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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.

bmurray March 20th, 2005 05:53 PM

Re: Sleeping with the Client
sleeping with the client is a little misleading...what are interesting clients ? Sorry that I asked but I wonder how someone could listen to the problems of other people seven to eight hours a day without nodding off. Listening is quite challenging and I wonder how one can become an active listener.
Barbara ;)

Lillian March 30th, 2005 04:16 AM

Re: Sleeping with the Client
This discussion irritates me, perhaps even makes me angry. I can understand that some clients may not have new and interesting stories for the counselors.. but do you realise how much a client has to pay( in a private practice), just that someone at least tries to listen!! Maybe a knock or bell for every euro that falls in your pocket may keep you awake!!

I think, that when you find yourself sleepy with a client, it is your responsibility to search for what is causing that and open the discussion with the client. Find an approach that keeps you more active, be creative

greetings, Lillian (the Netherlands)

KounselorK April 7th, 2005 02:54 PM

Re: Sleeping with the Client
I used to have the same problem. I finally discovered that this would happen regardless of sleep or diet. For me, the problem came with where my attention was. I would always get sleepy when I would allow myself to follow the client story instead of focusing on what it all meant in regard to my client's issue.

EDeRosa April 9th, 2005 03:39 PM

Re: Sleeping with the Client
I guess you have to be very sincere with your patient/client, and tell him how one´s feeling, ( if falling asleep ). Some people are really boring, I maybe that´s part of the problem they are trying to resolve.

emjaybee May 22nd, 2005 08:26 AM

Re: Sleeping with the Client

Originally Posted by Lillian
This discussion irritates me, perhaps even makes me angry. I can understand that some clients may not have new and interesting stories for the counselors.. but do you realise how much a client has to pay( in a private practice), just that someone at least tries to listen!! Maybe a knock or bell for every euro that falls in your pocket may keep you awake!!

I think, that when you find yourself sleepy with a client, it is your responsibility to search for what is causing that and open the discussion with the client. Find an approach that keeps you more active, be creative

greetings, Lillian (the Netherlands)

Lillian, thanks for your honesty about your irritaion. I notice you are a student. As a student I hel a belief similar to yours. Then experience with clients taught me that some of them are actually boring. No, human pain and suffering is not boring, but there are some clients who will drone on about the same thing week after week. It can be soporific. Plus, therapist are human. We get tired and sleepy for the same reasons as everyone else. Several people mentioned lack of sleep the night before. Personally, I have a chronic medical condition that causes total exhaustion by mid-afternoon. I struggle with this on a daily basis. Please don't chastise others for being huma.

Now, that said. I agree with you that the therapist has a responsibility to find out what is making them sleepy and address it. In my case I am working with my doctors to find ways of coping. There is no cure for my illness. We can treat the symptoms and I have to find ways of coping. I've used every suggestion mentioned in this thread and others.
In other cases, I agree with the others who said they examine what it is about that client that makes them sleep and address it. If it's something within the therapist s/he needs to deal with it. If it's something related to the client, avoidance, the way s/he presents, it needs to be addressed with the client.

tonymoco June 9th, 2005 01:02 PM

Re: Sleeping with the Client
I find it both fascinating and disappointing that none in a group of psychology "professionals" has commented on the two most glaring aspects of this thread:

-- First, that you were initially atttracted by the sexual innuendo of the title and the hope that it would be a chance to discuss/vent/react/confess around the real issue of your desires to have sex with your clients. I don't know WHY you apparently have such difficulty discussing that issue (fear of peer condemnation about something that is very human?), but you do.

--Second, the many instances in which your own "feelings of sleepiness" have to do with your own unresolved issues/experiences...places where you went to sleep (literally or figuratively) as a child in the face of overwhelming emotional challenges. Regardless of what triggers them, they are YOUR feelings of sleepiness. Attempts to find a client based explanation for them --especially as it relates to a judgement of the individual as "boring" - are irresponsible.

These are the kinds of professional patterns of denial which justifiably give therapists a bad name.

Stuart Moore September 8th, 2005 08:07 PM

Re: Sleeping with the Client
I'm going to ignore the last entry into this thread because it's either a joke or it's someone who totally misses the point. There are clients who will put me to sleep if I let them. That's not a function of my lack of sleep or lack of caffiene. I can have my next client come in and can be very interested in what they are saying.

There are other client's who will bore me to death. I don't think your doing those clients a favor by ignoring these feelings and pretending to be interested.

Suppose you say (in a non blaming, non judgemental, just an observation) that "you know I'm getting really bored here and I just know that I need to tell you that." Therapy is not a place where you win a lot of points by conforming to the social conventions, it needs to be real.

Sometimes those clients need to learn social skills. Other times there is a real issue that they are avoiding by droning on about something else.

My two cents worth.

xippurg September 29th, 2005 03:52 AM

Re: Sleeping with the Client
To sleep with arbitrary client is disgusting. It's obvious. Real pervert may consider this question to be serious. But I can't.

Moana N. Tofi February 8th, 2006 02:10 AM

Re: Sleeping with the Client
Sleeping with the Client??? Well I find it interesting as I was once a client of your kind of profession. Unfortunately, I was not one of those boring one, but one that it was impossible to predict.

I smile a lot when I talked about my situation. That smile is a comfort and help me to cope with my fears. However, I was jokingly asked by the therapist to leave the room as there was nothing wrong with me. Again I agree with student that mentioned the cost of therapy yet was not part of consideration.

Anyway, perhaps an honest mention of the boring part may of help to both you and the client. This might not be the case for some clients, but I'm sure some client will appreciate that honesty. It can be a stepping stone for some people to start creating new ideas of explaining themselves let alone find help. My thought about been honest its more likely you are showing that person the mirror of themselves. That was the case for me when a friend who was not a therapist bluntly told me that when I was trying to explain my situation.

Some client probably don't like what they are looking at when you show that mirror and decide, its time to put on another act that might entertain you and stay awake.


alexandra_k February 9th, 2006 03:45 AM

Re: Sleeping with the Client
> Regardless of what triggers them, they are YOUR feelings of sleepiness. Attempts to find a client based explanation for them --especially as it relates to a judgement of the individual as "boring" - are irresponsible.

Lol! And thank you. I'm glad someone else was thinking that.

I think that it might be worth exploring whether there is something about the clients interpersonal style... But only AFTER considering whether it is the result of some kind of transference.

And as for the 'boring' judgement...

I agree 100% that it is attitudes / comments like that that give therapists / the process of therapy a bad name. And I am really very pleased that this has occured to someone else too.


As for the last post to the thread...


Have you read the thread?

The actual nature of the question might suprise you...

Dragos Alexandru June 9th, 2006 09:01 AM

Re: Sleeping with the Client
this is a problem when you feel sleeping with your client as you no longer participate ...
sleeping is the best mecanism of defense that we have.
if you feel to get to sleep try to focuse on WHY, then talk about it with a specialist, a collegue of yours, rather then try finding solutions for how to stay awake.

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