Things Psychotherapy Clients Can Want That Won't Help Them Long Term

When clients see a counselor they often get helpful things they want, but can't easily get from other people:

However, sometimes clients come into therapy wanting certain things that they believe will help, but the therapist won't give it to them, or at least not much, because they know from experience it won't actually provide much benefit in the long run. I'll go into many of them below.

It doesn't mean someone's made a mistake or that they're a bad, toxic person if they want one of these things from counseling. Their therapist isn't inwardly scoffing at their clueless rookie error. When people struggle with certain issues their mind can naturally go in certain directions, through no fault of their own. They may not even be consciously aware of what they want, or that they're asking for it. Part of therapy can be learning about these counterproductive needs, and more helpful alternatives.

Endless reassurance

At times getting reassurance is useful. You have a worry, you ask a professional about it, they let you know you have nothing to fear, and you feel better. Reassurance is great if you can take it in and accept it.

Some types of anxiety can drive you to ask for reassurance, and getting it makes you calmer for a little while, but then the worry comes back, and you want to be reassured again. No matter how many times you get it, it's never enough. For example, you're afraid your partner is secretly getting sick of you and going to dump you out of the blue. In therapy you may keep directly or indirectly trying to get your counselor to insist your relationship is safe.

The urge to ask for reassurance can be very strong. You can feel like your anxiety will boil over if you can't hear you'll be okay. But that just keeps the unhelpful cycle going. Your therapist may explain the pattern and let you know they can't provide endless reassurance, that they'll point it out when you're asking for it, and help you find better ways to manage your nerves.

Constant venting

It usually feels good to vent when you're upset. If you've had no one to talk to about your problems it can be useful to see a professional and finally get everything off your chest. It can be such a relief that the next session you want to come back with even more annoyances to offload, and then the next, and the next.

Some venting is normal and healthy. Only venting week after week, month after month can keep you stuck in your problems. For one, it can trap you in an angry, aggrieved headspace. You may have a very valid reason for being upset in the first place, and at times there are benefits to exploring and working with those feelings, but at some point you likely need to move into another mindset to address the issue.

Venting can also prevent you from making needed practical changes in your life. Something is bothering you, and the pressure builds up. Then you vent to your therapist, and release just enough steam that you can tolerate the annoying situation for another week or two. The pressure accumulates again, but you let it off in the next session once more. Your therapist may point out this pattern and encourage you to direct that pent up energy toward solving the actual problem.

There are clients who, for various reasons, have real barriers to changing any time soon, and having a place to vent once a week is at least something, and helps them get through their days and keeps them from getting worse. Counselors realize there are always exceptions, but for the most part they'll steer clients away from long-term venting.

Validation that it's all someone or something else's fault

Sometimes clients come to therapy believing their issues are the fault of another person, or an outside situation. At times they're right. They truly are the victim of unfair mistreatment or unlucky circumstances. They need to be validated that it's not all in their head, or that they're not being crazy and melodramatic. After that they still have to try to do something about it all, but at least they know they're not deluded about where the blame lies.

At other times the client has a part to play in the problem. It doesn't mean they're evil or doing it on purpose, but they are contributing to what's going on. For example, their critical attitude is a factor in their marriage problems. Thinking everything is their spouse's fault isn't doing them any favors, and a therapist will try to help them understand that.

Being told what to do

Clients can come to therapy not knowing how to handle a situation in their life, or what choice to make in a tricky dilemma. They may want their supposedly wise counselor to decide for them. Therapists won't do this. They can help their clients arrive at a decision on their own, but can't run their life for them. It's not their place to do that. It could also create dependency.

At most a counselor may "tell a client what to do" in the sense of giving them some straightforward advice about how to handle a particular problem. Like they may provide a bunch of suggestions for how to assertively confront a rude co-worker. Though even, then those tips aren't an order. The client is free to use or ignore them if they want.

A perfect reliable, dependable nurturing figure

Some clients didn't have reliable caregivers growing up, and the mental wounds that caused are at the heart of their issues. Consciously or not, they may want their therapist to become the ideal parent figure they never had, someone who's always there for them, who will never upset or abandon them, who will always say the right thing. They may even want their counselor to officially declare they'll be this kind of person for them.

There are types of therapy where the therapist does take on some nurturing qualities, to give the client's mind a sense of what that feels like and help them work through various baggage, but there are still boundaries and limits in that approach. The counselor knows they can't become a full-on substitute parent for a client. No one can. There's no uber-mommy who can swoop in and solve all their problems. The client has to work through the fallout of what they didn't get as a kid, and figure out ways to develop healthy, balanced relationships as an adult.

To talk about everything they want to cover that session

Some clients have a lot of stressful things happening in their lives, and can come into an appointment with a big list of things they're bursting to talk about. They can feel an inner pressure to get it all out in the open. As always, there can be benefits to doing that, but sometimes the therapist will realize their client always has so many points they want to hit that it prevents them from ever going into one issue in any depth. They may help their client narrow down the focus of a session, even though it can feel frustrating that they won't get to talk about everything.

At other times a client may always have a ton to talk about because they're trying to stay in control of the appointment. They think if they fill all the air time they'll keep the reins, and the therapist won't be able to head in a potentially upsetting direction. When their counselor notices this dynamic they can help the client let go of their defensive strategy.

Permission or help to stay in your comfort bubble

Many mental health issues lead people to want to stay in a comfort zone where their upsetting symptoms don't pop up as much day to day. For example, someone with social anxiety may only ever interact with people they already know well, and avoid anyone new. They may want their therapist to give them tools to help them further reinforce their comfort bubble, or validate that they need to stay in it, that they couldn't handle it if they left, and that everyone else pushing them to leave it needs to back off.

The problem is that while a comfort zone may make you feel better for the moment, in the long run the avoidance it allows maintains or can even amplify your anxiety. You build up more and more conviction that you can't handle your fears. I realize it can be scary to push your limits and make changes, and a therapist won't force you to take on more than you're ready to. A decent counselor will help you move out of your anxious comfort bubble slowly, but they will gently, patiently nudge you to keep going in that direction.

Intellectual analysis

Some clients want to spend their sessions discussing their problems from an intellectual, analytical headspace. This isn't always bad. At times it's appropriate to dissect things in a more rational, scientific way.

Some clients intellectualize too much, and unconsciously use that approach to avoid accessing or feeling some uncomfortable, scary emotions. They think they're steadily chipping away at their problems, and may make some progress that way, but they're out of touch with a big facet of their issues. A therapist who observes this is happening will help the client get out of their head and be more in touch with their feelings, as cliche as that sounds. If you're used to being hyperanalytical, that may sound vague and woo woo, but it's a core part of counseling.

Listening to you talk about your plans for changing

Some clients like to talk about all the things they could do to make positive changes. There's obviously nothing wrong with that on the face of it. It's a necessary step in the process of overcoming your problems.

Sometimes a therapist will notice their client tends to explain all the ways they could change, and talking about it seems to fire them up and make them feel better in the moment, but they don't follow through on much or any of it. It's like speaking about all their big plans gives the client a little jolt of relief and optimism, and that's satisfying enough that they don't feel the need to make actual improvements in their life. It's also possible they may think talking about what they're going to do will get everyone off their back and buy them time to stay in the status quo (again this may or may not be a conscious move). If the therapist believes that's what's happening they may point it out, encourage the client to focus on actually implementing the changes they want to make, and help them explore any blocks or fears that come up.

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Helping you take much faster, more extreme steps in your trauma recovery

In trauma therapy the general rule is it's best to go at a slow, steady, manageable pace. When it comes to processing very painful memories or emotions it's easy to bite off more than you can chew, have it backfire, and end up further back than before.

It's frustrating to go so slowly though. The symptoms of trauma can be excruciating. The therapy to heal them is often hard work as well. Some clients understandably want to be done with it all more quickly, and will push to go faster. It's also common for trauma clients to have a false sense that if they just have a couple of really big, dramatic, cathartic sessions then it will all be out of their system. Unfortunately it usually doesn't work that way. As I said, a knowledgeable trauma therapist will be wise to this issue and help you go slowly enough, even if it feels like you could be doing a lot more, and yesterday.

A punching dummy

Some clients have a lot of anger. Others may find their therapist reminds them of someone annoying in their life, like their father or manager. They may want free rein to take their frustration out on their counselor and be rude and hostile to them. They may even think it's serving a therapeutic purpose, that they're using their psychologist as a stand-in to work out their baggage with their parents.

In certain types of therapy the counselor will strategically allow a client to express some hostility toward them, with the understanding that it's not really about them, but who they unconsciously represent in the client's mind. However, not all therapists work this way. Some won't tolerate any disrespect, and don't think it's serving a client's interests to give them a free pass to be abusive. They think that's just encouraging an antisocial outlet for their emotions. Even of the counselors who do allow themselves to be a punching bag, they don't give clients carte blanche to go off on them whenever they want.

A friend or lover

This one is well known. Clients may like, depend on, or feel attached to their mental health worker and want a connection beyond the professional boundaries of a client-therapist relationship. They may want a friend, or a romantic or sexual partner. An ethical, professional therapist knows these kinds of boundary violations have the potential to really, really hurt the client. As much as a client may like their counselor, or think they're hot, or believe they could have been great friends if they'd met in other circumstances, the relationship needs to stay within its professional limits.

Lots of contact and support outside of regular sessions, extra weekly sessions, or longer than usual sessions

Some clients feel like an hour of counseling a week isn't enough. They're in a bad place and need more time with their therapist. They may want an arrangement where they can call or text their counselor whenever they want, or ask for extra sessions each week, or request longer appointments.

Sometimes a therapist will decide this is all perfectly appropriate, fits the style of therapy they do, and are accommodations they're willing to take on. For some clients it may be a reasonable intervention. For others the counselor may decide more access to them is encouraging dependence and preventing them from learning to cope on their own, or find other sources of support. They may also determine multiple or longer sessions a week is unnecessary and more than the client needs.

Permission to keep doing a harmful behavior while treatment goes on

Like with so many other points in the article, this one depends. Clients may be struggling with harmful behavior, like heavy drinking or drug use, self-injury, or disordered eating. They may feel they're not able to stop before counseling starts, and want the therapist's go ahead to work with them while they're still engaged in it, but trying to get better.

Many therapists are okay with this. They accept the client isn't able to quit right away, and are willing to work with them to explore their motivation to change, or explore options to stop or cut down. In other cases the therapist may decide it's too risky for the client to carry on with their dangerous behavior, or that letting them continue while talking about changing is just enabling the issue. They may say the client has to stop first, for example by going to rehab, and will only work with them once they're sober, with a focus on doing what it takes to stay clean and prevent a relapse.

Sometimes, a particular diagnosis

Not all types of psychotherapists can give clients a diagnosis, so this only applies to the ones who can.

Sometimes getting a diagnosis is helpful, or just a neutral piece of information. At other times it can be negative, like if a client is misdiagnosed and given harmful or useless treatment because of it, or if they get a label that's accurate, but causes other people to stigmatize or pigeonhole them. On occasion a client may want to be given a certain diagnosis, but the counselor doesn't think it fits their symptoms. They don't think it will benefit the client to receive it, or may even cause them to move in directions that don't help them, like prematurely giving up.

Sometimes, particular types of medication

Like with the last point, many types of therapists can't prescribe medication. If they can they may determine the client wants access to a type of drug that won't help them long term. The most common example is when people with anxiety want an ongoing supply of benzodiazepines. Those are effective at calming anxiety that day, but they're very addictive, can be horrible to withdraw from, and can become a crutch that prevents someone from learning to deal with their nerves in healthier ways. This isn't to say there aren't cases where, all factors considered, it makes sense to prescribe someone a benzo, but it's often not what a client needs over the long haul.