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Saturday, May 16, 2015

Psychotherapy Blog: Developing a Sense of Safety and Trust With Your Therapist

Being able to trust your therapist and feel safe in therapy is an essential part of psychotherapy that develops over time.

Developing a Sense of Safety and Trust With a Therapist is a Process
Developing trust can take a while, especially if you have a traumatic history where your trust was violated by family members or other people in your life who were supposed to be trustworthy.

Developing a Sense of Safety and Trust With Your Therapist

Skilled psychotherapists know that the initial stage of therapy is about building a rapport and a sense of trust, and it's up to the therapist to create a therapeutic environment that fosters trust and safety (see my article:  The Creation of the Holding Environment in Therapy).

Feeling like you can trust (or not) isn't an all-or-nothing process.  Trust develops gradually by degrees over time.

From the moment a client walks into a psychotherapist's office for the initial consultation s/he is trying to assess whether or not the therapist can be trusted.  Often, this is more of an unconscious process that occurs not only in a therapy setting but also in most situations where people are meeting someone new or coming into a new environment.

But, unlike many other settings, since you're coming to work on personal problems, you're more emotionally vulnerable in therapy than you are in more casual circumstances.  So, it's understandable that most people feel a degree of apprehension and ambivalence when they begin therapy (see my article:  The Psychotherapist's Empathic Attunement).

How to Use Your Therapy Consultation Session
When potential clients contact me about therapy, I usually tell them to think of the first session as a consultation.  It's an appointment to talk about their problems in a broad way, to ask questions about how I work in therapy and my experience, and to get a basic sense of whether they feel enough of a rapport to come back for another session.  It's also a time for me to assess whether or not I feel I can help the client.

Most clients don't take the time to ask questions on their own about the therapist's background, skills and whether she has worked with other clients on this same issue (see my article:  How to Choose a Psychotherapist).

These are important questions that can save you time and money as well as help to ensure that this is the right therapist for you (see my article:  Getting the Most Out of Therapy).

Assuming that you set subsequent appointments, the process of assessing whether you can trust a therapist and if you feel safe in therapy continues over time.

Some tips to consider as to whether a therapist is right for you:
  • Do you feel heard by the therapist?
  • Does the therapist seem to be empathetic?
  • Is she reliable and professional?
  • Does she seem to have your best interests at heart?
  • Is she clear about her policies with regard to fee, cancellations and appointment times?
  • Has she collaborated with you about the treatment?
  • Does she have the therapeutic skills necessary to help you with your problems?
  • Does she adhere to the fee structure and other policies?
If, after a few sessions, you feel that you and the therapist aren't a good match, it's best to talk about this in your next therapy session.  Don't just abort treatment abruptly.

Most experienced therapists know that every therapist isn't right for every client, and this often has nothing to do with the therapist's skills.  Often, it's an intuitive sense that the client has.

To evaluate this for yourself, it's important to be honest with yourself and to be able to distinguish your possible discomfort with dealing with your problems in therapy vs. your comfort level with the  therapist.

It's easy to fool yourself and tell yourself that you're not comfortable with the therapist when maybe there's an unconscious part of you that would rather not deal with your problems at all, no matter who the therapist is.

Once again, if you come from a traumatic background, the idea of "safety" is a relative issue.  It might be challenging for you to trust anyone, so the initial stage of treatment might be about how you can know if you feel safe and trusting enough.

Getting Help in Therapy
Allowing yourself to be vulnerable enough to start therapy can be challenging.

Many people avoid therapy, even though they feel they need it, because they're too afraid to take that emotional risk of finding out if they can trust a therapist.  But, even for people who feel most vulnerable, when the thought of continuing to be affected by their problems feel worse than taking the risk of being vulnerable, they will consider coming for a consultation.

Most people can use their instincts as to whether they feel they can trust a particular therapist, especially if they remember that it's a gradual process and not an all-or-nothing event.

Getting help in therapy can make the difference between continuing to suffer with your problems or working through your problem and living a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.


















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