ABSTRACT
Based on individual and group experience, this chapter focuses on patients’ reactions to being late to a therapy session and all that can be learned from exploring this occurrence. The patient’s response—or non-response—to being late can have a variety of meanings depending on the phase of therapy, the state of the therapeutic alliance, the developmental level of the patient, the patient’s default position, the therapist’s attention to the framework of therapy, the nature of the transference, the patient’s degree of investment in the therapy, and a host of contextual factors. Has the apology over time become a ritual that suggests that the patient does not yet fully appreciate the difference between friendship and a therapeutic relationship? Does the explanation for lateness involve external factors—traffic, snowstorm—or the patient’s internal world? What is the tone of the explanation? In the later stages of a successful therapy there may be no explanation because the patient realizes that in being late the loss is hers, her therapist is not looking for an explanation, and since she is paying for the time, she is not hurting or inconveniencing her therapist. In group therapy, much can be learned from the way a patient responds to questions from other group members about his/her lateness.
