I Saw My Therapist in Public: The Therapy Relationship in a Small Town

Saw your therapist in public and unsure whether to say hello? Learn the ethics of small-town encounters, the feelings they stir and how your privacy is kept.

It is Saturday morning and you are picking out tomatoes at the local street market. When you look up, two stalls away you see someone with a string bag in hand, haggling over parsley: the psychologist you sit across from every Tuesday to talk about your most difficult feelings. Suddenly your heart starts racing. Should you say hello, pretend you haven't seen them, move to a different queue straight away? If your partner beside you asks, "Who's that?", what will you say? When you get home, one sentence keeps going round in your head: "I saw my therapist in public." In this article I look at why these encounters, which are especially common in small and medium-sized towns, feel so strange, how you might behave in these moments, which principles therapists follow and what can be talked about afterwards.

I Saw My Therapist in Public: Why Does It Feel So Strange?

Do you remember the moment as a child when you saw your teacher at the supermarket? Seeing that they had a life outside the classroom, that they bought bread too, that they could be tired or untidy, created an odd kind of surprise. Running into your therapist is similar, but it carries a far more intense feeling.

There are several reasons for this:

• The therapy relationship is one-sided. Your therapist knows a great deal about you, and you know very little about them. When you meet outside, this imbalance suddenly becomes visible: they are someone who knows you at your most vulnerable, and now they are in front of you in an ordinary setting.
• The therapy room is a protected space. A session is framed by a particular time and place. A chance meeting outside suddenly pierces this frame, putting two worlds side by side: "me in the room" and "everyday me".
• Privacy worries kick in. If someone is with you, the fear that they will realise you are in therapy may come up. In circles where going to therapy is still something people are wary of, this worry is even stronger.
• Your therapist's human side becomes visible. Seeing them with their child or partner, out shopping or in an irritable moment can clash with the image in your mind.

None of these feelings is wrong, and it is normal for them to last a few days after an encounter. All of them are signs of how special and meaningful a place the therapy relationship holds.

Therapy in a Small Town: Are Chance Meetings Inevitable?

In big cities the chances of running into your therapist are relatively low. But in towns like Çorum, where everyone knows everyone from somewhere, shopping in the same market, attending the same wedding, having children at the same school or sitting in the same hospital waiting room is quite likely.

Places where these encounters often happen include:

• Street markets, supermarkets and the town centre,
• Social occasions such as weddings, engagements and condolence visits,
• School parents' evenings and children's activities,
• Gyms, walking trails and hairdressers,
• Hospitals and health centres,
• The homes of mutual acquaintances during bayram (religious holiday) visits.

This does not mean that going to therapy in a small town is risky. It simply shows that it is useful to accept the possibility of meeting from the start and to talk about how to behave. Many therapists are aware that they work in a small town and raise this subject themselves in the first meetings.

There is another side to the coin. A therapist who lives in the same town also knows its daily rhythm, its family structures, its neighbourly relationships and, at times, its unseen pressures. When you say, "You know how a divorced woman is looked at around here," or "Everyone in the market knows everyone," you don't need to give long explanations. In other words, the closeness that creates the chance of running into each other also offers the opportunity to work with a therapist who understands you in your context. What matters is setting the boundaries of this closeness together and openly.

I Saw My Therapist in Public: Should I Say Hello?

There is no single right answer to this question, but there is a principle widely adopted in the profession: the client decides how to behave in an encounter outside. The therapist usually does not greet you first, does not show that they know you, and follows your lead. The aim is not coldness but protecting your privacy. If you do not say hello, the therapist will act as though they don't know you; if you do, they will respond briefly and politely.

Depending on the situation, your options might look like this:

If you are alone: A brief nod, a smile or a "Hello" is enough. There is no need to get into a long conversation or touch on subjects discussed in sessions; most therapists will gently keep the conversation short in this situation.

If someone is with you: Whether or not you say hello is entirely your choice. If you do, and the person with you asks, "Who's that?", you decide how much information to share. Saying "Someone I know" and saying "My psychologist" are both legitimate.

If you run into your child's therapist: Children often get excited in this situation and wave. The therapist may respond to the child's reaction warmly but briefly. Afterwards, telling your child, "She was pleased to see you, but what you talk about there stays between the two of you," reinforces the idea of confidentiality in language they can understand.

If you see your therapist with their family: To respect their private moment, a greeting from a distance or no greeting at all can put both of you at ease. There is no need to think of this as rude.

If you will be in the same place for a long time: If you need to be in the same hall for hours at a wedding or a meeting, a polite but reserved manner is usually the most comfortable solution. Your therapist will most likely take the same care.

In an encounter outside the room, you draw the line; your therapist's job is to protect that line for you.

What Happens on the Therapist's Side?

Therapists also pause for a moment in these encounters. But their professional training and ethical principles determine what they prioritise at such times.

Confidentiality comes first. Your therapist does not show in front of others that they know you; they do not tell anyone that you come to therapy, and they do not say "my client". They do not share any information about you in a conversation outside. You can find detailed information on the scope and limits of this principle in the article on confidentiality in therapy.

Therapy does not happen outside sessions. If you meet outside, your therapist will usually not enter a conversation that begins, "By the way, about what we discussed last week...", and will gently redirect you to the next session. This is not a lack of interest but a way of protecting the frame that keeps you safe.

Dual relationships are avoided. In a small town it is sometimes unavoidable for a therapist to be in the same settings as a client, but the therapist takes care that these encounters do not turn into a friendship, a business relationship or a social tie. This is to protect the integrity of therapy.

Therapists are human too. When they see you, they may also be surprised for a moment, perhaps even as uneasy as you are. But their professional stance lets them get through the moment by putting your comfort first.

What Feelings Might the Encounter Stir Up in You?

Even a brief encounter can stir up unexpected feelings. When talked about in a session, these offer very valuable information.

• Shame: Thoughts such as "They saw me like that" or "Did they look at what was in my shopping basket?"
• Hurt: "They ignored me, so they obviously don't care." The distance a therapist keeps to protect your privacy can sometimes be experienced as rejection.
• Curiosity: Seeing your therapist's partner, child or friends can raise new questions about their life.
• Disappointment: Seeing your therapist tired, flustered or in an ordinary moment can shake the idealised image in your mind.
• A sense of closeness: Some clients, on the other hand, say that after such an encounter they felt their therapist was more human and approachable.

Let's say a client working on fears of abandonment believes that their therapist saw them in a crowded shopping centre and only nodded. Back home, they spend the whole night uneasy with the thought "They didn't want to talk to me." When this experience is discussed in a session, it opens an important window for understanding not just the encounter but how the person interprets distance in relationships. Feelings like these that arise in the therapy relationship are some of the most valuable material that can be worked with within the therapeutic relationship.

Should I Talk About It in the Next Session?

The short answer: yes, if the encounter stirred something up in you. Sometimes it stirs up nothing; even then, mentioning it briefly and looking together at whether "there is anything we need to talk about" is enough.

Talking about it can be useful in the following situations:

• If you feel reluctant to go to your session after the encounter,
• If you keep going over your therapist's manner in your head,
• If a worry about your privacy has arisen,
• If you want to be clear about how you will behave in a similar encounter in future.

In this conversation, your therapist can explain how they prefer to behave in encounters outside and ask about your preference. A simple agreement such as "Let's not say hello when someone is with me, but let's say hello when I'm alone" makes future encounters much easier.

When Fear of Running Into Your Therapist Gets in the Way of Therapy

For some people, the possibility of running into their therapist is strong enough to stop them starting therapy altogether. Questions such as "What if someone sees me at the psychologist's door?" or "What if the therapist knows my partner's relatives?" can lead to putting off getting help.

In this case, several options can be considered:

1. Saying it openly in the first meeting: Discussing chance meetings and privacy with your therapist from the outset greatly reduces the worry.
2. Thinking about session times: You can choose times that reduce the chance of meeting acquaintances in the waiting room.
3. Considering online therapy: Especially for people living in small towns, online therapy both reduces the chance of meeting in person and removes the burden of travel. Even so, this choice should be made to meet a real need, not to feed avoidance.
4. Checking for mutual connections: If you and your therapist have close mutual acquaintances, sharing this at the very start allows the therapist to assess whether the situation is appropriate.

Which of these options is right depends on the person's needs and how strong their worry is. Fear of running into your therapist can sometimes be part of a broader social anxiety or a fear of "what other people will think". In that case, the anxiety itself is also an important subject that can be worked on in therapy.

How Are Encounters Outside Therapy Worked With in Sessions?

When working with a client who comes to a session saying, "I saw my therapist in public and it hasn't left my mind since," the therapist's aim is not to play down the moment or brush past it quickly, but to understand it. This conversation can be approached in different ways in different therapies.

From a cognitive behavioural perspective, the automatic thoughts that came up during and after the encounter are examined together. The evidence for and alternatives to thoughts such as "They ignored me," "They must have seen what was in my shopping basket and judged me," or "My partner will now realise I'm in therapy and tell everyone" are discussed. This examination often makes visible that the person carries similar tendencies towards mind-reading and catastrophising in everyday life too.

From a schema-focused perspective, the old feelings revived by the encounter are explored. For someone with an emotional deprivation schema, the therapist's brief greeting can seem to confirm the belief "Nobody really cares about me anyway." Someone with a defectiveness schema may be sure that their therapist was disappointed on seeing them "in real life". Talking about these feelings in the safe setting of the therapy relationship gives the person the chance to test their old belief against a new experience: the therapist is still there, has not lost interest, and the relationship is solid enough to withstand this small jolt.

Sometimes the encounter also becomes an occasion to revisit the practical frame of therapy. Small agreements about session times, how the waiting room is arranged, mutual acquaintances or possible future encounters help both client and therapist feel more at ease. In this way, an unavoidable fact of small-town life serves to make the safe frame of therapy even clearer rather than damaging it.

Frequently Asked Questions

Can I follow my therapist on social media?

Many therapists do not accept friend or follow requests from clients, in order to protect confidentiality and the frame of therapy. This is not a rejection but a professional boundary. Following a therapist's public professional accounts usually causes no problems; if you are not sure, you can ask in a session.

We go to the same gym; do I need to change gyms?

Usually not. Discussing the situation with your therapist and agreeing how you will behave when you run into each other is often enough. If it noticeably bothers you, you can think about solutions together.

What should I say if the person with me asks, "Who was that?"

How much you share is entirely your decision. A short answer such as "Someone I know" or "Someone from work" is as legitimate as saying "My psychologist". You are not obliged to tell anyone that you are in therapy.

Can my therapist talk about me to other people?

No. Therapists are obliged to keep your identity and what you share confidential, including the fact that you come to therapy. There are exceptions to confidentiality only in limited situations, such as a serious safety risk, and these are usually discussed openly in the first meetings.

• #therapy process
• #confidentiality in therapy
• #therapy in a small town
• #therapeutic relationship

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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