Session 266: Am I My Therapist’s Favorite Client? And Other Things You Might Be Wondering

Session 266: Am I My Therapist's Favorite Client? And Other Things You Might Be Wondering

Dr. Joy: Hey, y'all! Thanks so much for joining me for Session 266 of the Therapy for Black Girls podcast. We'll get right into our conversation after a word from our sponsors.

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Dr. Joy: The relationship we have with our therapist is unlike any other we have in our lives. They typically know lots about us while we usually only know a little about them. This is designed so that our emotional safety and needs are prioritized in this space but it can also lead to lots of questions that sometimes go unanswered. Joining me today for another one of our group chat conversations are my friends and colleagues, Dr. Ayanna Abrams and Dr. Joy Beckwith, both psychologists in Atlanta. We’re answering some of the questions you might have about your therapist that you didn't want to ask.

During our conversation, we chatted about whether we actually have favorite or funniest clients, how we handle seeing clients publicly, what it means if you find yourself attracted to your therapist, and whether or not it's okay to be friends with your therapist after you're done with therapy. If something resonates with you while enjoying our conversation, please share it with us on social media using the hashtag #TBGinSession or join us over in the Sister Circle to talk more in-depth about the episode. You can join us at Community.TherapyForBlackGirls.com. Here's our conversation.

Dr. Joy: The infamous group chat is back once again, back in action. I just love that y'all come and add such great information because I think these are some of the conversations we're talking about in our group chat, but I also think it's just great for people to hear about some of the dynamics that happen in therapy that we don't always know about. Something I wanted to chat with you all about today—or at least start the conversation because we know when we get to talking, who knows where this conversation will end up. But I have recently been seeing a lot of jokes on social media around wanting to be a therapist's favorite client. I feel like I am my therapist’s favorite client or she always looks really happy to see me. I've even seen a joke around somebody being in a waiting room and overhearing the therapist laughing with another client and feeling like, oh, she doesn't laugh that hard when I'm with her. Like, am I not her funniest client? Am I not her favorite? And I think that this is a real thing. People mention it in passing but I think it really speaks to all of these different dynamics that happen with our therapists that we don't even know.

Dr. Beckwith: Oh yeah, absolutely. I wasn't aware that it was a thing. It caught me off guard and I had that exact same experience, Dr. Joy, once where my client was waiting in the waiting room and I was walking another client out and we were chuckling, like we’d just finished chuckling or whatever to end the session. And I remember starting with my person and her saying, “Oh my gosh, you look really happy. You don't laugh like that with me.” I think I sat with it afterwards, like wait a minute. Things that you don't think people notice, like do I make you happy?

I know, I think just like in the larger world, therapy is not exempt from that. We want to be liked. We have this social desire for us to be liked and to be seen as a pleasant person, so that is there and we're not exempt from that. And so to see it in therapy, although it was shocking to me in that moment, like, hey, do you like me as much as you like that person? Or am I just as funny? It's like, wait a minute, you are not here for my entertainment. This is not a contest, like who made me laugh the most during therapy. And you don't know if I just tripped and like, oh, let me gather myself before I go into the waiting room or you don't know what that chuckle was about. I get it, I understand the need to be seen in a positive light, but I just didn't think about it until that day. So I remember that yeah.

Dr. Abrams: I think most people when they think about therapy and therapists, they don't recognize that it's a relationship. That it is a social relationship. It's an atypical social relationship because there's not this back and forth sharing kind of vulnerability and kind of growing like we do in our other relationships, but it is still social. And as social beings, we have this innate need to want to connect and belong and be liked and there are certain cues that we receive that tell us that this person likes us. Laughing and smiling and a warmth that's in the room, or like these kinds of things that we tend to look for in our typical social relationships also show up in the therapeutic relationship. And that's the main point of therapy, is that people think that they're like different people in the therapist’s office and you're not.

You bring in your stuff to us and it actually gives us an opportunity to really work through these things that we know show up in your day-to-day life. If there's a client who comes in and says, hey, I'm curious and maybe I'm even a little bit jealous that you might not laugh that same way with me, my guess is that shows up in other areas of your life, and now we have some stuff that we can talk about here. But I recognize that I think largely the population, whether they go to therapy or not, unless you have a certain kind of therapist who's actually more relational and intentional about talking about our relationship, they don't recognize that this is really about the foundation of our relationship together. And the safety and kind of how we show up with each other, and our identities and our needs, and all those kinds of things.

I know that there are ways in which many clients, if not all clients, wonder about if their therapist likes them, cares for them, thinks about them outside of session. Gets annoyed by them, thinks they're a burden. We see all these things. I have clients who say sorry for crying. I don't want to..., right? It's all these same dynamics that show up because I want you to like me and I don't want to be too difficult for you. I want you to have pleasant thoughts about me because that is how we want everyone essentially to be able to respond to us, so it makes sense.

Dr. Beckwith: You're right. The information, if you're wondering, do you like me? Or, oh, my gosh, I feel like I'm being a burden to you, of course, is great information for us. Is this a feeling that you're having in multiple relationships? Do you feel like you are a burden in other relationships? I think we don't help it and we're very well trained. We are very well trained to be like this blank slate and to not show this gamut of emotions. And that is, as you mentioned, like we have this atypical relationship. So it's like, here's an interpersonal relationship that is atypical where I'm expecting you not to have any thoughts or any opinions or to feel any type of way. I'm supposed to just kind of pour. Whereas there are other signs and signals where a person's nodding or smiling or, oh, you're giving all of these other cues as you approve of this. Oh, that's just as jacked up to you as it is to me, you know, we don't give you that. So here it is this blank slate, here it is this person that's not giving me a lot of verbal feedback or affirmations back or you're not affirming my experiences. And I was like, okay, what do I do? Like, does she think I'm off or does she think this is normal? Do you like me? Am I too much for you? Are you mad at me? Do I think like others think? And so being able to still show up in that space and to talk about those feelings, of course, it's important. So we can see, is it a me thing, like our relationship thing, where you're experiencing this in therapy? Or is this something that is consistent throughout various relationships?

Part of the dynamics of this atypical relationship kind of waters this, well, wait a minute—you didn't blink, you didn't smile, your cheeks are not up. Or those things that we normally get our signals and our information from. They're kind of turned down in this relationship. It makes sense that we're wondering. It’s like, well, we don't know. That’s why I’m looking at the waiting room because I can't tell if you really like me or not so let me find some other cue. Like you're laughing there in the waiting room.

Dr. Joy: You bring up a really good point, Dr. A, that I want to hear y'all talk more about this idea. Because I think it's a very real thing of does my therapist think about me? I think a lot of people, in some ways, are hesitant to even try therapy because it feels like a paid friendship. You know, like, oh, I gotta pay somebody to listen to me. And do they really care about me? But I'm paying them so of course, they have to care, right? How do you address those kinds of concerns or thoughts?

Dr. Abrams: I have had clients literally say that to me when I am, I call it kind of an interpersonal process, when I'm checking in with how they might receive something that I said and how it landed. And I've had some clients say it does matter to me that you think this way or like I trust you and you know me in such intimate ways that I'm really kind of leaning into how you are assessing this. And I've had some other clients say that I'm paying you so I know that you can't be mean to me, I know that you can't really like disagree with me in here. And I'm just like, well, that's not true. I can disagree with you. Again, I have a way in which I would do that therapeutically but I think that does factor into, depending on who the person is, how they even kind of understand or see the services.

Do they see it as a service? Do they see it as a relationship? Do they see it as kind of something short-term? I need you for this, you're gonna move me through these three things I need, boom, boom, boom. Am I here because I'm mandated? I think all those things mitigate how they even see the relationship. And if they do see it as a relationship and there is trust. And more than likely, even if it's long term and there's been vulnerability in there, it does tap into this desire to be cared for and thought of in certain ways. And not only cared for in terms of “you answer my questions about this,” but do you actually care for me and my identities and when I'm out in the world when I'm not here? And as Dr. Joy said, they have no clue unless we say it. They have no clue whether I think about them outside.

Even if I say to them, yeah, I think about my clients probably too much. I'll be walking down the street and think about something like, oh, I think they just mentioned that they were here the other day. Like we think about you all much more than you think we think about you because we're also trained to not add our stuff into the relationship. But what I've noticed, depending on how clients even make it to therapy and if they see it as a valuable relationship and or service, really mitigates what I notice of their concerns or even interest in me thinking about them, past what they're saying to me in session.

Dr. Beckwith: Absolutely. You're getting at what is that thought rooted in? Do you think about me outside of therapy? What is that rooted in? Is it rooted in do you feel that this is a paid relationship, so it's like, okay, you're done and okay, got my money and you're gone? Is that what you think you're worth? Is that what you think? That, oh, people are kind to me because I pay them. I love that you said that, Dr. A. I think I'm also not afraid—within boundaries, within limits—to let people know that we’re human. Here you are it's like, hey, here's a therapist. And it's like it just doesn't turn on and turn off. And so yes, I do care about your experience (like you said, Dr. A) sometimes too much. You're out and you're like, oh, my gosh, they've been wanting a nice place to go to. Or it seems to be there are a lot of people that are here and that are studying, this may be good for such and such.

So yes, I am thinking about you and hoping that you're well and I am thinking about how can I add to your treatment. Like this place may be a good place. Or if I see a book or if I'm reading something where I think about you. Or sometimes I'm like, you know, I really want to make sure for next time we talk about this,” and I may do a lot of homework outside of the session to make sure that I am caring for you as best as possible in the session. So do I think about you? Absolutely, I think about you. It doesn't mean every single day you're on my mind, but it also doesn't mean that when you're out of sight, you're out of mind. And so being human to be able to say, yeah, it's not that switch that goes on and off. At least the therapists that I know, my friends, this is not like a paid friendship. This is not an I deeply care about you and genuinely care about you, your life, and this work. And so, yeah.

Dr. Abrams: I think this also goes back to many people not understanding what therapy is. They think that therapists are here to be nice to you and to coddle you and to make you feel better. That's actually not what therapy is. I think it's also because of that. I've been seeing those infographics floating around the internet saying something like, “That's why people think that their friends are their therapists.” Because they think it's just about talking about the thing and sharing advice versus like a treatment plan. We're talking about this and like we're processing this. That's why you think your partner can be your therapist. That's why you think your friend can be your therapist or your hairstylist can be your therapist. Because you actually don't understand that there's a really kind of formal way in which we're moving through understanding it.

And that's why this is not a friendship, that's why we're not sharing things about each other. Because there is a formalized process within a lot of this vulnerability and conversation and opening and all this kind of stuff. So I think it's also about people, when they don't really understand what therapy is, whether in terms of how we're doing level setting or where they're getting information from. They look for it to be a friendship so they're going to do the same things they would do and expect the same thing that they would expect of their friends.

Dr. Beckwith: Which is why you're looking for those same cues that you will look for from a friend to say like, hey, does this person accept me? Do we belong? You're looking for like those social cues to say, hey, we are connected, we are good, they agree. You're looking for that external validation that you would normally look for in a friendship. Like you said, Dr. A, we know that for those who have been in therapy, you've been in therapy for quite some time, you realize, no, they don't just tell me all the positives and just validate my experience. It's like, no, some days you leave and it's like, oh, man, that was tough. Or, ooh, I didn't like to hear that piece of information but it was necessary for me to hear it. And so it is not this paid friendship where you are having coffee and you're just laughing and talking about what your experience has been. No. There is structure, there is a treatment plan, and we do what we call the work.

Dr. Joy: Yeah. I think to both of your points around therapy being a relationship but atypical. Because you're not hearing all about our weekend plans and there's not that kind of reciprocal nature to it. But I do think, when those moments happen, at least for me, that makes the work so much richer because now I get a fuller picture of what's going on with you. So we know that there's the thing that clients come in with, and then there's all this other stuff. Yes, maybe you're having panic attacks and we're working on some stuff around that. But then you have these conversations, like, oh, you were laughing really hard with this client in a waiting room, and do you like me in those same ways? So now we have an opportunity to talk about where else in your life is that showing up? And what does it feel like you're needing from me and what does that say about our relationship in terms of working together? I think those kinds of situations make the work so much richer, to me.

Dr. Beckwith: It's like collateral information where you don't necessarily come in and say, you know, hey, I people please or I need to be liked or whatever these things are, but we're able to see it. Whether we address it in that moment or later on, it just kind of helps to paint the picture because the goal is to make sure that you are living life as boldly as possible. So yeah, you may not say it but it's like, okay, I'm noticing that. Or you're complimenting the therapist a whole lot. And of course, there's a time and place where we talk about that and you realize, okay, let's talk about the dynamics of this relationship to make sure that, you know, is this how you're behaving in various other situations? Or is there something going on with us where you feel the need to be liked by me, so to speak? And so you're complimenting my hair, my clothes, or you're apologizing a whole lot. Is there something going on where you're starting to feel like you're a burden? Or did I write too much and you're like, okay, well *[inaudible 0:16:55] was clear before I came in here, whatever it is. But, yeah, that additional information is very much helpful.

Dr. Abrams: It also makes me think about the different kinds of therapeutic styles. I know that I have therapist colleagues that if a comment like that were to come up, because they're more solution-focused, they're not doing any of that relational work. They're not interpersonal relational. They're holding that, they might talk to a colleague about that, but they're not bringing it back into the space for us to kind of process or explore. So I think also thinking about what kind of therapist you are and or what kind of therapist you might be seeking, in terms of that kind of relational work. Because that is oftentimes more theoretical and stylistic, and many therapists are not going to do anything with that information.

The more kind of cognitive or other kinds of treatment don’t really look at how we are functioning here together and naming that. I also find that to be something that I think has more room or has more legs, which I find it in a great way, when black women therapists are working with black women clients—to kind of name those things. I think about my clients as I think about my own therapy. Those kinds of relational conversations that I think are more likely to happen, depending on the certain identities of the therapist. So I think other therapist modalities also just don't lend for this kind of processing or exploration.

Dr. Beckwith: I'm happy you said that, Dr. A, because I think one thing that we want to be clear about is that everything is not indicative of something deeper or something bigger. You walk in, and it's like, I got new hair, I got new hair today, it’s like, okay, girl. Again, the dynamics of the relationship. Like okay, I see your hair. That could just be how we're talking to each other and it's like we've been working together for a long time and that is totally fine. It doesn't mean like, oh, my gosh, I cannot say that because she's gonna read more into that. Why did I compliment her? I think it's really clear that we say that everything doesn't have to be indicative of something deeper. I think what you're talking about is that need to be liked. Where that need to know that you're thinking about me or that you care deeply about me.

Dr. Abrams: Where I find you’re complimenting me every week, that might be something that I'm just kind of paying attention to. That you mentioned my hair a lot or you asked me about my clothes a lot or you've asked about what I do outside of therapy. Those are things that are a clinical judgment, really picking up on what might be happening between us or with you to be able to process. But one-offs or maybe even two, I probably wouldn't kind of lean into any more processing or exploration.

Dr. Beckwith: Yeah, it's not a pattern, it's not something that is your regular mojo every single time that I see you.

Dr. Joy: The other thing I've seen come up a lot for people, and maybe this is a little different now because I think a lot of us are still operating virtually. But I've also seen a lot of conversation around if you are going to therapy during your lunch hour or during dinner time or like if you're picking up coffee, do you bring one for your therapist? What are the rules or the ethical guidelines around those kinds of things? I think we have guidelines around gift giving and receiving gifts from clients. I think we do have to be careful. I know we had lots of conversations in grad school around particularly when you're working with a diverse clientele and how gifts mean different things culturally. But how do you all think about that and how do y’all process that with clients if that comes up?

Dr. Beckwith: I think it goes back to what we were saying earlier, this is a different type of relationship. So if I were going over to see Dr. Joy and I'm like I'm just gonna stop off and grab me a cup of coffee on my way, as a friend in these social relationships—yeah, I would probably say like, hey, can I bring you something from here as well? I understand that gear, but also to understand this is not that. That you don't owe me any type of drink, you don't have to give me a gift. And so yeah, we have these ethical guidelines around being able to accept gifts and those things so I love talking about it if it comes up. Like, oh, I started to get you this or I started to get you that, then what's tied to that? Oh, I wanted to get you a gift because I understand that you typically get the people you care about or the people you appreciate gifts. And that's fine to have that thought or the idea, knowing what the therapeutic relationship is. What are the dynamics of this relationship where you don't owe me a coffee or tea? I don't like you more because you thought to bring me a coffee or a tea. I'm not expecting you, if you walk in with coffee or tea, that, oh, where's the one for me?

So being able to talk about I understand because you're a kind person, that's just who you are. If you were going to see anyone else, you probably would have brought one but it's okay not in this context. That's not the expectation, that's not the type of relationship that we have. Not making it to be a bad thing because you had that thought or it crossed your mind. And also, some people don't ask if they could or would. Once someone came in like, oh, I brought you a blank, blank, blank. And it's like, oh my gosh, that's so kind. And I recall putting it on the desk behind me and then just sitting down and engaging in the conversation as I normally would. Not to be offensive, but not to also like, “Oh, my gosh, thank you so much. I'm so happy you brought it.” No. Being mindful of the conversation around if a gift does come. To be able to talk about, oh, you didn't have to do that, and to carry on.

Dr. Abrams: Again, things that clients don't know and aren't necessarily supposed to know, the ethics around this. That the rules have said. That one thing between gifting and sex—no, no, no, no, no. You cannot do. And breaking confidentiality—no, no, no...

Dr. Beckwith: If you know nothing else, you know those two are off limits. If you know nothing else.

Dr. Abrams: I think that as also there have been more communities of color that are seeking therapy, there have been more conversations around the ethics and kind of nuances of when people share those kinds of cultural norms with you because you are a person in their life. And again, they don't see it as this atypical social relationship; you are a person and this is what they do for people who help them. This is what they do around the holidays for people they care about. So I think really, really being able to hone in or at least kind of process or explore the motivations around that.

And also your clinical judgment around how you know this person. I have had, it might have been two clients, who have been on the way and they brought me something to drink, something like that. And I recognized that as a kind social gesture, so not anything for me to say anything a lot about. Like you were saying, I said thank you, I put it down, I didn't engage in it. But I also didn't go into, “Tell me. You bought me this drink. Is that about something else? Do you want to be liked by me?” Like I didn't go into all of those details around it and it was also a one-off. My hunch is that if that would have happened the next week or the next session, I would have been open and been like, hey, I notice that this is the second time that you've brought me something to drink. A really kind gesture. Just wanted to explore what that was about. Thank you for thinking...” Like those kinds of things, right?

I think it also depends on what the thing is. I think there's a difference between somebody passing by and kind of grabbing two drinks while they're on their session, versus somebody baking something for you or making something for you. Versus somebody buying something for you that might have a certain budget. I think some of the ethics is that if it's a gift that's under maybe five or like $10 or something like that, that there's some movement, there's some agility around that. But if you buy me a pair of shoes, if you buy me a sweater, if you gift me something that I have heard you say is for very important mother figures in your life, we're going to have a different conversation around this thing.

Because again, what I know of you, what I've been able to kind of glean of your culture and or our relationship—that lends itself for different kinds of conversations and maybe some boundaries around that. But not in a harsh or punitive way. Oftentimes, I think people just don't know. People do not know that this is an atypical social relationship. And yes, I would love the coffee, I'm probably tired, but that has other implications in this kind of relationship so I will put it right there and I'm going to thank you for the gesture.

Dr. Beckwith: Absolutely. I understand it. I understand that that seems like more of a social response because you're going to be three minutes late. I'm gonna be three minutes late because I really need his coffee because I'm tired, and so I just thought to bring you one. And then I also think that it allows us to take a look too. Like you did it the last five times, am I looking sleepy during your session? I actually feel good. Did I not offer something? Never done that before, but is it happening in your six o'clock session? Am I pulling something from you that is making you feel that you need to gift me or you need to bring me coffee when you come for your session? Or is it more of, like you said, this social thing because the social dynamics or your cultural dynamics—you do gift people who have significantly helped you. And also freeing you from that. You get to have a relationship where you get to just be and I know that you are appreciative of the work that we do together. And guess what, you owe me nothing as a result of it. The gift in itself of you getting better is the gift back.

Dr. Joy: Yeah. More from our group chat conversation after the break.

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Dr. Joy: I feel like on the other end of the spectrum, and we talk a lot about this atypical relationship because there aren't (I don't think) any other relationships in our lives like the one that we typically have with our therapists. Sometimes when strong feelings come up, we don't have language for what's happening. I think then that leads to people having crushes or feeling like they're having a crush or in love with their therapist. I don't know if either of you watched this show Grand Crew that came out earlier this year. It was on NBC, a pretty good show. There was a storyline around a guy in therapy who had a crush on his woman therapist. And I do think that this happens because we sometimes have these strong feelings. In other relationships in our lives, what this looks like is that there's a romantic attraction and so sometimes we also label that with our therapist. Can y'all talk about whether you've had those experiences? Or how can people make sense of any strong attraction kinds of feeling they're having for their therapist?

Dr. Beckwith: I think you're speaking a little bit to like transference in a way, where you have these strong feelings, these strong emotions that are coming up for you in the therapeutic setting with your therapist. I think, Dr. Joy, you're spot on in that it's such a relationship where we know that vulnerability is like the bridge to connection. So here's a space where, guess what I'm doing, I am feeling accepted. I’m feeling heard, she's listening to me, I'm sharing, feeling cared for—all of the dynamics that we normally experience in the context of an intimate relationship. And it's just like, I love the way we talk, I love the way we communicate, I love the way that you listen. And it's like, so what is it bringing up for you? Oh, I would love to be in a relationship with this person or I'm in love with this person. You're speaking of this transference of energy and emotions that normally would equal a relationship outside of the therapy room, and now it's in the therapy room. You would love that in a relationship, yes, but this is a different type of relationship.

Dr. Abrams: Yeah, absolutely. These are really intimate relationships. Really, really intimate relationships. Particularly for people who do not have any access to that kind of intimacy outside of this relationship, it makes it mean a lot, like so much more. Not only is it around the intimacy that is created as it relates to the vulnerability of what they're offering, but also ideally what's happening in therapy is that we're offering you a corrective experience. So you are now sharing things with us that you more than likely have tried to share with other people and you have felt invalidated, harmed, hurt, unseen, unheard, and now there's this person who does this. And does this week after week after week after week, right? And the relationship is building and growing, it gets more intimate as you continue the work, as you kind of talk about different areas of your life.

So it also makes sense that there’s an emotional attraction to the space and to the person who can offer you these things that you may have been longing for since you were a young child. Of course, you gravitate towards this space. I think what can also happen is—depending on who the client is, depending on who the therapist is, age dynamics, possibly similar cultural groups, possibly similar backgrounds—all these different things also add into the therapist may be a person this person would date. This would be a person that they would find on an app. This would be a person, had they met them out, they would want to get. Per what they know of me because outside, we're not the same! But I think it also factors into the limited way in which you know the therapist.

I’m not saying the therapist wouldn't be a great person to date, but because you have this fairly limited relationship with them, where the therapist is all these things for and with you, you expand that into a relationship. This is all you know of them and if this is how they are with these parts of me, they'd be great in all the other parts. And then also adding in if there is a physical attraction. If the therapist is someone's type and or if the therapist represents any identities that subconsciously this person longs for in some way. I haven't had this particular experience but kind of seen it where that transference looks like, hey, I'm attracted to you because you also look like or act like or smell like someone who has rejected me in the past. It can also show up that way.

I've had two clients who have named being romantically attracted. And depending on how you work, and if you are interpersonal relational theory or not, you can create room for that kind of conversation. I had skills I didn't know I had because I had never experienced this before, but being able to move this into this process of vulnerability and validation and not kind of immediately saying like, nope, boundaries. We can't do this, we can't do this, we can't do this. I actually hear therapists respond in that harsh way because of what we learn about attraction and transference and countertransference. But really being able to move that into a therapeutic conversation that normalizes, hey, it makes a lot of sense. You're not wrong or bad. And normalizing that people have fantasies about things. That fantasies are thoughts and that it’s okay to have fantasies about these things. But then how do we also navigate if that is something that is getting in the way of your therapeutic care?

What I've also offered to some of my clients it’s that, hey, in a different life and in a different kind of space or world, I could see us get along. We share so many same identities, area, age, like all these. Like I could see those things happening but because this is not that kind of relationship, what does it mean to grieve that kind of friendship that you might be fantasizing about? But I also validate, sure, you’re picking up on the same things and we're cool. We are cool. So I think also offering that kind of normalizing to them can also be really helpful for clients. That they're not making it up, that we have a good relationship, and that we have a good vibe going. But I will also hold the boundary and help them to hold the boundary and that's my responsibility.

Dr. Beckwith: I love that you said that because one of the things I wanted to highlight, Dr. A, we were talking about this transference thing in the sense of an intimate relationship. That it does not have to only be like this intimate sexual type relationship of transference of emotions. Where we may see it where it's like, oh my gosh, like you are so kind, so cool. All those things we talked about in an intimate capacity. Where, oh my gosh, I want to be your friend. Can we have coffee? I’d love to travel with you. And it's for all of those reasons that you mentioned before—here is a different type of relationship where we communicate well, I'm helping you to understand yourself, you're helping me to understand you, there's a corrective experience, there is no judgment. And it's like, wow, for a lot of us, we don't have friendships like that. Where it's like, you know, oh, you're really opinionated or you're angry with me for days, and whatever those friendships may be like outside of the therapeutic room, here it is like here's a person that I see on a weekly basis and I can basically be seen and be very open. Like I tell you my life and you are accepting, you are understanding, you still see me, all of those things. And it's natural that a person would say, hey, this is a person that I would be friends with.

It's up to us, as you mentioned, Dr. A, to have some boundaries. Like we have to be able to know what the boundaries are, to honor those boundaries, and to also understand—I know why those emotions are coming up for you, I know why they are present. It makes sense. When there is a void in other areas, I understand why this feels sweeter to you. And like you said, yes, we do connect, we do have a great relationship. What you are feeling is real. I do understand you, we do communicate well, all of those things are real and that's fine. Because I have boundaries and you have boundaries, it doesn't mean that we... We don't have to terminate the relationship. We can have an understanding of kind of what is happening here. There is some awareness. How do we spin this and turn this into (if need be) part of our treatment plan?

Dr. Joy: What both of you are talking about, I feel like requires a great deal of self-assessment. Again, depending on how you operate theoretically and stylistically. For some people, a client coming and talking about feeling attracted to them, I think would have all of their wires going up. Like, oh, we’ve got to terminate this. Can y'all talk about how do you develop that as a therapist? What kinds of things do you need to be paying attention to for yourself in assessing so that you are actually handling these kinds of conversations with care?

Dr. Beckwith: I think the first thing that's coming up for me (not sure if it even answers the question) is that there also can be countertransference, too. You’re talking about self-awareness, where the client could have these feelings in these strong emotions. It's like being aware of, do you also have these same feelings and these same emotions? Or is there something that you are doing because, okay, this is my client but I am dressing a certain way. In the sense of like I'm more casual, but on Thursdays, your girl turns it up a little bit because of XY and Z. Being aware of making sure that there's no countertransference on your end because it does not work just one way. I think self-awareness is just from that part really, really key. Is there something going on with you, where that's impacting your ability to be able to treat and to be able to see what's going on in this relationship?

Dr. Abrams: That is it. It's that self of therapist work. What is coming up for me around this? Because even if a client is to share that they have these fantasies, there's some relationship that I have with fantasies or some relationship that I have with people who are like my client and then having fantasies about me. More than likely, that's getting activated in some way. And then what do I even understand about that? Before it even makes it to how I can respond to them and still care for them and care for the both of us in this relationship. For me, I don't feel threatened by fantasies. I separate those from actions or intentions or those kinds of things. But if that is something that has shown up in your personal life in some way, you're probably going to have a different relationship to it.

So thinking about how that shows up in gendered ways. I imagine that if there is a client who you are working with who either you're attracted to and or maybe have some misgivings about because of how they show up in the room—you're gonna respond differently to them saying something that you might hear as boundary violation because it's stepping outside of this therapeutic norm or rule. But again, it's really about how you are thinking about those things, and what's your awareness about where that lands in you? And then you can fill in the gap between how it makes it to the client. But I think a lot of that (if not the majority of that) is our work and our own boundaries around those kinds of things. Because we're also human. Not to say that therapists are perfect at kind of holding these kinds of boundaries, but when there's lower self-awareness, there's going to be more kind of diffused or kind of loose boundaries in those kinds of areas.

Dr. Beckwith: You’re talking self-awareness is to do our own work, and oftentimes that does come with having our own therapist or even our consult groups, our peer groups, so that we are continuously learning and being able to talk about, being able to share, being able to assess and evaluate. I think when we are self-aware and doing our own work, then we can respond appropriately to this situation. So if there is something that you're feeling, then being able to process that with your own therapist. If there's something that is transference from the client to you—oh, why did you respond that way? You were really ready to shut that down and whatever. Is their inability on your part to hold boundaries in place? To be able to process that. Do you have something too? So now that I know this person likes me or they have these strong feelings, is that going to make the work difficult for you to continue? And so really being aware and having a place where you can do your own work as well?

Dr. Joy: Yeah, you're right because I've heard therapists talk about working with clients who like remind them of their mothers, and they have a difficult relationship with their mother. And so, yeah, we are talking about the romantic piece, but there are lots of different ways countertransference can show up and really impact the work that you do with your clients.

Dr. Beckwith: You're going real hard for her because she reminds you of your mom and she accepts you and she sees the beauty and she's so proud of you and those things. It’s like, you know what, you're working on the weekends for sister such and such because it's a mom replacement or it kind of helps to target that area that you feel most vulnerable in.

Dr. Abrams: I also wanted to offer an example because what I've also seen countertransference-wise is that without the self-awareness, are you viewing and valuing that what someone is doing is because they have a crush on you? I've seen therapists talk about, well, they're dressing this way when they come to session with me and they're doing these things, and it's just like, are they? What is coming up for you around that because you are noticing that you are seeing a certain part of a person's body and you are assuming that that is for you? I’m having a conversation, what makes you think that she ain't got somewhere to go after you? It doesn’t mean that that is for you.

But there's that countertransference piece and that was related to this particular clinician's relationships with women who he had dated. So just thinking about, hey, what's my stuff that might be coming up, and am I projecting that onto how my clients are showing up? Again, that's where I've got to do some of my own work in terms of these assumptions I'm making about why they're showing up in a certain way. And if we haven't done our own work, we think about those things as clinical judgment but they actually might be countertransference.

Dr. Beckwith: Can a person show up as dressed well or whatever, and you're not going to be hit on? Like can I just come and just be who I am without you feeling like, okay, you know what, because I look like this and when I wear this then, oh, she must be trying to get with me? Or can a person come well-dressed in your office because they want to be seen? I want to carry myself a certain way, I honor and value your time and your work your expertise and so I come a little more dressed up to my sessions. Not because of anything else—because I value me and I value you. Is that, okay? It doesn't have to be, “You’re trying to impress me.” Again, everything doesn't have to be a problem. I get it, we're looking at patterns and everything else that comes along with it and not in isolation when we make that assumption, but yeah.

I remember reading something on social media a long time ago with relationships and they were saying that kindness and generosity and these behaviors are so uncommon these days, that a person thinks that you being kind to them means that you like them or you want to be in a relationship with them. And it's like, no, I'm just being kind. I'm just listening. I'm checking on you. I don't want to be with you. I think we get the opportunity to give a person that experience where you get to be that you are enough. You get to talk with me, you get to sit, we get to process, you get to be accepted. It’s modeling the correct response. And if you show up and give me all of that, abandonment does not have to result. You don't have to be rejected because you showed who you truly are, because you shared this part of you.

Dr. Joy: We've talked a little bit about why there are ethical guidelines for us. And sometimes clients don't like those because it's like, oh, I want to have coffee with you after we terminate our relationship. What are some of the other ethical guidelines that you maybe have had to talk with clients about that you find some pushback around? Or things that exist that clients don't quite understand why they exist?

Dr. Abrams: Contact in between session. Social media.

Dr. Joy: When you say contact in between session, what do you mean?

Dr. Abrams: Texting, long emails. Screenshots of conversations of a fight that they had and they want to get my feedback on it. It's usually around contact in between session. I've had some things come up around social media—not a lot. Sometimes clients saying stuff to me on social media and then not getting a response and then will process that. Although they signed my social media clause. They know, hey, I don't engage with you on social media for your protection. You are in charge of your own confidentiality but I'm in charge of our confidentiality in terms of our relationship. Those have been the two main or recent ones. I know there have been others. Not with clients, but when people in the community who I know socially want to receive therapy and the ethical guideline is I can't be your therapist because we have a social relationship. Or my family. I can't see my cousin, I can't see my cousin's cousin’s son. Even if I haven't seen him since he was four years old, he could still not be my client. So I actually have more pushback from non-clients about ethical boundaries than my clients these days.

Dr. Beckwith: I definitely see that a lot in wanting a dual relationship. Because we work on this board together or because we sat on this panel or we do this community work, I can't be your therapist. I've definitely seen the text messages or wanting to text or wanting to send this long email as you would with like your girlfriend, and what do you think about this? This transmitting of all of this private information, doing therapy online. Or wanting to invite you to their baby shower or to their fortieth birthday party. Because you're important to me, I care about you, I appreciate you, wanting you to celebrate this milestone. Or coming to my graduation, these other boundaries or these other guidelines that are in place. It's like, nope, can't quite do that but I do understand. I've seen those—the texts, the emails, the phone calls, the invitations to places.

Dr. Joy: More from our group chat conversation after the break.

[BREAK]

Dr. Joy: What are the guidelines? Like why can't you see somebody who you were on a board with? Like we meet once a quarter to talk about finances for some organization, why can't you be their therapist?

Dr. Abrams: You’re going to make me go back to the EPPP.

Dr. Joy: I know it is about dual relationships, but for people who don't understand. Like if I don't really know you, you don't really know me, why can't you be my therapist?

Dr. Beckwith: It's the dual relationship. And doesn’t it also speak about just wanting to make sure that there is not a compromise of care? Like will our relationship impact my judgment and my ability to care for you as if I don't know you? Sometimes it's like, oh my gosh, I'm doing a whole lot of work and I'm going to do all of these things because, hey, this is my board member. And so being able to work and to serve with you, to take care of you and to work with you without having these other things that may be pulling on your judgment or impacting the relationship. Oh, I feel that I have to kind of show up and do this, I have to answer this email because this is the president of my HOA Association and we're friends. So it's giving us the opportunity to work together in a way that will not compromise the care that you're getting and impact our judgment. I think it goes back to that.

Dr. Abrams: And I think that most of the general population, they don't recognize the power of the subconscious. I have a lot of people say, no, we're fine. There's not gonna be any issues, I only see you once or this, that you haven't even met them in this way. But they don't understand how the subconscious really functions and how that can really change our motivations and change our behaviors. And that this is out of protection for clients and of our relationship. Because biases are there and they are unconscious and subconscious and those things come up for both of us on either end.

Like you said, there could be this example of, “Okay, I feel the need to work in a different way with you than I would with my other clients,” and we're also ethically bound to offer similar care across the board. But because this might have other consequences for me and or for you socially, if I make you upset in some way therapeutically, now is my housing in jeopardy? It's those kinds of things that come up in these ways. We can’t have dual relationships where there are things involving money or gifts. Like are you going to start giving me more gifts and kind of doing these things because there's something that you want for me as a therapist? It can get really, really murky and muddy. And because historically there are a number of therapists who have dealt with this in the past, they made this a rule for a reason. They made this a guideline for a reason. Because when these things were not guidelines in these ways, things got really blurry.

People I think also don't recognize how vulnerable they are in the therapeutic relationship. Because there is inherently a power dynamic and they don't really recognize how that vulnerability can really tie into what they look for or what they need. How they might respond to ways in which I am outside of session, and all these expectations that can be set up. You're my therapist, so you should call me back. Or you should choose my kid on the softball team if you're also a coach in the community. There are all these things that can come up and get really, really messy. And we also want to keep the relationship boundary in terms of the information that I have about you is the information that you share with me, not all this collateral information that you might not want me to know. Whether that's a clinical issue or not, I want to keep it to “our relationship is about what you want me to know and what you offer me about yourself, not stuff that I'm gathering from all over the place.” Because that can also shift my objectivity.

Dr. Beckwith: Yeah. And to think about as well—we're talking about our ability to care and treat and how that may be impacted but I also think about it from the client's perspective too. Do you feel comfortable sharing with me this level of information and detail, knowing that we sit on the church board together? There’s a level of honesty and vulnerability and openness that is required to do the work in therapy. It's like, yeah, that can be compromised as well. Oh, you know what? If you were someone else and I knew that you did not know me or you don't know my person who knows my person who knows my person, then I will be honest and open and share this with you. But because we're so connected, because we are part of the same small group, I'm not going to share that with you. Like you said, Dr. A., now that I have all of this collateral information as a result of sitting on this board together or as a result of being in the same small group, do you feel comfortable sharing with me because I know you so intimately in another environment? And so I think it protects the work that we do together on both sides.

Dr. Joy: I know one of the first conversations I think a lot of therapists have with their clients are around like if I see you in public... That's one of the very first things we address in that initial kind of intake session. If I see you, I'm not going to speak to you because I never want to put you in the position of having to identify who I am. But if you speak, then I can speak back. And it sounds like some of that same stuff happens on social media. You mentioned, Dr. A, a social media clause that you have—can y’all talk about some of the ethical guidelines as it relates to interacting or not with clients on social media?

Dr. Abrams: Sure. I have public social media accounts because I'm providing a lot of psychological education, I do have a few clients who have found me. Which is different than me saying follow me. I don't say follow me. If you just happen to find me, it's a public page. So that's what's also part of the clause. But the clause states that I do not recommend that you make comments or send me messages. If you happen to do that, also know that I will not respond and more than likely we can talk about those things in session when I notice these things.

But it's also this piece of if and when you see me out in the streets or in the social media streets, if and when I do not respond to you, that's not because I don't like you. It's not because I don't care about you but that is me holding this frame. And if it is something really important, one, don't post clinical stuff because that is you breaching your own confidentiality in those ways. But if it is something important, we can always talk about it in session. Those aren't spaces that are confidential or protected—I don't own Instagram, I don't own my [*inaudible 0:49:41] Who knows behind the scenes who's seeing all of these things? So it's also to protect your confidentiality in those ways.

Dr. Beckwith: That's exactly what it boils down to and I think that's what the social media clause speaks to. It’s that I am going to protect your confidentiality and these are the ways in which I intend to protect it. And then also you, there's a level of protection that you offer as well, and if you breach that, that is on you. But let's talk about some of the ways in which you may unintentionally breach your own confidentiality. Of course, I'm not saying follow me. I'm not looking for you, like what's your social media so I can follow you? But if you've done good work and I don't want to shame you if you say, “I'm so thankful to my therapist such and such and such and such,” let's talk about I'm probably not going to respond to that. And are you going to be okay if you've given this huge big shout-out and I don't respond to it?

But also knowing that someone may say, hey, you know what, maybe you've listened to a podcast or you read something that I've written and you've given me a shout-out. That doesn't mean I'm your therapist—that just means that you may have seen me talk somewhere, and thankfully, because of that relationship or because of that interaction, you're shouting me out. So just to know that if you mention me, it does not mean like, oh, I'm in therapy with this person but to know that I'm not going to mention you. And being able to revisit that because we signed that social media contract at the very beginning when we started working together.

And at that moment, it becomes like, oh okay, yeah, of course. Oh no, you don't have to respond to me. You can't even imagine that you ever need that. Or like, okay, you first? So you're not going to speak to me when you see me out in public or whatever? It's like, okay, good. But you know what? When the rubber hits the road and when you’re at me on social media—because you've signed it so long ago. And so being able to kind of remind them at some point like, okay, I saw that you followed me online (if I see it), reminding you of what that may look like so that you don't have this feeling of rejection or whatever. Or you just gave these large kudos and it's like, oh, and she has said nothing. “I tagged her and added her and nothing at all.”

Dr. Abrams: What I will say is I have had clients in the past who will come across something on social media or in the media in some way, and whether they might send me an email or something like that saying that something resonated with them. When I do receive that, that is something that will bring into session. Like, hey, I know that you said that something resonated with you, let's talk about that thing. But I'm not engaging in a whole DM conversation, processing this post with them or kind of processing what came up for them or any of those things. But it does give me some additional data about something they came across in the week. But that's also that like in-between contact. You send me something—cool, I will more than likely receive it and then we will talk about it next session.

I don't even have to say to you anymore like, hey, let's talk about this then. I will say it in some way and if I don't and I don't mention it, oftentimes clients will say like, hey, I sent you this thing. And I’d be like what was it? And then we can go from there. But I'm not doing a deep clinical dive unless we're gonna have another session during this or we're gonna have some type of prorated situation. Or in crisis stuff, that also relates to that kind of in-between contact stuff. I think even as we were talking about before like is that something about I want you to like me? I want you to acknowledge me, I want people to know that I have this relationship with you because you are popular on social media. What are some of the things that might come up for this kind of social media contact? And really just using your clinical judgment.

Dr. Beckwith: Yeah. And looking and knowing that a one-off, it's like, okay, it is what it is. But is it a pattern? So just because they saw Dr. A on a panel and they post like, “Hey, my therapist is going to be on this panel,” that should be a dynamic panel. Again, that's your breach of your own confidentiality. I'm not going to respond to that. I'm not like, oh, thank you so much for reposting that. None of that. I'm not going to respond and are you going to be okay? And did you just do that because, hey, I saw you on there, I wanted my followers to know that, hey, this should be really good? Or are you seeking to be in my good graces? Or did you do it because, hey, she's popular on social media and I want people to know that's the one that I see? Like I have a good one, so when you see me, you see her. You know, getting to the bottom of what was that about? You know how it is!

Dr. Joy: One final thing that I want to chat about, as it relates to all these dynamics that people don't understand or don't expect to kind of turn sour in some ways. I've also, especially running the therapist directory, had lots of questions around like why can't I find a review of these therapists? If I'm looking for a dentist, if I'm looking for a new OB-GYN, I can read all about their client experiences. And you cannot find that with therapists. You can, but ethically, reviews, we are not supposed to be soliciting reviews. You won't necessarily find a bunch of sites with reviews of therapists. Can you talk a little bit about why therapist reviews are not considered a good thing?

Dr. Abrams: Yeah. I think that that goes back to what we were just naming around the ethical protections around getting testimonials. I think the ethical code says we're not allowed to solicit testimonials from people. Because what that could turn into in some more kind of subconscious (sometimes conscious) way is that somebody will think that they are doing something nice and kind for us. I want my therapist to like me so let me say all these positive things about them because they’ve asked me for something that they need. Which can change the dynamic of the relationship when a client thinks that they are helping you with something. So we have these explicit guidelines around soliciting testimonials on websites and stuff like that.

That I find is different than... Because I think if we have a public profile and we have a Google site or office space, people can write reviews of us but we cannot respond to them. Because again, us responding would be a breach of your confidentiality. That will be us letting the whole entire Google know that I know who you are and I know you in this way. So it puts a lot of therapists in a really difficult position, particularly when they might have negative reviews and they want to be able to say out loud, “That didn't happen. Never met this person. They needed something that I don't even offer.” Like all that kind of stuff that comes up. But you typically will not see a therapist respond to a Google review. Again, atypical social relationship, right? While this is a business, it is a medical service. That gets us all tripped up all the time, that we cannot breach a client's confidentiality. That's one of the number one ethical concerns, is the confidentiality breach.

Dr. Beckwith: And to know that we can work together and you don't owe me anything. This is not a tit-for-tat relationship. You get to receive and you don't owe anything back in response. And so, yes, it all boils down to the protection of your confidentiality. And then this whole thing of being liked. “Well, I saw they wrote a review. She got five reviews from these, are these the people she's laughing with when she comes in the waiting room?” Or if I wrote a review, will she answer my emails outside of the session now? So like you said, these subconscious things that we are not aware of and you may think that it's just an innocent review or post or whatever, but it boils down to you get to have a relationship where you get to just be. You don't have to work in that capacity in this relationship.

Dr. Joy: And I think that that is the thing that also makes therapists so different from our colleagues in other professions. If I go to a dentist who has great bedside manner, very knowledgeable, always starts on time—that’s stuff that's probably standard across the board. But I think because therapy is so individual, me having a good experience with a therapist does not necessarily indicate that you will. And so when we're looking for reviews—of course, because of who we are and our medical discrimination—I understand why people want it but I think it's also important to acknowledge how therapy is very different than maybe other medical professions. And how even somebody having a good experience with a therapist does not mean that you will.

Dr. Beckwith: And then what did you consider a good experience? Am I saying that she gave me a good experience because I walked away with clarity or because I felt validated? What do we consider, especially because the treatment is so individualized? What is this good experience? And you're right, I don't want you to go see her based on what I said was good, because that could just do something totally different for you.

Dr. Joy: Well, another incredible conversation. Y’all are always such a wealth of information. Thank y'all for showing up again and chatting with us. Again, remind us where we can find you if we want to contact you.

Dr. Beckwith: I am occasionally on Instagram @AskDrJoy.

Dr. Abrams: I am on social media a lot more than Dr. Joy is, @Dr_Ayanna_A.

Dr. Joy: Perfect. Thank you all.

Dr. Abrams & Dr. Beckwith: Thank you.

Dr. Joy: I'm so glad Dr. Beckwith and Dr. Abrams were able to join me again this week. To learn more about them and their work and to check out the other conversations we've had here on the podcast, be sure to visit the show notes at TherapyForBlackGirls.com/session266. And be sure to text two of your girls right now and tell them to check out the episode.

If you're looking for a therapist in your area, be sure to check out our therapist directory at
TherapyForBlackGirls.com/directory.

And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It's our cozy corner of the internet designed just for black women. You can join us at Community.TherapyForBlackGirls.com. This episode was produced by Fredia Lucas and Ellice Ellis, and editing was done by Dennison Bradford. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.