05/17/2022
“I think they’re a narcissist…” are sometimes a new client’s first words to us when they sit down in our offices to talk about relationship problems. Because of my specialty, I hear that a lot, of course, and there are a few different ways you can meet the client right there in that moment.
When I first started out, regardless of their first words, I spent time going over my informed consent, billing practices, scheduling protocols, and all the administrivia we ethically need to do. That plan met criteria for how-to-conduct-an-appropriate-intake. I also noticed that when I started that way, there was a visible deflation in my new client. And heightened anxiety. They became antsy and short with their answers. I’m 95% certain they heard, “blah, blah, blah” as I mentioned the risks and benefits of therapy and how they can file a complaint.
So I did it “right”, but seemed to lose an opportunity to build immediate trust with the client. A client, I might add, who doesn’t trust themselves, doesn’t trust their partner or other high conflict person, and maybe doesn’t even trust the therapy process if it’s been used by the high conflict person to manipulate them. While trying to meet other expectations, I was signaling to those clients that my stuff was more important than theirs.
What I’ve started doing instead is letting clients, especially ones in high conflict relationships, lead out the initial session. I ask things like, “So, what’s been going on?” or “Where do you want to start with what’s been happening?” The clients who are in relationships with someone they’ve diagnosed as being narcissistic want and need space to say out loud to a professional what they experience.
Stay tuned for more in this “tips for practitioners” series… And if you want to learn more about ways to help clients in high conflict relationships, sign up to be the first to hear about Jenni’s upcoming HCR-P certificate training for mental health professionals… www.jennimcbridemcnamara.com
