A Complicated Love Triangle
Season 1, Episode 3
Nikki realizes that two of her clients are in a love triangle, except they don't know it! She tells us how she realized that the client who shared that her husband is cheating on her with an unknown person and the client who shared they had a new relationship is actually talking about the same person. Nikki discusses navigating this tricky situation ethically and morally, while ensuring she is doing no harm to her clients.
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Episode Transcript - A Complicated Love Triangle
Allie Joy 00:07
Have you ever asked yourself, am I a bad therapist? Well, you're in the right place. I'm Allie Joy, a licensed professional counselor and registered art therapist.
Kathryn Esquer 00:17
And I'm Kathryn Esquer, a clinical psychologist and you're listening to Am I a Bad Therapist?
Allie Joy 00:25
Join us each week for stories from behind the closed therapy door.
Kathryn Esquer 00:29
You'll hear experiences that made us ask, am I bad therapist? Including bloopers, jaw droppers, and other difficult moments that normalize the unique struggles of modern day therapists.
Allie Joy 00:42
This is a space with no experts, no gurus and no hierarchies, just humans sitting in similar chairs.
Kathryn Esquer 00:50
And while we're not the gatekeepers for good and bad therapy,
Allie Joy 00:54
because we're bad therapist too,
Kathryn Esquer 00:56
we are here to shine a light on the difficult decisions therapists face on a daily basis and normalize that mysterious gray area of clinical practice that no one wants to talk about. So Allie, what is the most common dual relationships that you run into in your practice?
Allie Joy 01:20
Well, I am one of the OG bad therapists, so I'll be honest, and tell you that I actually come across them a lot. So I work with a lot of college students and it happens a lot where, you know, we have state universities here in Connecticut, which are pretty big, like UConn, obviously, is well known. But the friends circles are surprisingly small. And I have it come up where sometimes I'll have people who are friends and see each other, and they also see me.
Kathryn Esquer 01:47
Wow, so how do you handle that?
Allie Joy 01:49
So the way I handle it is, if they come into it, like saying, they know someone else sees me, I always give a disclaimer of, I'm always going to pretend like I don't know the other person, I cannot disclose anything that's shared between the sessions, things like that. I kind of have my spiel I run over. It has come up in the past where I found out later on that someone knew someone who saw me but they did not tell me. And in those instances, I just did maintain the confidentiality, kind of keep it to myself. And just I always am checking in with myself to make sure that I'm not inadvertently sharing information, not crossing any lines. And I always kind of phrase it like I literally pretend like the other person does not exist when I'm in session with the other clients. That's how I handle them. Because again, kind of Connecticut is a kind of small state, you know, so it definitely comes up a lot. How about you you're I know you're in a really small community. Has it come up for you?
Kathryn Esquer 02:40
Oh, yeah. Oh, my gosh, absolutely. A similar situation. And I also think back to when I did my postdoc in a college counseling center, and literally best friends would like conspire to get the same therapist and not tell the therapist until after they both got assigned to them. And so managing dual relationships has been absolutely part of my practice from day one, from postdoc, but even before. But as much preparation as you and I put into our practices and the spiels, we have down pat for dual relationships, I don't think we could have prepared for what Nikki is going to share with us about how she had to manage holding information about two of her clients that could make or break two pretty significant relationships in their lives. So let's hear from Nikki.
Allie Joy 03:31
Yes, absolutely. She takes the cake. You guys are gonna love this story. And this is episode number three of Am I a Bad Therapist, let's get into it!
Kathryn Esquer 03:42
Welcome, Nikki.
Nikki Lacherza-Drew 03:44
Hi, thanks for having me.
Kathryn Esquer 03:46
So glad you're with us today. I feel like we talked throughout the week. But this is nice to be able to sit down and really dive in to why you're a bad therapist. But before we get there, can you share with everyone a little bit about yourself and your clinical practice?
Nikki Lacherza-Drew 04:02
Of course! So I am Dr. Nikki Lacherza-Drew. I am a licensed psychologist, physically located in New Jersey, but I am licensed and certified to provide therapy throughout New Jersey, New York, Vermont and Florida. I do have a private practice. It's just myself and one other person that I supervise, and we are 100% remote and virtual. I actually decided to give up my physical office space with everything going on with the pandemic. So we are 100% virtual, and we provide services to children, teens, adults, we see a variety of mental health issues. We are more generalists than having a specialty or a niche. We do individual therapy, group therapy, and evaluations. Outside of private practice, I also teach undergraduate and graduate psychology courses, and I am pretty active, you know, I'm going to take that back... I'm very active on the teletherapist network and host the monthly book club because I am a book nerd at heart.
Allie Joy 05:06
Yes, love it and love reading so much. And I still I never have it on my schedule, but I'm going to join one of the book clubs very soon. It's always on my list. And somehow I always miss it. But I promise I'm coming soon.
Kathryn Esquer 05:19
There's some good ones coming up.
Allie Joy 05:28
Well, thank you so much for sharing everything. It's so nice. Like Kathryn was saying, we see you on the network and everything. But it's so nice to be able to sit down today and get into this. So tell us, why are you a bad therapist.
Nikki Lacherza-Drew 05:39
So bad therapist moment. And before I jump in, I will just put out there as I'm sure you guys already will, but just putting out there that all the names have been changed to maintain the confidentiality of the people that I see. And some things have been changed too so there's no identifying markers. But bad therapist moment happened after working with two individuals that I was seeing both of them separately, they didn't know each other. And I had been working with both of them for well over a year. And the moment popped in and I was like, oh, no, like my education prepared me. All the training brought me to this moment. So, I was meeting with a cis female she identified as straight, she was married, we will call her Sally for the purpose of the story. And I had been working with Sally for about 18 months, we're just doing individual therapy working on some anxiety, some depression, you know, nothing too crazy. I'm not trying to downplay anxiety and depression, but it was pretty, you know, cut and dry. So I was working with her and then at the same time, I was working with a cis male who had recently come out as identifying as gay. And we will call him, Greg. So Greg and I were working on him exploring his sexuality, the struggles he was having with coming out where he was, you know, being on the LGBTQ spectrum was not very well received. So we're kind of going through struggles with that. And I had been seeing Greg for probably about a year. So working with both of them individually and fast forward, you know, Sally comes in one day and tells me that she found out that her husband, who we will call Bob was actually having an affair. So Bob had no idea that Sally found out but there was very incriminating evidence. Sally didn't know who it was, but was obviously very upset over it. So our sessions kind of shifted into talking about well like, what are your options? What do you want to do? So we were focusing on that, and about a couple of weeks later, Greg came into session, and was super excited to tell me all about this new relationship that he had. He had met somebody, great relationship was, you know, throwing around phrases of like, this person might be the one, like he was in it. So we're talking and I didn't know Greg's boyfriend's name, but I was getting some more information about him. I knew Sally's husband name was Bob and had some information about him. And about a month or so later, I realized that Sally's husband, Bob was actually Greg's boyfriend. So, and like I said, Sally knew the affair was happening, but didn't know who it was with. And Greg had no idea that Sally existed .Greg didn't know that Bob was married.
Kathryn Esquer 08:49
This is deception on so many levels.
Nikki Lacherza-Drew 08:52
Yes. In my head, I was like, this is turning into like a Lifetime movie. This is a reality TV show. Am I on candid camera right now? Like what is going on? So yeah, bad therapist moment came when I was like, first and foremost, as soon as the realization hit me, my first thought was, keep your neutral therapist face on. Because I learned very early on in my academic career from professors that I tend to wear my emotions on my face. And they would like look at me, Kathryn, you're like, yeah me too.
Allie Joy 09:25
1000%, I'm an open book.
Nikki Lacherza-Drew 09:28
Yeah, they would like look at me in class and be like, oh, okay, like, I didn't bring this up or like, you don't like this topic. So it's something I've been very conscious of. So in the moment that it hit me, I was like, neutral therapist space. And I was like, oh, crap. Now what? And kind of spiraled down the the rabbit hole of ethics. How do I not be a bad therapist in this moment?
Kathryn Esquer 09:54
Can I jump in? Who were you sitting with when you realized that Bob and Greg were dating. Were you sitting Sally or Greg?
Nikki Lacherza-Drew 10:03
I was sitting with Greg. And it hit me and I was like, oh God.
Kathryn Esquer 10:13
I don't know if you can protect confidentiality while sharing this but what piece of information? Or was it just, they all kind of came together at once? Was there something that tipped you off and you made the connection? If you can share it?
Nikki Lacherza-Drew 10:27
Yeah, I don't know if like thinking back on it, there were like little pieces leading up to it. Like once, like I said, I knew Bob's name from Sally. And then once Greg had said, Bob, like, in my head, and maybe this was like my unconscious, picking up on it before anything else. I was like, oh, like Bob and Bob, like, that's interesting. And then just learning about like, the likes and dislikes. And then I was kind of piecing together when like, Bob would be out of town, according to Sally, and then like, Greg and Bob did something that same week.
Kathryn Esquer 11:03
So this went on for a while that you did not know.
Nikki Lacherza-Drew 11:07
It took me I would say about a month where like, I really pieced it together. And I was seeing them both individually. So it was about four weeks. And I was like, okay, like this is now all coming together.
Allie Joy 11:20
Oh my gosh. It's funny, in our intro, we say like, you'll hear bloopers and jaw droppers and we like laughed about it. But I literally just, like my jaw dropped while you're telling this story. I think you have lived up to our intro, which I wasn't, we weren't sure how it would go. But this is a jaw dropper Nikki.
Nikki Lacherza-Drew 11:40
It was a jaw dropper in my mind that I was like nope, therapist face on, don't actually drop your jaw.
Kathryn Esquer 11:48
So here you are. And I've had moments not like this, but moments where I'm like something clicks in my head, whether it's personally or clinically or something in the therapy room. And my head is just off somewhere else. And I'm like, pulling at myself and like come back to the room come back to the room, neutral face, come back to the room. How did you maintain composure? Did you maintain composure? How did you handle the in the moment?
Nikki Lacherza-Drew 12:16
I hope I maintained composure. I think I did because Greg never said anything like, you know you're making a face or anything like that. Thankfully, it was towards the end of session. So I kind of did like a mental check of like, okay, you just have to get through the next like 15 minutes. And then you can, you know, scream into a pillow, do whatever you need to do before my next person. But just kind of focusing on I did like a lot of grounding techniques, which is my go to have like, focus on Greg, what is he saying? What is he wearing? What are we talking about?
Kathryn Esquer 12:49
So here you are, you have a situation in which you're working with two clients, one of which is grieving an affair in her marriage, and the other in which came out as gay. And is this his first you know, homosexual relationship?
Nikki Lacherza-Drew 13:11
It was, yes.
Kathryn Esquer 13:15
His first homosexual relationship with a, obviously a man, and this man happens to be the husband to your other client who just found out about the affair. So you have all of this knowledge and you're working, it sounds like weekly with these two people. What questions are running through, what specific questions, are running through your head as you work through this after the fact?
Nikki Lacherza-Drew 13:39
I feel like the, the ethics code like literally just popped into my head and I was like, okay, like, how do I remain unbiased? How do I make sure I'm doing no harm to either of these two people? How do I make sure I'm not engaging in a dual relationship? How will the heck do I keep confidentiality now? And like, can I do those things and still work with either of them, or both of them? I kind of went down the rabbit hole of ethics. And I do remember after Greg left my office, I did have a break in between sessions.
Allie Joy 14:12
I was gonna ask you that!
Nikki Lacherza-Drew 14:15
I had a break wasn't like, it was already planned. So there's nothing I needed to do and I pulled out the APA ethics code and I was like, is there anything else that I am missing?
Kathryn Esquer 14:27
What did you discover?
Nikki Lacherza-Drew 14:29
So it's definitely like confidentiality, we always talk about that with the people we see. And like that is first and foremost. So there was no way of, you know, of maintaining confidentiality with either of them. And like exposing it like I couldn't go to Sally and be like, hey, you know, I found out that Bob is actually in a homosexual relationship right now without risking the confidentiality of Greg because what if Sally like did something and found, you know, Bob and Greg together? Like, how like she's now going to know that like, Greg was obviously a patient of mine. And same thing with Greg, like, I couldn't be like, hey, I actually know for a fact that Bob is married. How do I know that? It's my other patient. Like, I couldn't do that.
Kathryn Esquer 15:18
You have no receipts to show.
Allie Joy 15:20
Right? Well, it's hard too because ethically, right, you're following the guidelines. But I feel like this goes into this like, we're also human therapists, we can't break it. But internally, what were you struggling with? Like any moral things? Like how were you feeling as a human therapist, like on the inside, aside from the ethical code?
Nikki Lacherza-Drew 15:38
Yeah, I feel like on the inside, you know, first and foremost, I was like, oh, my gosh, like, I have information that could make or break a marriage right now. And information that could make or break a relationship that Greg is like, he could be the one. Like, for me, as a person, I'm like, I have all of this info that could help or hurt either of these people right now. And like, what the heck do I do with this?
Kathryn Esquer 16:05
Its a lot. It's a lot to carry. Did rapport ever go through your head? If one of them were to find out you knew? Or?
Nikki Lacherza-Drew 16:16
Absolutely, yeah, rapport was, because then in my head, I was like, okay, like, if I can't remain unbiased, I have to refer either of them out or like both of them. And like referrals in general, I feel like, you know, for the sake of therapists out there, I'm gonna make a general statement and feel free anybody to call me out on it. But I feel like referring out is like, really, really difficult in this profession, especially with people that you already have a therapeutic relationship with. And there's been plenty of times where I've had to refer people out like, oh, you're moving to a state, I'm not licensed in, you know, this problem came up that I don't have training in. Like, there was a legitimate reason. And in my head, I was like, if I have to refer them out, I can only say that there's a conflict of interest. Like, I can't even go deeper than that, because of confidentiality. And like, that's going to damage the rapport I have with them.
Allie Joy 17:12
Yeah, absolutely. That's, like, so strong. And I feel like they would be like, well, what is the conflict of interest? But you can't say.
Nikki Lacherza-Drew 17:20
Exactly, I can't say. There's just a conflict of interest.
Kathryn Esquer 17:26
So I think it's about time, I would love to know, what did you actually do?
Nikki Lacherza-Drew 17:33
So after I had a mini panic attack in my head, I right away went to, you know, trusted colleagues, and said, okay, like, this is the situation like, these are the ethical codes that came up. These are, you know, the moral codes, which, honestly, I was able to put the moral codes aside, I think I have a tendency to just say, like, you know, what I believe, like, doesn't really matter. It's the person in front of me. So I was more focusing on the ethical codes. And so you know, how do I first and foremost, maintain confidentiality? How do I make sure I'm doing no harm? The more I thought about it and talked with other providers, you know, I didn't think that there was necessarily a dual relationship that popped up in that moment, there could be in the future, depending on how things played out. But in that moment, Sally and Greg, were both completely separate people. Bob was not, you know, a person I was seeing. So really, Sally and Greg had no connection to each other. It came down to, could I continue to be unbiased. And in those couple of weeks, as I was figuring it out, I really had to check in with myself, like, when I was exploring in session when I was asking them questions. Were these questions and was this exploration for them? Or was this me peaking my lifetime movie curiosity. So there was lots of check ins with myself. And ultimately, I had decided that I was going to refer both of them out. I had it in my head that that's what I was going to do. But that's actually not what I wound up doing because I didn't have to.
Allie Joy 19:14
Oh, my gosh, you're such a great storyteller. I'm hanging on the edge of my seat right now. Well, waste no time what happened?
Nikki Lacherza-Drew 19:26
So plot twist. I had it all in my head, you know, to the point where I had already had referrals lined up for both of them. So when I had the conversation, it was you know, here are three referrals that I think would be appropriate for you. Um, it wound up that Sally was like, I don't care you know, about like, I don't care who the person is that Bob is having the affair with the fact that he is having an affair like that's a hard no for me. So she didn't want to try to work on the marriage. She was like I'm getting a divorce. So filed for divorce very soon after and Bob did not give up a fight. Greg and Bob actually then broke up. I never knew, it has never come up, if Greg found out about Sally, but Bob actually wound up breaking up with Greg.
Kathryn Esquer 20:26
Aw, poor Greg and poor Sally. She also dodged the bullet. I don't know.
Nikki Lacherza-Drew 20:29
Oh, yeah. So like the ethical dilemma kind of dissolved itself, because like Bob was, like the attachment wasn't there anymore. Greg moved on, Sally, you know, went through the divorce and our sessions kind of more focused on the divorce. And I didn't have to refer either of them out.
Kathryn Esquer 20:53
This is a really great example of how you allowed yourself to have this knee jerk panic attack response, but you didn't act on it. You sat with it, you sought consultation, you allowed yourself to feel through it, you came up with a game plan. And had you know, a lot of us when faced with really tricky situations, we want to like escape ASAP, right? We want to fix it ASAP. And you were thoughtful and purposeful about it. And it ended up resolving itself. That's incredible.
Nikki Lacherza-Drew 21:25
Yeah, I was very happy that it resolve itself on its own. Because honestly, like, you know, going back to talking about rapport, like I didn't want to have to refer either of them out. Because the stuff that we were working on, it was within my scope, we had established rapport, I really didn't want to see them have to start over with another therapist. And that could be like, you know, my own stuff, like coming through. But I was like, I can't remain unbiased. And I don't know, like going back to like, do no harm. Like even though I'm not directly harming them, like, in a way I was like, I am harming them, because I have this information for both of them that I can't share.
Allie Joy 22:03
Yeah, absolutely. I will say it was coming through my mind like this is a hypothetical, but it's good that they were telehealth because I can imagine if you had a waiting room. Oh my gosh, imagine if something like that would have happened, like the paths that could have crossed like that would have made it so much more complicated. Or I'm assuming this was when you were telehealth.
Nikki Lacherza-Drew 22:24
It was when I was telehealth, yes. And that's happened before of just like people I learned later on are in like the same circles. Like they might go to the same school if there's teenagers or whatnot. And I'm very conscious of like, when I scheduled who and when I was in the office, I would stagger my appointments, I would do 10 to 15 minutes between them. So the likelihood of people running into each other was minimal. And I was so grateful that this was telehealth, but also in my head I was like, oh my gosh, like I hope like, for whatever reason, maybe Bob isn't home when like Bob usually wasn't home when I met with Sally, but like, could he see me? Does he know my name? Does he can he make a connection? Is he going to find out that I see both of them?
Allie Joy 23:04
That's such a good point. Wow.
Kathryn Esquer 23:07
It reminds me, so I do have a waiting room. Still I do probably about 50%, telehealth 50% in office. And this was before COVID. But I literally had, so my waiting room is also a waiting room for primary care office, for an imaging center office, for PT office. So it's like there's a lot of people in the waiting room. It's a very big waiting room. And I had one patient literally hide in the bathroom until someone they knew left the waiting room because they knew that that someone knew who I was. And if they saw them taking me taking the client back, they'd be like, oh, you see this, you know, psychologist? So I did not think of the waiting room situation. But I should have. Good point, Allie.
Allie Joy 23:52
So, interesting. Well, again, thankfully, it's all hypothetical. It was virtual. And that didn't come up.
Kathryn Esquer 23:59
We had a waiting room situation. We need one of those.
Allie Joy 24:03
I've had one of those. But we'll go into that another time.
Kathryn Esquer 24:07
I've had one of those too. There could be like another episode.
Allie Joy 24:10
Yes, you'll have to come back and we'll do like our waiting room storytelling.
Kathryn Esquer 24:16
By the bathroom. There you go.
Allie Joy 24:18
Oh, my goodness. Well, looking back on it, Nikki, I mean, from my standpoint, again, I admire you so much on the network and just what I see from you, you have ironclad boundaries, you are someone I look up to and that like example, I feel like you have such a wonderful, you know, ethical standpoint. So I don't think there's anything you could have done differently but for yourself looking back and reflecting Is there anything that you would have done differently, handled differently, thought about it differently?
Nikki Lacherza-Drew 24:43
Well, first thank you. I will be the first to admit that sometimes my boundaries can be too rigid. But looking back I don't think you know that was one of the things when I initially like found out about everything and then now you know constant looking back of like, hindsight is always 2020. Could I have done and anything differently? And I don't think I could have, you know, when I still had a physical office, and even now so even with telehealth, like there are screener questions that I do, that my admin does to make sure you know, there aren't dual relationships if we can avoid them. But this wouldn't have even come up in a screener question. You know, it wasn't anything of like, you know, like, I don't even there wasn't anything that could have come up, screening wise that I could have done differently. I am happy that I didn't have that knee jerk reaction. I think early on in my career, I would have had that and like, right away, like ran to a supervisor and been like, I have to, you know, discharge both of them. And oh, my gosh, this is horrible. But I think with time, I've realized like, the knee jerk reaction is like me being a human being, and I can still be a human being, but also an effective therapist. And that might mean that I need to sleep on it, I need to seek consultation, I got to pull out the ethical codes, and almost have a consultation with myself, I remember pulling out the codes, pulling out my legal pad and like going through them and like having an inner dialogue with myself. And I don't know if there's really anything else I could have done differently.
Allie Joy 26:14
Great, but you know, we have to ask!
Nikki Lacherza-Drew 26:17
No, and honestly, if whoever's listening to this, if there's something that pops in your head that you are like, you could have done this differently, put it on there, like I am open to learning. So I hope this doesn't happen again in the future. But if it does, I can learn from any mistakes I made.
Kathryn Esquer 26:32
Well, speaking of happening again, in the future, if you know, a clinician listening to us right now, is in the exact same situation or finds themselves in the exact same situation in the next couple of days or weeks. What advice would you give them?
Nikki Lacherza-Drew 26:50
First, no knee jerk reaction, keep your your neutral therapy face, you know, ponder it on your ride home when you have a break. But I really value you know, having consultation and if need be like supervision with others. I appreciate when other people can call me out and be like, no, like that thinking is faulty, or you know, you're on the right track. But like you haven't thought of XYZ, it doesn't make you a bad therapist to say like, I don't know what to do in this situation, or like, give me feedback. And I'm not promoting the networking anyway, but I am grateful for the network, because it is literally like a safe space that like there are other professionals there. And in a variety of mental health professions, like they're not just all psychologists, so I'm hearing I just found out something today that I didn't know, you know, a different ethical code that didn't apply to psychologists, like, I'm always learning new things. And I'm grateful that I have the network to drop in on a consultation or to just kind of like, shoot something out there of like, hey, what does everybody think? And, you know, to see if I have blinders on or anything. So I think in the field, it can be difficult of you know, risking, you know, if I seek consultation is now this person not going to refer to me, because they think that I'm a bad therapist? Like, first and foremost, like we're humans first therapist second, like we're allowed to make mistakes, and we're allowed to ask for help. So I think if anybody finds themselves in any gray area, and there's so many gray areas in mental health, like get the consultation, like, and document that. That was the other thing I did, as soon as I got consultation, I documented the crap out of both of them. Like, this is who I spoke to, this is what we talked about. So if it did come down to a referral out or if it came down to, you know, a blow up happening, I had the documentation already there that, you know, I was dotting my i's, crossing my t's and doing everything I could moment to moment in an ethical and legal manner.
Kathryn Esquer 28:54
That is beautifully put again, absolutely. Well therapy, you know, is not meant to be practiced alone, because we don't know what we don't know. And so identifying those blind spots really can only come from other, identifying our human blind spots can only come from other humans. So yes, it's absolutely important to have that supportive group. So and I'm just so grateful you're part of ours.
Allie Joy 29:19
Yes, absolutely.
Nikki Lacherza-Drew 29:20
I like that you put too, like we practice therapy with other people like we practice it. So there's going to be mistakes that we made, you know, practice doesn't actually make perfect, they're just learning opportunities. And this, this was a learning opportunity for me.
Kathryn Esquer 29:37
Yeah, you learn more about yourself, your tolerance, your your patience. Absolutely. And your clients lives, I guess.
Nikki Lacherza-Drew 29:46
Yeah, it was interesting. And I will say to this day, it hasn't been brought up in session, but I don't think Sally ever found out that Bob was in a relationship with another guy.
Kathryn Esquer 30:01
And with that, thank you. Thank you for sharing your story.
Allie Joy 30:04
Thank you so much. And Nikki, If anyone wants to connect with you outside of the podcast, where can they find you?
Nikki Lacherza-Drew 30:11
I will definitely say the easiest way is our website, which is www.vicipsychcare.com. So it's VICIPSYCHcare.com That was like major spelling. But I'm sure you guys will link it to it. On our website. There's all our social media media handles to contact the office, however you feel comfortable. But everything is there.
Allie Joy 30:37
Awesome. Well, thank you so much, again for sharing this jaw dropper. I was thoroughly invested in this story. Thank you so much for sharing it.
Nikki Lacherza-Drew 30:46
Thanks for listening!