Should I hide behind the magazine rack? Duck over to the canned goods aisle? Uh oh, she already saw me! Now what? Do I say hi? Pretend I don't see her?
Whenever we see people out of a familiar setting it can be awkward. The other day I was having dinner with my husband at a restaurant when a very familiar lady walked by and stopped to say hello. I couldn't remember for the life of me where I had seen her before. My poor brain sifted through the files until finally it reported that she worked at the library where my kids and I go once a week. Whew. Embarrassment averted.
Occasionally I run into old or current patients in public resulting in another kind of challenge. Do I say hello or not?
In my Dad's day there would be no question. Psychoanalytic thinking was very clear back then. Both patient and therapist should pretend they don't see one another, even if it's obvious to both that they have.
There are reasons many therapists still feel that way. One is that it could be seen as inappropriate, even harmful, to acknowledge the working realtionship outside of the 'therapeutic frame' meaning the clear boundaries of the time and day of the session and the four walls of the office.
Plus there are the issues of confidentiality. Saying hi to my patient in public might put them in the uncomfortable position of explaining who I am and why they know me.
While these are good reasons to take such unexpected encounters seriously, I don't believe we need to be all rigid about it.
Salman Akhtar, MD, renowned psychoanalyst and author, says that if a therapist runs into his patient outside of the office and the patient says hello, of course the therapist says hello back! That's just common courtesy and it can be done in a therapeutic, professional manner.
Here are a few guidelines to help public encounters between patient and therapist feel as safe and comfortable as possible:
Rob, thank you for this comment and for the idea for this post.
Feeling of like a fraud can hit the best of us. Therapists are not immune, at least not this therapist. On and off throughout my life I have wrestled with that feeling Rob describes, the "If only they knew I'm not that person they think I am," feeling.
You won't find Impostor or Fraud Syndrome in the DSM-IV. It is not a diagnosable mental illness. It is, however, a collection of feelings or symptoms that together may serve to hold you back from fulfilling our potential.
Take this Impostor Syndrome Quiz*
Do you secretly worry that others will find out that you're not as bright and capable as they think you are?
Do you sometimes shy away from challenges because of nagging self-doubt?
Do you tend to chalk your accomplishments up to being a "fluke," “no big deal” or the fact that people just "like" you?
Do you hate making a mistake, being less than fully prepared or not doing things perfectly?
Do you tend to feel crushed by even constructive criticism, seeing it as evidence of your "ineptness?"
When you do succeed, do you think, "Phew, I fooled 'em this time but I may not be so lucky next time."
Do you believe that other people (students, colleagues, competitors) are smarter and more capable than you are?
Do you live in fear of being found out, discovered, unmasked?
If you answer yes to any of these questions, you are not alone. In fact, many very intelligent, successful, accomplished people feel exactly the same.
Personally, the Impostor Phenomenon has gotten in the way of my development, especially regarding my career as a writer. It slowed me down because as soon as I pushed myself beyond my comfort zone, a little voice inside my head said, "Who do you think you are, you're not the Almighty you know," and I'd pull back.
Where did it that voice come from? Before I answer, I want you to know, I'm not about blaming the parents. I believe we need to take responsibility for ourselves in order to change. For some of us, though, there is no denying that our possibly well-meaning parents did a number on us. Without realizing it, my Dad expected perfection from his kids. He built me up with praise with one hand and kept me in my place with the other. That left my self-esteem feeling confused and diminished.