After many sessions of psychodynamic therapy dan at some point experiences reluctance

The items listed below are significant red flags and important information for anyone in therapy or considering therapy. If any of the following red flags appear during the course of your counseling, it may be time to reevaluate your counselor or therapist.

Should you recognize one of these red flags, the first step, in most cases, is to discuss your concern with your counselor. Try talking candidly about what’s bothering you. A good therapist should be open and willing to understand your concerns. If your counselor doesn’t take your concerns seriously or is unwilling to accept feedback, then it’s probably in your best interest to consult with another therapist about it. Most therapists mean well and are willing to take accountability for their own “stuff.” So, it’s also important to give your therapist the benefit of the doubt … all people make minor mistakes. And sometimes what people think is their therapist’s issue is actually their own. These “blind spots” can be the most difficult to see and are well worth talking about with your therapist.

It’s also important to note that the following red flags have varying degrees of significance. Some of them are very serious violations of ethical standards, such as a therapist attempting to have a sexual relationship with a client. There is no exception to this rule, and if you find yourself in such a situation, you are advised to report to the state professional licensing board and consult with other professionals. However, a number of the red flags listed below do have “exceptions to the rule” and depend partly on the context. For example, it’s generally unacceptable for therapists to have dual relationships with their clients. So if a counselor is treating the neighborhood barber for his or her depression, the counselor goes to a different barber to avoid confusing the “client-therapist” relationship. However, in small communities it can be impossible to avoid certain dual relationships. Ethical guidelines are flexible enough to take this, and some other exceptions, into account.

In no particular order, it is a red flag if you find your:

1. Counselor does not have sufficient and specific training to address your issues and/or attempts to treat problems outside the scope of the practice.
2. Therapist is not interested in the changes you want to make and your goals for therapy.
3. Counselor cannot or does not clearly define how they can help you to solve whatever issue or concern has brought you to therapy.
4. Therapist provides no explanation of how you will know when your therapy is complete.
5. Counselor does not seek consultation with other therapists.
6. Therapist makes guarantees and/or promises.
7. Therapist has unresolved complaints filed with a licensing board.
8. Therapist does not provide you with information about your rights as a client, confidentiality, office policies, and fees so you can fairly consent to your treatment. Note: The requirement for information provided to new clients by therapists differs by state and licensure requirements.
9. Counselor is judgmental or critical of your behavior, lifestyle, or problems.
10. Therapist “looks down” at you or treats you as inferior in subtle or not so subtle ways.
11. Counselor blames your family, friends, or partner.
12. Counselor encourages you to blame your family, friends, or partner.
13. Therapist knowingly or unknowingly gets personal psychological needs met at the expense of focusing on you and your therapy.
14. Counselor tries to be your friend.
15. Therapist initiates touch (i.e., hugs) without consent.
16. Counselor attempts to have a sexual or romantic relationship with you.
17. Therapist talks excessively about personal issues and/or self-discloses often without any therapeutic purpose.
18. Counselor tries to enlist your help with something not related to your therapy.
19. Therapist discloses your identifying information without authorization or mandate.
20. Counselor tells you the identities of other clients.
21. Therapist discloses they have never done personal therapy work.
22. Counselor cannot accept feedback or admit mistakes.
23. Therapist focuses extensively on diagnosing without also helping you to change.
24. Counselor talks too much.
25. Therapist does not talk at all.
26. Counselor often speaks in complex “psychobabble” that leaves you confused.
27. Therapist focuses on thoughts and cognition at the exclusion of feelings and somatic experience.
28. Counselor focuses on feelings and somatic experience at the exclusion of thoughts, insight, and cognitive processing.
29. Therapist acts as if they have the answers or solutions to everything and spends time telling you how to best fix or change things.
30. Counselor tells you what to do, makes decisions for you, or gives frequent unsolicited advice.
31. Therapist encourages your dependency by allowing you to get your emotional needs met from the therapist. Therapist “feeds you fish, rather than helping you to fish for yourself.”

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33. Therapist believes that only the therapist’s counseling approach works and ridicules other approaches to therapy.
34. Therapist is contentious with you or frequently confrontational.
35. Counselor doesn’t remember your name and/or doesn’t remember your interactions from one session to the next.
36. Therapist does not pay attention or appear to be listening and understanding you.
37. Counselor answers the phone during your session.
38. Therapist is not sensitive to your culture or religion.
39. Counselor denies or ignores the importance of your spirituality.
40. Therapist tries to push spirituality or religion on to you.
41. Counselor does not empathize.
42. Therapist empathizes too much.
43. Counselor seems overwhelmed with your problems.
44. Therapist seems overly emotional, affected, or triggered by your feelings or issues.
45. Counselor pushes you into highly vulnerable feelings or memories against your wishes.
46. Therapist avoids exploring any of your emotional or vulnerable feelings.
47. Counselor does not ask your permission to use various psychotherapeutic techniques.
48. Therapist tries to get you to exert overt control over your impulses, compulsions, or addictions without helping you to appreciate and resolve the underlying causes.
49. Counselor prematurely and/or exclusively focuses on helping you to appreciate and resolve the underlying causes of an issue or compulsion when you would instead benefit more from learning coping skills to manage your impulses.
50. Your counselor habitually misses, cancels, or shows up late to appointments.

If there are other warning signs or red flags you’d like to share, please leave a reply in the comments section below.

© Copyright 2008 by Noah Rubinstein. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

How you attach to other adults strongly corresponds with how you attached to others as a child. Four distinct styles of attachment have been identified — and perhaps recognizing yourself in one of them is the first step toward strengthening your relationships.

The four child/adult attachment styles are:

• Secure – autonomous;
• Avoidant – dismissing;
• Anxious – preoccupied; and
• Disorganized – unresolved.

Adults with these attachment styles differ in a number of significant ways:

• how they perceive and deal with closeness and emotional intimacy.
• ability to communicate their emotions and needs, and listen to and understand the emotions and needs of their partners.
• modes of responding to conflict.
• expectations about their partner and the relationship (internal working models).

There are three primary, underlying dimensions that characterize attachment styles and patterns. The first dimension is closeness, meaning the extent to which people feel comfortable being emotionally close and intimate with others. The second is dependence/avoidance, or the extent to which people feel comfortable depending on others and having partners depend on them. The third is anxiety, or the extent to which people worry their partners will abandon and reject them.

The outline below describes four adult attachment styles regarding avoidance, closeness and anxiety — and prototypical descriptions of each.

Secure: Low on avoidance, low on anxiety. Comfortable with intimacy; not worried about rejection or preoccupied with the relationship. “It is easy for me to get close to others, and I am comfortable depending on them and having them depend on me. I don’t worry about being abandoned or about someone getting too close to me.”

Avoidant: High on avoidance, low on anxiety. Uncomfortable with closeness and primarily values independence and freedom; not worried about partner’s availability. “I am uncomfortable being close to others. I find it difficult to trust and depend on others and prefer that others do not depend on me. It is very important that I feel independent and self-sufficient. My partner wants me to be more intimate than I am comfortable being.”

Anxious: Low on avoidance, high on anxiety. Crave closeness and intimacy, very insecure about the relationship. “I want to be extremely emotionally close (merge) with others, but others are reluctant to get as close as I would like. I often worry that my partner doesn’t love or value me and will abandon me. My inordinate need for closeness scares people away.

Anxious and Avoidant: High on avoidance, high on anxiety. Uncomfortable with intimacy, and worried about partner’s commitment and love. “I am uncomfortable getting close to others, and find it difficult to trust and depend on them. I worry I will be hurt if I get close to my partner.”

The outline below explains the four adult attachment styles; the behavioral, cognitive and social aspects of each style; and the way in which they differ regarding closeness, dependency, avoidance and anxiety. It is common for adults to have a combination of traits rather than fit into just one style.

Autonomous (Secure):

                                                                  

• Comfortable in a warm, loving and emotionally close relationship.
• Depends on partner and allows partner to depend on them; is available for partner in times of need.
• Accepts partner’s need for separateness without feeling rejected or threatened; can be close and also independent (“dependent–independent”).
• Trusting, empathic, tolerant of differences, and forgiving.
• Communicates emotions and needs honestly and openly; attuned to partner’s needs and responds appropriately; does not avoid conflict.
• Manages emotions well; not overly upset about relationship issues.
• Insight, resolution and forgiveness about past relationship issues and hurts.
• Sensitive, warm and caring parent; attuned to child’s cues and needs; children are securely attached.

Dismissive (Avoidant)

                                                                                          

• Emotionally distant and rejecting in an intimate relationship; keeps partner at arm’s length; partner always wanting more closeness; ” “deactivates” attachment needs, feelings and behaviors.
• Equates intimacy with loss of independence; prefers autonomy to togetherness.
• Not able to depend on partner or allow partner to “lean on” them; independence is a priority.
• Communication is intellectual, not comfortable talking about emotions; avoids conflict, then explodes.
• Cool, controlled, stoic; compulsively self-sufficient; narrow emotional range; prefers to be alone.
• Good in a crisis; non-emotional, takes charge.
• Emotionally unavailable as parent; disengaged and detached; children are likely to have avoidant attachments.

Preoccupied (Anxious)

                                                      

• Insecure in intimate relationships; constantly worried about rejection and abandonment; preoccupied with relationship; “hyperactivates” attachment needs and behavior.
• Needy; requires ongoing reassurance; want to “merge” with partner, which scares partner away.
• Ruminates about unresolved past issues from family-of-origin, which intrudes into present perceptions and relationships (fear, hurt, anger, rejection).
• Overly sensitive to partner’s actions and moods; takes partner’s behavior too personally.
• Highly emotional; can be argumentative, combative, angry and controlling; poor personal boundaries.
• Communication is not collaborative; unaware of own responsibility in relationship issues; blames others.
• Unpredictable and moody; connects through conflict, “stirs the pot.”
• Inconsistent attunement with own children, who are likely to be anxiously attached.

Unresolved (Disorganized)

         

• Unresolved mindset and emotions; frightened by memories of prior traumas; losses from the past have not been not mourned or resolved.
• Cannot tolerate emotional closeness in a relationship; argumentative, rages, unable to regulate emotions; abusive and dysfunctional relationships recreate past patterns.
• Intrusive and frightening traumatic memories and triggers; dissociates to avoid pain; severe depression, PTSD.
• Antisocial; lack of empathy and remorse; aggressive and punitive; narcissistic, no regard for rules; substance abuse and criminality.
• Likely to maltreat own children; scripts children into past unresolved attachments; triggered into anger and fear by parent–child interaction; own children often develop disorganized attachment.

Attachment patterns are passed down from one generation to the next. Children learn how to connect from parents and caregivers, and they in turn teach the next generation. Your attachment history plays a crucial role in determining how you relate in adult romantic relationships, and how you relate to your children. However, it is not what happened to you as a child that matters most — it is how you deal with it. Many people go from victim to overcomer.

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