Clients sometimes ask me why I do not send them reminder texts or emails for their appointments.
My answer to this is that therapy differs from medical appointments in that it is a collaborative relationship. The client and the therapist work together. I normally address this in the initial session, as part of the contract. We discuss the nature of the relationship, and the expectations. I would inform clients that I retain their slot on the agreed times, and would await them as scheduled. We discuss if the terms are agreeable, and negotiate them if needed.
So, part of the work together is for both parties to responsibly to show up. We come to a working agreement together, like a set of SOPs, where we work towards the therapeutic goals.
We live in a generation where people tend to ‘flake’- meaning that the tendency to fail keeping appointments and committing to plans are quite high. When someone ‘flakes’, there is normally little or no advance notice. When this behaviour is enabled, it can perpetuate, and become a behavioural pattern.
Sometimes it can be a sign of severe anxiety and/or depression. Other times, it can reflect the fact that the plan made is of low importance- that there is little effort in keeping one’s word, one’s commitment.
There is also the question of the other people involved. How does one’s unattendance affect others? In a social event, would the host be disappointed? In a therapeutic setting, would absence be preventing another person in need from getting help? What about one’s sense of integrity?
Some of the fundamental building blocks of personal growth is commitment, accountability, and agency.
Committing to therapy in itself is an investment, it is a significant aspect of recovery, healing, and transformation.
Some sessions may be more fruitful than others, some may be more painful or challenging… but it is simply part of the process.
Progress is not always a consistent a y=2x upward trend.
However the ‘progress chart’ may look like, it may be worth discussing that in a session rather than skipping sessions.
A Tibetan monk, Sogyal Rinpoche said, "So we ignore what could be really the most revealing experiences of our lives, if only we understood them. This is perhaps the darkest and most disturbing aspect of modern civilisation- it's ignorance and repression of who are."
You might just miss out on some golden nuggets of realisation where you don’t dig. Or perhaps, your work with your therapist have come to an end. In this case, some closure in the form of a review, a last session, or even a phonecall can be very beneficial for both parties.
But of course... life happens, and things can get pretty overwhelming at times. The key is in communicating truthfully. We can only try our best, but as we keep trying, our best gets better.
For example, I have had clients on occasion request for a reminder when they foresee a hectic couple of weeks coming up.
Such requests truly makes me feel respected as a person and as a therapist. I am always more than happy to oblige. After all, it is a collaborative relationship.
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