Trust in psychotherapy a common problem

Many clients who go to a therapist may prematurely drop out of treatment because they do not trust the therapist.

Trust in psychotherapy –  a common problem (photo credit: TNS)
Trust in psychotherapy – a common problem
(photo credit: TNS)
Distrust of psychotherapists is more common than you might think. It is also a primary reason that prevents many people who need professional counseling from seeking help. Moreover, many clients who go to a therapist may prematurely drop out of treatment because they do not trust the therapist.
For many people, it takes time to build up confidence and believe that the therapist, a professional “stranger,” will be able to be of help. The following two examples exemplify the issue.
• JIMMY WAS a client in his 20s who joined a group that I was forming for single adults. He reported the following dream before attending the first group session:
“It was evening and time for the first group session to begin. I was eager to meet the other people who were supposed to be in the group. Being very punctual, I showed up exactly 10 minutes before the session was going to begin. I walked through the door into what was supposed to be a group therapy room, but it was not. Instead, for some strange reason, it was an auditorium. The therapist was seating at the front of the auditorium and waved to me to come forward. I was actually the first to arrive.
“He suggested that I pay for the session before it began, just to get the fee collection out of the way. I took out my hard-earned cash and paid. I still could not understand why there was an auditorium. As I waited, a few more people had arrived, each paying the therapist and then taking a seat. I was shocked as the auditorium slowly filled up with 200 people, all having paid the fee for what was supposed to be a small group experience. I woke up shaking in a cold sweat with my heart pounding and my thoughts in a state of shock and disbelief. I felt exploited and could not believe what a con artist this therapist was.”
Obviously, Jimmy feared that the therapist would exploit him. As therapy progressed, I learned that Jimmy did in fact grow up with a very angry and narcissistic father who never credited Jimmy for any of his accomplishments, and always pointed out to him that there was nothing special about his achievements by saying “anyone could do it.”
This was in spite of the fact that Jimmy was the first member of his family to graduate college. He put himself through medical school and graduated at the top of his class. Jimmy suffered emotionally because he could not feel good about his accomplishments. I learned together with Jimmy that he had expected something negative and critical from me.
• SALLY, A client in her 20s, resisted seeking out a therapist for years, even though her life was not going very well. She was unable to develop a healthy relationship with a man, was depressed, and suffered from severe migraine headaches. Sally grew up in a home with a caring but passive father, and a very narcissistic and vindictive mother who continuously degraded Sally.
Sally started to get migraines at age 15, but her family doctor told her there was nothing medically wrong with her and all she needed to do was to learn to relax. Nevertheless, she could not relax and now, as a young adult living away from home, her life was in emotional turmoil. Her friend suggested that Sally go to a therapist and gave Sally my name.
Although Sally initially resisted following her friend’s advice, she became so depressed that she decided to call me. For Sally, focus on her mistrust of me became her first issue in therapy.
BOTH JIMMY and Sally had enormous ambivalence about trusting people, which stemmed from their mistrust of one of their parents. Psychotherapists describe this phenomenon as “transference,” when a client projects onto the therapist emotions and beliefs that originate from primary caretakers, like parents and significant others while they were growing up.
The client’s inner voice says, “If I didn’t trust my mom/dad, why should I trust you?” Clearly, this negative transference was a factor for both Jimmy and Sally and placed a major barrier preventing both seeking out and trusting a psychotherapist. Once helped to overcome their initial distrust, they both were able to move on and begin to work on their core problems.
In conclusion, it is important to be aware that mistrust of therapists is very common and can be the major problem that blocks someone from getting help. Remember, do not give up too quickly on the therapist you choose. Instead, let this person know that you have a problem trusting people. The good news is that people who acknowledge their problems often succeed at overcoming them.