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By Esther Mann, LCSW
Dear Esther,
I am 25 years old, single, and live with my parents and siblings. Over the past few years, I’ve developed a close relationship with my internist. I started going to her because I was having symptoms of anxiety and didn’t really understand what was happening to me.
I live in a crazy house. I’m the oldest of six children and it usually feels as though everything is out of control. As the oldest, I try to instill some order, but my parents often undo anything useful that I try to accomplish. I’m not going to go into the history, but rather ask a question that I’m wondering about.
After confiding in my internist and sharing information with her that I’ve never shared with anyone before, she encouraged me to get into therapy. I’m probably the most normal person in my family and it’s everyone else who needs to be in therapy, but after some resistance and claiming that I don’t need it, I realized, with the encouragement of my doctor, that at least a therapist could teach me coping skills to survive my environment.
I haven’t told anyone about this new adventure of mine, and it’s not something that has ever come up in conversation. My internist gave me a referral, and I walked into my first appointment without a clue of what therapy is all about and what to expect.
I’m writing to you because I feel uncomfortable with what takes place in my sessions, and I want to find out whether my expectations are too high or if this particular therapist is not typical.
I’ll call the therapist “Linda.” Linda keeps her cell phone on when I’m with her and usually takes at least one personal call—and sometimes more—in the middle of our talks. Linda works out of her home office, and it appears she has young children. There is always something going on that needs her attention. The phone calls don’t last long, but the first time I saw her answer the phone I was shocked. It made me feel meaningless, as though I were totally unimportant—which is the last thing I need to be feeling right now.
I’ve seen Linda five times already. Twice she’s actually gotten up, probably run into her house to take care of some urgent matter, and returned with a smile, as if nothing wrong had taken place. I may have smelled the distinct scent of Bounce, leading me to think that she ran out to throw a load of laundry into her dryer. Again, the whole thing made me feel like I was some kind of afterthought. I’m not the most confident person in the world, but wouldn’t anyone feel that way?
Some of our conversations are insightful and give me food for thought, and I’m grateful for that. But sometimes I get the distinct impression that she is bored and anxious for the session to end. Twice, she’s ended it five minutes early. Sometimes I catch her yawning.
I’m wondering what to do now. Do I put up with her behavior and concentrate on taking the nuggets of insight that I believe have been helpful so far, or do I just walk away? I hate the idea of starting all over again with someone new, but my gut tells me that something here isn’t right. What’s your take on my therapist?


Dear Uncertain,
I’m glad that your internist encouraged you to seek out therapy, because it sounds as though you have a lot on your plate and can use advice, support, insight, and encouragement from a good therapist who can help you grow in meaningful ways.
Being in therapy is a serious undertaking; it shouldn’t be taken lightly. Like all important relationships, it has to feel right, feel safe, be imbued with respect, and, at the very least, be a good fit.
I’m pleased to hear that you have taken your internist’s ideas to heart and no doubt have grown from the conversations you’ve had with her. Since there is so much going on in your home and, as the oldest child, you find most of the chaos and responsibility landing on your shoulders, having a sympathetic ear is, in itself, a huge relief for you. Hopefully, the two of you worked on the important goal of creating healthy boundaries so that you can begin to live your life more fully and move on to a certain extent, since it’s not your job to fix your parents or your siblings. It’s usually hard to create these shifts alone.
However, just because your internist recognized a need in you and offered a helpful solution doesn’t mean that she necessarily knows who is terrific and who isn’t, in the world of therapy. Or who would be terrific for you! It’s possible that one of her patients is a therapist and happened to hand her a bunch of business cards one day with the request to pass them along when needed. Maybe your internist heard your therapist’s name mentioned in some context, but doesn’t know much about her actual work ethic or successes. It’s hard to know how your internist came about suggesting this particular therapist to you.
Getting down to your question, firstly, I think it’s awful that your therapist takes personal calls during a session. If, once in a blue moon, there is a “situation,” where your therapist must keep her phone on because of some kind of emergency, that’s one thing. Anyone can have a crisis and need to be reachable. But in general, I believe it is unacceptable, inexcusable, and disrespectful.
Running out of a session midstream for some personal household duty is also a negative game-changer. It completely compromises the therapeutic alliance and certainly breaks the rhythm of a session, which is valuable and time-sensitive.
When you walk into a therapist’s office, you should be made to feel that during the session you are the most important person in that room, and all eyes are on you. If that isn’t the feeling you experience when you walk into your therapist’s office, then something is indeed amiss. Within most relationships during our lives, it’s never supposed to be just about ourselves. One of the special features of therapy is that it is all about you and really only you.
It sounds as though your therapist possesses certain skills that have enabled you to learn a thing or two about yourself and your situation. This was helpful to you, and so your time spent with her has not been a complete waste. Sometimes learning even one new insight or skill can make an experience worthwhile. But you can do better! You can certainly find a therapist who not only encourages you to think in a healthier way and live your life more fully, but who always treats you with the respect and consideration you deserve.
My advice is to take the positives from this experience, but know that your gut was not wrong when signaling that something was off-kilter. As with everything else, we learn what works and what does not through experience. It’s rare that we find our first attempts at new things immediately successful. Sometimes we need to shop around just a little to really get it right. But it’s worth the effort.
I know that most people have a hard time going through their entire history yet again with a new therapist. It can be annoying and frustrating. But you get it done and move on in a more satisfied way.
Ultimately, when you walk into the office of a therapist who is right for you, you’ll know it right away. And when that happens, you won’t be questioning your therapist’s actions because the session will flow in a comfortable way. You will feel your therapist’s presence internally and together embark on a remarkable journey toward a better place. You deserve that!


Esther Mann, LCSW, is a psychotherapist in Lawrence. Esther works with individuals and couples. She can be reached at or 516-314-2295.

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Posted by on October 2, 2014. Filed under In This Week's Edition. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.