Honesty and Loyalty in Therapy

Honesty and Loyalty both play an important role in mental health care. Sounds weird, right? Let me explain…honesty and loyalty play a major role in mitigating symptoms of mental illness because they create an environment that is hospitable for emotional growth and change.

Having allegiance and loyalty to your treaters (e.g., your therapist, psychiatrist, and any support staff such as a case manager, art therapist, music therapist, etc.) is key to your ultimate success. Why? Because if you flit from treater to treater (or quit therapy altogether) whenever you scratch beneath the surface and avoid the hard work necessary to get better, you're just treading water at best. At worst, you could be making things exponentially worse by letting emotional wounds fester.

Is loyalty to your treaters ALWAYS warranted? Absolutely not. Treaters mirror the rest of society: most are good people with good intentions, but not all like or are good at their jobs – some are neglectful or even harmful. Some therapists are more interested in provoking you, treaters who make you feel unsafe (run fast and far), and treaters who make (wildly inappropriate) sexual advances. Some treaters are simply ineffective; I cannot stress how much damage a lousy therapist can wreak on an unsuspecting client.

I urge anyone with a therapist who is actively working against your interests or whom you feel you are making no progress with to re-evaluate the relationship. If a treater is being inappropriate, RUN. Period. If you feel like you've hit a wall, ask yourself why: if it's something on your part, that's one thing; if you don't have faith in your therapist, a change may be in order. When therapy quits progressing, it's time for a frank conversation – either find a path forward or find a new treater. Loyalty should be earned – and should never be blind.

Loyalty is an important aspect of any relationship, and it's certainly an important aspect of a treater-client relationship. It feels good to have loyal people in your life. Being able to count on people is incredibly important, and I might argue even more so for those with mental illness, who often have issues trusting. People, treaters or otherwise, must earn your loyalty. Note: everybody makes mistakes now and then (including treaters); it is the big and/or repeated mistakes that bear closer examination. The most important question is whether the relationship is healthy and if you are improving.

Honesty is also important for various and sundry reasons. For starters, if you're dealing with mental illness, there are two people you most need to be honest with: your treater(s) (therapist/psychiatrist) – and yourself. If you aren't honest with your treaters, you are wasting your money. No treater, no matter how talented, can help you properly if you don't level with them.

Now, if you are someone who is slow to trust, I urge you to level with your treaters as much as you can as soon as you are able. Some of us have been hurt so badly that telling another human being our innermost thoughts and feelings is almost beyond the pale. As for me, I did not trust my therapist (of 27 years this month!) when I began seeing her. In fact, she recalls that I did not say a single word for the first six months I saw her (I was so traumatized that I honestly barely remember those sessions).

It may be difficult to be brutally honest with your treaters. That's normal. Note: as with loyalty, honesty is earned when a treater proves themselves trustworthy, and is in no way presumed. Issues with loyalty and/or honesty will almost certainly crop up with your treater – even the best, most dedicated treater can fall short of the mark. While serious violations should make you consider jumping ship and looking for a new treater, there is an important concept to remember: "rupture and repair."

Just as with non-professional relationships, things won't always go smoothly with your treater(s). At times, you'll come into loggerheads with them, and this opportunity for "rupture and repair" mirrors your relationships in the larger world. Working through issues of loyalty and/or honesty with your treater can set you up for success in the larger world.

Being honest with your treater (and yourself) is incredibly important in fighting the Beast of suicidality. To beat the Beast back, there must be a culture of honesty between you and your treaters. Loyalty to your provider, loyalty that is built between the two of you, loyalty that is earned, is a building block of trust, just as is honesty. Building a healthy relationship with your treaters gives you a fighting chance against the Beast, and sets the stage for creating healthy relationships with people throughout your life.