Yawning during sessions

[artsyann]

I’m wondering if anyone has experience with repeated yawning/stifling of yawns during sessions? Either being on the receiving end or being the one doing it. Have you had a client terminate because of such an issue? Or have any ever talked to you about it? I am on the receiving end of a provider who noticeably stifle yawns throughout all sessions. It’s made me self-conscious about what I share and how I share it. I haven’t it brought it up to the provider thus far, but am considering just terminating rather than having an uncomfortable conversation. Any thoughts?

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[WisNeuro]

I think it would make a good opportunity to do a little research on the physiology of yawning. It is not generally a sign of boredom. Perhaps the provider didn't get enough sleep, perhaps they have MS, perhaps they have liver disease, perhaps they are diabetic, perhaps they have had a stroke, perhaps they are on certain medications, etc, etc. Are there other issues within the therapy sessions, or are we just hung up on the yawns?

 

[artsyann]

I think it would make a good opportunity to do a little research on the physiology of yawning. It is not generally a sign of boredom. Perhaps the provider didn't get enough sleep, perhaps they have MS, perhaps they have liver disease, perhaps they are diabetic, perhaps they have had a stroke, perhaps they are on certain medications, etc, etc. Are there other issues within the therapy sessions, or are we just hung up on the yawns?

Good question. I think there may be other issues. The provider is different than any other I have seen in the past. I thought it might be good to try something new. However, they don’t speak much at all during the sessions, which I think may be contributing to my feeling they are bored. It’s a new dynamic for me. If the issue is a lack of sleep, and it’s recurring, it would make me question how present they are during the sessions. Sometimes, they ask questions (mundane ones) that I have answered before, so again makes me question their attentiveness. Obviously, if I was feeling great about the sessions, the yawning wouldn’t faze me. But I guess I am on the fence. Is it something you recommend me discussing with them or just politely terminating? I’ve never had this experience with any other provider, so I am not sure how to handle it.

 

[blakjak12]

I think it is somewhat of a judgment call, which may not be helpful to hear. Perhaps it's worth considering where you are at right now and the alternatives available.

One option as you have identified would be to tactfully raise the issue of yawning and what seems like the bigger issue of this provider not bringing much to sessions. Perhaps that leads to treatment being more constructive and rewarding, although of course there is no guarantee there.

Another option would be to terminate and look for another provider who may be a better fit (or I suppose just not being in treatment at all). It sounds like this treatment course may be useful for at least identifying what you do not want in a provider. The downside of terminating and looking elsewhere is that it could be some time until you are able to start with someone new, which I am sure you already are aware of.

 

[WisNeuro]

I think it's always a good idea to bring up things that bother you during sessions. On both sides. Many times it leads to some very good discussions and occasionally some very good insights. At the very least, it helps with assertiveness and fighting back against avoidance strategies that are too often utilized.

 

[artsyann]

I think it's always a good idea to bring up things that bother you during sessions. On both sides. Many times it leads to some very good discussions and occasionally some very good insights. At the very least, it helps with assertiveness and fighting back against avoidance strategies that are too often utilized.

Great points. I suppose how they respond will also be helpful in figuring out if it’s the right fit for me. Ironically, part of my issues deal with a SO with communication issues. I don’t have them normally, but in this setting it’s a different dynamic. Thanks gor your insight.

 

[artsyann]

I think it is somewhat of a judgment call, which may not be helpful to hear. Perhaps it's worth considering where you are at right now and the alternatives available.

One option as you have identified would be to tactfully raise the issue of yawning and what seems like the bigger issue of this provider not bringing much to sessions. Perhaps that leads to treatment being more constructive and rewarding, although of course there is no guarantee there.

Another option would be to terminate and look for another provider who may be a better fit (or I suppose just not being in treatment at all). It sounds like this treatment course may be useful for at least identifying what you do not want in a provider. The downside of terminating and looking elsewhere is that it could be some time until you are able to start with someone new, which I am sure you already are aware of.

Thanks for your insight. I’m not worried about finding a new provider. Luckily, there are many local to me. I also am fine if I have to wait. I am not in a crisis or anything serious.
The provider does ask me at the end of the sessions how I felt about the session, so I should work on an honest and constructive response.

 

[Grenth]

I had a yawning tic that was prevalent when I was a child and it still pops up sometimes when I'm really stressed/low on sleep. I had a client mention once that she noticed me stifling a yawn to say she didn't want me to feel like I couldn't yawn which led to a great discussion on how she felt about her sessions overall. I try to show my engagement and attention in many ways to override the yawning and it seems to work. Your therapist may appreciate it if you bring up what you notice and it can open up a constructive conversation.

 

[foreverbull]

You might want to say something like "hey, I was wondering if we could chat about therapy progress and/or how we're working together" and gently mention that you'd like more feedback and you could briefly mention the yawning as part of the nonverbals that have made you wonder what's happening for him/her.

 

[artsyann]

You might want to say something like "hey, I was wondering if we could chat about therapy progress and/or how we're working together" and gently mention that you'd like more feedback and you could briefly mention the yawning as part of the nonverbals that have made you wonder what's happening for him/her.

I like that approach. They do ask me how I feel about the session, so it’s pretty open to me being honest. At one session I did say I didn’t feel better at all and they asked how we could remedy that. I didn’t have an answer but maybe it’s something we can come up with together. Thanks for the suggestion. I appreciate it very much.

 

[LaceyLPC]

See, I worry about this, because one of my medicines makes me yawn. Generally, I work with kids so I often make them yawn in return (since yawning is "contagious,") and we just giggle about it. However, with adults, I do try to make them a point to tell them, "I'm not bored, I promise." However, I've also never had anyone confront me about it.

I think it's a fair conversation to have with your counselor; it's important to not immediately run away/terminate if you don't like something. Approaching it will not only build rapport, but also teach you to be assertive toward other problems.

 

[foreverbull]

See, I worry about this, because one of my medicines makes me yawn. Generally, I work with kids so I often make them yawn in return (since yawning is "contagious,") and we just giggle about it. However, with adults, I do try to make them a point to tell them, "I'm not bored, I promise." However, I've also never had anyone confront me about it.

I think it's a fair conversation to have with your counselor; it's important to not immediately run away/terminate if you don't like something. Approaching it will not only build rapport, but also teach you to be assertive toward other problems.

It's good to be proactive and address it head on with clients...that's how I'd handle it if it did have a medical cause or if I was super tired one day. Otherwise, clients might interpret it as boredom, and the OP's therapist hasn't proactively discussed it even though it could be misinterpreted.

This is an interesting topic because our clients are reading our nonverbals just as much as we read theirs, which is something I think about during session because I have had a tendency to furrow my brow when I'm thinking/processing information, which might look like an emotional reaction/anger/frustration, so I've worked on that a lot over the years, seemingly effectively because it didn't show up in my recorded sessions on internship (I was worried I could be doing it too much, but I wasn't). We all have little nonverbal quirks, so its good to be aware of them!

 

[smalltownpsych]

I mostly yawn if I am very tired for some reason like maybe I was called into the ED at 2:00 a.m. Patients will respond in various ways depending on a myriad of factors and I will respond or address it depending on what makes sense in the context of the individual case. I never have a problem with patients asking me questions about anything. In fact, quite the opposite, I encourage them to ask away as I have a good sense of appropriate professional boundaries and how to set them without damaging rapport. Great way to model effective interpersonal relationship skills.

*edit to add* Just wanted to clarify that practicing interpersonal skills is frequently a focus of my treatment and theoretical perspective so other clinicians will vary.