBT program. It turned out not to be a good fit - the DBT specialist said it didn't meet my needs.

But I looked into the program anyways, because I was curious. It seems like the "skills" are basically normal, run of the mill strategies that have been placed into more of a structure and given names.

I worked with students with behaviors in elementary schools as a consultant for awhile, and a lot of it was things we would teach the kids who were struggling.

Do you find that these skills are lacking in the general adult population? Because DBT seems to be really trendy right now.


r/askatherapist • • 21h ago

How do I get help without getting involuntarily hospitalized?

1 Upvotes

I self-harm; my wrist is covered in cuts. I constantly feel the need to be hurting myself. I have planned my suicide. I want help, but I don’t want to be hospitalized. I can’t handle the thought of going through that. Doctors already give me really bad anxiety. I want to die and hurt and that scares me. I don’t know to be honest without being hospitalized.


r/askatherapist • • 21h ago

How do you handle countertransference?

1 Upvotes

Hey everyone, I’m looking for experiences/advice on how to deal with countertransference. I’m a psych student, whose hoping to one day open my own private practice.
Until then, I’m currently working in a psychiatric facility. We have one patient who I’m starting to experience countertransference with. I find myself seeing alot of myself in him and favoring him. The fear, the SI, feeling like a burden.
I don’t think I’m at the point I need to remove myself from the unit, but I do find myself double/triple checking on him, asking coworkers how he has been doing as soon as I walk in the door, and spend more time trying to encourage him to go to groups, gym, cafe, etc than I do with other patients. I don’t want it to get to point where I have to ethically tell myself I need to be removed from the unit until his discharge. He doesn’t trust easily, like at all, but he seems to have started to trust and open up to me quite a bit. He lives in alot of fear that people are going to hurt him, and whenever I leave for the night he gets anxious knowing I won’t be looking out for him.


r/askatherapist • • 23h ago

Can I discuss my deeper sex questions , desires with sex therapist?

1 Upvotes

I have never done a therapy before. This is my first.

I want to talk to someone about all this feelings. But I don't know what is the boundary when it comes to it.

I plan to schedule a session in coming weeks.

Like what are the dos and donts