I have noticed that many of my clients have certain behaviors that are possibly impeding the therapy progress. Whether it's commenting at length on the curtains in the office or complaining about the poor parking situation at Dr. Steve's office suite (which, for the record, is completely understandable as the parking is horrendous there), these behaviors are possibly interfering with the therapeutic work if only for the fact that they are cutting into our valuable time to work together on problems.
In the past I've talked with clients about these behaviors in detail to understand them better: are they occurring as a way to avoid talking about painful material? Are these behaviors a way to learn more about me? Are they simply a function of self-consciousness? Given that I am a Cognitive Therapist and not a Psychoanalyst these conversations are proving to be more a waste of time that a moment of enlightenment.
Unless I believe these behaviors are truly relevant to a client's difficulties they will be abolished from this point forward. To that end I, Dr. Robert Allen Dobrenski, have decreed a small number of rules and regulations to be enforced in the private sanctuary that is my office. In addition to the standard sanctions against intoxication, nudity, bare-feet, verbally abusing me, physically assaulting me, refusing to pay for services, laughing at my new haircut, calling me 'funny looking,' spitting on my floor and/or furniture and other faux-pas that are highly forbidden in a professional relationship with me, there are new prescripts that are required starting immediately:
1) Stop Looking at me Looking at the Clock
I need to keep track of the time at a few standard moments during the session. The details of time structure for a cognitive therapy session are beyond the scope of a single blog post but it's important to realize that I need X number of minutes for multiple topics: updates since the last session, review of any therapy homework, summary of the topics covered today, planning for the upcoming week and feedback for the session, not to mention other items.
If I'm not on top of these things very often nothing gets done and the session turns into a glorified coffee hour. While I enjoy my coffee just as much as the next person, this is unacceptable. It's a waste of clients' time and money and they deserve better than that. What is also and perhaps even more unacceptable to me is being called out as 'looking bored,' 'wanting me (the client) to leave,' and 'thinking about how much money I'm making per minute.' I'm only looking at the clock to keep the well-oiled machine that is the office running smoothly and efficiently. So stop staring.
2) Stop Wondering why I'm Yawning
I am not the best sleeper, and writing blog posts at 4 AM, as I am doing right now, doesn't help that issue. If I'm very tired on a particular day I will usually inform a client of that fact before the session starts as a pre-emptive strike against offending someone if I yawn or have a glazed look in my eyes. This also protects me against false claims of heavy drug use. The reality is that yawning is going to happen at times no matter how riveting the conversation. I am not necessarily bored if I feel sleepy in session. And even if that were the case it is certainly not the end of the world.
No client is responsible for being the most entertaining or amazingly interesting person who comes through the door. Life is often slow and uneventful and if there are moments of boredom for either therapist or client in session it should be discussed and not taken as some personal affront that the client is the most unbearable person on the planet. Dr. Pete is insufferable, my clients are usually not.
3) Do Not Comment That I Look "Up and to the Right" When I'm Deep in Thought
I've been doing this since I was 12 and I have a feeling that's never going to change. I do it in my own therapy sessions, when socializing, really any time someone asks me a question or I'm pondering something of any importance. That's why I don't think much when I'm crossing the street in New York City. I'll end up staring at a cloud and getting run over by a cab driver who will later sue me for breaking his engine grill with my face. The eye movement is just one of my few thousand quirks. I don't know why I do it and unless my Ophthalmologist says I'm going to give myself retinal cancer from it I am not going to fret over it.
4) My Wardrobe is not Part of the Therapy Discussion
I wear either a) khakis and a button-down shirt or b) jeans, a button-down shirt and a blazer. I don't own a suit and perhaps never will because I hate ties. I also have bad taste in shoes - so bad that Dr. John's sister said that I was an "embarrassment to feet" - so let's just ignore that part of my work attire as well.
5) We are not Going to Analyze Whatever Book is on my Desk
Reading Buddhism for Dummies doesn't make me an anti-Semite and A Confederacy of Dunces on my desk doesn't mean I hate the South. In fact my Jewish friends tell me I'm quite open to all religious viewpoints and SEC football is top-notch so I'm not a hater on these fronts. I'm sure there is some deeper meaning behind what I'm reading at any given moment but we're not getting into that during therapy time. That's what I pay my own shrink for so let's make her earn her money.
These are the new rules which are non-negotiable. I haven't as yet thought of a swift and acute punishment for breaking the new rules other than having to talk about it with me, but since the client is already there to talk it's not much of a punishment. Make no mistake, however, I will come up with something so repugnant that clients will never comment on my eyes, clothes, shoes, books, clock-watching habits or my sleep patterns. Maybe I'll raise my fee $1 if clients breaks one of the rules. That'll teach 'em.
Posted by Rob Dobrenski at 12:38 PM