Most of us think of therapy as a place where we'll get all sorts of helpful insights, skills, and observations. So it can seem awkward—if not impossible—to be the one giving feedback to the mental health professional in the room. But as uncomfortable as it may seem, giving your therapist feedback can be incredibly powerful and sometimes even necessary when it comes to getting the most out of your sessions.
Maybe you're just not sure if you're meshing with your therapist or their style of therapy. Or maybe they did or said something that really rubbed you the wrong way. Maybe they're consistently five minutes late, and that bugs you. The point is, if something is getting in the way of you feeling open, engaged, and productive in therapy, that's worth bringing up.
"The therapeutic alliance is crucial in therapy, so it's important that a patient not keep those things to themselves, because it can actually impede their progress," Monica Johnson, Psy.D., licensed psychologist and host of the Savvy Psychologist podcast, tells SELF. "Holding onto these feelings or these thoughts won't help at all in that process."
So, here are a few tricky therapy scenarios you might find yourself in, and how to bring them up with your therapist.
If you're not quite feeling seen or heard in therapy…
Let's say you sometimes feel like your therapist is making observations and insights that don't really ring true for you. While it might seem awkward to correct them (in the moment or afterward) that's a great thing to give feedback on.
"A good therapist will always be open to correction," Jessica Stern, Ph.D., clinical psychologist at NYU Langone Health, tells SELF. "Sometimes therapists will get things wrong—they'll make incorrect observations or incorrect conclusions." So don't be afraid to correct them when it feels appropriate—your therapist should actually welcome that feedback. "The truth is oftentimes when people correct their therapist, that's actually an indicator that they're capturing something really important in themselves."
Or maybe after reflecting on your last session you wonder if your therapist actually "gets" you. "Maybe they said something that you don't think fully fits, or maybe you got the impression that they didn't quite understand what you were trying to explain," Pooja Lakshmin, M.D., board-certified psychiatrist and writer, tells SELF. "A great strategy is that next week to say, 'Hey, actually, I was thinking about this more and I'm not quite sure if we got it right.' Or 'I'm not quite sure if you understood exactly what I was trying to convey. Can we dig deeper into that?' And a good therapist is going to be delighted that you're bringing this up."
Remember, your therapist isn't a psychic that you're expecting to get everything just right in order to validate their expertise. "There's never a right answer. It's more about exploring and figuring out what's going on," says Dr. Lakshmin.
"However, if you're constantly correcting your therapist or you feel like your therapist is on a totally different planet than you, that's a major problem," warns Dr. Stern. In that case, it may be time to look for a better fit.
If they said or did something that offends you…
As with any other relationship, it's possible your therapist may say or do something that makes you feel hurt, invalidated, or offended. "Therapists are human beings too," says Dr. Johnson. "They're not infallible." Maybe they misgendered you or said something insensitive about your race, culture, religion, sexual orientation, or another aspect of your identity, and you're left wondering if this is someone you can trust to be fully honest and vulnerable with. This is absolutely something to bring up with your therapist. You might try one of these lines suggested by the experts:
"I'd like to address something that happened in our last session.…"
"That didn't sit well for me. I felt offended by that statement. Can we talk about this?"
"This is challenging for me to bring up, but in our last session, you said/did [blank], which made me feel [blank]. I would appreciate it if we could explore that together."
Being direct, specific, and honest is key, says Dr. Johnson. "Microaggressions can and do happen in therapy," she says. "If microaggressions are addressed appropriately in therapy, then the therapeutic alliance can be rebuilt and therapy can proceed, and there can be a benefit to the patient moving forward."
Unfortunately, this does put an additional burden on the patient, particularly patients who belong to marginalized groups, says Dr. Lakshmin. But it can also be really great practice for having these conversations out in the real world. "It actually can be such a growth process to deliver feedback to somebody who is in an authority position and be able to work through that."
While one insensitive comment or action isn't necessarily a reason to break up with your therapist, it really depends on the severity of the situation and their response to your feedback. "Do they welcome that feedback? Are they willing to explore that with you and do better next time?" asks Dr. Lakshmin. If you don't get a response that satisfies you—they don't apologize, they seem to brush you off, they continue to misgender you, etc.—then that's a sign that this probably isn't a safe, supportive environment for you. In that case, you may need to look for another therapist, and it could be worth prioritizing someone with more experience (whether that's lived experience or specialized training) around issues that relate to your specific identity.
"If you're BIPOC or gay or trans, these factors have to all also be addressed in therapy appropriately because of things like racial trauma and minority stress and the additional mental stressors that that puts on the individual," says Dr. Johnson.
When looking for a new therapist, if you’re at all uncertain about their cultural competence, Dr. Johnson suggests asking about the last time they did any continuing education on a diversity-related topic, and also paying close attention to the language and imagery on their websites. "If I go to somebody's website and there are 34 pictures and every single one is of a white person, that doesn't give me an indication that they know how to treat BIPOC people," she says. "Or if I have to scroll all the way to the bottom of the web page where the footnote is for them to say, 'Oh, yeah, we see gay people here,' that doesn't communicate the message that you're going to provide me with affirming treatment." Know that you are not being picky by looking for a therapist who will treat you as a whole person.
If you don't seem to be getting anything out of your sessions…
We all go into therapy expecting some sort of results, and it can be frustrating to feel like you aren't getting anywhere. If that's the case for you, definitely speak up. "Remember, you are the consumer here," says Dr. Stern. "If you're paying for a service, you should be satisfied with that service."
Try not to worry that you'll offend them and remember that a therapist's ultimate goal is to get you the treatment you need. "If I'm not the one who can do that for you, I'm always very happy to get you to a person who can," says Dr. Johnson. "Because that's the thing that's most important to me."
And while it can be tempting to just stop showing up, the experts advise using this as another opportunity to practice your interpersonal skills and articulate your needs. "There's a phenomenon of ghosting in therapy," says Dr. Lakshmin. "But just like in relationships, there's a lot of healing and growth that can happen in delivering direct feedback and saying, ‘This isn’t working out for me, I've decided that I'm going to find another provider, thank you so much.'" You could also do this over email or a phone call if you're sure of your decision and don't want to pay for another session.
The bottom line is that therapy should not be viewed as a one-way flow of skills and insights, but as an exploration and collaboration between you and the therapist. Your sessions are yours to use to process through whatever you're feeling and thinking—even if that includes the dynamic in the therapy room (or virtual room).
"I see a big part of therapy as a willingness to engage in experiments. And I would see this as another experiment. If it goes well then you have more evidence that it is okay for [you] to take up space and set boundaries," says Dr. Johnson. Yes, it might be uncomfortable, but...a lot of therapy is uncomfortable.
"This is what we're here to do,” says Dr. Johnson. “We're here to help you work through awkward moments."
See more from our Guide to Caring for Your Mental Health here.
Related:
