In day-to-day life, we often spend a lot of time holding in the feelings and thoughts we have about others. These thoughts may be about people we love, someone we’re in relationship with, those we work with, or even just people we dislike but need to interact with regularly.

Life is about relationships; the quality of those relationships can contribute to how fully alive and happy we get to be. The authenticity and honesty in our closest relationships are strong markers for a healthy life—but we still hold back.

Why Do We Hold Back?

Part of the reason for this is maturity. Many of us know what it’s like to be with a child who doesn’t have a filter. They might tell a stranger that they’re ugly or let Great-Aunt Abigail know that her birthday gift was the same as last year’s—and it wasn’t appreciated then! This child hasn’t yet learned that little white lies can be okay and that there are times we aren’t blatantly honest in order to protect the feelings of others.

Another contributing factor is that we can get so used to holding in our thoughts and feelings that we lose awareness of them. And when they do make it awareness, we often say, “Bah! It’s not that big of a deal. Forget it.”

There goes another repressed feeling.

When Repressed Thoughts and Feelings Surface

Maybe we unload into a journal or speak with a friend or partner (not about them, but about each other.) Perhaps those feelings get displaced onto others, or even somatized into physical symptoms. Suddenly, all the little things we didn’t think were important are coming out in unexpected, unhelpful, and unhealthy ways.

We must learn to bring into consciousness the small cuts that build up in our lives and hold us back from more intimate relationships.

We think, “Okay. Let’s head to therapy! That will help with my anger, anxiety, or depression.”

In a counseling session, we may talk about Great-Aunt Abigail’s cheapness and how it seems to show how little she’s cared for us all along. Maybe we talk about a demeaning boss with whom we can never express our full frustration. Perhaps we get to share about all our friends who willingly take and take but never seem to return all we do for them.

Realizing Your Therapist Is Human

We should talk about all of these issues with our counselor. But over time, something else often becomes apparent: we discover our therapist is also a human being. We begin holding back the same kinds of thoughts and feelings from them.

A few examples of these thoughts include:

• “They looked at the clock a few more times than they usually do, but maybe they’re just hungry and looking forward to lunch. Never mind that it made me feel expendable.”
• “Okay, they stumbled when remembering my child’s name—I’ve only been talking about the little brat for 8 months now. But they must have so many clients, right?”
• “That was definitely a yawn. A yawn! How dare they. Oh, come on, it’s 8 p.m. It’s not a big deal. Stop thinking about it.”

Why Should I Share These Thoughts With My Therapist?

We often censor feelings and thoughts about our therapists because we know that’s the mature thing to do. We certainly won’t make too many friends if we’re constantly telling the people in our lives how they’ve let us down. But we’re not in our “daily lives” in therapy. We’re in therapy. We’re in this experimental petri dish to get to know ourselves better, something we can only do in relationship to someone else. We must learn to bring into consciousness the small cuts that build up in our lives and hold us back from more intimate relationships.

Talking with your therapist about any of the thoughts listed above may not get them to change or apologize, although that may happen. The main purpose of verbalizing these feelings is to give you the experience of exploring how these slights, which are most likely replicated in real life and often in bigger ways, affect you and your relationships with others. Discussing these thoughts in a trusting therapeutic relationship can help you work toward spending less energy holding them in on a regular basis. It can help to find a trusted therapist near you with whom you can explore these feelings.

Over time, you may find you are not holding grudges for as long as you used to or that your expressions of anger are not as strong as they’ve been in the past. This may mean you’ve begun to release yourself from the grasp of those slights and the repressed thoughts that often accompany them.

While it’s stereotypical to be asked about one’s feelings in therapy, a common counter to that question is, “I don’t know!” or, “I’m not feeling anything right now.”

Part of my job, then, is often to alert people to the possibility they are having a feeling and they may be getting in its way.

Perhaps the most important part of therapy is asking yourself the feelings question when you’re outside of the counseling room. As it turns out, there are some surprising signals that you may be having a feeling. Let’s look at a few possible tells.

Beyond the Story

Feelings have less logic than thoughts. Many people who seek therapeutic support have thought their way backward and forward about their issue, yet they may be missing the emotional aspect.

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Stories are compelling. When a person in therapy is good storyteller, it can be enthralling. Of course, they are probably enthralling to others; they don’t need to pay me to be one more member of their audience. This leaves me with the somewhat challenging job of interjecting.

“Okay, but what are you feeling?” I ask.

Sometimes, there are physical signs of something being experienced internally.

Physical Clues to Feelings

No, I don’t think there is a deeper emotional meaning in everything.

Sometimes a cough is just a cough. But occasionally, if I’m sensing someone is clouding their emotions with some avoidant behavior, I take a chance and ask a strange (if not impertinent) question about what else is happening for them. (My hope is that the person coming to me for support will start doing this on their own, outside of therapy.)

A few examples that might be worded more carefully in the moment:

Sure, some people laugh. Some get angry. But once they sit with these questions, a good 75% of the time we discover something we weren’t talking about that we can now bring into the room.

• Burping: What’s coming up for you? Figuratively, of course.
• Drinking water/coffee/tea: What would happen if you didn’t take that sip right now? What might you be swallowing?
• Going to the bathroom during a session: Is it possible you’re pissed at me?
• Yawns or expressions of fatigue: What feelings are being put to sleep?

Sure, some people laugh. Some get angry. But once they sit with these questions, a good 75% of the time we discover something we weren’t talking about that we can now bring into the room.

I’ve been on the other end. Many times. All of this comes from years of my own therapist asking me these sometimes laughable, sometimes absurd, but often accurate and helpful questions.

Sometimes I just need to pee, but I know how much I’ve worked on my anger, so it doesn’t hurt to take a few minutes to explore if I’m holding back something. Maybe it’s mild irritation that my therapist isn’t “getting me” today. Maybe it’s full-on rage at something I’ve been stuffing.

These are just a few possible cues. You know yourself. What physical tics may be an indication of a feeling for you?

Now What?

The feedback I get after expressing this stuff to a person in therapy is usually, “Okay, now what?”

Well, now you get to let the feeling be. Now you get to come out of your story. Now you get to park your thoughts and see what might be driving. You get to examine what might be getting in the way of connecting to your partner. You get to consider what might be stopping you from following through on tasks for a boss you don’t like.

When you can acknowledge your feeling, you don’t have to spend energy squelching it and hiding it from others.

Hey, you’re one of the lucky ones. You’re in therapy. You can express that feeling without judgment and without it taking control of you.

Who knew a seemingly ill-timed burp could hold so much?

(Excuse me.)

It’s one of the most important questions in therapy. It’s stereotypical. Sometimes, it’s disruptive. It can lead to anxiety and self-examination.

And it’s not going away.

Your therapist asking you what you’re feeling is a staple of most forms of counseling, and for good reason.

What you do with the question can begin to free you.

Yes, we all know therapy is about feelings. Before any of us stepped into a therapist’s office, we probably saw a cartoon, TV show, or movie in which a therapist asked the person sitting across from them: “How does that make you feel?”

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The thing is, people come to therapy for a million different reasons. It could be to deal with depressive or anxious symptoms, trauma, or unhealthy expressions of anger. The list could go on and on.

Few people come to therapy with the stated goal: “I want to better understand and connect with my feelings.” For everyone else, it may not seem productive to be asked each week about what they’re feeling. All they know is they want to feel better!

A common response to the feelings question is frustration and annoyance. Especially if it occurs during a the telling of an event or a story from the past. If you’re focused on something from the weekend or from work, the feelings question may disrupt your flow.

Well-timed, the question can lead to breakthroughs regarding unhelpful patterns, difficult feelings, and negative interpersonal relationships.

Of course, it could be an ill-timed question by the therapist. Maybe it would be more helpful if they waited a bit longer to move you toward reflection. Maybe not, though. Perhaps the question is coming from the therapist’s sense that there are feelings you may be unaware of.

Well-timed, the question can lead to breakthroughs regarding unhelpful patterns, difficult feelings, and negative interpersonal relationships. It can reconnect you with any feelings you may be trying to avoid by overthinking the situation.

So, yes, the question may be an attempt to interrupt and go deeper. But if it’s making you angry, tell your counselor. That’s important information too.

This Is Not a Test

A common response to the feelings question is anxiety or, worse, a sense you’re doing something wrong if you’re not sure what the feeling is. Suddenly, it may feel like you’re being “quizzed” or tested.

This, too, is important information to bring up. The intention is (hopefully!) not to make you feel like a failure. You’re in therapy to learn about yourself and how to better understand your feelings. You’re not expected to know all the answers, let alone anticipate questions. Speak up if you sense pressure to perform or expectation from your counselor.

Remember that “I don’t know” is an acceptable answer. You may not be aware you’re having a feeling because you don’t tend to stop and check in with yourself. If the feelings question comes up, it’s a chance to do that.

And maybe you’re having zero feelings in that moment. Again, good information.

The Feelings Layer Isn’t the Only Layer

Becoming more aware of how you’re feeling at any given moment is not the only aspect of emotional well-being, but it’s an important layer to explore. Knowing your feelings may help you understand your actions better. It can inform your future choices.

Becoming aware of your feelings may help you feel less helpless. It may help you feel more in control.

Perhaps best of all, knowing your feelings gives them less control over you.

People seek out therapy for any number of reasons: anger management, trauma, relationship issues, or anxiety, just to name a few. But whatever the issue or concern bringing a person to therapy, when they are able to express a full range of feelings they have the potential to achieve even deeper healing.

When I talk about feelings here, I’m not just referring to the person’s feelings about their own experience, especially because some people may hold off on that for a while, wanting to fully trust their therapist before they share that. I’m talking about a person’s feelings toward their therapist and the therapy experience.

It’s my opinion that many people who go to therapy are just too … nice. By “too nice,” I mean they aren’t open with the therapist about negative feelings, such as disappointment, they might develop toward the therapist. They don’t, for whatever reason or reasons, speak up and let their therapist know what they really think and feel about them. But feeling open enough to express your disappointment about your therapist to your therapist could really help your therapy shift.

Are You Protecting Your Therapist From Yourself?

Sure, I’ve got some skin in the game when I’m working with people, and I’m likely to be affected by how they express themselves to me and what they say about me. But being able to manage the transference of people expressing all kinds of negative and positive feelings is all part of a therapist’s training. And I continue to do my own work, outside of the time I spend with the people I’m working with,  as part of my ongoing upkeep. I work to know myself as well as I can because the feelings I have in response to your feelings inform how I support you. (If you’re interested, this is called countertransference.) [fat_widget_right]

In other words, in order to be fully present and helpful in the therapy room, my personal work involves sorting out

1. My feelings
2. Your feelings
3. My knowledge of systems
4. Life cycle issues
5. How people change

Part of my job is being fully present with you, and I want you to also be fully present with me. In order to be fully present with me, you will first have to be fully present with yourself and then share that presence with me. I encourage you to share those thoughts and those feelings you are having, even—especially—those feelings you may be editing out for my benefit.

A New Office

When I moved into my new office, I was excited. I got to buy all my own furniture, wall art, etc.—I got to make the space mine, instead of having to remake the space every time I came in for my day, like I had to do when renting from someone else.

Of course, one consideration with designing my own space was realizing that not everyone who came into my space (such as people coming to therapy) would feel the way I did about it. Some of them didn’t like my lamp, others had issues with my bookcase, and some even disliked the pillows I chose.

There were also some things about the office that weren’t in my control. For example, it wasn’t on the top floor of a building in the financial district, and it didn’t have a gorgeous view. In fact, it was windowless and had a rickety elevator.

Some of the people I worked with expressed their disagreement with the style choices for my office and even the location. They told me my choice in furniture was off, that they resented that my space wasn’t, well, different than it was.

My inner responses?

• First, I was angry and annoyed. “This is my space!”
• Second,  I felt like I had screwed up. “I have a horrible office. I have no taste. I shouldn’t have gotten this chair.”
• Third, I realized,“I’m so glad they’re sharing this with me.”

Now while my job is to get to that third response, I need to go through the first two responses to get there. The third response, of course, is the one I would share with the people I work with.

Part of my job is being fully present with you, and I want you to also be fully present with me. In order to be fully present with me, you will first have to be fully present with yourself and then share that presence with me. I encourage you to share those thoughts and those feelings you are having, even—especially—those feelings you may be editing out for my benefit.

The first two responses are what most of us deal with in our daily lives. They’re what tend to lead to friends and family members having arguments: “How dare you say that? Couldn’t you have said it in a nicer way?” But the third response isn’t always gotten to in life, even though it’s an important layer.

I’m not just glad you share your feelings with me for masochistic reasons. I’m not even glad because venting is good for the soul. I’m glad when you share because then we get to unpack the response and see how it lets us know more about you.

Maybe you feel you don’t deserve a therapist with a beautiful office. Sure, the initial response is to put my space down, but then this unlocks the door to talk about your sense that you never get top-shelf treatment in life. This may correspond with how you were treated as a child. Where else might you be bringing this resentment? And if I can hear your disappointment, if I can withstand it without striking back, maybe you’ll come closer to it not having such a strong emotional hold on you.

Or maybe you need to find fault because you’re disappointed you’re not making as much progress as you feel you should be making. Putting down my space allows you to, less directly, put down my work with you. In a way, you may be indirectly expressing anger that you’re still dealing with depression or anxiety. And once you express these emotions and feelings, we can, together, decide to go deeper into them.

If I can get to my third response above, then I can push for this conversation. I can assist you with a more direct expression of your feelings. And your disappointment can be just the tool you need to move forward and unblock your therapy.

Every part of therapy can be informative. The moment you enter the room is no exception.

Different therapists have different styles, but in psychodynamic work there’s usually space left for you to start the session. What you do with that time is important. How you feel about that time is even more so.

This Is Not a Test

If your therapist doesn’t say anything when you enter the room—and I mean not even a “hi” or a “how are you?”—it doesn’t necessarily mean they’re being rude. It’s not a test, and it’s not meant to make you feel a certain way.

Believe it or not, the space is there so the therapist has less influence over the session. We don’t want to focus on what we think is important or, even subtly, walk over a feeling or thought you are having. Therapy time is your time.

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Do you want to pick up from last session?

Do you want to talk about that incident with your brother-in-law over the weekend?

Do you want to discuss what happened with the guy who sold you a coffee just before you arrived at my office?

It’s up to you. Entirely.

Sure, we may hope to hear about how that discussion went with your partner, the one we’ve spent months gearing up for—but we may not ask about it. Perhaps you’ve moved on. Maybe you didn’t have the discussion and our asking about it might make you feel like you should have had it—in which case the therapy becomes about whether you’re doing what you’re “supposed” to do (and suddenly we’re replicating a relationship with your dad that you’ve been struggling with).

The only real exception I make is if you’ve talked about an ill or dying loved one. I’ll probably ask about that (but maybe I shouldn’t!).

How Do You Use the Time?

Often, people say they don’t know what to talk about. Not because they don’t know what they want to talk about, but because they don’t know how to start.

In those early silences, when you’re struggling with starting the session, it’s good to become aware of the feelings that are filling that silence.

Many people who come to therapy, particularly those who often put others first, have a difficult time just jumping in and talking about themselves. A giveaway for this is when a person immediately asks about my week. They may tell me they’re doing so because it’s polite and they’re making small talk, but therapy is fully about you. You’re paying me and you want to know how my week was? It’s a nice thing to do, but didn’t you say in our first session you want to be more assertive? That people take advantage of you? Well, guess what—that’s what we’re working on by talking about what’s happening between you and me.

Pay Attention to the Feeling in Those First Few Moments

In those early silences, when you’re struggling with starting the session, it’s good to become aware of the feelings that are filling that silence. This can help us understand your (perhaps) social anxiety, your reluctance to speak up in a class or group, your tendency to “live in your head” and intellectualize everything.

Awareness of the shyness, nervousness, anger, worry, or whatever else is in the silence can inform all those other times outside the therapy room when you don’t jump in and say what you want to say. Once you’re aware of the feeling, we can explore it to stop it from getting in the way of your action (or inaction).

Conclusion

Your therapist probably isn’t trying to be a jerk by not starting the session for you. We’re aware of how difficult it can be. To that end, we may, after a time, ask a starter question along the lines of, “What’s it like to be back here today?”

Sometimes we’ll process the silence or the “how are you?” and sometimes we’ll just see where you take the conversation. The major point I’d like you to take away from this is to talk about what’s going on for you in relation to the therapist.

Tell your therapist how awkward it is and how much you wish they’d just start for you. How angry you are because your therapist should be the one to direct the session; you’re paying them for their expertise, after all! Or how overwhelmed you are because of all that’s happening and you just can’t prioritize and need help doing so.

Or, just maybe, you feel you have nothing to say. Well, say that then. We’re here to guide you, but also to do all we can to not influence you.

Have you ever felt shame while talking to your therapist? Have they ever said or did something that triggered this feeling?

I’m hoping your therapist has never intentionally instigated shame, but it’s possible that, at some point, the way they ask a question, respond to you, or make a particular facial expression may initiate a shame response. Perhaps their eyes widened when you spoke about a fetish or sexual practice, related an argument you had with a friend, or described something you did on an interview that didn’t go well.

On one hand, maybe they were shocked. We therapists hear a lot, but even the most experienced therapist can be surprised at times. On the other hand, we may noticeably react for a different reason. Maybe we’re making an association with something in our own life. Or maybe we’re having gas. You, the person we are working with, has no idea which of these is the case. But that’s not the important part. The important part is that you picked up on something from us that caused you to feel shame. [fat_widget_right]

And that is something that should be discussed.

Building Trust to Examine Our Shame

Most of us go through life learning how best to avoid shame and have likely developed (consciously or unconsciously) any number of ways to do this. One of the benefits of therapy is that it allows us the opportunity to examine and challenge a well-honed (overdeveloped?) shame response.

But of course, we can only exercise this opportunity if we are comfortable enough—and trust our therapist enough—to let them know when shame arises. Because not only are we good at feeling shame, we have also, in most cases, become very good at hiding our shame. We might get angry instead. Or we might cry. Sometimes we hold in our emotions and experience them physically, in the form of stomach pain or headaches, for example. In some cases, our shame might even be converted into a panic attack.

Telling someone their reaction to something we shared caused us to feel shame is a hugely brave thing to do. What better place for that act of bravery than in the therapy room?

Finding Relief from the Weight of Shame

Talking about shame can often open a portal, as it can serve to expose so many of the reasons we aren’t living the life we say we want to be living. Why we’re not taking a risk on a career, for example, or why we’re not opening up to a partner—even though by not doing so we could end up losing them. I can’t tell you how often I begin working with men who tell me they’re finally trying out therapy because too many partners have said they can no longer continue a relationship with them until they are able to share more. They aren’t aware yet that it’s the shame stopping them.

Talking about shame can often open a portal, as it can serve to expose so many of the reasons we aren’t living the life we say we want to be living.

These aren’t men affected by ideas of toxic masculinity, either. These are men who know they are supposed to express themselves more, men who have received all the messages supporting increased empathy, compassion, communication, and so on–everything a so-called “Modern Man” should be—but they’ve never been taught how to be that man.

But many of these men, once they begin talking about this shame and related issues in a supportive environment, begin to realize how much of their energy has been going to defending against it. The relief they experience can be astounding!

Shame isn’t everything. There are many reasons people choose to seek out counseling. Shame is no small concern, though, because the energy we put into pushing shame away could be energy spent addressing and working to heal from our anxiety, our depression, our trauma.

If you trust your therapist, take the risk.

(If you don’t feel comfortable bringing up this issue with your therapist, please remember it’s always all right to seek a second opinion. If you’re concerned your therapist is intentionally shaming you, you might consider reviewing these warning signs of bad therapy.)

Has it happened to you? A few months into therapy and you’re scratching your head wondering what you’re still doing here. Things started off so strong. You were exploring your relationships or talking about work issues, maybe even venturing into a little family history. Maybe things have been a little better since you started. Maybe things haven’t changed much. Perhaps they even seem a bit worse since you’ve been talking about all these difficult things you’d rather not think about.

But you’ve gone over all that material and you’re still coming in each week. You’re still paying hard-earned money. And you’re still not being told what you should do differently.

You spend the whole time traveling to your appointment trying to come up with something to talk about, some problem in your life, some point of conversation that will take you through 45 minutes before you return to work or head home.

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And you’ve come up with nothing.

And now you’re in a staring contest with your therapist, who doesn’t seem to be coming up with anything, either.

And you think to yourself, I’m bored.

So you skip an appointment and “take the week off.”

You may consider this boring feeling a signal you should move on.

You might text or email your therapist and say you’re done. You’ll call in a few weeks if you need anything.

When reflecting on this, you’ll say to someone, “You know, therapy just didn’t work for me.” There’s no hard feelings, just … it’s not for you.

As both a therapist and a person who has been in therapy, I can empathize. I’ve felt all of these things at one time or another. But I’ve come to understand something about “boredom”: I’m not convinced it really exists.

I like to talk about anger as often being a secondary emotion. It can be used, often unconsciously, to protect us from feeling (or showing) some of our more vulnerable emotions, such as fear, insecurity, and sadness.

But anger can be just pure anger. I’m not convinced boredom is, in and of itself, its own thing.

When I notice I’m feeling bored, I tend to get curious. What else is in there? What am I avoiding? What is the “boredom” protecting me from?

When I notice I’m feeling bored, I tend to get curious. What else is in there? What am I avoiding? What is the “boredom” protecting me from?

Back in my performing years, when I’d spend evenings in rehearsals for off-off-Broadway productions that didn’t pay and days in corporate offices as a temp, I remember spending hours doing mindless data entry. I became “bored” pretty quickly. But as I later came to realize, what I really felt was anger that I had to be there at all as opposed to making a living doing what I wanted to do.

I’ve even been to parties where I felt bored, but, upon further digging, I was feeling kind of insecure. Likewise, I have days when I’m at home and think I’m bored, but what I really want in those moments is to hang out with others. That is, I’m actually feeling lonely.

Boredom covers for all of these feelings. Because who wants to be angry at work, self-conscious at a party, or lonely at home?

When a person in therapy starts to talk about feeling “bored” in therapy, especially around the three-month mark, I’m psyched. I’m psyched because they said it and didn’t just fade away, as many do. They are creating an opportunity with their therapist to process the feelings beneath their “boredom.”

Some are upset because they’ve been coming week after week, spending a lot of money, and they want results! They want me to tell them what to do or what not to do. They want to know if there is going to be relief.

I may not have the answers to these questions. I may not be able to put their mind at ease with a timeline or guarantee, but I will provide the space for them to express what they usually squelch and speak about some new ways to handle it all. I’ll provide a space to let out the anger, the frustration, the sadness, the hopelessness, the whatever, and see that it’s not going to push me away. That it’s not going to destroy them.

Once the real feeling is expressed, therapy gets real. And it’s anything but boring.

Therapists go on vacation. Therapists need time off for health reasons. Therapists have emergencies.

But what does it mean for you when your therapist needs a break?

It can be difficult to wait an extra week between appointments, let alone two or three. It’s a reminder your therapist has a life outside of the office. Often, we like to think of our therapist as ours and ours alone. Are you connected with the feelings that arise when your therapist tells you they’re going to be away?

Many people tell me they are “fine” with me not being around for a session or two. Depending on the person, I sometimes ask a few more questions about that. Not for personal reasons—I’m not trying to get a person in therapy to make me feel important and needed—but to help them bridge that feeling to other relationships in their lives.

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While you may know intellectually your therapist takes time off, just like you (hopefully!) do, that doesn’t mean you won’t feel a whole swath of feelings when it happens. Some common ones are abandonment, sadness, and anger, but also happiness and even relief!

Whatever you feel upon hearing your therapist will be away, it may be helpful to dig deep to see if there is a small spark of feeling that may be familiar. Once you connect to the part of you that is angry (even just a little), for example, you may be able to bridge that to another time in your life when someone left. This is a great opportunity: You get to use the therapy session to let the therapist know how you felt back then. You get to see you can say, “I’m angry you’re leaving” and know the therapist can take it. You can have what we call a “corrective emotional experience.”

“I’m angry you’re leaving. If you really cared about my well-being, you’d make yourself available.” That might sound confrontational, but it’s actually progress.

You can even go a step further: “I’m angry you’re leaving. If you really cared about my well-being, you’d make yourself available.” That might sound confrontational, but it’s actually progress. It’s being vulnerable with your therapist, which is both really, really difficult and incredibly important.

You’re not going to change your therapist’s plans, but you’re going to know what it’s like to say how you’re feeling. It opens the door to an exploration of hurts you’ve experienced in the past—but had nowhere to go with.

Boundaries and Safety

If the prospect of your therapist going away causes anxiety or worry, talk to them about what you can do in their absence. Some good questions are:

• “Can I call or email or text you?” You need to know your therapist’s boundaries. Some therapists take calls while on vacation; sometimes, only in special circumstances. Know before the therapist goes away.
• “Is there someone else I can talk to in the meantime?” Some therapists provide the name and contact information of someone you can call if the therapist is unreachable. This is rarer, but it’s good information to have.
• “What do I do if I’m really stuck or thinking of harming myself?” If you’re struggling with thoughts of self-harm or suicide and your therapist is aware of this, you may already have a safety plan with your therapist. Go over it with them before they leave, and if you don’t have one, create one together. No matter the circumstances, if you are ever in crisis or concerned about hurting yourself, call 911 or go to your nearest emergency room.

Your therapist going away can open some old wounds and bring up surprising feelings. Listen to those feelings and bring them forward. They could lead to breakthroughs that serve you not only while your therapist is unavailable, but long after you’ve parted on your terms.

Goodbyes suck.

They really do. They’re often uncomfortable. They’re also inevitable.

Goodbye experiences are as final as a death and as common as leaving the embrace of your partner to get a snack from the kitchen.

They begin the first time someone takes us out of our mother’s arms when we are born (or maybe we didn’t even get there; for some of us, they start at birth).

Well, we say, everything comes to an end. Or, harsher, we all have to learn to live with disappointment.

Our first “task” as humans is to learn what psychoanalyst Erik Erikson called basic trust. Developing basic trust means learning that even though our parents leave us in our crib, they will come back. Someone will feed us, hold us, change us, and comfort us.

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Hopefully we learn that. Not all of us are so lucky.

For those of us not given the chance to develop basic trust, goodbyes can be even harder. They’re hard because we’ve barely learned how to connect and attach to someone else and we think if we don’t attach, we won’t feel bad when the time with that person ends. Or so the theory goes for people who try hard not to connect.

Over time, we realize that strategy doesn’t work. We continue to get hurt and, worse, don’t understand why.

As a young clinician, I hated goodbyes. I resisted the idea and would have preferred therapy just end. “Oh, you’re done? Goals met somewhat satisfactorily? Good luck, so long, be well!”

But I was taught to allow people in therapy to have an ending—or “good goodbye,” as we called it. (The technical term is “termination process.”) So many people have stories in which other people just disappeared from their lives—a common core issue in therapy—that the therapeutic relationship should not only not replicate this, but heal it.

At least, that was the message I was given. But it was difficult to sit with.

This process could last three months, and the difficult part was what happened in those three months.

Have you ever noticed what happens when you know something is coming to an end? Think about the last time a friend moved. Notice anything in how you treated others?

As endings near, we get to see the stuff that was being held back. Maybe you snap at someone you never felt angry with before. Perhaps you find it important to make their final party perfect or hold out hope that when they see how much they will be missed they will change their mind. Maybe you start to see and remember only the amazing and wonderful things about this person and forget the difficult times you’ve had together.

If you’re having a really strong termination process, you’ll cycle through all of these. Because if you can move through the stages of denial, anger, bargaining, and depression, you can get to acceptance. You can really say a “good goodbye.”

Endings are powerful because, if we allow, we get to release all the feelings we’ve attached to the other person. When we do that, we are truly in relationship with them.Endings are powerful because, if we allow, we get to release all the feelings we’ve attached to the other person. When we do that, we are truly in relationship with them.

Allowing this process to happen with your therapist can be incredibly helpful—sometimes the termination may be the most insightful work you do in your therapy.

Because it’s so difficult to fully trust that someone will hang around after they’ve seen the “worst” of us, we inevitably hold stuff back. From friends, from relationships, from family, and from others. It’s rare we show all of ourselves to anyone.

When saying goodbye, there’s a “what-do-I-have-to-lose” quality at play. And we can become closer because of it.

Sometimes, we avoid the goodbye because we’re really angry. A friend of mine was telling me the other day she stopped seeing her therapist. She had been working with this therapist for several years and said the treatment was very good … at first. It was helpful to talk about much of what she’d been holding in, but she wanted something else and wasn’t getting it. So she emailed him and ended the therapy.

By emailing, she missed out on letting her therapist know how disappointed and angry she was.

Of course, she also avoided the discomfort. Why put yourself through that?

But that’s also what you’re going to therapy for: to be able to say all you feel and have it be heard without being judged. You might not get that chance anywhere else.

I love to talk. I can sit and watch one of those movies where nothing seems to happen except a bunch of people sitting around a room chatting. I can still be riveted because I love hearing ideas. I like words.

But talk therapy doesn’t always mean a lot of talking. Sometimes it gets quiet in therapy, and that’s okay.

In fact, it can be good.

If you think I’m “talking” out of both sides of my mouth here, it’s probably because I’ve written on this site about how talking about anything, even if it’s not something you think is related to your issue, can bring you to new realizations. It can open a door to your psyche. It can make connections about why you do things that you might not have figured out without the winding, goal-less, meandering free chat.

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Yet, in some cases those words could obscure what’s really going on. They may get in the way of some important feelings. In fact, talking can be the very defense we use to avoid having certain feelings.

The Ultimate Therapy Cliché

“How are you feeling?”

It’s a pretty clichéd therapy line. So much so that when I was a young therapist I told myself I’d never say it. I didn’t want to be compared to the long line of bad TV and movie therapists; I’d have something much more insightful to offer.

Ha.

I soon realized that it’s a cliché because people often don’t know what they’re feeling.

Sometimes the question is actually fairly stressful, and for good reason. Some people spend so much time thinking and talking that they never really connect with what they are feeling. If they are asked, “How are you feeling?” the most honest answer they may be able to give is, “I don’t know.”

And that’s fine. “I don’t know” is always a fine answer. At least as a starting point. It can be a relief to say it. Correct: you don’t know. That’s why you’re here.

And then … silence. And then you sit with that unnamed feeling.

Finding the Feeling in the Silence

If you’re a storyteller, then these are important, rich, and scary moments. It can be exasperating because you often really, really want to know. And I’d love to tell you—but I don’t know how you feel, either. My tool is I’m very aware of how I’m feeling when I’m with you. And that can be helpful to share.

Therapy is not a “conversation.” It’s not a normal situation. It’s a petri dish, an experiment, a place to look at the way we interact on a meta level.

But in general, we need the silence so you can check in with yourself and see where that feeling is. Maybe it’s in your body—many physical sensations are signs of a feeling we’re having before we’re aware of it.

Heck, the “anger management” field is practically built on the idea that if we can sense that first sensation indicating we are angry (tight stomach, hot face, clenching fists), we may be able to prevent ourselves from being taken over by an uncontrolled feeling expression.

For my part, often if I have a headache, it’s a signal I’ve been feeling sad and I need to allow that feeling in. Sometimes the headache needs to pound to let me know I need to stop thinking, stop analyzing, stop talking—and just feel.

Why Silence in Therapy Is Different

Therapy is not a “conversation.” It’s not a normal situation. It’s a petri dish, an experiment, a place to look at the way we interact on a meta level. It’s often pushing against what generally makes sense as to how we go about our lives. This is why it takes time to build trust with your therapist. It’s so when you sit in silence, you can trust that you and your therapist are both still working. You’re both allowing a process to unfold and occur and not know where it’s going.

The silence gives you time to connect with your therapist—and then tell them—what you’re feeling. Something like:

• “When we’re not talking, I get upset because I feel you’re not helping me anymore.”
• “If you don’t talk, I feel like you’re abandoning me. It makes me feel very alone.”
• “You’re getting paid for nothing! You must love it when we don’t talk. What am I to you, just a cash cow?”
• “I don’t know what to say. I’m stuck.”

How refreshing would it be to say that to someone whose job it is to process it with you? It’s a chance to better understand how you come across in an environment with someone who won’t leave you.

Trust this part of the process.

Trust the silence. It can say so much.