Establishing Trust

Underlying the concerns our clients bring to therapy, perhaps the most crucial task they face is establishing trust: trust that they can heal their psychological/emotional wounds, trust that counseling has something useful to offer, and trust in themselves as they move toward a fuller sense of self.

Stefano* doesn’t trust me at all when he first arrives at my office. A difficult childhood where he was both ignored and gaslit by his parents means he starts out being polite and deferential during sessions. His eyes remain wary, though—constantly darting to the bookcase to his left, or the window view behind me. Stefano says he wants to feel more "connected" in his life (to his wife, his child, his work, and to himself), and I think about the link between vulnerability (requiring trust) and connection. Therapy represents a huge risk for him; as he begins to trust me a little, he becomes more vocal about his doubts and challenges me with more verbal forcefulness:

“I don’t mean to argue, but how do you know I should have been raised with more kindness?”

“Ok, but if I let people know me, I might get hurt. You must see that!”

One day, he took the risk to ask, “I pay you to listen to me ... how do I know you actually care about me?” His voice was choked with emotion and vulnerability, and I knew he'd reached a pivotal moment of trying to trust.

Stefano’s direct, raw resistance to trusting is so very congruent with all the questions he never got to ask growing up, and all the challenging he never got to do. If I push him to move more quickly toward trusting me (or the therapeutic process), he would most likely back away. It isn’t easy to feel so consistently challenged, but I understand the purpose behind it. I stay engaged and responsive as I watch Stefano sort out layers and layers of uncertainty.

In more than 40 years of working with clients, I’m moved by their struggle to trust. Whether they’re struggling to trust me, the therapeutic process, or themselves, it’s a powerful process of reckoning. Each client’s unique journey toward trust has my utmost respect.

Samantha is wary for different reasons. A 32-year-old single mom, she describes a previous counseling experience where the therapist consistently made strong declarations regarding Samantha and her needs. “If I told her that her perspective wasn’t quite how I saw things, she’d get defensive, and explain her point of view—again. It was like she needed to be right, and I was there to accept her take on things.” In that dynamic, Samantha’s confidence in herself slowly faded.

During sessions, Samantha watches me like a hawk and I’m careful to defer to her as the “expert” on what is true for her—even when she frames a situation slightly differently than I might frame it.

“You’re the expert on you,” I tell her. “I can offer my take on things, but it’s important that you listen to what feels true for you. Don’t believe me. Believe yourself.”

At one point, she chuckles when I say this, and says, “You always say that.”

“And I always mean it,” I reply. With this exchange, I know she is nearly free of the mistrust she’s carried.

While clients establish a sense of trust in themselves (or in me), I rely on an abiding trust in myself. If a client doesn’t agree with my perspective, that’s fine. I know we can get “there” a different way or at a different time. I can hold my ground when I think it’s useful—but it’s essential to hold it in a deeply neutral, clean manner that doesn’t trigger a power struggle or a damaging kind of self-doubt for the client. I want to stay curious, engaged, and willing to be wrong.

Trust might not happen, no matter how hard I try. I can miss a cue as to what the client needs or misunderstand the way they communicate their needs; I can "drop the ball" at an inopportune moment or fail to meet them as fully as they need. In those instances, the door to trust can swing closed. (If I’m skillful enough, I might be able to repair these sorts of "gaps.") Rather than being right, I need to deeply trust my capacity for listening, compassion, and curiosity, asking the client to help me piece together a useful lens for working with their concerns.

These questions might help you explore the process of trust in therapy:

• How do you respond to clients’ mistrust as they begin the process of therapy? Do you talk about it with clients? How do you notice/stay aware of their trust issues?
• In your clinical training, what kinds of support or input did you receive with regard to dealing with clients’ trust issues?
• Are there times when a client’s distrust is hard for you? What response gets triggered in you?
• Do you remember times when you personally struggled with learning to trust in new ways? What was most helpful in finding your way through that?

*All names have been changed for privacy considerations.