Black Friday and Cyber Monday usher in the season of gift giving for many of us.  A number of my clients have started sessions by telling me they are already done buying gifts this year.  Others have shared how stressful it is to think about buying gifts for family members and friends.  Some begin to talk about past holidays, past gifts, and loved ones who are no longer with us.  And then, there are those people who walk into my office with a wrapped gift.  “This is for you!” they say as they hand me a package.

Gift giving and receiving aren’t reserved only for the holiday season.  But the holidays are a time when gifts---either giving or receiving---have greater likelihood of manifesting in all our relationships, and our relationships in psychotherapy are no different.  Yet, giving and receiving gifts in our therapeutic relationships has engendered much discussion and analysis. 

Some organizations have policies about receiving gifts from clients: “Staff are to accept no gifts from clients,” or “Gifts received from clients can be worth no more than "X" amount of money.”  There may also be policies around giving gifts to clients, sometimes with the very same parameters.  I struggle with these universal policies around giving and receiving gifts.

Acknowledgment and Acceptance

I met Zack in one of the groups I facilitated for survivors of childhood trauma.  He had been severely abused by his father and, despite disclosures to his mother, had never been believed.  The abuse continued into his adolescence, and was coupled with degrading comments about Zack’s lack of athletic prowess and criticism about his artistic abilities.

As an adult, Zack tried on multiple occasions to repair his relationship with his parents and his extended family.  Zack’s sisters also knew about the abuse, but they too, would not acknowledge it happened, perhaps because their acknowledgment would require they adjust their relationships with their parents as well. 

Much of Zack’s energy was channeled into creative outlets.  He wrote poetry. He made pottery.  He welded.   And he created amazingly beautiful watercolors.  He shared some of his creations with family members as part of his attempt to reconcile, and while these gifts were accepted, they were never verbally acknowledged or appreciated in a way that was affirming.  Like his disclosures of abuse which his family “received,” his efforts at full acknowledgment and affirmation were squelched with each of his attempts to “be seen.”

After Zack and I had known each other for several years, he came to one of our sessions with a beautifully crafted ceramic bowl he had made after learning how to throw pottery on a wheel.  He looked away as he handed me the bowl.  “I made this for you,” he said quietly.  “I wanted to thank you for our work together.”

I looked at the bowl and looked back at Zack.  I could almost feel his heart beating quickly and noticed his shallow and rapid breathing.  He was readying himself for my response---or more accurately---for my lack of response.  I held the bowl and turned it over, seeing his initials carved on the bottom.  I tried to notice all the intricacies and colors of the bowl before I responded:  “This is one of the most beautiful bowls I have every seen!  Thank you!” 

I saw Zack’s shoulders relax.  “May I put it on this table by the couch,” and I gestured to the table next to him.  He shook his head yes and I gently placed the bowl on the table.  While our work together ended many years ago, to this day, the bowl remains on the table next to my couch.

Sometimes a Bagel Isn’t a Bagel

Steve was one of my very first clients many years ago and someone I wrote about earlier this year. He believed he was always the one reaching out to his friends; that if he didn’t call them, he would never engage in social activities.  He also believed he was consistently the person who “gave” in relationships.  He wanted others to give to him. 

As our work progressed, a consistent pattern developed.  He brought me a bagel and gave it to me at the beginning of each session.  Since our meeting was at 8:00 am on Saturday mornings and he bought one for himself, he explained, he brought one for me as well.

Upon first glance, it may be hard to see any connection between this ritual of giving me a bagel and his presenting concerns.  I thought, however, it might merit some exploration.  The next time I met with him, I asked him more about bringing me bagels.  I invited him to consider how this concrete act of giving might somehow parallel his experience in his life outside of therapy.  His initial reaction was to look at me quizzically.  He wondered why I was making any kind of an issue of him bringing me a bagel.

After some thought and gentle probing, he began to question whether this giving to me (and to others) somehow made him feel less vulnerable.  He wondered if maybe he had more control when he gave than he did when he received.  And as we talked more about his relationships outside of therapy, he realized that his pattern of giving was a way of precluding others from giving to him in a way that felt authentic—not simply a perfunctory response to his giving.  

If he continued to give and give, maybe there was no space for others to give to him.  Or when others give to him, were they only giving because they feel like they “have to” because he gave first? This was an important realization for him. The most palpable consequence of our conversation was the absence of bagels in subsequent sessions.

This Is For You

Whether we accept a gift with grace, respond to a gift with gentle questions and exploration before accepting or not accepting it, or respond to an offering by sharing the policy of our organization or perhaps the personal policy we have established around accepting gifts, may be dependent upon our theoretical orientation, our training, our years of experience, or the context in which we work. 

Hopefully, more than anything, when we are offered a gift in the context of our therapeutic relationships, the relationship itself trumps all other factors as we consider how to respond.  In Zack’s case, had I questioned the gift or given voice to a policy, I might have been enacting a pattern and history of dismissive and abusive responses from his family.  I hoped that by accepting the gift and honoring its beauty and meaning, I might somehow offer him just a glimpse of the acknowledgment and acceptance that were so absent in his family.

With Steve, it was clear that his weekly gifts to me were a different kind of enactment and one that placed him in the role of “giver,” in yet another relationship.  He came to therapy because of his dissatisfaction with his relationships where he saw himself as the one who gave and in which there was never reciprocity.  Bringing me the gift of a bagel allowed us to explore how he perpetuated his role of giver, protecting himself from vulnerability and, in so doing, from receiving tangible and intangible gifts from others.

There is no “one size fits all” response to receiving a gift.   If we invasively or analytically question each gift we are given, automatically convey our personal or organizational policy, or simply say “thank you” to each offering, we miss an opportunity to uniquely respond to the meaning behind each person’s gift.

If you were to enter my office today, you would see Zack’s bowl on my coffee table, an oak leaf plaque hanging by my office door, several stained glass pieces hanging on my windows catching the eastern light, a variegated philodendron plant in a painted clay pot, and a glass paperweight engraved with the words “thank you.” 

I spent time talking about some of these gifts with the people who gave them, while others were received with a smile and words of thanks.  In each case, my hope was to respond in a way that met the needs of the person offering the gift. 

I would be lying if I said I didn’t get anything from receiving these gifts.  As I sit with my current clients in my office, and notice the objects given to me over the years, I’m reminded of the very important work that we do as therapists and the trust that is placed in us.  For that I feel grateful and give thanks.

“Certain other gifts, real property, personal property, in-kind gifts, non-liquid securities, and contributions whose sources are not transparent or whose use is restricted in some manner, must be reviewed prior to acceptance due to the special obligations raised or liabilities they may pose.”

—National Council of Nonprofits