Dear Diary

I am softly certain that the strong majority of my clients appreciate my offerings. They tell me so, are invariably friendly, though maybe some are just courteous. One would think that the general tone of my work – drastic, history-focused and feeling-centered – would create a serious and sober therapy culture. But this is rarely the case. The reason is that from the beginning, I establish with everyone a casually intimate friendship-type relationship. It often starts off with an invitation to contact me, text or email, about “anything” of concern. I will then respond to the questions, requests, observations, complaints or even cartoons in a concerned, warm, sometimes humorous and re-inviting way. And from there on, I am underwater. My clients now see me through their slightly compartmentalized mind: serious therapist, spontaneous and easygoing confidant.

Why is this a self-screwing? Because the clients will inevitably produce a reason, possibly legitimate, to miss that day’s session, then “ask” if they can “reschedule” for the following week.

Why “ask” is in quotation marks. When a client asks, like a friend, if it’s all right to cancel and pick up next week, what can I possibly say but “It’s all right”? Can I reply, “No, it’s not OK. I am an Independent Contractor, not on salary, and this is my sole income.”? Can I say – “Wouldn’t you want to reschedule for later in the day, or tomorrow?”? No, as that would be begging, and worse, it would be begging them to be what they are apparently not: needing therapy that critically. I have to assume that their decision, frivolous as it may be, is where they are at the time, and therefore valid.

 

Why “reschedule” is in quotation marks. This one is easy. To “reschedule” for the following week is simply to miss a week. Please: Don’t euphemize with me.

I am left with this thought assumption: Being casual and more giving, I lose profes­sional respect that I would naturally have had by virtue of the work. Clients blandly squish me. Being less intimate, more boundaried and formal, I maintain their respect. Is this true? Should I distance myself from my clients, be more coat-and-tie 9 to 5? Would that make them less likely to hand themselves walking papers?

What I will do is cut back. Fewer offers to “be there” as late as 11 p.m. or Sundays. No more clever jokes. No more psychoeducational email essays or twenty-line text-message empathy and suggestions. No more responding to free-floating head-pat-seeking plaints like: “I’m getting tired of going to doctors.” No more.

Addendum, next day. Then again, maybe nothing will change.