More than a year ago, I published a post called What Are the Rules for Texting With Your Therapist? It has been, by far, my most commonly read post, I suppose because there are a lot of people who would like some clarity on this murky issue.

Bad luck for all the readers of that post, however, because that earlier post didn’t provide any answers. Instead, it just raised questions, as I had only recently started texting with the amazing E, my therapist of many years.

Now that it’s been a full 19 months of texting back and forth (with no end in sight), and having survived a few misunderstandings on both sides, I’m in a much better position to write about what the rules are. Not the rules for everybody, of course, but the rules that work for me and my therapist.

1. If I am very close to a suicide attempt, do not text her. Instead, I must call 911 or go to the hospital.
2. If I feel suicidal but am not quite on the verge of an attempt, I should not text her. Instead, I should call her. She will get the message faster that way.
3. I need to understand that she cannot necessarily respond right away. I need to deeply, deeply understand this. There are many reasons she may not write back for hours and hours. That she doesn’t care about me is not one of those reasons.

Those are really the only three rules. Perhaps more important than the “rules” is the insight I’ve gained over these many months and literally hundreds of texts. From this more experienced perspective, I would offer the following advice:

• It’s worth having a conversation about the purpose of texting in the context of your particular therapy relationship. In my case, E wanted to give me space to practice reaching out and being met with care and kindness. We have had a lot of exchanges that are some version of “Are you still there?” “Yes, I am still here, still caring for you.”
• Similarly, it’s worth talking about how often it’s appropriate to text. Texting was not something E regularly did with clients, so when she and I started texting, we agreed to check in to see if it was working for each other. In the end, she has not set a limit on number of texts, and at first we used to text almost every day (though often it was very short: “Good morning!” “Good morning to you, too. Enjoy the sunshine!”). Now it might be twice or three times a week, unless something is up.
• If you are going to text because you want something, be as clear as possible about what you want. For a time last summer, E sometimes complained that my texts were “cryptic.” It took me a while to realize I would hinting at something because I was afraid to ask more directly. So I have learned to say, “I could use a reminder about how to calm down this sense of desperate shame…” or “It would help to have some reassurance that this won’t last forever…” or “I just want someone to recognize how hard this is.” or even “I am checking on our connection.” It is good for me, anyway, to learn to identify my needs after decades of pretending I didn’t have any.
• In my case “cryptic” meant I wasn’t clear about what I wanted. But remember that it’s easy to misinterpret a short text, without tone of voice or body language. I remember feeling really hurt early on when I texted E something about the excellent weather (really just to see if she was there), and she texted back “It’s great. More tomorrow!” I thought she meant she was done texting or was busy and would talk to me more tomorrow. Later she said no, she just meant it was going to be sunny again tomorrow. Yep, that shows you how much I struggled with trusting the relationship for a long time, how sure I was that she was tired of me.
• If you feel you need to write her a rant at 4:00 in the morning, go ahead. But don’t hit “send” until a decent hour, say after you have finished breakfast. I say this because I have sent E a long rant in the middle of the night. Later, I regretted it thinking: What if she left the sound on her phone and the ping of an incoming text wakes her up? What if she wakes up exhausted, picks up her phone and sees a long, seething text from me? Won’t that make her sick of me? Or at least feel overwhelmed at the start of her day? After I’ve eaten breakfast, I might feel better and not need to send the rant at all. Or maybe I will just take the rant into a therapy session and say, “this is how I felt in the middle of the night.”
• Don’t text on her vacations. I mean, you and your therapist will have to work this out for yourselves. On this last vacation of hers, E even told me I could text her on her vacation. But I didn’t want to. I mean, at some level I did want to, of course. I missed that connection. Yet it seemed more important to me that her vacation be a genuine break, so she could feel refreshed. Okay, and add to that she wasn’t sure what her reception would be, off camping in the mountains, and I didn’t want to text her and then feel abandoned if she didn’t get it and/or couldn’t reply. Overall it just seems better for me to find other ways to support myself in her absence. Something that has worked really well on two vacations now has been for her to write me a note and have someone mail it to me partway through her vacation. It warms my heart to get a card she’s handwritten to me. I keep them and re-read them now and again.
• Last point: I consider it a privilege she’s granted me, not a required part of her work. I also see it as something that has helped me deepen my trust in our therapy relationship. For both of these reasons, I try to be respectful, and when in doubt, to err on the side of not texting, or waiting to say something in therapy if it seems problematic via text. I am grateful to her for the extra time she has put into communicating with me out of session. I don’t want her to regret it.

It’s tricky, I think, having out-of-session contact with a therapist, trickier than I’d imagined before we went down this road. I have come to see why some therapists won’t do it, or only allow it for particular types of interactions. I can imagine that it might not work for E in the same way if she still had kids at home or more client sessions (she has two days a week she doesn’t see clients but rather works on other projects, which I think might make this less overwhelming for her). But for us, for now, it works, and I’ve found it to be very healing to know she’s willing to be available to me.