Therapists Are Not Robots: How We Can Show Humanity in the Room

Curt and Katie discuss how big life events (a big diagnosis, a huge personal loss, injuries and medical conditions) can show up in the room. We explore how much humanity is okay to share with our clients. How do we decide what we tell our clients (and how do we manage their reactions)? We also look at how we take care of ourselves while also taking care of our clients. Therapists aren’t robots, but we certainly need to be aware of our clients when life happens.

Transcript

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In this podcast episode we talk about appropriate self-disclosure practices for modern therapists going through life events

As therapists it’s important that we hold a professional exterior during therapy. But can it be helpful to share with clients the big moments in our lives? How can we be human in the room?

What are some considerations for therapists when deciding to self-disclose?

  • Showing your humanity can help bond a client with the therapist.
  • Self-disclosure may be different for planned or unplanned life events and whether they come into the room or private/hidden and in the background of your life
  • Deciding when and whether to tell clients
  • Clients often will use the therapist as an example on how to handle big life events.
  • Not all settings are appropriate for therapist disclosure.
  • Clients do not have the same confidentiality requirements as therapists; if you self-disclose to a client, it could be known by others or other treatment team members.
  • In self-disclosing, the therapist will need to process the disclosure with the client.
  • Processing difficult personal material with multiple clients could be difficult for the therapist.
  • How much you disclose will depend on the client, but you might share more with a long-term client than a newer client.

“In evaluating both the psychotherapy relationship and the actual relationship you have; I’d guess you’d probably be looking at some of the clients and how long you working with them as a part of the decision-making process. If it’s a brand-new client, it’s probably not a great thing to say ‘hey I’m going through this super emotional and vulnerable thing on my own right now.’  It’s a lot different if this is a long-term client you’ve been with for several years”
– Curt Widhalm

Are there ethical considerations for therapists sharing about our lives?

  • There are no BBS outlined ethical considerations for sharing personal disclosures in therapy.
  • The therapeutic environment should encourage a client to question the therapist.
  • The therapeutic environment should encourage clients to participate in self-advocacy.
  • Remember that certain self-disclosures might be triggering for clients; be mindful of what you share with who.
  • Document all ruptures in relationships in your note and what you did to help heal the rupture.
  • Be mindful – clients could be retraumatized or try to care take after a therapist’s disclosure.
  • Not all clients need to know everything; know your population.

“We harm the client if we don’t acknowledge, we don’t apologize, we don’t repair. If we try to pretend something didn’t happen, that’s where we can get into trouble and that’s when we get in trouble.” – Katie Vernoy

What should new counselors and therapists know?

  • Therapists are human! Life will continue to affect you even while working.
  • It is important for therapists to take time off when they need it.
  • Ruptures in the therapeutic relationship will happen; it’s all about how you handle it.
  • New counselors often want hard rules for how to act, but it gets easier with experience.
  • The most damage happens from not acknowledging or apologizing for ruptures.
  • When ruptures occur, be honest and accountable to your clients.
  • Sharing our human moments with clients can create a deeper and richer relationship.
  • Don’t forget you don’t have to do this alone – always consult if unsure on disclosures!

Our Generous Sponsors for this episode of the Modern Therapist’s Survival Guide:

Thrizer

Thrizer is a new modern billing platform for therapists that was built on the belief that therapy should be accessible AND clinicians should earn what they are worth. Their platform automatically gets clients reimbursed by their insurance after every session. Just by billing your clients through Thrizer, you can potentially save them hundreds every month, with no extra work on your end. Every time you bill a client through Thrizer, an insurance claim is automatically generated and sent directly to the client’s insurance. From there, Thrizer provides concierge support to ensure clients get their reimbursement quickly, directly into their bank account. By eliminating reimbursement by check, confusion around benefits, and obscurity with reimbursement status, they allow your clients to focus on what actually matters rather than worrying about their money. It is very quick to get set up and it works great in complement with EHR systems. Their team is super helpful and responsive, and the founder is actually a long-time therapy client who grew frustrated with his reimbursement times. The best part is you don’t need to give up your rate. They charge a standard 3% payment processing fee!

Thrizer lets you become more accessible while remaining in complete control of your practice. A better experience for your clients during therapy means higher retention. Money won’t be the reason they quit on therapy. Sign up using bit.ly/moderntherapists if you want to test Thrizer completely risk free! Sign up for Thrizer with code ‘moderntherapists’ for 1 month of no credit card fees or payment processing fees! That’s right – you will get one month of no payment processing fees, meaning you earn 100% of your cash rate during that time!

Melissa Forziat Events & Marketing

Today’s episode of The Therapy Reimagined podcast is brought to you by Melissa Forziat Events & Marketing. Melissa is a small business marketing expert who specializes in marketing advice for businesses that have limited resources.

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How to Win at Social Media is packed full of information. Usually a course as detailed as this would be priced in the thousands, but to make it accessible to small businesses, it is available for only $247.  PLUS, as a listener of the Modern Therapist’s Survival Guide, you can use promo code THERAPY to get 10% off.  So, if you are ready to go to the next level in your business, click THIS LINK and sign up for the How to Win at Social Media course today!

Please note that Therapy Reimagined/The Modern Therapist’s Survival Guide Podcast is a paid affiliate for Melissa Forziat Events & Marketing, so we will get a little bit of money in our pockets if you sign up using our link. Thank you in advance! 

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Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Struggles of the Novice Counselor and Therapist  by Thomas M. Skovholt and Michael H. Rønnestad

Abstract: Shared Trauma: The Therapist’s Increased Vulnerability by Dr. Karen W. Saakvitne

Relevant Episodes of MTSG Podcast:

Impaired Therapists

When is it Discrimination?

Navigating Pregnancy as a Therapist

Infertility and Pregnancy Loss

Document Every F*cking Thing

Getting Personal to Advocate for Compassion, Understand, and Social Justice: An Interview with James Guay, LMFT
Walk & Talk and Other Non-Traditional Therapy Settings: Part One

Walk & Talk and Other Non-Traditional Therapy Settings: Part Two

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

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Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

 

Katie Vernoy  00:00

Thrizer is a modern billing platform for private pay therapists, their platform automatically gets clients reimbursed by their insurance after every session. Just by billing your clients through Thrizer you can potentially save them hundreds every month with no extra work on your end. The best part is you don’t need to give up your rate. They charge a standard 3% payment processing fee. By using the link in the show notes, you can get a month of billing without processing fees just to test them out for your clients.

Curt Widhalm  00:26

Listen at the end of the episode for more information.

Katie Vernoy  00:30

This episode is also brought to you by Melissa Forziat Events and Marketing

Curt Widhalm  00:35

Melissa Forziat is a small business marketing expert who specializes in marketing advice for businesses that have limited resources, including the very special course How to Win at Social Media, Even With No Budget. Stay tuned to the end of the episode to learn how you can get the most from social media marketing, even with little to no budget.

Announcer  00:55

You’re listening to The Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm  01:08

Welcome back modern therapists. This is The Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast about all things therapists for therapists the things that we do how we are in the world. And today’s episode is about our humanity, of the things that come up in our personal lives that may end up affecting the things that we relate to clients. And we’ve touched on this in a number of episodes before but potentially having a little bit more nuanced conversation here today. This is a topic that’s been discussed in the literature for quite a while. And Katie and I have heard varying pieces of advice, we’ve given different advice. And I think that we’re going to summarize this a little bit later in the episode. As we’re going into this, Katie when you think of humanity, at least from the therapist side, what comes up for you?

Katie Vernoy  02:12

A lot of things come up. I mean, when I first started as a clinician, I talked with a supervisor about some of this stuff about being a human about things that come up. And at one point I was I was having physical ailments, that meant that there were times I may not be able to stay present in the session, and even in talking about how to manage that, you know, I’m sorry, I got to quickly take care of something and another room, you know, whatever it was there always felt like and this was obviously like 20 years ago, there was always this thing of trying to hide anything that might be bothering me physically wrong with me anything that was happening to me and so I have that element of it, which is like okay, you know, the the training on the blank slate and and being completely neutral in session, which we’ve talked about a million times around, that that’s just can’t exist. And we’ll we’ll link to a lot of these episodes in the show notes. But then I also reflect on how much time I spent in kind of mileu settings at client’s homes. We even talked about some of this in the non traditional therapy settings episodes related to walking and falling down or having some of those situations. And so to me, being someone who’s had life happen over the last 20 years, and we’ll talk about some recent stuff as well, as well as someone who’s got physical ailments. And is just super clumsy. I show up as me in session all the time. And that’s not something that I can hide. And so I’m looking forward to this conversation today. Because I think it’s something where a lot of therapists struggle with sorting through how much humanity can they bring into the room or into the relationship and I something, I feel like I’ve managed until recently, and I feel like I’m grappling with it again. And so it’s a tough one.

Curt Widhalm  04:18

The framework that we’re gonna follow here in our episode is from an article from apaservices.org, called occupational vulnerability for psychologists. This was prepared by Karen Saakvitne, I’m hoping that I pronounced that right. And this is from 2008. I think it holds up still pretty well. And speaking to some of the nuance of we’re humans in this fields that we are going to have like things that come up things that are going to affect our work, things that are going to affect ourselves and potentially impact our clients. This is a proposed framework that looks at a lot of different dynamic factors that I think it helps to maybe frame this, as I think a lot of the advice that we get early on in our career is, err towards that blank slate side.

Katie Vernoy  05:19

Sure.

Curt Widhalm  05:20

And it’s potentially because there’s maybe a belief that new therapists don’t know what they’re doing. And therefore, they’re safer advice in not risking sharing too much in order to not put an emotional load onto clients. I’m also going to make a suggestion that there’s probably some patriarchal gender bias in that that a lot of theories and stuff are based out of men who are socialized to not share a lot of emotions, that having even more straightforward rules of not sharing things. And it doesn’t surprise me that potentially over the last 30 or so years, as the demographics of our field have shifted, that the conversation around this has shifted. And, and I think that it’s probably more likely that those who practice in settings like Katie was describing those who practice for more humanistic models or social justice oriented models might be more open to sharing things. First and foremost, I think that we have to talk about you as the individual, and you as the individual therapist, and that’s what’s outlined first here in this APA article, we each have our own personal histories. And that is going to affect a lot of things, it’s going to affect our choice of where to work, the clients that we work with how we work. And part of it’s really just taking ownership of yourself first.

Katie Vernoy  06:54

When when we’re talking about our personal histories, I think they’re the things that we’re still working on and need to be aware of, and continue to show up for ourselves, whether it’s in our own therapy or in other things, there are things that are in our personal history, or part of who we are now, that may may may lead us to be impaired. And we have a whole episode on impaired therapist, so I won’t go there. But there’s that argument that some folks have that if we can’t be perfectly healed, we shouldn’t work with any clients. And I think that we can still be impacted by our personal histories and work with our clients.

Curt Widhalm  07:31

Sure.

Katie Vernoy  07:32

The nuance is determining does that impact which clients you take? So some of it may be about whether or not we can kind of curate our clients to be able to support who we are competently, confidently able to work with? We go into some of that nuance in Is it Discrimination that episode as well. But to me, I think that acknowledging and being very aware of ourselves, helps us with some of this personal history stuff.

Curt Widhalm  08:00

This takes a lot of our own internal process in order to get to that point. And I think that, you know, this is something where we are not as a field, very good at encouraging emotional discussion, from therapists from, you know, trainees from supervisees, that if you over share in therapy, then or in supervision, then you’re going to be seen as not predictable enough. But if you under prepared, then, you know, you’re at least going to be towards that blank slate end of things. And that’s at least going to make things nice for clients. But how often do we hear from each other and from our audience as far as just like, oh, some of those vulnerability sort of things are what actually humanized you and made me want to work with you more. There’s such a gatekeeping process around emotions just that are allowed to even come up. And it’s that we’re not taught how to reflexively demonstrate those in supervision that can then have some sort of an enactment in our therapy sessions that teaches us how to do this well. And so we get kind of this vague advice of like, you know, go and do your own work, go and go to therapy, figure your stuff out, when really, some of this stuff could be modeled a little bit better in the way that we teach people of like, here’s, here’s the how of how you show up. I think we’re focused too much on like, the what, of what you’re allowed to say, and therefore it becomes kind of restrictive rather than supportive in this process.

Katie Vernoy  09:51

We’ve gone through that supervision relationship and these things and other episodes and I think there’s there’s so much nuance there that we can’t dive deeply into that. But I think kind of summarizing that point, I think we’re saying know what, what impacts you have emotional conversations, get consultation or supervision that allows that to happen. And and be aware that you can’t avoid it. And so if we move on to other elements of things that could be vulnerable in session, we’re really looking at what’s happening now. Right, like the things that happen as they go along. And I think those things are harder, because sometimes they can be predicted, like we had a conversation on, you know, pregnancy, and therapists preparing for that, and subsequent episodes around pregnancy loss and those kinds of things. But I think it’s something where we’ve talked about predictable things. But there are also things that are very unpredictable that can happen in our lives, family emergencies, I recently had a personal family emergency, and a death in my family. And so I’ve been recently dealing with something that’s very sudden, very surprising that I’ve had to then navigate with my clients. And I think, to me, what was surprising about it is this is I think, one of the most impactful things that has happened in my life. And I had had other deaths happen while I was a therapist, I’ve had, you know, my own fertility journey as a therapist, I’ve had so many things, but this one was surprising because in trying to be present, I had to navigate different elements of my relationships with my clients. And to me, I think, it felt a little bit like I was starting fresh. And so I know you’ve had other big things happen in your life as well, I think we’ve mentioned in previous episodes that you had a major bicycle accident, what was your experience in trying to navigate those things, because I think when we can prepare for it, when we know when it’s something we’re bringing to the table, I think we have, although not enough guidance, we have some guidance. But when there’s something all of a sudden that happens in our lives that deeply impact us, I think that’s where it becomes much harder, because we’re so human, in those moments.

Curt Widhalm  12:03

It definitely brings up the humanity, and those things that are hidden, the relational things, the grieving things that you’re talking about. And then they’re the things that absolutely make it into the room, you know, my bike accident, I had my jaw wired, I’ve had other surgeries in the time where I’ve had, you know, bandages on my hands that are obviously different things from the last time that I’ve seen people, and this comes down to personality and work styles too is, you know, I’m somebody that, hey, alright, you’re bringing it up, let’s talk about it. Or I know that you’re the kind of person who’s gonna bring it up. So I’m gonna bring it up at first just to kind of alleviate the discussion about it as much as possible. And it’s kind of with that reassurance of like, I’m alright, I’m getting treated for this, this is me showing up in my humanity, that the vast majority of my clients were like, Oh, you’re not making a big deal about it, we’ll spend a couple of minutes and then move on with our lives, I think it’s a lot harder when it comes to those hidden or covert sort of things that are going on in our lives. With those particular things all of my clients could see what was going on with me, it’s some of the other things that they can’t see, they fill out the rest of my life, I’m okay talking about it now. But several years ago, I got a phone call from my wife right before going into sessions. And she said, hey, the test results are back and I have cancer. Not having really the opportunity to process that, on my own time, even before going into sessions. But it’s something that I really didn’t share with clients until after her treatment was over. That it was something that my population didn’t really have the need to know that, that if I had to rearrange appointments to you know, to help be a part of treatment, or any of those kinds of things. It was just kind of business as usual, as far as my clients were considered and it wasn’t so much a, you know, super conscious, like, I’m not wanting to talk about this. It was more of a selective like, this really doesn’t impact my clients right now.

Katie Vernoy  14:21

Yeah, when I got the call recently, I knew I needed to cancel everything for the next couple of days. And I basically just cancelled and said I’m there’s a family emergency I’m dealing with. And so there were folks that knew was an emergency. And then there was also folks who were scheduled who I sent out an email or a text or those kinds of things, saying that I had an unexpected death in the family. And I only told folks who were scheduled or trying to schedule in those weeks. And that felt very strange to me, because those folks there’s a conversation about it. It is one of those things that’s a little bit more private. I don’t know hidden or covert sounds like I’m trying to purpose had something but it’s something that’s more private, where me grieving and going through that is not something that necessarily is relevant to my clients, as long as I am paying attention to my own level of competence and being able to be present for my clients. But it’s interesting because there’s, I’m seeing the difference between the clients who know, and the clients who don’t. And I, I feel like as a therapist, I’m present, and I’m taking care of myself, but for the clients who know. And some clients know exactly, you know, not exactly what happened, but more detail than others, just depending on the relationship. And that was more in the conversations, but I’m finding clients checking in with me, I’m, you know, there are definitely clients who this has brought stuff up for them, which is not necessarily certainly something that I want to process with them. I feel like I know my limits of capacity there, I don’t want to be processing this major loss with my clients. And I also understand that they may have their own stuff that I’m trying to figure out how to help them process. But I’m also finding with some of my clients that they’re wanting to check in. And they’re seeing this as an example of how to manage a big loss. And so I’m talking about structure and meaningful activity is helpful to me, and I’m making sure to pay attention to my energy, and I’m focusing in on this, and this is how I’m doing it, and I’m okay. But this is clearly a loss, that’s going to be hugely impactful. It’s life changing. And some of them know what that is. And so I’ve had clients get teary, actually start crying, there was times when I’ve had to redirect because they feel like, well, but what I’m bringing to you isn’t even as important as what you just are going through. So how do I even be, you know, how do I even be a client here? And I’ve been able to successfully redirect those clients. But I, I feel like it’s been such an interesting process, because I’m having such a wide array of experiences in navigating this. All the while, grieving and trying to sort out how do I be a therapist during this time, and I feel like I’m doing it, okay. But I also, this is a traumatic loss, this is something that I don’t even know what’s going on for myself, and so. So it’s really, it’s really interesting.

Curt Widhalm  17:11

So a couple of things from the APA article that you’re highlighting here is, in evaluating both the psychotherapy relationship, that the actual relationship that you have, I would guess that you’re probably looking at some of the clients and how long you’ve been working with them as part of this decision making process. Like if there’s a brand new client, like, not a great thing to just be like, Hey, I’m going through this super emotional vulnerable thing on my own right now, it’s a lot different if this is a long term client that you’ve been with for several years, part of it’s, you know, as you know, some of the clients that if this is going to be something that, you know, potentially as a possibility of triggering, or re traumatizing them about something going on in their lives, that you’re gonna be a lot more selective about.

Katie Vernoy  18:06

Yes, and I think that it’s interesting, because I did have, I’ve had some newer clients that I’ve had to navigate this with, who I did have to cancel knew that there was a loss, and I was able to do it at a very high level, where it’s like, I’m okay, I’m managing it, this is how I’m taking care of myself, and we moved on, whereas longer term clients are more interested in exactly what happened and taking care of me. I think the other thing, and this is in this article is the clients who typically seek me out, you know, we’ve talked about I do sacrificial helping syndrome and, and I have caregivers. And so I also was very aware through this process and continue to be aware that there are some of my clients that will want to take care of me, because that’s why they came for therapy. And so I’m, I’m trying to very actively engage in some of that dynamic with them, to help them to see how they get their needs met, how I’m taking care of myself, and being able to do that, because it’s, it just it’s very interesting to be able to sort this out. But it’s, it is very much case by case for my clients.

Curt Widhalm  19:13

And, you know, part of what we also have to talk about here is you and I both work in private practices that can tend to be more intimate just in their expectations. It’s potentially different than higher need work settings where some of the vulnerabilities just might not be as appropriate, just due to the needs level of clients in those particular situations.

Katie Vernoy  19:45

And I think with those situations, oftentimes when I’ve had bereavement or other kind of big things going on in my life, I had, you know, 27 clinicians who could take on each one of my cases and have that covered. And it was something where there was structure set in place for there to be a full treatment team and other people available now. Everybody’s overwhelmed and busy. So that’s never a good plan. But But there wasn’t something where it’s like I see them, or I have a colleague who has a little bit of capacity who could potentially see them or be available to them. And they’re not likely to actually take me up on it, it’s it’s that planning is very different in private practice versus an agency because in an agency, there are a lot of other people that have their eyes on the case.

Curt Widhalm  20:36

Part of this speaks to just kind of the roles that we have, as you’re demonstrating here that, you know, if you’re in those case managers situations, you can step in, you can assign other people to it, that there’s a universality of experiencing vulnerability, there is not a universality of how to handle it, especially with these unexpected situations that arise. That kind of nuance is what’s sorely lacking in the way that we talk about this in our fields, because we tend to, especially earlier in our careers want nice, structured here’s, you know how the answers are. And the longer that we practice, the more that we understand kind of the it depends of the situations and that it depends isn’t necessarily the same from one client to the next. Now, some of the risks that come along with that, though, is that what you’re talking about your clients are not bound to the same confidentiality that you are. And another, you know, consideration just as far as your workplace goes, it’s just going to be that one person finds out whether it’s another staff member, whether it’s a client, potentially everyone knows, even if it’s not something that you necessarily know that some of your other clients can and should be aware of.

Katie Vernoy  22:00

With social media, and all of those things like I typically am fairly private, but I have been a little bit more open sharing obituaries, for example, or the things that are going on, I still try to keep it with just friends, but you know, friends of friends and screenshots and all that kind of stuff. And so I think it is important to remain aware of those things. And it is important to, to continue to kind of take care of myself within those things. Because a client may pop up and say, Hey, I heard about death in your family. Why didn’t you tell me and I, I honestly am trying to both take care of myself and my clients in doing so because any moment of talking about the death in my session can be clinically appropriate, but maybe more challenging for me to be able to refocus on the session. And so it’s it’s a weird, it’s a weird balance that I’m trying to strike. And it’s said in this context of in society, especially Western society, US society, we don’t know how to manage grief as it is there’s expectations either that you were destroyed and can’t do anything, or that you are out for three days, and then back to work with no problems, or anywhere in between. But the nuances of this becomes very hard to navigate. And different clients know different things. There’s stuff publicly that people can find. And there’s also the strangeness of the relationship as a therapist with a client on what actually is in that relationship. What do we what do we owe our clients? What information do they need to know how well do they need to know us? And that’s also an it depends based on client by client. But it’s, it’s just such a strange thing to navigate. Because there’s not I don’t think there’s clear guidance as society on how we talk about these things much less, as therapists we’re supposed to have this higher level of functioning, because we have to take care of our clients.

Curt Widhalm  23:56

You know, kind of one last point is as far as how we’re talking about the way that this is expressed in early career clinicians. Skovholt and Ronnnestad had a 2003 write up that talks about how novice counselor struggled to find the balance between porous and rigid emotional boundaries. New counselors try to work on that balance between rigidity and under involvement with the client and softness and over involvement with the client. And I think that part of this is, again towards that, when in doubt, be safe. But as you’re highlighting here, there’s a lot of just other available information about us. I think as we become more seasoned in our work, and part of this as some of these things end up happening and coming up, we get better at handling the awkwardness of situations when clients who might not want this information might not be ready to handle this kind of information about us that we get better handling those ambivalent situations that could be therapeutic ruptures, if it wasn’t handled gracefully, or in those times when it’s not, that we’re better at being human in our responsiveness to some of those mistakes.

Katie Vernoy  25:18

I really want to highlight the rupture element, because I think that there are times, you know, being a therapist for 20 years, or more than 20 years at this point, there have been ruptures based on my own humanity. And there certainly have been things where I’ve not been able to be as present for my clients, because what’s going on with me. To really highlight the point you just made, I think there’s that element of, we can be human, there are times when our humanity is going to mean that we are doing unethical or illegal work, you know, and so we have to do the best that we can to not show the humanity in that way. You know, that’s the impaired therapists thing. That’s the the other episodes that talk about that element. But but there are times when my physical health has not been up to snuff. And I’ve not had the spoons or the bandwidth to be able to interact appropriately with clients and have had and said things that were not helpful. Sometimes they actually were disruptive. And we can reach back to the the notes episode on on documenting things that are disruptive, because you’re overwhelmed. To me, if you are unable to be fully present and vulnerable and recognize within yourself. This was about me. And is that okay with a client? And if not, how do I get to a place where I can actually process that with them, and be available to them in a way that’s helpful. I think that’s where we get in trouble, we harm the client, if we don’t acknowledge if we don’t apologize, if we don’t repair, if we try to pretend something didn’t happen, I think that’s, that’s where we can get into trouble. And that’s where we can actually be harmful. But there will be ruptures based on our humanity, hopefully not gigantic ruptures. And certainly if your humanity is your drunk in session, or you’re sleeping with your clients, no, thank you. That’s not what we’re talking about here. We’re talking about you’re grieving or you’re worried or you’re jacked up on hormones, or whatever it is, that is going on that means you need to be extra aware, extra available to your clients and have the conversation with your clients of, if I’m doing something that’s not helpful, or you’re not sure what’s going on, in how we’re interacting, let me know and actually seek that feedback and have those open conversations. I think that’s when the the blanket, don’t share anything is more helpful. Because if you if you can’t sit with clients telling you like, Hey, I didn’t like your response to that, or you seem really spaced out right now, or, you know, your, the way that you’re talking about these things don’t make sense to me. If your clients can’t say those things to you, you have to be more accountable to your humanity than if they can.

Curt Widhalm  28:04

And I like that you’re bringing up the the ruptures can also happen in the absence of saying anything when your clients are picking up that there’s something going on with you that you’re not available that you’re not, you know, following up on extra resources between sessions. Do you have any suggestions as far as like, when those clients do set up, like, Hey, I’ve been expecting more of you, you’re not showing up or you might feel compelled to disclose something more than what you’re prepared to share at that time?

Katie Vernoy  28:37

When I’ve had more of those types of conversations with clients. I mean, it always goes to it depends. There’s been some clients where they’ve read into things that weren’t there. And so I’ve talked about I’m sorry, I had a headache, you know, and it was, it was not something that was personal. It was, Hey, I didn’t mean to do harm, I see what you’re saying. And it really was a headache. And it’s not some other thing that you’re talking about. And that doesn’t always work, like just kind of say like, Hey, it is something but not what you think let’s move on. But recently, I had a client that disclosed something really personal to me that hadn’t been shared in long standing client. And it was something where I had my own response to it. And I was kind of busy trying not to over emote about what I was hearing because I was so heartbroken for this client. And I was disconnected. And when this client reached out to me and said, Hey, I felt really invalidated because you were disconnected. We were able to have the conversation, I was able to say, hey, my intent was to take care of my own emotions in that situation. It was something where I was also exploring my own potential responsibility of not being able have you not feeling comfortable to share that with me prior. And now let me share with you my responses and what that gave was an opportunity for me to actually process through, and it was something where I was able to then say, hey, this was what was going on for me without it being so raw in the moment. But in truth, I think it’s it’s hard to have a blanket like if someone says, Hey, you’re not present, you know what’s going on with you, because I think there is so much nuance for some folks, it could be as simple as saying, like, Yeah, I’ve been, you know, really overwhelmed, or I’ve been working on something, and it was distracting to me, I apologize. Let me get back on track. For others it might be, what you’re bringing up is something that really is very resonant for me. And so I’m working hard to manage my reaction so I can be present for you. And other folks, you know, like I said, there’s clients that have asked what exactly happened, and how are you handling it. And I’ve been saying, like, this is what happened, this is what’s going on. And this is how I’m handling it. And needed that true humanity and self disclosure that then allowed them not to kind of make up their own stories in their head about what I was doing and how I was taking care of myself. And so I don’t think there’s one answer, but I think being present to your clients in those situations and reaching out, and sometimes it’s even like, Hey, you’re having a reaction, what’s going on? And then that gives them an opportunity to say, well, like, I didn’t like what you just said, right there. You know? So I don’t know if that answers your question completely. But I think it’s that that element of being as present and human as possible in the room, recognizing that there is the therapist version of humanity that kind of sits there that that has some of these extra boundaries in place. So that you’re not saying like, yeah, I, I’m really pissed at my spouse, or I’m, I’m having a moment, or I don’t know that I want to be a therapist anymore, whatever that is, you know, I think there are things that we don’t there’s, there’s humanity, we don’t share with our clients. And there’s humanity that if we can curate, that’s maybe that’s not the right word. But if we can thoughtfully and deliberately choose how we share our humanity with our clients and open ourselves to them being available to that, then we can, I think, have deeper richer relationships where clients feel truly heard and seen and connected.

Curt Widhalm  32:18

I think to maybe give you a direction to go here on this is, if you’re going through something don’t feel like you have to make the decisions yourself. You’re allowed to be human but consultations, always great idea and get some other perspectives and join our modern therapist community and know that we have a pretty good following of people that understands thinks in very much similar ways to the way that Katie and I do and rely on those who have been there before to help you guide you through some of this process. You can find our show notes over at MTSGpodcast.com and you can also join our Facebook group the modern therapist group, follow us on social media. And until next time, I’m Curt Widhalm with Katie Vernoy.

Katie Vernoy  33:17

Thanks again to our sponsor, Thrizer.

Curt Widhalm  33:21

Thrizer is a new billing platform for therapists that was built on the belief that therapy should be accessible and clinician should earn what they are worth every time you bill a client through Thrizer, an insurance claim is automatically generated and sent directly to the clients insurance. From their Thrizer provides concierge support to ensure clients get their reimbursements quickly directly into their bank account. By eliminating reimbursement by cheque, confusion around benefits and obscurity with reimbursement status they allow your clients to focus on what actually matters rather than worrying about their money. It’s very quick to get set up and it works great in complement with EHR systems.

Katie Vernoy  33:59

Their team is super helpful and responsive and the founder is actually a long term therapy client who grew frustrated with his reimbursement times Thrizer lets you become more accessible while remaining in complete control of your practice. A better experience for your clients during therapy means higher retention. Money won’t be the reason they quit therapy. Our very special link for Thrizer is bit.ly/moderntherapists you sign up for Thrizer with the code moderntherapists you will get one month of no payment processing fees meaning you earn 100% of your cash rate during that time.

Curt Widhalm  34:32

This episode is also brought to you by Melissa Forziat Events and Marketing.

Katie Vernoy  34:37

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Curt Widhalm  35:07

How to Win at Social Media is packed full of information. Usually a course as detailed as this would be priced in the 1000s. But to make it accessible to small businesses it is available for only $247. Plus, as a listener of The Modern Therapist’s Survival Guide, you can use the promo code THERAPY to get 10% off. So if you are ready to go to the next level in your business, click the link in our show notes over at MTSGpodcast.com and sign up for the How to Win at Social Media course today.

Announcer  35:39

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