When a Clients Get Angry at their Therapist

"Sometimes you say things that really piss me off" my client told me.

What I just said was one of those times. I was flattered. Clients do you a great favor when they tell you they didn't like what you told them.

You've reached a different level of honesty with them.

It is impossible to do "good therapy" without either being profoundly wrong at times, or equally problematic, painfully right. Often, when profoundly wrong, they either don't tell you, or they correct your misunderstanding. Everything about the way they speak to you, when you are wrongheaded, tells you that you missed the mark.

When I'm on target, however, and perhaps something less than "gentle" in delivering my message, I make you angry. Most often, I make you most angry when I'm protecting that side of you that least wants my advocacy, never mind my acknowledgment.

When you are very hard on yourself, dear client, encouraging words like "go easy on yourself" work only for the mildest of cases. These sorts of reassurances most people want and need from spouses or close friends, as a sort of "attaboy!"

In therapy, especially when the destructive self-hatred is very entrenched and resilient, kind words are worse than useless. They encourage that "hateful side" to dig in deeper, convincing you that not only are you despicable, but you are an idiot for picking a useless therapist. After all, therapists are "suppose" to be kind and positive, right? Dr. Kathy may be kind, but does she have a clue? Has she really missed how truly rotten I am?

In situations like this, when the relationship between my client and I are strong, it is time for tough talk. I outline what I see happening: how such an attitude is both protecting my client and preventing him or her from seeing the possibility of change. They have become entrenched in a pattern of thinking or acting that they are now actively holding on to, while claiming they are helpless to do anything differently.

Clients have learned that you don't mind being wrong, and aren't in love with your ideas.

"Pissing off" a client is only effective for therapists who aren't really "in love" with their ideas, notions or (especially) their theoretical models. The most practical advice I ever read, was from Carl Whitaker, a family therapist, who said "Learn to advance and retreat from any position." Needing to be "right" is often the very problem that brings clients into therapy. A therapist compounds the difficulty when they insist on their point of view as being the correct one. A good therapist prefers to be effective, rather than "right." They hold their theories lightly, and always in the service of their clients, not as a weapon to hit them with.

Clients have confidence that you are working with their best interest at heart, even if it doesn't feel like that from moment to moment.

Most people can't possibly trust that their therapist is working in their best interest, except over time and through experience. Therefore, I seldom find myself "pissing off" my new clients. They don't know me, and they have no reason to trust me. They have even less reason to make themselves vulnerable, by saying that I've made them angry. If a client is very angry at me, very early in therapy, it usually has more to do with the client's way of being in the world, than my way of doing therapy. I know myself and the effect my personality has on most people. Most people like me, as a therapist, and I give them very little reason not to, as we begin working together.

Clients learn that you are strong enough to allow them to be angry at you.

Most clients are extremely protective of even ineffective therapists. Most don't want to hurt or offend their therapists, and would rather quit therapy than confess that they are angry at the therapist. Often, in our "4-6 session therapy world," clients hardly know the therapist well enough to develop an opinion, never mind share it. When a client can get angry at you, it usually means they know you well enough, care about you enough, and believe, deep down, that they won't crush you with their hostile emotions. This is usually an excellent sign.

Clients know you won't retaliate.

That comes with trust that develops over time. Many clients come to therapy because they grew up with people who had power over them, and often used it unpredictably, or underhandedly. Learning to be upfront about the impact people have on you, emotionally, particularly people who have a great deal of influence over you, requires some sort of belief that you will be safe to do so, without unpleasant unexpected consequences. \

Often my reactions aren't what they expect. I often thank them for their honesty, or tell them I'm flattered by it. Sometimes, I tell them that they may be even feeling angry because they believe I was "on target." I sympathize that it is one thing to be angry at someone for saying something that made you angry because it was not true. It is even more infuriating when it IS true. I invite them to feel entitled to their angry feelings, while at the same time, watching and mulling over what was said. That's often an unexpected response, but not an unpleasant one.

Clients know you have your own perspective and don't "catch" their emotions.

We often live in a world where getting angry at someone causes that person to get angry back. Such "contagiousness" of emotions is often the norm. Good therapy doesn't work when emotions are contagious. I'm most often curious when clients have strong feelings, and move into a closer relationship with them, rather than respond defensively.

"What part of that got you angriest? What do you imagine I meant by that? Is it true? What did I leave out by saying it that way? Wow. That's really interesting. I never thought about it that way before. No wonder it made you angry to hear me say that. I might have felt the same way, if I took it that way."

People don't often feel flattered by someone getting angry at them, nor do they want to hear more. A more typical response is to attempt to either appease the angry person, or distance from them. Paradoxically, however, anger is an APPROACH emotion. It is often an attempt to bring the person you feel angry at into closer contact, not drive them away. Anger enables us to express ourselves and be better known to the other person when it is done effectively.

I truly appreciate my clients telling me about their emotional state, even when that state is anger, and even when I am the target of that angry feeling.