Safety in Therapy
I wish somebody had told me many years ago, when I started my own healing journey in therapy, what safety in therapy looks like. For those of us with marginalized identities, unhealthy family dynamics, or trauma, safety may not be the norm. At its core, what matters most in therapy is the healing nature of a safe and caring relationship (1). Not the modality or type of therapy. When you consider how much hurt happens in a relational context, it makes sense that having a reparative relational experience could be so crucial in healing that hurt. Yet, many folks coming to therapy have no idea what that could look like, or that they could even expect it.
You may have been taught to ignore your feelings and distrust your intuition. You may have been conditioned to accept what people in positions of power tell you about yourself and what you can or cannot do. Maybe you are worried you will get hurt but you don’t know how to address it in a way that feels safe. Here is the list I wish I’d had when I was starting my healing journey. You can modify it to fit you as an individual. This is your healing journey, after all. And no one knows you better than you know yourself.
A Client’s Bill of Rights in Therapy
1. You have a right to say no
Consent applies to therapy, too. There is an inherent power differential at play in the therapist-client relationship. Look for a therapist who gets this and shows it by honoring your boundaries, your autonomy, and your knowledge of yourself. You don’t have to explain your ‘no’. Though there may be space offered to share your ‘why’, it should never be coerced or demanded. You can change your ‘yes’ to ‘no’ and your ‘no’ to ‘yes’- consent is an ongoing process and you can change your mind.
2. You have a right to know the process at play- what you’re doing and why
Transparency is another important component of creating safety in a relationship. You probably wouldn’t let a total stranger take your hand and steer you, blindfolded, wherever they wish. You can ask where your therapist is guiding you, and take a role in the direction yourself.
3. You have a right to define what safety means for you
You have agency and choice in therapy, and this includes naming what feels safe for you. This could look like saying it feels safer to start a session with something that feels grounding or easy to talk about. Or maybe safety feels like being able to talk with no filter.
4. You have a right to decide what to share or not share
Therapy isn’t an interrogation. It’s a warm, inviting unfolding that welcomes you where you are and values all you have to share- spoken or unspoken.
5. You have a right to choose what you want to focus on
Nobody can decide your goals for you (though we can certainly brainstorm together if you’re feeling stuck!) You know better than anyone else the things that keep you up at night, the stuff that you can’t just think your way out of, the things that impact your relationships and quality of life.
6. You have a right to fire your therapist
Really! You don’t have to stay in a relationship that’s not working for you. Sometimes it can be therapeutic to work on the relationship, other times it makes more sense to move on. You have choice.
7. You have a right to dictate the pace
You can say when something feels too fast or too slow. Maybe digging into your family history is something that needs to be a multi-season series rather than a 3-part miniseries. Or you could feel like you are ready to plunge right in.
8. You have a right to name when something feels hurtful, uncomfortable, or otherwise impacts the therapeutic relationship
I know this can be a challenging one for a lot of folks. You may have had experiences where any sort of feedback feels like conflict and damages the relationship. You may have been told you’re overreacting or too sensitive when you share how something impacts you. Some of the most powerful moments I’ve been a part of in therapy have happened when hurt or discomfort is named, processed, and responded to with care. What an amazing opportunity for healing this is.
9. You have a right to set boundaries and limits
A boundary could look like, “when you ask me to take deep breaths and connect with my body, I’m not going to do that because it feels too scary or unsafe right now”. A limit could look like, “Please do not use this phrase when describing my symptoms”.
10. You have a right to disagree
This could look like saying “that interpretation doesn’t make sense for me” or “no, that’s not what I’m feeling, that’s not what’s happening for me right now”.
11. You have a right to say “this isn’t working, can we try something else?”
You don’t have to force it. If it doesn’t fit, you can ask to try something else, or see if there are ways to make it fit. Maybe that breathing technique doesn’t work for you, and you need a different grounding tool, or a different way of using this tool.
12. You have a right to be heard
Your voice matters here. Full stop. The mic is yours. Say what you need to say.
13. You have a right to be respected
No judgement, no looking down upon, just unconditional acceptance and positive regard.
14. You have a right to express anger or frustration
Sometimes you may find yourself feeling anger or frustration towards your therapist. You can feel this and you can share it with your therapist. Obviously, your therapist will likely have some of their own limits- like no name-calling, abusive language, or physical violence/intimidation. But there is space for all your feelings in therapy- even the ones that come up towards your therapist.
15. You have a right to ask for what you need
Some things I hear are “I need you to ask that in a different way” or “I need to use some fidgets or have a screen open while we talk to help me focus”. This could also include asking for help in identifying what you need. Maybe you come to session just feeling bad overall, but don’t know what you need or where to start. You can ask for help!
Looking at this list, what stands out to you the most? Is there anything that feels challenging? Does it call to mind any experiences in other relationships, whether these rights were honored, or there wasn’t space for them at all? What would you change or add to this list?
Safety in therapy is built over time, by listening to yourself and honoring your needs. Take some time to reflect on this list and your own needs, and what you might be looking for in a therapist.
References:
Psychotherapy and Therapeutic Relationship, Opland, C., and Torrico, T.J. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK608012/