by Nicholas Hack, Psy.D.

“THANKS FOR THE CHAT, DR. HACK.”

One of my little joys is seeing how people enter and leave sessions. 

Whether it’s an exuberant “What’s up?!”, a simple “Hi,” or a loaded “I know I’m not supposed to ask you how you’re doing, so I’ll just say I hope you’re doing well,” entrances and exits somehow feel quintessentially of the patient, and there’s something delightful about that. 

Over the years, I’ve been struck by how many people end sessions with some version of that title quote—thanks for the chat, thanks for listening, thanks for letting me talk at you—and I’ve watched my reaction to that sentiment change over time. 

Early in my career, referring to treatment as a “chat” brought up my insecurities. “Oh no,” I’d think. “Is that all we did today? We just chatted? Did I not ‘do therapy’ with them?” 

I’d worry they were providing me with what Patrick Casement might call unconscious supervision, a subtle expression that they were needing something different. My anxiety said that I wasn’t working hard enough, or that I was missing something important, or that I needed to be offering more interpretations. Whatever it was, I worried the patient was letting me know that I wasn’t giving them enough.

In other eras, I heard something very different in the same sentiment. Depending on the patient and the day, I might wonder about it as a much needed diminishment of the power of what was happening in treatment. For the client, suddenly switching from such an unguarded communion to the regular flow of life might be too much. Gently reducing our time to a “talking at you” could be incredibly important for navigating that transition. 

And yes, I also heard the aggression that might be hovering in the background.

Given the many ways I’ve thought about this, I have to laugh at myself that at this point in my life and career I’m actually hoping to create something like the feel of “a chat” in sessions. I don’t mean that I want it to be superficial or informal. I’m not trying to be the patient’s friend or the good object.

What I am striving for is something that feels grounded and real. I want to be an embodied, available partner in the wildly asymmetrical but still deeply relational dance of therapy. I want to welcome my own anxiety, not from a place of insecurity, but because it signals that I’m allowing myself to be vulnerable in how I think, feel, and act.

In the end, I hope I stay curious about the varied ways people show up to and exit sessions. But I also hope—and I had to write this article to realize—that I don’t get so focused on the latter half of the opening quote that I miss out on the start of it. Clients may be communicating many complex things, but one of them is actually quite simple: Thank You.