What If I Run Into My Therapist in Public?

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:

> Therapists usually take their cue from the patient. We will steer clear of saying hi unless our patient indicates in some way that it's OK. You are free to make the choice that feels right to you at the time. There is no judgment either way.

> If you do greet each other, the therapist does his/her best to put the patient at ease, keeping conversation friendly, short and sweet. Because the therapist is the professional in the relationship the onus is on him/her to give guidance at a time when the patient may feel vulnerable.

> Neither party will say anything referring to your therapeutic work or relationship like, "Doc, I'm having trouble with that homework you gave me." or "We'll talk about that in our next session."

> If other people are present, do not feel obliged to introduce your therapist. Your therapist will understand your need for privacy. He/she probably won't introduce you to whoever they are with, but if they do, you are not required to say anything beyond, "Nice to meet you."

> Debrief the encounter in your next therapy session if you have any lingering concerns. Whether or not you actually greeted each other, if you have any thoughts at all about running into your therapist in public, what you said, didn't say… air it all out together.

> An ounce of prevention… Ask your therapist what to expect if you run into him/her in public before it happens. Such a conversation could be helpful to you both.


  • It is such a scary thing for patients, who need their therapists and fear being rejected – that in “real life” the therapist won’t “like” them. And of course, therapists struggle against the impulse to be therapeutic on off-work hours when they should not have to treat their patients. It never ceases to amaze me what feelings come out in a session after such an awkward encounter has happened – patient’s feelings and fantasies about it are sometimes incredibly frought with very deep emotion…this is a great topic.

  • Natalie

    Knowing that you have a Facebook page also, I’m curious… what is the consensus about “friending” clients (past or present) on social networking sites? To me, there’s a difference running into a therapist in public vs. having a therapist as a friend on Facebook, which is a bigger window into both parties’ lives.

  • Great question. I don’t know that there’s a consensus among therapists about social networking. (Claudia, do you have an opinion?) But I do know more and more of us feel social networking is a valid and useful tool to let people know who we are professionally and how we work.
    My Facebook page and Twitter account are public. I use them as an extension of my blog, as a way to serve the public and share information with professional contacts and colleagues. In other words, it’s a work centered page. Whenever I update my status or post a link I am aware that it is very public and my professional reputation is reflected there.
    I never ‘friend’ former or current clients. That choice is entirely theirs. If they choose to ‘friend’ me, I accept the invitation but I never go to their page.
    So far I have not had any trouble with Facebook but I know people who have chosen to get off (or never got on) because it was too intrusive, professionals and clients alike.

  • Thank you, Claudia. You are right, of course, that we can’t take the feelings involved for granted, so discussing it in session is imperative and can be therapeutic ‘grist for the mill’.


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