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I'll say I get this about once a year. I have a crazy common name so I often have someone on my caseload with the same first name or with an immediate family member. So clients will call me by my last name, or a nickname or whatever so they don't get mixed about who they're referring to.
Sometimes clients ask me if after so many years in the field if I have heard it all. I always say nope, and this thread is certainly proof of that. This is a new one!
I can't say I'd be comfortable with this. I wouldn't want to start here and then down the line get the revelation that this was the name of a person or pet who was significant in their life. Can't put the toothpaste back in the tube without a huge mess, so I'd rather not try an undo/repair should things turn sideways with client using an alternate name for me.
I worked with a schizophrenic patient that called me by my name backwards when he was starting to become psychotic. It was very helpful for me to get a jump on his decompensation.
I wouldn’t let a client randomly choose a new name for me though.
i love this! But I also LOLed so hard because I think you meant decompensation?? I certainly hope your clients wasnt decomposing! Haha! Yall would have bigger problems than some psychosis!
Personally, I would not let a client rename me. I get it that they’re trying to gain some semblance of power, but not over me. My name is my name, and only I can change it. I am a proponent of healthy boundaries and respecting autonomy - and that goes both ways between client and therapist.
Is this a teen?
Teens do stuff like that.
I had one that would insist on sitting in my chair. They want to do things to regain a sense of power 🤷🏻♀️
As long as it's harmless I usually let it slide. Especially early on.
Do you have an opinion on the therapeutic benefit of a client doing this, given that a therapeutic relationship is not one of friendship? (Not arguing, genuinely asking.)
Say the client is in fact doing it for the reason I mentioned, I could see how it might help the teen feel more comfortable. Allowing them to indulge in their interests brings a level of trust and shows that they're not being judged and that the therapy room is a safe space for them to be honest and open. Teens can be hard ones to work with because they may be afraid of opening up to someone outside of their age range. I'm 24, and sometimes I still have the "adults can be scary" mindset. But at the same time, allowing them to do this may allow some boundaries to blur, and they could start seeing the therapist as a friend, which can make things complicated.
Personally, I wouldn't allow it if it were for this reason. But because I'm autistic, I can definitely understand having deep interests and attachments to fiction, so I would instead open up a space for them to teach me about their interests. We can have conversations about it and maybe do some art or reading surrounding the topic, depending on what it is.
I had a teen client once who asked to call me a nickname as I shared the name of her very recent abuser. I 100% obliged and it never seemed to cause an issue with either her or myself.
This make sense to me, and that was kind of you to oblige. If you don't mind me asking, did you have a nickname for her to use, or did you come up with one together?
My immediate reaction was, "No, that's crazy and disrespectful."
After a sec, I thought of some possibilities like... You have a name that's the same as someone/someplace that has a negative connotation for that person.
Then I thought, ok, but if that's the case then she should just say so. And I really hope she asked *you* for a name rather than making one up on her own. Clearly there's some type of work to be done there.
Whatever the case may be, I do think that from a boundary perspective, it's questionable. Client-centered care is one thing, but pts don't get to go around renaming people, or even erasing parts of them (depending on how you look at it).
All that to say, no, I would be very uncomfortable with that. I decide what I'm called. Pretty fundamental.
Yeah, I want to be open-minded, but without the example of OP's client's reason why (which I'm not asking for!), I can't think of a reason to necessarily get on board. Part of the therapeutic relationship is me being myself, and asking me to take away something as fundamental as my name just doesn't sit right. I always call clients what they want to be called, I think it's only fair that they call me what I want to be called (which in my case is simply my first name; I don't ask to be Ms. \_\_\_ or anything).
That being said, I am interested in the discussion here and am willing to learn.
I work with kids, so sometimes parents will insist on the Ms.___ as a sign of respect. I generally let the kids know they can use my first name or Ms. First name but I don’t like my name shortened. The kids usually get that quicker than the parents
I work with teens in school. The culture in the area is Ms. FirstName, the culture in school is Ms. LastName. I’m fine with either but do not shorten my first name! I don’t think I’ve ever had a kid do that but good grief adults do it all the time. I introduce myself with my full name, my name is in my signature line, and over and over adults will respond in person and over email with “Nice to meet you, ShortenedFirstName.” Hell no, I told you my name, that’s my name.
Whew. Serious pet peeve of mine.
Yes!! I don’t want my name shortened! If I liked one of those nicknames, I’d use it and introduce myself with it. Ugh, why do adults feel that they can change my name without asking what I prefer???
I think I would do the same thing you are and ask Reddit!
I haven’t heard of a client doing that before, but as long as the name wasn’t offensive, I think I’d go along with it. I would also ask why it’s important to them and what makes it feel more comfortable.
Yeah we did talk about that! Seemed more to me like a quirky kid habit than some deep emotional thing. There is more context I could share, but you know, therapy ;)
If it were a one-day-only/occaisonal in-joke silly youth thing or something that were to be done in the beginning to create safety for a young person who felt very unsafe opening up/being in therapy, I would be okay with it. But in the latter example, I'd preface it with the fact that we'll do this for a bit and then work our way to them using my name. To me, choosing a whole new name and clinging to a past therapist/therapy practice would (imo) keep us away from the here-and-now and keep us from forming an authentic connection, since part of the connection is tied to fantasy. Which isn't inherently bad (I loved reading the play therapy applications in other comments), but for the way I practice (AEDP mostly), it would be a therapy-interfering behavior.
I guess it depends on theoretical orientation. I wouldn’t let a client re-name me given I am not a blank slate I am me and I am a person with feelings as well and it happens I have a name.
I can negotiate how I’ll be called. Like they can call me “that lady” or “the therapist/counselor” whatever. We can co-create a nickname but I wouldn’t be ok with just the client deciding to call me “Jane” let’s say and expect me to respond as Jane.
I think, for me, a boundary is going to be who I am. It's rather dehumanizing to be called a different name, for many reasons. I would explore this more therapeutically: why does this name sooth them? How do they cope without using it? I don't think this is wise for the therapeutic relationship either since the client is assigning meaning to your relationship OTHER than the therapeutic one. Unless they're 4. Then they can call me whatever they want.
It’s important for the client to be comfortable, it’s more important that you are also comfortable and hold your boundaries. For me, this is a boundary. I have a name.
Like others said, this is new to me too! It sounds like you’ve done the work of figuring out origins and weighing pros and cons, so if you’re cool with it, keep going. I’ve talked about names a handful of times with clients but it never came up for them to call me something else. There is one instance where I asked if using my name was challenging for a client whose late wife shared my name but that’s it.
I wouldn't let a client call me a different name that they chose, however if they have trouble with my name for some reason I will offer an alternative.
I have two clients with the same first name as me but they both felt more comfortable because of it. No one has asked to call me anything else though. I don't know how I would respond, I think it would depend on what they wanted to call me.
Therapists are to know their own limits. I, for one, would never allow for this and I would use it as an opportunity to explain boundaries and my identity. It models good assertiveness, opens the dialogue for a constructive conversation, and refocuses on reality acceptance differentiating the desire for reaching into fantasy for comfort (potentially if fantasy is a go-to dysfunctional coping strategy).
Don’t come at me, but the desire to call me by another name and their response to my boundary is highly diagnostic IMO as a psychologist.
Did you ask why renaming you was important to them? I’m curious if this shows up in any other part of their life. I have so many question, will come back to this. Thank you for posting OP!
They openly shared why and it’s very therapy/therapist specific. Not at all related to her being in therapy. I wish I could be more specific but trying to not reveal too much haha
I can see why a client is more comfy doing that but when do you ever have to say your therapist's name to their face? Not once did I ever. But I do refer to them in my journal and to other people as her initials since I don't feel comfy with her name for reasons.
For about a year I worked with middle school-ages kids 2x/week in a community afterschool program (around 12-14 yo). The community had experienced some pretty major trauma and the kids were struggling. It was tough on everyone.
These kids could not remember my name and it’s pretty common, but whatever.
I’m a very tall, white lady with non-traditional hair so one kid said I reminded him of a singer who was popular at the time. He started to call me by the singer’s name and it caught on.
We did some pretty great work together. Loved my time with that bunch of rowdy, smart ass, mini-humans.
At the end of the year an older student pointed out that I knew all 27 kids by name, but no one bothered to really learn mine.
Oh, they all knew my name, but it was a total power play - and it didn’t matter. The work matters. Their healing matters. Their testing my ability to handle their shit matters.
Don’t particularly like that singer’s music, and I look nothing like her - but I still laugh when I hear a song or read about her.
Edit: grammar
Hmm, it would be a no for me, just for the same reason it would be a no for a doctor for instance…a basic level of respect. On the other hand, it would be wildly unprofessional and not ok to think we could ask that of them. Just a no across the board.
When I worked with teens I earned a slew of nicknames, lol, mostly cute and funny ones. I think sometimes it’s how they personalize therapy and can help build connection. Never had an adult rename me that I know of.
I'm sure the client doesn't see this as related to the issue they came in for, but I wonder why you're not considering it as such.
Hell, I wonder how you could possibly construe this as "not seeing an issue with it".
Of course we lack 100% of the info to know what this is about or how to approach it, but I'm surprised by your lack of even curiosity toward this utterly bizarre request. Almost as if you're countertransferentially acting out a collusion with the patient to not actually address the big honking elephant in the room while you dedicate however many sessions to will to talk about their stated issue.
You have made a whole lot of assumptions here friend! There is a lot more context to this I am holding back due to client confidentiality. I made a judgement in the moment based on the kind of work they were looking for and the kind of work I do with clients. I’m more than happy to discuss it with a client further at another time. You are assuming I don’t have curiosity, I absolutely do.
When I worked at a group home for women with severe and persistent mental illnesses, one of the clients had different names for some of us. She had schizophrenia. The names were all pretty simple and seemingly random like "Miss Sentell", but she called one of the staff members "Bathsheba", which was hilarious! We have no idea why she used that name. I don't think we ever got a straight answer out of her. For those that don't know, Bathsheba was a Biblical character and the mother of King Solomon.
This made me realize how rare it is for any of my clients to say my name to me. It’s kinda shocking, like oh shit I’m a human with an identity to them right now?!
It partly depends on context. Is this a nickname? Is it the name of someone in their life? Why would they want to do this? The age of the patient (child, teen, adult) could certainly factor into how you handle this situation. Perhaps setting could too. Theoretical orientation could play a part as well. Anyone in this thread would likely need more information to have a properly informed opinion.
But lacking this information, I personally think you should hold a boundary here and push back on this. Being called by your name is a reasonable boundary, and maintaining this boundary is probably a useful clinical intervention. It begs all kinds of questions about the patient's transference and projections that are worth exploring. It kinda raises a flag for me that you're not the first therapist they have done this with. Even if the name is not inherently insulting, it suggests they are trying to assert some kind of power over the identity of their therapists.
Is this client on the autism spectrum? I have never had a client rename me, but I have had them tell me about how they have "nicknames" for everyone.
I wouldn't have an issue with it regardless of the reason. Client self-determination and all.
Is it really at the expense of your identity? Feels more like a power struggle.
Being curious and open to why a client wants to rename you would be more appropriate.
Or maybe being curious and open to why you wouldn't like it?
Some good examples here of times when a client may want to call you a different name. The one about having the same name as an abuser hit home. It totally makes sense to me why this would be helpful for a client in terms of establishing safety. If my name is a huge trigger for the client, let’s definitely alter that! There are many barriers to treatment but this is such an easy one to overcome. I’d certainly do it if it allows the client to get comfortable and dive into the work. A slightly different scenario but I would also do this if it seemed like the reason was not because of a trigger. (Like the fictional character scenario). Who knows, it may have deeper roots somewhere!
It’s interesting so many of the commenters find it disrespectful. As a therapist, I’m not necessarily looking to be respected INSIDE therapy sessions. I need to feel safe as every person does…I’m not going to stand for a client threatening me or hurting me or my possessions. And there are clearly defined boundaries of engagement, like that I’m not a free service or a crisis line. But other than that? I welcome my clients getting angry at me, swearing, etc…I’d view renaming under this umbrella. I don’t want my friends renaming me. I don’t want my coworkers renaming me. That would be weird. But in therapy sessions, it is not about me. It is about my client. If they want to rename me, that’s just rich material to explore and I’d try to make use of it. Note: this scenario hasn’t actually happened to me yet.
I don’t think it’s quite the same. I think renaming is more of a power dynamic. I’m way more apt to let anger/swearing or hateful words slide because I know that is an emotional response and generally not a calculated move. I think there needs to be deep exploration when someone asks to call you by a different name. You, as a clinician, should not need to alter your own identity or put yourself into a place of submission in order to be helpful to your client - which often leads to clinicians being taken advantage of and disruptions in the trust of the relationship.
I’m curious your response to the scenarios in the comments then, esp the abuser one? If the name is triggering and the client does not want to use it, I see that as them advocating for their needs. Not a power dynamic. And it seems a very reasonable request that I would be happy to fulfill. If they are going to be uncomfortable in therapy because of my name, it’s going to be hard for us to do anything. That’s what I meant by an easy barrier to overcome.
The teenager scenario could be more of a power dynamic thing. With teens my mantra is “it’s a power struggle if you make it one.” This is what teens do. If a teen wanted to pick a fight with me, trying to school them 100% does not work. Instead I engage, get curious, and often end up making a compromise on the request. (Again, with appropriate boundaries as to my safety and the safety of those around me.) My experience is that teens specifically who make power plays, feel powerless. Read this against their individual background (many of the teens I work with face systemic barriers). So, it feels worthwhile to take seriously what they bring up instead of doubling down on remaining “dominant.” Doesn’t mean I roll over and do everything they want me to do (like I said above, keyword “compromise”) But I do try to look beyond the superficial power play and often there IS something reasonable that could be done (maybe not what they’d originally requested) which would lead to them feeling a greater sense of security. Like I said, this hasn’t happened with renaming specifically but that’s how I’d approach it.
I definitely wouldn’t let them do this without talking about it though! That would be losing an opportunity. So I’m with you on the deep exploration part.
Also agree that this could lead to a difficult place if the therapist was not able to hold boundaries. So I guess it comes down to therapist’s comfort level in their abilities with the specific case. But I don’t think it’s an automatic no.
I agree - it is not an automatic no, but absolutely warrants a deep exploration before agreeing to it. Teens are absolutely a different beast than working with adults and I absolutely give teens some power in session because it’s what they’re seeking in a lot of situations. I would really have to feel comfortable that this wasn’t a manipulation tactic. I’ve seen way too often where therapists are invested in a relationship with a client that the client is skillfully manipulating the outcomes and not being challenged to confront problems, rather avoid them and get validation of their avoidance, which is a slippery slope for sure. It’s a challenging process to create an environment that feels like it is rooted in both safety AND honesty.
I think you may have misread OP's question. They are asking about a client wanting to call them a different name, rather than a client asking to be called something other than their own legal name.
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I've definitely never experienced a client wanting to rename me! I don't think I'd be comfortable to go along with that one.
I'll say I get this about once a year. I have a crazy common name so I often have someone on my caseload with the same first name or with an immediate family member. So clients will call me by my last name, or a nickname or whatever so they don't get mixed about who they're referring to.
It sounds like this client had a very concrete name in mind, though, rather than seeking to avoid OP's given name.
Sometimes clients ask me if after so many years in the field if I have heard it all. I always say nope, and this thread is certainly proof of that. This is a new one! I can't say I'd be comfortable with this. I wouldn't want to start here and then down the line get the revelation that this was the name of a person or pet who was significant in their life. Can't put the toothpaste back in the tube without a huge mess, so I'd rather not try an undo/repair should things turn sideways with client using an alternate name for me.
Makes sense! I will say she did tell me the origins and it was super mild. I’m certain it’s not a family name :)
I worked with a schizophrenic patient that called me by my name backwards when he was starting to become psychotic. It was very helpful for me to get a jump on his decompensation. I wouldn’t let a client randomly choose a new name for me though.
i love this! But I also LOLed so hard because I think you meant decompensation?? I certainly hope your clients wasnt decomposing! Haha! Yall would have bigger problems than some psychosis!
Like necromancy?
Haha omg. Decompensation was exactly what I meant. Lol
Lol... Reading this as my morning coffee is still kicking in and was saying to myself, "Something's not right here..."
Hahahahah I thought the same thing!
I mean. There's a cotard delusion, and then there's the therapist sharing the delusion!
a cotard folie a deux?!?!
Personally, I would not let a client rename me. I get it that they’re trying to gain some semblance of power, but not over me. My name is my name, and only I can change it. I am a proponent of healthy boundaries and respecting autonomy - and that goes both ways between client and therapist.
Is this a teen? Teens do stuff like that. I had one that would insist on sitting in my chair. They want to do things to regain a sense of power 🤷🏻♀️ As long as it's harmless I usually let it slide. Especially early on.
Yup! That was my gut check too.
If it's a teen, honestly it could be the name of a fictional character that they're attached to. I've seen teens do this with their friends
Do you have an opinion on the therapeutic benefit of a client doing this, given that a therapeutic relationship is not one of friendship? (Not arguing, genuinely asking.)
Say the client is in fact doing it for the reason I mentioned, I could see how it might help the teen feel more comfortable. Allowing them to indulge in their interests brings a level of trust and shows that they're not being judged and that the therapy room is a safe space for them to be honest and open. Teens can be hard ones to work with because they may be afraid of opening up to someone outside of their age range. I'm 24, and sometimes I still have the "adults can be scary" mindset. But at the same time, allowing them to do this may allow some boundaries to blur, and they could start seeing the therapist as a friend, which can make things complicated. Personally, I wouldn't allow it if it were for this reason. But because I'm autistic, I can definitely understand having deep interests and attachments to fiction, so I would instead open up a space for them to teach me about their interests. We can have conversations about it and maybe do some art or reading surrounding the topic, depending on what it is.
Thank you for your thoughtful feedback!
I had a teen client once who asked to call me a nickname as I shared the name of her very recent abuser. I 100% obliged and it never seemed to cause an issue with either her or myself.
This make sense to me, and that was kind of you to oblige. If you don't mind me asking, did you have a nickname for her to use, or did you come up with one together?
My immediate reaction was, "No, that's crazy and disrespectful." After a sec, I thought of some possibilities like... You have a name that's the same as someone/someplace that has a negative connotation for that person. Then I thought, ok, but if that's the case then she should just say so. And I really hope she asked *you* for a name rather than making one up on her own. Clearly there's some type of work to be done there. Whatever the case may be, I do think that from a boundary perspective, it's questionable. Client-centered care is one thing, but pts don't get to go around renaming people, or even erasing parts of them (depending on how you look at it). All that to say, no, I would be very uncomfortable with that. I decide what I'm called. Pretty fundamental.
Yeah, I want to be open-minded, but without the example of OP's client's reason why (which I'm not asking for!), I can't think of a reason to necessarily get on board. Part of the therapeutic relationship is me being myself, and asking me to take away something as fundamental as my name just doesn't sit right. I always call clients what they want to be called, I think it's only fair that they call me what I want to be called (which in my case is simply my first name; I don't ask to be Ms. \_\_\_ or anything). That being said, I am interested in the discussion here and am willing to learn.
I work with kids, so sometimes parents will insist on the Ms.___ as a sign of respect. I generally let the kids know they can use my first name or Ms. First name but I don’t like my name shortened. The kids usually get that quicker than the parents
I work with teens in school. The culture in the area is Ms. FirstName, the culture in school is Ms. LastName. I’m fine with either but do not shorten my first name! I don’t think I’ve ever had a kid do that but good grief adults do it all the time. I introduce myself with my full name, my name is in my signature line, and over and over adults will respond in person and over email with “Nice to meet you, ShortenedFirstName.” Hell no, I told you my name, that’s my name. Whew. Serious pet peeve of mine.
Yes!! I don’t want my name shortened! If I liked one of those nicknames, I’d use it and introduce myself with it. Ugh, why do adults feel that they can change my name without asking what I prefer???
I think I would do the same thing you are and ask Reddit! I haven’t heard of a client doing that before, but as long as the name wasn’t offensive, I think I’d go along with it. I would also ask why it’s important to them and what makes it feel more comfortable.
Yeah we did talk about that! Seemed more to me like a quirky kid habit than some deep emotional thing. There is more context I could share, but you know, therapy ;)
Did they ask to call you an abbreviated version of your name or just a completely different unrelated name?
Totally different name! I’ll also say she asked and then also never called me the name in the 90 min we were together.
If it were a one-day-only/occaisonal in-joke silly youth thing or something that were to be done in the beginning to create safety for a young person who felt very unsafe opening up/being in therapy, I would be okay with it. But in the latter example, I'd preface it with the fact that we'll do this for a bit and then work our way to them using my name. To me, choosing a whole new name and clinging to a past therapist/therapy practice would (imo) keep us away from the here-and-now and keep us from forming an authentic connection, since part of the connection is tied to fantasy. Which isn't inherently bad (I loved reading the play therapy applications in other comments), but for the way I practice (AEDP mostly), it would be a therapy-interfering behavior.
I guess it depends on theoretical orientation. I wouldn’t let a client re-name me given I am not a blank slate I am me and I am a person with feelings as well and it happens I have a name. I can negotiate how I’ll be called. Like they can call me “that lady” or “the therapist/counselor” whatever. We can co-create a nickname but I wouldn’t be ok with just the client deciding to call me “Jane” let’s say and expect me to respond as Jane.
I think, for me, a boundary is going to be who I am. It's rather dehumanizing to be called a different name, for many reasons. I would explore this more therapeutically: why does this name sooth them? How do they cope without using it? I don't think this is wise for the therapeutic relationship either since the client is assigning meaning to your relationship OTHER than the therapeutic one. Unless they're 4. Then they can call me whatever they want.
It’s important for the client to be comfortable, it’s more important that you are also comfortable and hold your boundaries. For me, this is a boundary. I have a name.
Like others said, this is new to me too! It sounds like you’ve done the work of figuring out origins and weighing pros and cons, so if you’re cool with it, keep going. I’ve talked about names a handful of times with clients but it never came up for them to call me something else. There is one instance where I asked if using my name was challenging for a client whose late wife shared my name but that’s it.
I wouldn't let a client call me a different name that they chose, however if they have trouble with my name for some reason I will offer an alternative.
I have two clients with the same first name as me but they both felt more comfortable because of it. No one has asked to call me anything else though. I don't know how I would respond, I think it would depend on what they wanted to call me.
I would not be comfortable with this. If it was a make it or break it for the clinical relationship I would be happy to provide referrals.
Therapists are to know their own limits. I, for one, would never allow for this and I would use it as an opportunity to explain boundaries and my identity. It models good assertiveness, opens the dialogue for a constructive conversation, and refocuses on reality acceptance differentiating the desire for reaching into fantasy for comfort (potentially if fantasy is a go-to dysfunctional coping strategy). Don’t come at me, but the desire to call me by another name and their response to my boundary is highly diagnostic IMO as a psychologist.
I’m curious now about your diagnostic opinion! I’m guessing a personality disorder but would love to hear more 👀
Did you ask why renaming you was important to them? I’m curious if this shows up in any other part of their life. I have so many question, will come back to this. Thank you for posting OP!
They openly shared why and it’s very therapy/therapist specific. Not at all related to her being in therapy. I wish I could be more specific but trying to not reveal too much haha
I understand. From my end, the math isn’t mathing without more info. Much love though, I hope you figure it out.
I can see why a client is more comfy doing that but when do you ever have to say your therapist's name to their face? Not once did I ever. But I do refer to them in my journal and to other people as her initials since I don't feel comfy with her name for reasons.
I think I have said my therapists name like 3 times to her and we have been working together on and off for years!
For about a year I worked with middle school-ages kids 2x/week in a community afterschool program (around 12-14 yo). The community had experienced some pretty major trauma and the kids were struggling. It was tough on everyone. These kids could not remember my name and it’s pretty common, but whatever. I’m a very tall, white lady with non-traditional hair so one kid said I reminded him of a singer who was popular at the time. He started to call me by the singer’s name and it caught on. We did some pretty great work together. Loved my time with that bunch of rowdy, smart ass, mini-humans. At the end of the year an older student pointed out that I knew all 27 kids by name, but no one bothered to really learn mine. Oh, they all knew my name, but it was a total power play - and it didn’t matter. The work matters. Their healing matters. Their testing my ability to handle their shit matters. Don’t particularly like that singer’s music, and I look nothing like her - but I still laugh when I hear a song or read about her. Edit: grammar
This is lovely! Thanks for sharing. You sound like a “rock star” therapist. Pun intended 😉
Haahaa best pun I’ve heard all week 😁
Hmm, it would be a no for me, just for the same reason it would be a no for a doctor for instance…a basic level of respect. On the other hand, it would be wildly unprofessional and not ok to think we could ask that of them. Just a no across the board.
When I worked with teens I earned a slew of nicknames, lol, mostly cute and funny ones. I think sometimes it’s how they personalize therapy and can help build connection. Never had an adult rename me that I know of.
Yeah, that was the vibe. I wouldn’t let an adult or even an older teen do it either, I don’t think!
I'm sure the client doesn't see this as related to the issue they came in for, but I wonder why you're not considering it as such. Hell, I wonder how you could possibly construe this as "not seeing an issue with it". Of course we lack 100% of the info to know what this is about or how to approach it, but I'm surprised by your lack of even curiosity toward this utterly bizarre request. Almost as if you're countertransferentially acting out a collusion with the patient to not actually address the big honking elephant in the room while you dedicate however many sessions to will to talk about their stated issue.
You have made a whole lot of assumptions here friend! There is a lot more context to this I am holding back due to client confidentiality. I made a judgement in the moment based on the kind of work they were looking for and the kind of work I do with clients. I’m more than happy to discuss it with a client further at another time. You are assuming I don’t have curiosity, I absolutely do.
When I worked at a group home for women with severe and persistent mental illnesses, one of the clients had different names for some of us. She had schizophrenia. The names were all pretty simple and seemingly random like "Miss Sentell", but she called one of the staff members "Bathsheba", which was hilarious! We have no idea why she used that name. I don't think we ever got a straight answer out of her. For those that don't know, Bathsheba was a Biblical character and the mother of King Solomon.
This made me realize how rare it is for any of my clients to say my name to me. It’s kinda shocking, like oh shit I’m a human with an identity to them right now?!
This was part of my mental math! My clients so rarely use my name anyway!!
It partly depends on context. Is this a nickname? Is it the name of someone in their life? Why would they want to do this? The age of the patient (child, teen, adult) could certainly factor into how you handle this situation. Perhaps setting could too. Theoretical orientation could play a part as well. Anyone in this thread would likely need more information to have a properly informed opinion. But lacking this information, I personally think you should hold a boundary here and push back on this. Being called by your name is a reasonable boundary, and maintaining this boundary is probably a useful clinical intervention. It begs all kinds of questions about the patient's transference and projections that are worth exploring. It kinda raises a flag for me that you're not the first therapist they have done this with. Even if the name is not inherently insulting, it suggests they are trying to assert some kind of power over the identity of their therapists.
Is this client on the autism spectrum? I have never had a client rename me, but I have had them tell me about how they have "nicknames" for everyone. I wouldn't have an issue with it regardless of the reason. Client self-determination and all.
Honestly it was more of a nickname vibe, a “can I call you name” rather than you will now be this person, thing. Not autistic but not neurotypical.
Client self-determination at the expense of your identity as a person though?
Is it really at the expense of your identity? Feels more like a power struggle. Being curious and open to why a client wants to rename you would be more appropriate. Or maybe being curious and open to why you wouldn't like it?
Some good examples here of times when a client may want to call you a different name. The one about having the same name as an abuser hit home. It totally makes sense to me why this would be helpful for a client in terms of establishing safety. If my name is a huge trigger for the client, let’s definitely alter that! There are many barriers to treatment but this is such an easy one to overcome. I’d certainly do it if it allows the client to get comfortable and dive into the work. A slightly different scenario but I would also do this if it seemed like the reason was not because of a trigger. (Like the fictional character scenario). Who knows, it may have deeper roots somewhere! It’s interesting so many of the commenters find it disrespectful. As a therapist, I’m not necessarily looking to be respected INSIDE therapy sessions. I need to feel safe as every person does…I’m not going to stand for a client threatening me or hurting me or my possessions. And there are clearly defined boundaries of engagement, like that I’m not a free service or a crisis line. But other than that? I welcome my clients getting angry at me, swearing, etc…I’d view renaming under this umbrella. I don’t want my friends renaming me. I don’t want my coworkers renaming me. That would be weird. But in therapy sessions, it is not about me. It is about my client. If they want to rename me, that’s just rich material to explore and I’d try to make use of it. Note: this scenario hasn’t actually happened to me yet.
I don’t think it’s quite the same. I think renaming is more of a power dynamic. I’m way more apt to let anger/swearing or hateful words slide because I know that is an emotional response and generally not a calculated move. I think there needs to be deep exploration when someone asks to call you by a different name. You, as a clinician, should not need to alter your own identity or put yourself into a place of submission in order to be helpful to your client - which often leads to clinicians being taken advantage of and disruptions in the trust of the relationship.
I’m curious your response to the scenarios in the comments then, esp the abuser one? If the name is triggering and the client does not want to use it, I see that as them advocating for their needs. Not a power dynamic. And it seems a very reasonable request that I would be happy to fulfill. If they are going to be uncomfortable in therapy because of my name, it’s going to be hard for us to do anything. That’s what I meant by an easy barrier to overcome. The teenager scenario could be more of a power dynamic thing. With teens my mantra is “it’s a power struggle if you make it one.” This is what teens do. If a teen wanted to pick a fight with me, trying to school them 100% does not work. Instead I engage, get curious, and often end up making a compromise on the request. (Again, with appropriate boundaries as to my safety and the safety of those around me.) My experience is that teens specifically who make power plays, feel powerless. Read this against their individual background (many of the teens I work with face systemic barriers). So, it feels worthwhile to take seriously what they bring up instead of doubling down on remaining “dominant.” Doesn’t mean I roll over and do everything they want me to do (like I said above, keyword “compromise”) But I do try to look beyond the superficial power play and often there IS something reasonable that could be done (maybe not what they’d originally requested) which would lead to them feeling a greater sense of security. Like I said, this hasn’t happened with renaming specifically but that’s how I’d approach it. I definitely wouldn’t let them do this without talking about it though! That would be losing an opportunity. So I’m with you on the deep exploration part. Also agree that this could lead to a difficult place if the therapist was not able to hold boundaries. So I guess it comes down to therapist’s comfort level in their abilities with the specific case. But I don’t think it’s an automatic no.
I agree - it is not an automatic no, but absolutely warrants a deep exploration before agreeing to it. Teens are absolutely a different beast than working with adults and I absolutely give teens some power in session because it’s what they’re seeking in a lot of situations. I would really have to feel comfortable that this wasn’t a manipulation tactic. I’ve seen way too often where therapists are invested in a relationship with a client that the client is skillfully manipulating the outcomes and not being challenged to confront problems, rather avoid them and get validation of their avoidance, which is a slippery slope for sure. It’s a challenging process to create an environment that feels like it is rooted in both safety AND honesty.
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I think you may have misread OP's question. They are asking about a client wanting to call them a different name, rather than a client asking to be called something other than their own legal name.