The client who fired me (and was right to)

A client fired me early in my career. She was polite about it, which made it worse. She said I’d spent two years helping her with a problem she didn’t have, while the actual problem got worse.

She was right.

I was practicing CBT the way I’d been trained:

• Take a full history,

• build the formulation,

• work the problem systematically.

I had a coherent story about her. The story was even true. It just wasn’t the thing that was killing her, and somewhere around month four I had stopped checking.

She’d told me the real thing in the first session. I wrote it down. Then I kept going with the narrative I’d already built because it was a good narrative and I was invested in it. That’s the part that should bother you, if you’re a therapist reading this. Not that I missed it once. That I kept missing it because I’d already decided what I was looking at.

I practice very differently now. I want to know what’s happening, what’s been tried, and what needs to change right now. I expect something to transform arleady in the first few sessions. If nothing moves, I’m not being thorough or direct enough. I’m dragging someone through my need to understand before I act. That’s bad therapy. baaaaaad therapy.

Your client tells you the real thing early. She tells you in the first session, often in the sentence she seems slightly embarrassed about, the one she throws in at the end like it’s a footnote.

If you’re still building the case at month six and she’s still stuck, the formulation isn’t the problem.

You are.

xx, so...

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