When I fiiiirst started out seeing clients individually, I remember one of my biggest fears was about how to sneak a peek at the damn clock without the client seeing!!
I did ALL kinds of things to avoid the client noticing that I was keeping an eye on the time, like:
Getting rid of all analog clocks and going to BRIGHT RED DIGITAL – I sucked at reading analog clocks as a kid anyway.
Buying a watch and subtly trying to see what time it was throughout the session, but digital wristwatches – not hip. Analog, see above. Disaster.
Waaaiting, waaaaaaatiiing until the client was lost in thought and then darting my eyes furtively towards the clock, rolling my eyes up and placing my hand on my chin thoughtfully if they happened to glance my way and catch me!
Hiding a clock under the couch, but also keeping a clock in the client’s view. This way, they could see me NOT looking at the clock, while I was secretly looking at the clock under the couch. (This worked magically until a client found the clock under the couch. AWK-FUCKING-WARD)
A ton of things! I did a ton of things to figure out how to get away with looking at the clock. The thing I didn’t do – at least not for some time – was ask myself WHAT WAS SO BAD ABOUT THE CLIENT SEEING ME LOOK AT THE CLOCK?!
Hm. Wow. That question certainly brings things to another level, doesn’t it.
Maybe your anxiety isn’t exactly about having the client see you look at the clock. Maybe it manifests in ending the session on time. Or stopping a client mid-cry in order to let him know the session is up. Maybe you have a ton of anxiety when a client runs late, because you spiral into wondering if they know you are still going to end on time and/or calculating how much you can run over without impacting the next client too much.
So what’s this about?
What makes it hard to end on time? What makes it hard to openly acknowledge that goddamn clock?
I’ve heard from therapists who say they feel “bad” cutting a client off right when they’re in the middle of something.
Or that they worry about hurting the client’s feelings by interrupting them.
I’ve heard of therapists who talk about “going a little over” because they’re worried that maybe they haven’t given the clients enough and – guess what – extra time is a clear value add…right?
It’s easy to tell ourselves it’s just a few minutes. Or that we’re being nice – giving the client a little something extra. But for therapist who continually go beyond the agreed upon time, I’m going to propose that something deeper is going on.
Ah’m about to get all existential on your ass. BOOM.
Let’s think about what time represents.
The fact is, time is going to keep plodding forward no matter what. Winter turns to Spring turns to Summer turns to Fall and back again. No matter how much I twist my panties, October 25th comes along every year and every year, I age just a wee….bit…more.
And, oh the agoooony! I can hire a personal trainer (check!), I can slather my face in all the lotions and creams (check!), I can disavow all whiskey drinks, once and for all (um. Ahem. about that) – but no matter how I FEEL, time continues. I get older. People around me die. And I wend my way, inevitably towards my own death.
Yikes. And that makes me sad to think about.
All this to say, refusing to end sessions on time, is a denial of the reality of death.
Look, dealing with the realities of ending – relationships, a great meal, a sunny day, a session – is hard, but it’s our job as therapists to help our clients navigate and come to terms with the reality.
By doing “nice” things for the client, like habitually letting sessions go on longer than we’ve stated they will or refusing to implement the cancellation policy because the client go sick or not charging the fees that we need to pay for our lives – all of these things are out of line with reality and avoiding these things in our therapeutic work is not being nice!
Avoiding reality is doing your client a disservice.
Our clients come to us because they are, in some way or another, struggling to cope with the reality that is before them. By pretending there are no consequences when we violate our practice policies, we are reinforcing the idea that reality doesn’t apply to them.
Here are some very real consequences:
Not ending sessions on time: You don’t have time to pee or do your notes or take a breath. You get worn out, overwhelmed and behind.
Not charging for missed sessions: You are in perpetual financial insecurity, worried about the ups and downs of private practice which leave you feeling maxed out, despite your justifications that everything is going just fine.
Not charging an appropriate fee: You are seeing too many clients and earning too little. Don’t believe me? How’s that student loan debt going? What about those credit card bills? When’s the last time you skipped out on a nice meal or a vacation because you worried about the money?
We’re indicating to the client that these situations don’t have consequences, meanwhile, our unconscious minds are paddling like mad to keep up with our acts of dissociation.
The truth is, it’s hard to enforce a cancellation policy when your client’s kid is sick. It feels uncomfortable to say, “It’s time to end” when your client is just getting into talking about the death of her mother. It’s hard as FUCK. And sad, too. It brings up all kinds of losses the clients have gone through. All the “misses.” All the abandonments.
What a lovingly professional thing it is to acknowledge the pain, acknowledge the loss, and be there with them in it.
You know what most people do? Avoid it. Try to make it go away. Pretend loss and endings and feelings of anger and rejection aren’t real.
As a therapist, you are quite likely the only person in that client’s life who is willing to both acknowledge the pain, empathize with it and survive it, vs. trying (falsely) to make reality different than what it is.
What a gift.
What feelings have kept you from ending on time?! Leave a comment in the comment section below and share ONE fear that has kept you from ending on time.
Share with us in the comment section below.
I love this article. I work for an organization for therapists. Can I print this in our newsletter?
Hi Nancy! What an honor!
Shoot me an email over at email@example.com and we can talk about printing this up for the CAMFT newsletter.
I like this blog entry. Any chance I can reprint this in a newsletter for therapists? I know they would love it. I’m the admin for a chapter in CA.
This was helpful! My thoughts usually are around then client is just beginning to get to the real stuff towards the end of the session. This said, I think thst I could have gotten them there faster is my issue.
Suuuper interesting, Denise! If a client has a pattern of to getting to the “good stuff” right at the end of the session, that sounds like a super important thing to bring up. It makes me wonder about the desire to cut the intimacy short (for protection? out of anxiety?) and/or keep the session going by getting juicy at the end and ensuring a few more minutes with you.
AND, great insight – you also bring up this could be something *you’re* doing, especially if it is a pattern that goes across all clients. If so, there is a ton of great learning about you that could be had here. Very exciting!! Take that shiz to consultation for sure and then send me an email and let me know what you learned!
I have struggled with this issue myself. I kept thinking that it was rude to interrupt, that if I just spent a little longer I could get to a good ending point, that if the client was late for a good reason they still were entitled to their full session time, hence I would go over… But what I have started doing is straight up telling clients that time-tracking is challenging for me. I have straight up set up my timer on my phone and warned them when it goes off that it means we need to start wrapping things up. They do not seem to mind at all! This practice has been good for me, and I’m still battling with my old habit, but I know that ending on time is about respect to me and to my client, and it forces me to show up in a different way. Rather than allowing them to speak on and on I have to direct the conversation to offering actual help, if they’re ready. If they are not ready and need to talk some more that is cool too, but I feel I can be more effective by structuring and directing a little bit more, so as to send the message that we are in therapy to do work, not just to vent about ongoing problems.
HA! What a great way to start challenging yourself to end on time. It seems you are enlisting your clients in helping you by having the CLOCK be the time keeper with it’s alarm-ing reminder that time is up. You KNOW there’s grist for this mill, Raquel. I wonder if there’s something uncomfortable about *you* being that alarming voice that keeps track of the time and then says, “It’s time to stop”. This clock is a great first step and it makes me Oh So Curious about what the next phase of your clinical journey will bring.
This is great and super helpful, Tiffany. In reading this, I’m thinking how I have sometimes let sessions go over because I felt like I hadn’t done enough yet. Like “they are paying me all of this money and what exactly have I given them in return?” It doesn’t come from a place of security, which of course gets back to all of your other awesome work on value and fees and stuff. So thanks for giving me another resource to manage it better when the insecurity forces try to show up!
Great insights, Jacob! It makes me wonder about what, specifically, would have to *change* in order for you to feel like you ARE giving them enough within the frame that you set. Hm…
I guess I’ve been afraid of coming off as rude if the client is right in the middle of saying something important, or if I really want to finish giving important feedback and it seems like the moment will vanish if I stop.
However, I need to remember that the time I allot to a client is enough. Clients sometimes wish they could see me many more times throughout the week if they could, and I don’t have endless capacity, so the time I do give needs to be enough. Sometimes I’ve found that less is more (eg, switching a client to every other week makes them make extra good, productive use of the session), so in reality, do they really need me to run over my time all the time? Hm, maybe that’s why I’m getting a bit burnt out?! And to think I used to not have this problem in community mental health; what the heck happened over the last couple of yrs?!
YES! Rebecca! Bull’s eye. You are onto something here. What would it be like to even take up this idea within the therapy, even if it’s only in your own head? Are you noticing patterns within your clients’ lives where they, too, have trouble identifying and sticking to their boundaries? What would it mean to use *your* going over sessions as a way to talk about the difficulty sticking to boundaries along with the importance of doing so? Modeling in vivo!
Great article, getting right to the core issue: the reality of life and death. If not us facing fears with clients, and our own anxieties, then who? Exactly! On point.
Thank you, Matthew! I love that you’re down with the depth.
All good!! With the added bonus of making the frame safe and setting a proper boundary! Something most of our clients (us too?) struggle with. If we don’t model boundaries and self care, who will? Also, if we don’t end on time, what else will we do that’s outside the frame?
Ooftah! YES, Teresa. “If we don’t end on time, what else do we do that’s outside the frame?” ==> BRILLIANT question and ripe for exploration!
You nailed it. I struggle when people are dealing with fresh grief or they are in crisis and I’m concerned about their well-being – in all honesty, when I’ve processed this with a client – they are actually quite capable of managing themselves and their life – I’m fussing and they just need my confidence in them that yes it’s painful but they will be okay. The boundary of the fee/ end of session seem to instill in them my belief that they can sort themselves out. I don’t need to mother them!
It IS tough to end especially when people are right in the midst of grief. I’m thinking just now of even beginning to wind down the session, so the client has the opportunity to begin soothing themselves near the end, something like, “We have just about 5 more minutes and I’m wondering about XYZ.” while also being aware that time is coming to a close. Then pay attention to how they respond/engage with the shared understanding that the session is about to come to a close.