Therapist's Bathroom Breaks: Impact on Session Documentation and Memory

When a therapist has to leave during a session to use the bathroom, the next logical question is: should notes be taken during the break? The answer, of course, is not black and white.

Memory and Documenation

Unless there are specific details like dates or numbers and the time gap between the session and documentation is several days, the therapist can rely on their memory for an accurate recount. Therapy is as much about the experience in the moment as it is about the recall afterward. Even without formal note-taking, the session is recorded in the therapist's mind.

It is important to note, however, that documentation is never a perfect reflection of the session. Even detailed notes taken during the session may not fully capture the nuances and feelings that arise during the interaction. Furthermore, any note-taking process, whether it is done immediately before or after the session, is an attempt to control memory, which is inherently limited.

Fantasy and Control

Notes are a form of fantasy, a means to try and control the present rather than observe it. This can be seen as a defense mechanism against change. The act of trying to document every moment can prevent the therapist from truly listening and reacting to the client's needs in the moment. This reluctance to observe the new can make it harder to implement real change in the therapy process.

Bathroom Breaks and Session Flow

If a therapist needs to leave for a bathroom break during a session, the best practice is to take notes before or after the break, not during. While notes taken during a bathroom break could be used later, they are less likely to be as accurate or reflective as those taken immediately before or after the session. This approach avoids any disruption to the flow of the conversation and allows the therapist to maintain a more robust mental image of the session.

Moreover, some therapists prefer to take notes during the session to avoid any potential awkwardness of interrupting the flow. They might also multi-task by bringing a clipboard into the bathroom with them. However, this technique is not without its drawbacks, as it can break the therapist's focus on the session at hand. Ideally, the therapist takes notes at moments when they can do so without compromising the client's experience.

Client Involvement and Recording Quality

When the therapist takes notes, it is also crucial to involve the client in the process, if possible. This inclusion can make the session more transparent and trustful. Additionally, notes taken after a bathroom break can be shared with the client, providing them with a detailed record of their session. This shared documentation strengthens the therapeutic relationship and allows both parties to refer back to the session for better clarity and understanding.

Best Practices and Conclusion

In summary, a therapist should aim to document therapy sessions either immediately before or after taking a bathroom break. Doing so allows the therapist to maintain focus and flow without disrupting the session, and to provide accurate and useful documentation to the client.

Ultimately, the effectiveness of therapy lies in the therapist's and client's ability to observe, understand, and react to each other in the present moment. Notes, while valuable, should not be a barrier to this process. As recommended by Freud, therapy should prioritize the here and now over the attempt to maintain a detailed record of every moment.

Note: References to specific historical figures, like Freud, highlight the long-standing traditions and ongoing discussions in psychotherapy regarding note-taking practices.