Let’s say one had a sister who lived in a distant land. Let’s say that sister broke her leg so dramatically the doctors told her it would take eight months to heal. Let’s say it was October.

What that says is such a sister could not possibly make it home for Christmas.

My sister couldn’t possibly make it home for Christmas.

My sister made it home for Christmas.

With blinkered commitment, she focused on an improbable rehab that saw her go from bed-bound to Piarco-bound in fewer than eight weeks. Her daily routine was to test the limits of her tolerance for pain, as directed by a physiotherapist. She had a goal and she had a therapist who helped her stay on track.

This is how we talk about physical therapy. We go to physical therapy with the expectation of getting some physical ailment fixed or at least mitigated. You signed up for it in the first place to fix your leg, neck pain, back injury.

There should be no mystery to the goal of any therapy. To be receiving therapy is to be seeking to have something made better – which generally entails knowing that something isn’t working as well as it should.

When the thing that isn’t working as it should is your mental health, however, somehow the goals of therapy can get a little out of focus.

It’s not uncommon for people in psychotherapy to lose confidence in their therapy in a way that simply wouldn’t make any sense if they were being treated for a physical ailment. If you’re not making any headway with your depression/anxiety/obsessions or whatever ails you, you need to find out why.

Situation the first: Therapist or tell-a-friend?

The worst of all the in-treatment failures. You love your therapist. So caring and understanding. Why, it’s just like talking to a friend. When you leave the office you feel uplifted. When you get home and your down-spiral resumes, you wonder what happened.

Here’s what happened: you have fallen into the habit of treating your therapist like a friend (a friend you pay). You talk. You both talk. You share. You laugh. You have so much in common. This scenario is not uncommon, but it’s not terribly helpful. It’s great that you get on well, but if the conversation does not come back around to what you need help with, you have a problem.

You can try to talk about getting back on track or – and this is going to hurt – you may have to break up and find someone else.

Situation the second: Yes, there are boundaries

There are guidelines governing the patient-therapist relationship, and there is simply good sense. I think any professional acting in your best interest should be aware of when you or they or both of you have crossed a line.

This bleeds into the first situation quite a bit, but is still worth a separate space. To put it plainly, you are there to fix you, not to talk about how much you both enjoy floral arranging.

It’s nice that you can empathise with your therapist’s problems but, I say again, and I say sharply, this is ab