Since coming to Quora I’ve learned that there are a number of things related to the therapeutic frame that spark controversy, as in therapists and clients hold some very strong views on these things.
One such controversy has to do with emailing between sessions. Is it even OK? How much is too much? Which clients benefit from it vs. which clients should steer clear? Some therapists are adamantly against it. What about HIPAA? It dilutes the therapy! It takes away from that magical hour. Other therapists use email as another therapeutic tool. One mentioned how he has his clients send a weekly check-in email midway between sessions with a structure and a particular set of questions to answer. I know of one client who actually does most of her therapy by email as it honestly works better at this stage in the game.
My own therapist seemed to be about as unopinionated about it as they come. “What is your policy concerning emailing between sessions?” I asked him during one session. “Oh, it’s totally fine, but I’m really bad with email.” Experience proved that to be fairly accurate.
At first I’d ignored my anxious feelings that would arise when I’d sent something and gotten no reply or acknowledgement from my therapist. But as I came to realize that those feelings were precisely the feelings to work through in therapy I spoke up more. I feel anxious if I don’t get a reply, I’d say. I don’t need a long reply and I understand it’s usually better to discuss it in session anyway, but a quick reply saying you got it and read it would really help me out a lot. He said he undesrtood and would do that for me. But a couple times I wouldn’t get a reply until within hours of our next session starting. I also picked up on some kind of vibe from him of being annoyed in relation to email. Naturally, being the client I assumed that annoyance was specifically related to my emails. Sure, he’d said that he had no problem with getting emails from me, but I have this expectation that people will politely lie to me. And, I was picking up on this vibe and interpreting it all on the unconscious level so I wasn’t really aware that I’d come up with all this analysis.
What I was aware of was that emailing my therapist seemed like a bad idea most of the time, something to avoid. And in any case, there were plenty of good reasons for that abounding on Quora. Dilutes the therapy, becomes a part of your medical record, all that stuff. I was also gaining security in our relationship overall and felt much less “need” to check in to make sure it was still there between sessions. Yes, it’s still there. He will be happy to see me when I show up for the next session. He will remember what we discussed the week before. He will value our time together and not be shy about letting me know. Yes, we have a relationship! Check. No, I really don’t need to be emailing him between sessions.
Until I do. This past week was a case in point. As soon as I’d realized that I was feeling this devastating sense of loss about our relationship due to something that had taken place during the summer, I knew I needed to fill him in, and I also knew that the likelihood of me being able to articulate it all coherently without breaking down sobbing was slim to none. I’d been writing about it all here on Quora—don’t ask me why it’s sometimes easier to write about it on a public forum than fess up about it in therapy, but this has been other clients’ experience as well—so I just copied and pasted the relevant posts into an email along with a bit of explanation. There were five posts in all so it made for quite the lengthy email. He told me in session that he was glad I’d sent it. “That probably saved us an entire session where you’d have been trying to explain what was going on,” he’d added.
We’d spent the bulk of the session working on that material and it was beautiful.
At the end of the session I asked again about emailing. Is it still OK? Can I know that if I send him something he’ll get it in time to discuss in session? How often does he check his email?
His answer to the last question: “I check it a whole lot more now!”
He went on to explain that when he’d been with the agency he’d gotten lots of administrative emails. An overwhelming amount apparently. It was to the point where he dreaded opening up his email and so he’d put it off. He was always happy to hear from clients, but… he’d have to find his clients’ emails among all the other emails he didn’t even want to see!
But now that he’s on his own, he doesn’t get all those unwanted emails any longer.
We only talked about email for five minutes tops. And that conversation was extremely clarifying and validating for me.
I realize now there had been a bit of a disconnect in my mind between what my therapist was consistently telling me about email and this vibe of annoyance I was picking up on (and assuming had to do with his feelings about my emails that he wasn’t telling me out of politeness).
My therapist was definitely not lying to me. He genuinely was happy to hear from me by email whenever I felt the need or desire to reach out.
And
He did feel some annoyance around email in general. That endless stream of administrative emails clogging up his inbox, making it difficult for him to attend to his clients’ correspondence! Yes, it turns out he was definitely annoyed about that! And I’d picked up on it. I can be quite hypersensitive that way. So, I’d interpreted its meaning inaccurately, but I wasn’t wrong about the annoyance!
Having these two seemingly contradictory parts of my emailing experience validated like that was a really big deal for me. It feels really good. I feel like I know exactly where I stand with him on that particular issue so no more need to worry about it. It’s more than just being informed of a policy and adhering to it. It’s getting a sense of the big picture, and having an experience where there was a discrepency between the words and the feelings coming from my therapist that did not mean I was being lied to. All of this is valuable to my healing.
Going back to the fact that in the therapy world email is controversial, I would say that the right answer, like with a lot of things, should have more to do with what is helpful to the client and what also works for the therapist, the alliance and the work than with some kind of rigid thinking or rule setting. With that said, if a therapist really doesn’t like email or prefers to not use it, I would think that’s fine too. I guess the important thing is that the therapist clearly communicate his preferences and the client be forthright about all perceptions and feelings she has about said preferences and the experience that goes with them. Sometimes those discussions can end up being the most healing part of the session.