Is "In Treatment" Really What Happens in Therapy?

People have asked me this often in the past few weeks. If you've been watching HBO's new series, "In Treatment," you would see a therapist go through the following:

Reciprocating romantic feelings for a client.
Having a client fall in love with another client.
Get into a physical altercation with another client.
Have a teenager attempt suicide in the office.
Go to their own supervisor for personal therapy.

Plus so much more!

In truth, therapists do have struggles and difficult clients, but since 1999, when I began working with clients, I have never experienced most of these issues, as well as practically all the therapists I personally know and affiliate with.

Do clients form romantic feelings for therapists? It can happen, and does happen to most therapists at one time or another. It's a process clients go through when the therapist has proved a safe, nurturing environment for the client to be able to work through their pain and begin to heal. That process is so strong, that a client's feelings may be misconstrued as romantic feelings. A competent therapist recognizes these feelings and uses this interaction to further process the healing.

In general, therapists don't fall in love with their clients (although it has been known to happen), therapists don't push their clients into bookcases, and don't have client attempt suicide in their office. This television show has some wonderful acting and some great moments that draw the viewer in, but remember, it's ultimately a TV show!

If you have seen it and have concerns, please post them! We can address them here!

Can I Be Friends with my Therapist?

Many people seek counseling due to some sort of crisis within their lives. They seek out someone neutral, objective, like a counselor, because their family and friends provide advice based on emotions and the connection with the person.

Once in counseling, you may start to have feelings for your therapist. This is very common. You start to feel like you really could like being friends with them. You feel like the therapist understands you and really listens to you. They may laugh with you n sessions, they allow you to cry when you need to. They accept you for where you're at. As a result, you may want to see your therapist over lunch, at a coffee shop, etc.

The California Association of Marriage & Family Therapists (CAMFT) establishes the Code of Ethics. They state, therapists should not engage "in a close personal relationship with a patient" as it may skew the therapy. Is this person now your friend or your therapist? How do they maintain that professionalism? Are you now paying your therapist or a good friend to help you? It can all become confusing and counterproductive.

Another issue is your relationship wasn't based on the makings of a friendship. Counseling is a business transaction with personal impacts. How much do you know about your therapist, really? Friendships are struck based on commonalities, such as interests, likes/dislikes, and personal experiences. How much of these things do you know about your therapist? Probably not as much as you think. Therapists don't disclose too much about themselves during your sessions. They can be likable people, but it doesn't mean you know that much of their lives outside the office.

CAMFT recommends a 2-year waiting rule to be extended to all types of relationships with clients, including friendships. There are several reasons for this. First, you may decide to return shortly after ending the therapy, which is common. Second, there is a belief that if a client and therapist want to engage in a relationship (friendship or otherwise) outside the therapy, 2-years to determine if a friendship could really sustain beyond the parameters of therapy.

If you have additional thoughts about becoming friends with your therapist, I recommend to discuss this directly with your therapist. It would be a good process for you in figuring out what characteristics you need for friendships as well as keeping the therapist in their role and allowing them to do their job...to provide you with a safe, valuable service.

Wanting More From Your Counselor

Counseling is a very interesting process. You come in spilling your guts to another person who is practically a stranger. You tell them things you've never told anyone else. You may have broken down in tears when you're upset, or maybe have turned to them when you're feeling like you're at your lowest point. And all this time, they've never judged you or shamed you...just provided the support and guidance you needed to get through these rough times.

Suddenly, you may find you are having feelings towards this person. You may want to become friends with them or even closer...maybe even have feelings of love. So what's the problem?

If your counselor is true to your therapy, they cannot reciprocate your feelings. It's understandable you would have such strong feelings for your counselor. You have put your trust in them and become vulnerable during some difficult times. For your counselor to share your feelings could have detrimental effects. They will not be able to maintain the objectivity, which you sought out in the first place. Counseling is a professional relationship which can sometimes feel very personal. However, it isn't personal. Do you pay your friends and family to talk to you? Probably not.

Your counselor is trained to deal with these issues. They can help you process your feelings in a positive way. However, if your feelings begin to overtake the therapy, your counselor may recommend (as a last resort) to transfer your therapy to another counselor, who can continue the work. Although this can feel like rejection, the counselor is really doing what is in your best interest. They want to see you succeed in life, and will not be able to help you achieve this if they are personally involved in your life.