Questions and Answers

[After about six months of psychotherapy] I had a dream [in which my psychotherapist was shown to be indifferent and uncaring]. My therapist trivialized the dream, as she does with most dreams that I tell her about. I have stopped telling her my dreams in fact. Ever since this dream, I seem to be getting nowhere in therapy and feel as though I am wasting my time. I tried to talk to her [about all of my feelings] as transference, and she got annoyed with me. . . . She made me feel very foolish. . . . When I told her I wanted to terminate with her . . . I asked for my file. She said that . . . she had no file, but rather notes on pads in different places. This stuck me as very odd. I have to wonder where these notes are lying around, and who is reading them. Do you find that odd?   It seems clear to me that your dream most likely was the result of your unconscious perception that your therapist lacks the ability to “treat” you properly—and I mean that both humanly and clinically. Her inability to interpret your dream, and her inability to respond clinically to your attempt to discuss transference both point to her being one of those “bad therapists” I mention on this website. It’s to your credit that you perceived this fairly early on in the relationship. I say the following about clinical records on my page about confidentiality in clinical psychology: In the US, federal laws governing the nature and confidentiality of mental health records may be overridden by more stringent state laws, so psychological practice can vary from state to state. But in general a psychotherapist is required to keep some basic records that consist of the dates of your sessions, your fees and payments, and clinical notes that describe and justify your treatment. The clinical notes can vary in length and detail according to the preference of the psychotherapist, but in general they shouldn’t be too detailed, and you have a right to ask about them. All this information is kept in your individual chart along with general office forms and any other information relating to treatment, such as the results of any psychological testing. Her lack of clinical records is therefore absolutely appalling and, depending on the laws of your state, could be considered both an ethical violation and clinical negligence. You don’t say what sort of “therapist” she is. If she’s a psychologist, you could contact the Board of Psychology and file a complaint. If she’s an MFT or an LCSW, then you would have to contact the appropriate agency for those licenses. (In California, the website for the Board of Psychology lists the addresses of the other licensing agencies.) Here’s a link to find the Board of Psychology in your state: Roster of Member Boards of Psychology. As for choosing a new psychotherapist, I have a page on that subject on this website; I can add here that you might look specifically for someone who practices psychodynamic psychotherapy. Of course, maybe that’s what this questionable “therapist” claims to practice. In addition, then, you could ask if the psychotherapist has had experience in dream interpretation. You can also ask about the person’s own psychotherapy—someone who has been in psychoanalysis is more likely (but not guaranteed) to be sensitive to dream work and transference issues. And then, use the very first session to determine how that person treats you; that is, does he or she give honest, non-defensive answers to your questions? Does he or she show a balance between listening and taking the lead to guide you? And, the best “test” of all is whether you leave that first session feeling that you have been both challenged and supported and that you have actually learned something new about yourself. Then pay attention to your dreams!    Back to the list of questions

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