I only saw the therapist a few times over a year ago, and she was helpful but I couldn’t maintain the appointments. My husband became good friends pretty quickly with her husband a few months ago. I ended up recently seeing the last name on Facebook as it is unique, and I confirmed it was her.

Eventually my husband will want us to have a double date or hang out together, maybe even go to their house. What can I expect or do? What if she knows already? What if she doesn’t and I surprise her at her own house?

What is the right way for her to respond too? Thank you for any help

So I’m very curious as to how an ED specialist can help someone if the person does not wish to change their diet/dietary needs?

For context; my primary therapist does not specialize in ED and is suggesting I see someone who does (along with still seeing her).

The issue is, I don’t believe I need this and also don’t want to change my diet at this time. So I’m wondering, is there even a point in seeking out an ED specialist ?

My first therapist, whom I don’t have very good memories of, told me to spend two weeks writing a journal about the life I wished I had, rather than my actual life. However, it made me feel even more depressed.
My second therapist, on the other hand, suggested writing honestly about my feelings, how I was doing, and what made me feel sad or happy.
Does journaling actually help? I’m curious about your experiences and opinions.

TL;DR: I'm autistic and have repeatedly tried to make friends without developing the meaningful connections I need. Generic reassurance and advice like "put yourself out there" haven't helped. I'm looking for practical, potentially hands-on therapeutic support with building individual friendships in ways that accommodate my communication style and limitations. What can a therapist realistically help me with, and what might that look like in practice?

I'm looking for some perspective, particularly from therapists, about what therapy can realistically offer someone in my situation. I'm also writing this with a future therapist in mind, because I want to be able to communicate what I've been struggling with and work on it concretely rather than having to reconstruct everything from scratch.

I'm tired of being told that I deserve friendship or that I'll eventually find my people. I understand the sentiment, but after trying repeatedly to make friends without getting the connections I need, reassurance alone doesn't help me understand what might actually change.

I'm autistic, I struggle with small talk and initiating interactions, and waiting for others to approach me often feels like the safest option. I want deep, emotionally meaningful friendships with people who can accommodate my communication style and meet me halfway.

My main question is: What can a therapist realistically do to help me build meaningful friendships, given these difficulties?

I'm not necessarily asking to become more socially capable in the conventional sense. I'm looking for a realistic path toward connection that accounts for how I actually function.

For example, I may need help with the practical steps involved in developing individual friendships: moving beyond an initial interaction, maintaining contact, navigating uncertainty as a relationship develops, and figuring out what to do when an approach isn't working.

I may understand what I'm supposed to do in theory, but that doesn't mean I know how to navigate it in practice. Advice to initiate conversations, put myself out there, or join activities doesn't address the parts I struggle with most. I may need someone to break things down into manageable steps, help me work through specific situations, and provide guidance as I put those steps into practice.

I'm wondering whether this kind of practical, step-by-step support is something a therapist can provide, and what it might look like.

Group settings aren't a realistic option for me, so I need approaches that don't depend on joining groups or attending social activities I can't comfortably participate in. I'm looking for ways to develop individual connections that work with my communication style, autistic needs, and existing strengths.

Another difficulty is that I don't currently have an in-person support system to help me navigate this process. I can't rely on a friend to help me build friendships when I don't have that kind of friend in the first place.

I don't expect a therapist to guarantee that I'll find close friends or to predict the future. I understand that some aspects of friendship are outside my control, because relationships depend on other people, too. However, I do want help distinguishing what's realistically changeable from what's outside my control, identifying approaches that might work better for me, and adapting those approaches when they don't work.

I'm discouraged and exhausted because I've tried repeatedly without getting the results I'm looking for, not because I haven't wanted connection or been willing to try.

I'd appreciate therapists' perspectives on a few questions:

What can therapy realistically help with in a situation like mine?

Can therapy include practical, step-by-step guidance with developing and maintaining individual friendships, rather than just general social advice?

How might a therapist adapt their approach for an autistic client who struggles with initiating interactions and can't comfortably participate in group settings?

If a client needs support implementing strategies in real-life situations, what kinds of support can a therapist offer, and what would fall outside their role?

How can therapy help someone build a support system when they don't already have friends or other people to lean on?

I'm not asking for a guarantee of a happy ending. I want to understand what options are realistically available, what a therapist might be able to help me work toward, and how to approach this in a way that respects my limitations rather than expecting me to force myself into methods that don't work for me.

Thank you for reading.

I had a crisis over a few days. My spouse left with my kids because of it. She has a roi with my therapist and they were in contact with each other during the crisis as i was also in contact with my therapist. She advised my spouse not to leave but she went against her advice which caused me to decompensate and my therapist was worried all weekend i wouldnt get through the crisis. Because of that she told my spouse no more communication. She said it triggered her and she was too involved with my family.

Now it feels like the relationship might change and feels like she took a step back from me instead of just asking not to communicate with my spouse. Sometimes im so shut down that my spouse would send an update about my weekend or what triggered me and it would help having them know. She would explain to her what was a trauma response and coach her in supporting me. The relationship and roi was just for supporting me. That's gone on for years and when it abruptly was told it had to stop my spouse is feeling helpless too. Im worried my therapist who i trust so much doesnt like my spouse anymore.

Did we do something wrong?

My sessions with my therapist have been feeling stagnant for the last year, and I am ready to move on. I have been seeing them for 7.5 years, and I know it's better to do it in person, but my sessions cost $400 out of pocket.

Can I end the relationship through email?

I'm a type 1 diabetic, diagnosed 23 years ago at 8 years old, and I recently got sensors to help me control my levels better. Unfortunately this means I'm being woken up by a low alarm every other night. Usually I just treat the low and accept that I'm losing sleep but sometimes I just cannot be bothered. The thought of not waking up because I died in my sleep from low sugar doesn't seem too bad so I silence my alarm and go back to sleep. Obviously this hasn't killed me yet, but I am aware that dead in bed syndrome is a real risk. I've never considered myself actively suicidal. I've definitely had moments of wishing I wasn't alive but I've never seriously considering doing anything.

I recently started seeing a psychologist and want to bring this up but always end up finishing my sessions without having mentioned it. I've only done 7 sessions so far and am still trying to get comfortable with the whole process and this feels like a lot to say out loud. I have written things down so I can show her my notes if I feel I won't be able to say it, but even showing her that fills me with anxiety. I was hoping to get some insight into how this information would be taken and how she might approach it. I think knowing what I could be going into would help me be able to face it. I guess I don't know if ignoring my low sugar levels counts as being actively suicidal and if she's going to think this is a lot more serious than I consider it to be. Any insights would be greatly appreciated.

I have a bit of a problem with my treatment plan, and I'm left to try to figure this out mostly by myself. I'm dealing with OCD and bad trauma. Years ago, I did a lot of trauma-based therapy where my OCD was never mentioned. It led to doing DBT twice, which I only found a little helpful.

Years go by, and I'm still dealing with trauma, but my OCD keeps consuming my life. I then start seeing a therapist who specializes in OCD but is aware of my trauma background. However, after about five months of making little progress, she is telling me, more or less, that she is struggling to treat the OCD since my trauma keeps popping up. She does not specialize in trauma. She thinks I need to get in a better place with my trauma so we can focus on OCD.

However, my trauma and OCD are connected. I obsessively ruminate about things basically rooted in trauma. So, I reach out to a trauma specialist despite the fact that I've done it for years, having changed back to an OCD focus to try alternative help, and I'm being told no one in that office specializes in both OCD and trauma. I did research in my area, and no one does both that I'm seeing. Is it that rare?

I plan on seeing the trauma based therapist because my currently therapist recommending it, despite the new therapist hesitant over my OCD. I asked my current therapist if I could get some 3rd party advice on what to focus on and who I could see, professional guidance in a treatment plan, like a case manager, but I guess that doesn't exist? I feel so lost.

I know I could see two therapists, but that is so much time and money. I'm about ready to give up on getting help since I can't seem to find a good treatment plan. My therapist agrees it is difficult and doesn't have a sound answer for me on what would be best. She is willing to keep working with me, but I feel like therapists keep hitting brick walls with me.

I'm frustrated since OCD and trauma are common issues, but I feel like I'm walking around with a third head when I'm trying to ask for help and guidance. I'm tired of being passed around the system when I just want more peace in my mind and life.

By the way, I'm really firm about wanting in person sessions. I'm not interested in online.

Thank you all for your input earlier.

https://www.reddit.com/r/askatherapist/comments/1wwenfz/what_are_the_general_disclosure_rules_in_the_us/

It was very helpful. She didn't have to disclose, and we discussed it.

The difference in our relationship is night and day from when I first saw her almost three years ago. It hasn't been straight through; the VA does this weird and harmful 12 sessions at a time and take a break thing. Between her and ketamine sessions, I have gone from being very closed off to being far more open, and we have gone to good places. Which is great; I have been going to therapy off and on for 30 years and never realized it could be so helpful.

Anyway, after we talked about what the other VA employee did to me, she said, "I wish I could hug you". I certainly wasn't fishing for a hug, but it got me thinking that she has never really touched me at all. Which is fine, but it is an odd thing to say if it is not allowed. She knows I have been alone for the better part of the past 25 years.

This isn't really that important of a question, just more of the nuts and bolts of therapy ethics. I understand that therapists and clients shouldn't touch on a regular basis. That makes sense, but is it completely off limits?

What type of person do you like to work with the most?

I've been in therapy for about 8 years now and I have switched therapists 7 times so far. When looking for a new therapist I always made sure to ask if they were comfortable with violent themes - all of the ones I went for confidently said yes! And yet...

I genuinely don't think I'm some kind of outlier, I assumed that most therapists would be comfortable discussing issues similar to mine. I'm socially competent and always tried to approach my own issues in an understandable and constructive manner.

I'm perfectly aware that my issues are strange, but I thought that's what therapy sessions were for, talking about my mental health problems...?

There was a common thread between all of my 7 therapists, whenever I talked about things that happened to me- or things that I have done in my childhood, they just hit me with some variety of: "oh wow that's interesting". And then silence.

Whenever I tried to talk about what bothers me in my daily life, they start fidgeting and switching the conversation to the weather.

I don't know what I'm doing wrong. When I answer their questions they make a surprised face and stay silent. When I try to talk more actively myself they also make a surprised face and stay silent.

Why has this happened so often?

Two of my therapists told me outright that we were not a good fit and that I'm "a little outside their comfort zone" - how this range is defined, I do not know, but I'm glad they told me instead of staying silent for all sessions and pulling funny faces.

I do genuinely feel like I need some kind of therapy, but I'm hesitating to resume it, because it feels like I'm wasting time and making other people's lives actively worse.

These therapists could be out there helping someone with issues that are easier to understand and easier to work on...

I would love to hear any insight from therapists, has any patient made you uncomfortable before?

If it makes a difference: I have never tried to be my therapist's "buddy" as in, I mostly talked myself and answered questions, and have not asked them any personal questions in return - maybe that is seen as rude?

I've been going to my psychologist every 2-3 weeks for like 6 months now, and I'm just not sure if I'm making progress. Every session I feel like we can talk about a lot of stuff and there's always something missing. Im not always sure what my conclusions of the session should be and what I should do. I've been dealing for example with anxiety showing itself as a deep pressure in my lung and short of breath (not hyperventilating but I need to take deep breaths to make it go away) and I just can't tell what to do with that and/or what triggers it. I asked her directly and she couldn't really give me a real answer. I feel lost.

One thing I'm low key worried about as I work towards my masters in MHC is crying lol

I am an empathy crier. Sometimes I cry just because someone else is. I think this is something I can generally stop if it's inappropriate; but there are certain triggers for me (specifically grief and dog loss) that I'm worried might make me start crying if a patient is talking about / crying about said subject.

Never thought about this until now!

Recently shared something with my T that I have never told a single soul about for over 30 years that included childhood abuse and revictimization in my teens. I ended up having a panic attack after she tried to explore it with me. She then stated that she wanted me to learn coping skills before unpacking it all. That was about 3 or 4 sessions ago. And all I've been taught is containment skill for racing thoughts, typical deep breathing, and to distract myself.

Today I went to session with a paper of my written feelings. I tell her I feel flooded with feelings that Ive never felt before following the disclosure, and I felt like I was grieving my childhood. She asked what I felt I needed and I told her to talk about them. All she said to that was asking me if I tried the coping skills and again she told me I should distract myself with exercise to help clear my mind.

I just feel so dismissed. I have a hard time sharing feelings and emotions and I feel I finally was able to share what I needed and got rejected. What's even the point then?

How can I talk to her about this? I don't even know where to begin.

I'm watching Ted Lasso and Lasso's ex-wife is seriously dating their former marriage counselor. That seems pretty inappropriate to me, like, you probably don't have the ethics to counsel people, inappropriate. Am I off-base? Is it cool? Frowned upon, but okay? Or getting reveiwed by an ethics board bad?

I'm on my third insurance with my T. Mostly due to my husband retiring. Having to get private coverage out of pocket. Then turning 65 and going on Medicare. With my other two plans, I always (and happily) had a co-pay. Now, I do not. Does that mean my T is making even less money? I feel kind of guilty about it.

A number of years ago, I was seeing a couple's therapist with my then-husband. He and I were together 14 years, and I had known him for about 23 years, since I was 17, so it was a very long-term relationship.

Long story short, his mistress of many years, with whom he had been living a double life and even bought a house in another state, reached out to me to tell me all about my husband's actions. That day, soon after learning a lot of devastating, life-changing info from his mistress, I reached out to the couple's therapist we were actively seeing at the time to tell her what had happened and request a last-minute appointment. I didn't want to talk with my husband unless someone else, ideally our therapist, was present. He got there first, and she took him in and spoke with him for a bit before allowing me in. When she allowed me in, she had very obviously been told lies by him and she told me I shouldn't believe the mistress. I told her that my husband is the one who had been lying to both of us (me and his mistress), which she didn't say anything to. I told him that I would be seeking divorce while we were in the therapist's office and then had a panic attack. Once I recovered from the panic attack, she ushered me out of the office and my ex stayed because apparently they needed to talk more?

Anyway, that part isn't truly relevant to my question. I'm getting in the weeds because it's a deeply emotional topic.

More relevant is this: I wasn't seeing any other therapist at the time, which she knew. I didn't want to have to go through my whole story with someone new, and I felt like the fit was good with her, so I asked her if she would continue to see me as a solo client. She told me she'd get back to me and then told me she didn't think it would be wise for her to do that. And that was it. She didn't refer me to anyone, and she didn't give me a reason (though, I'm guessing the possibility that she might be called to testify in a court proceeding might have been a factor maybe?). The ex put me through a lot of hell that she knew about. And she knew my life had just changed in a really big way. It felt really, really fucking shitty. I definitely felt abandoned in many ways.

So my question is this: Did she have a professional obligation to do more, to at least refer me to someone? Or does being a couple's therapist mean she's totally off the hook in the context of abandonment?

I've wondered this for many years and would just appreciate the insight. Thanks.

I have been seeing my therapist for about 5 years and he has been very patient and supportive this whole time. He has helped me tremendously, but I have an eating disorder and I have gotten to the point I’m having a really hard time being present and staying connected in sessions.

My brain fog is getting worse and I just can’t retain information or remember a lot of the work we are doing. I’m scared he might feel frustrated or think “oh my god we just keep going in circles, what’s wrong with her? she is not trying hard enough. What isn’t clicking? I don’t know what to do with her. She’s wasting my time. Why is she even showing up?”

I wouldn’t ever ghost him because I want to be respectful, but I do think I’m going to reach out and say “hi, I would like to take a break and stop sessions. I will reach out in the future if/ when I’m able to start back up again. Thanks so much for your patience.”
Does that sound okay? Would you be offended or annoyed by a client quitting suddenly, after putting in so much time, energy and work in?

I am now over the age of 30 and I had some abuse that took place. If I talk to her about that and the abuser doesn't have access to any children - is she meant to report it? Based in CA.

​

I really appreciate this community- I've learnt a lot here.

I have a really great social worker who I've started doing trauma work with him.

I get really dissociated and really flat in session. I always worry it's hard for him to feel connected to me or that I'm making it hard to care which I know is probably connected to trauma stuff.

He was really careful to say he is engaged and interested when I shut down but that I'm experiencing something real shifting in our connection because he feels super foggy when I shut down, and we are less connected.

I know I'm over reacting in a sense but all I heard was - at my most vulnerable, I'm making it hard for someone to care, be connected to me, and want to support me.

I guess I'm looking for some perspective on how therapists feel when their clients dissociate? What thar lack of connection is? Does it make it harder to care and connect? I am not totally sure why they told me thst too?

I'll bring it up with them. I just feel so hurt and am trying to get perspective before seeing him again

Thanks everyone.

I was terminated abruptly from my former therapist after expressing interest in filing an ethics report against the clinic owner. I have since sent a notice requesting my records within 30 days. I was refused under the bizarre claim it "would cause harm for me to view my own records". There was no reason given for this claim, nor have I ever expressed any reason I am aware of that viewing my own records would cause me harm.

I sent a follow-up at 37 days, again requesting records, and pointing out that federal guidelines for refusals were not followed. The response I got is that they are still refusing, no further ressoning was given, and that any further contact with the clinic will result in a harassment order. Neither of my messages were harassing, they were legal templates stating my rights and requesting records.

At this point, I am stumped as to what to do. I have reached out to a few attorneys, but they only seem interested in trial cases, not helping me get my records. Can therapists really just refuse with no consequence? Do any therapists here have any thoughts for what to do about a therapist that is blatantly disregarding ethics and laws regarding records? I did report to HHS, but, sounds like that can take months to years, if anything is even done at all.

To keep a complex situation simple, I've been seeing my therapist for about 4 years now and we've hit a point of disconnect for a while now. They're an incredible person who's been with me through some life situations that would've ended me on my own. They've guided my trauma recovery to a place I never believed I could reach. Yet, we've been at a disconnect for several months now. We talked about it and they're suggesting a break for a few months or moving on to a new therapist. Their suggestion is from a place of care and I hold great admiration for them yet I've stalled. We are rarely on the same page anymore. How do I figure out what I need?

Hey everyone,

I’m currently running my virtual clinic out of a spare bedroom in my house. Right now, it’s completely empty except for my desk!

I’ve been trying to gather inspiration on Pinterest, but almost everything that pops up looks like a physical therapy clinic or a traditional face-to-face office space.

Since I essentially have a long blank wall behind me, I want to make it look warm, professional, and welcoming on camera without feeling cluttery or cold.

If you run a virtual practice, I’d love to know:

• What does your background setup look like? (Feel free to drop photos)
• What elements or decor made the biggest difference in making your space feel cozy and friendly on video?
• Any tips for lighting or wall decor that translates well on camera?

Thanks in advance for any ideas or inspiration!