Did Your Therapist Let You Down?

Disappointment with your therapist can result in the decision to end therapy.

Reviewed by Lybi Ma

Key points

• Alexithymia is difficulty identifying, understanding and expressing your emotions.
• If you are forced to choose between two or more options, you will be disappointed regardless of the outcome.
• People who think about the consequences of their decisions more let their emotions guide them less.

In a world where disappointment is just a coin flip away, how do we deal with so many fractured fairytales?

So your therapist let you down

A 2022 paper by Eliane Sommerfeld sampled 119 subjects about the disappointing disconnect they had experienced with their therapists and the resulting actions they took.

The focus was on four things:

1. Emotional reaction following the disappointing disconnect, namely a change in emotional closeness experienced as a result of the disconnect
2. Level of alexithymia, often referred to as emotional blindness, or being unable to feel, act and express their emotions
3. Their level of emotional dysregulation, namely how upset the incident that led to the patient's disappointment made them feel. Disappointment is often accompanied by anxiety, fear, surprise, and confusion.
4. How much their therapeutic alliance and trust with their therapist needed to be readjusted in their mind (alliance negotiation)
5. Whether they chose to stay with their therapist or terminate therapy

Not surprisingly, the study found that disappointment with your therapist frequently results in the decision to end therapy before your goals have been fully realized.

Alexithymia (difficulty understanding and expressing your emotions) and difficulties regulating your negative emotions are often accompanied by passive or destructive responses to disappointment in therapy.

For example, "forgetting" appointments, self-sabotage as it relates to your treatment goals, and initiating inflammatory arguments rather than seeking to understand the meaning behind the therapist's words or accidental actions.

When your therapist disappoints you, it may throw you off course and out of therapy. If you let it.

Regrets and decision-making

A study by Matarazzo and colleagues posited the following: To have regrets about a decision, you must have had free rein to make that decision, if not you wouldn't have taken the blame for these actions.

Research shows that if you are forced to choose between two or more options, you will be disappointed regardless of the outcome.

Regret without free will is disappointing.

With the freedom to choose, your regret usually is dependent on whether you achieve the desired result or not. For example, in an election, where you choose to vote for one candidate or another, you are likely to experience disappointment only when your chosen leader does not win.

Also, no one ever expects to be wrong.

A 2000 paper by Zeelenberg and colleagues found that disappointment can come from making a decision that in retrospect seems like the wrong one, or when the right decision doesn't live up to your expectations.

The brain, disappointment, and decision making

Curious as to what your brain on disappointment looks like?

Me, too!

A study by Tzieropoulos and colleagues examined the brain waves of people during their decision-making process.

Not surprisingly, people tend to change their behavior in ways that are often unpredictable to avoid disappointment.

People who think more about the outcomes of their decisions (in a less emotional way) rely on different neural generators to contend with neutral and unexpected outcomes.

What does this mean?

They let their emotions guide them less and their previous experiences guide them more.

Get over it

To be clear, it's not that simple. Unless you can improve your resiliency.

Resiliency is the ability to bounce back from the drama life throws at you. And it involves adopting a flexibility that is not only conscious and mental but also emotional and behavioral.

How can you improve your resiliency?

1. Develop a survivor mentality: Pretend you are the protagonist in the movie, the main character who everyone knows will survive. Know you will survive.

2. Identify your emotions and know that they will pass: Think of your worst day. It ended.

3. Remember that there is a solution to every problem: You just have to figure out how to find that solution.

4. Be kind to yourself. Failing is a part of living: Forgiveness is vital to your survival.

5. Learn from this experience: There will be another opportunity for growth when another challenge comes around.

Is there a theme that keeps coming up in your life? A pattern you could learn from? Identify the problem, solve it, and feel better prepared for the future.

Conclusion

Remember, we have been disappointed before and we will be disappointed again. Every day we all get a little smarter, a little wiser, and will find more ways to troubleshoot for a win the next time around.

Don't be afraid to be hopeful. There will be a next time. For all of us.