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Padraig O'Morain August 8th, 2004 06:20 AM

Sleeping with the Client
I gather that even very distinguished therapists like Irvin Yalom confess to having to fight off the desire to fall asleep when listening to certain clients. Has anybody out there developed some good tricks/strategies/tactics for staying awake?

John Grohol August 9th, 2004 02:32 PM

Re: Sleeping with the Client
Well, of course, the best trick is to get a good night's sleep as much as possible. If you find yourself regularly nodding off with clients throughout the day, that's probably as much a sign of not receiving enough sleep as anything else.

I never learned any tricks from others in this regard. When I did therapy, I would just try and ensure I was ready for the next 50 minutes, whether that included getting a cup of coffee, going outside for a brisk walk, or whatever. If time allowed, a mid-day power nap also helped from time to time.

Carol Ann Rowland August 9th, 2004 02:39 PM

Re: Sleeping with the Client
I agree that going for a walk - and above and beyond getting enough sleep when possible - are good strategies.

I also try not to eat a lunch that is heavy in carbohydrates as when I do I am more prone to sleepiness.

The worst time I ever had with this was when I was pregnant. It was later felt that my thyroid had probably been out of whack but none of the professionals at the time thought of that. I was so sleepy it was a nightmare in the afternoons. Most of my clients I would arrange to see in the morning or very late afternoon which seemed better. One could only come at 2pm and no matter what I did the fatigue would hit me. I was so tired I actually had tears rolling down my face (no way of passing it off as empathy) and would drape my legs over the side of another chair. A few times I caught myself wondering with serious intent if it would be TOO distracting for the client if I lay on the floor as she talked. Was just able to stop myself from asking her.... :eek:

The odd thing was she did not seem to mind and just talked as if nothing was happening. I apologized and encouraged her to talk about what that was like for her, but she said she was (and truly appeared to be) unaffected. She saw me since well before my pregnancy and knew I had not been like that then, so maybe that helped her to not personalize it - I don't know.

It rarely affects me now, but when it does I generally try to acknowledge to the client that I didn't get enough sleep or whatever so that hopefully it feels less personal. I think generally clients will notice anyways so it's good to acknowledge it. If I find I have a run where a particular time of day is bad for me, I avoid booking during that time period when possible.

Padraig O'Morain August 9th, 2004 06:13 PM

Re: Sleeping with the Client
I read somewhere that in one experiment tapes of clients who made therapists sleepy were played to other therapists who all felt sleepy on hearing the tapes. The explanation put forward was that when clients want to conceal something they unconsciously made their therapists sleepy!
Well, I've replaced my comfortable chair with a wooden chair which seems to help. Odd, though, how I've never, ever felt tired or sleepy with most clients.
Sounds a bit daft, I know, but there might be something in that theory about therapists feeling sleepy when clients don't want to reveal something: perhaps they engage in inconsequential talk which bores the poor old therapist.


Jacqueline September 3rd, 2004 01:38 PM

Re: Sleeping with the Client
In reading a book on Gestalt Therapy, I came across a chapter mentioning that same problem, feeling sleepy with some clients, but not all. What was said was that if you are becoming sleepy it is probably due to the clients boring droning voice and content of their conversation. What the therapist did was actually say to the client, "you sound rather bored with where you are at right now, how do you feel". Having shone a light on their boredom of the area which the client was talking about, the therapist was able to help them move on to an area whch was more productive! Don't know if that is any help!


Melody Victor, Ph.D. September 29th, 2004 09:31 PM

Re: Sleeping with the Client
I've never felt like falling asleep, specifically either...but I have sure as blazes been bored by some clients. Now I try to take a more active approach with them when I feel this way...even interrupting them at times by summarizing what they said and where I think they're going with it - then checking out if they agree this is acurate. It's not my favorite approach, but with "boring" clients, I think it's actually more respectful than just letting them prattle on in a boring manner. Perhaps over time my summarization skills will rub off, and they can learn to say what they're trying to get across in a less "boring" way.

I understand fully that this is can be a dangerous approach and I don't take it lightly. I would never suggest interrupting most clients rather than listening to them and allowing them to process what they're saying as they say it.

Trainee Katie October 20th, 2004 12:14 PM

Re: Sleeping with the Client
I've certainly read Yalom talking about this problem, and he mentioned that he thought his therapist may have had the same problem with him - his therapist always sat in an uncomfy wooden chair!

I've found not yawning to be a problem. It does not imply I'm sleepy, just the stuffy consulting rooms. I thought I'd mastered the art of the closed mouth "hidden" yawn, until one of my clients told me to just yawn if I wanted to!....which actually opened the way for a great session about my reaction to my client and how they perceived I thought about them.

I find a museli bar pre-session and a big glass of ice cold water during the session helps!

bleary January 8th, 2005 08:37 AM

Re: Sleeping with the Client
My experience with the above has been this. Generally I get a good nights sleep--though if I eat excessive carbs at lunch I am fighting the fatigues, so I don't do that--when the client's call me on nodding off--which has embarrisingly happened more than once it jolts you right out of what ever fatigue you were in. I always let them know that it isn't them, even if it is the same story--I have either a cup of coffee or soda late in the morning and that pulls me through the rest of the day.

Head Shrinker, MD March 11th, 2005 11:30 PM

Re: Sleeping with the Client
I agree that I am most likely to get sleepy if I am bored. And if I am bored in therapy that almost always is a sign that the patient isn't working hard enough, or trying to distract the two of us from the real issues. So far in my young career I have only fallen asleep once. It was after staying up for 36 hours after I was on call one night during my residency. I was quite mortified at the time. Given the unrealistic demands on residents though, I have been able to eventually forgive myself (can anyone say 'harsh, punitive superego'?).

Phil Brownell March 12th, 2005 04:48 PM

Re: Sleeping with the Client
During my internship I co-facilitated two process groups, and I noticed, along with the facilitator, that I would tend to fall asleep on certain clients in the group, but not on others. I was thankful for the approach; "let's see if we can pay attention to this and learn what kinds of clients affect you this way." Indeed, there was a certain type that did it. They were the avoidant ones who would run their typical excuses about using drugs, using people, circumstances all against them, etc. By the time I had reached my internship I had been working for 3-4 years on an ICU for a psych hospital specializing in dual-diagnosed clients, and I was bored to sleep with a familiar kind of presentation. It was like throwing a switch on my mind. Try as I would (literally pinching myself in various places (!) to stay awake), when these people would get going I would check out. Once I got out into private practice, and the clients became more interesting again, I didn't have this trouble, but I do recall nodding off on this one person; when I popped back to, I noticed he was looking right at me, so, I asked him, "Did I nod off there?" (expecting for us to talk about that, because I knew I had), but the client just said, "No." That puzzled me for several minutes and kept me awake all by itself.

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