Good Therapy, Bad Therapy, & Everything in Between
July 1st, 2008 |
by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org
We named our organization GoodTherapy.org for a handful of reasons. First among them, good therapy is what most therapists are striving to provide. Regardless of orientation, nearly all therapists can be included in the group of dedicated and caring folks who strive to “do no harm” in the healing process. Secondly, we want to express, in the title of our organization, the importance we place on quality in the psychotherapy process. Thirdly, “good therapy” is catchy. The expression, “I (or he or she) could use some good therapy,” has been around a long time. And finally, GoodTherapy.org sounds better than www.JustOkayTherapy.org. :)
But the phrase “good therapy” encourages a misconception: the idea that there is such a thing as pure good therapy, a process exempt from any problems or issues. In the same way that a perfect marriage is not one without problems, but rather one that works through problems, so is good therapy. No therapist is perfect and no therapy can be provided perfectly, no matter how ideal a therapy may be in theory. Even those of us who do the best we can to be conscious of our inner world and attuned to the therapeutic process have aspects we are unaware of, pieces of ourselves unhealed, and mistakes we make.
It is for this reason that we, as therapists, can’t blindly work with anyone who walks into our office, although many of us would like to believe otherwise. The responsibility we carry as healers requires us to seek not just consultation, but our own therapy, especially when working with someone who is provoking something significant within us. The danger lies in situations in which we are unaware that we are unaware, or unaware that we are defending against something inside ourselves. And because each of us harbors pockets of unawareness which impact our capacity to remain calm, curious, compassionate, and connected, aspects of “healthy” therapy and “not so healthy” therapy exist together in our work like the weave of fine cloth, inseparable. Again, like a marriage, good therapy is a process, not a state, and it is filled with the good stuff and, unfortunately, sometimes the not so good stuff.
So, in responding to the question of what is good therapy, our best answer is that good therapy is defined by the nature of the whole process and perhaps by the outcome, but unlikely will it be devoid of problems.
Good therapy is the sum of all the experiences, internal and external, that occur as a result of the imperfect psychotherapy process, and it leads toward self-awareness, growth, and the release of extreme feelings, energies, and beliefs. And what a blessing it is that even the best therapy can be lined with areas of unawareness, mistakes, even challenges to the therapeutic relationship, and yet still turn out good, like a marriage. And for me this highlights the idea that, like a yin-yang diagram, we even need a little bad therapy mixed in with all the good. As paradoxical as that sounds, I believe it’s true. I am thinking of the beautiful repairs my wife and I have made, the important problems I’ve worked out with my friends, and the strong repairs made in therapy with the people I work with. A solid repair makes the connection and the trust deeper and better. So, cheers to road bumps in therapy, within all relationships, and within ourselves!
My hope is that the therapist members of GoodTherapy.org will be among the group of healers in the world who make a conscious effort to heal themselves, to identify their hidden payoffs and blind spots, to avoid harm, to reach for deeper self-awareness, and will recognize that the growth process is a never ending journey for all of us…especially therapists. Click here to contact Noah and/or see his GoodTherapy.org Profile
© Copyright 2008 by http://www.GoodTherapy.org Therapist Sarasota Bureau - All Rights Reserved.
11 comments so far
This is fantastic! There are so many people who come for counseling sessions and want to be “fixed” without ever dealing with any of the tough issues. I think that it is a key role of ours as counselors and therapists to remind our clients that with the good comes the sometimes not so good, but this is a journey that we all have to be willing and able to pursue in order to become freer and more whole as human beings. The term good therapy encompasses this all. It may not feel good at the time but it may be positive and therapeutic for us, and will make us stronger for enduring it in the end.
I really appreciate your focus on the imperfect, fallible, very human nature of therapy. We therapists aren’t without flaw, we’re only fellow travelers joining our clients as they discover important parts of themselves. And I agree; the most powerful healing can come from the repair of mistakes that are inevitable in any meaningful relationship. Thanks for your site.
There are still people though who do not want to experience the therapy realm because they are afraid it will hurt them. They are faraid of what will come out and how this will affect a lifestyle that now feels comfortable to them.
That’s true. I am sometimes not sure I really want to know what is going on deep inside my head. It has taken me a while though to learn and really understand that without that knowledge I will never be the whole person that I was put on earth to be.
What a revelation! There is something to be said for therapy no matter what school of thought you originate from. For some people even the bad things they discover they will see as doing good because it will help them to determine their essential selves. I tend to agree. For me no matter what the ugly truth is I know that there is something good to be derived from it in the end so I just keep trudging on, looking for that hidden truth within.
As a counselor I think that is one of the cleverest names I have seen thus far in my career. There are so many positive results and rewards that can come with therapy and not all of them feel good at the time. But I think that once most patients have been through the experience and and have had positive outcomes they will acknowledge that with the bad came the good and they will be happy with the results in the end.
Agreed. There is something to be said for getting your patients to realize that therapy will not be a cakewalk but will rather be a fulfilling and often emotional journey well worth taking. I think that the term Good Therapy encompasses all of that and so much more. great job!
I like it. There is much to be said for a name that immediately lets you know what you are going to get.
Excellent article, Noah. While empirical evidence is important, so much of effective treatment is not clearly measurable in practical settings. Too often empirical support is taken to mean a manual of treatment that removes all therapist discretion. Often such approaches are only tested on a very narrow and defined population that does not match what we see in clinical practice. It is interesting that the one “variable” that consistently shows the most effect on treatment is the therapist-client relationship.
Nice work.
Art
I agree that therapist are human and make mistakes BUT one of your members that I saw for four years could not be accountable for her boundary crossings errors that destroyed us. And instead of being human and talking to me, she thought I was going to file with the Board and created a fraudulent police report and used that to get a TRO. It has been hell. I have never had a problem with the law or with therapists until now. And I am very scared.
She is listed with you and I think it’s wrong.
Dear Gabby,
This is Noah Rubinstein, I’m the Director of GoodTherapy.org (GT). I noticed your blog comment this morning and wanted to let you know how sorry I am to hear about this. It was these kinds of boundary crossings, in part, that led me to start GoodTherapy.org. As you may know, GT has high standards for who is allowed into the GT directory. Yet it is, unfortunately, impossible for GT to control the actions of our therapists. Our team cannot guarantee that every therapist listed in the GT directory works in a healthy, collaborative, and non-pathologizing way, but I do think GoodTherapy.org comes closer to the ideal than any other directory. Sadly, there are therapists who make gross errors, who unconsciously seek to get there own needs met by their clients, and who are simply ignorant; and know not what they are doing. It sounds to me like this may be the case with the therapist you worked with.
I think that the best course of action is for you to consult with another therapist about the situation and to get advice on what actions you should take. If I were advising someone on this, I would recommend, among other things, that she file a complaint with the state licensing board.
The state licensing board has the resources and the know-how to investigate a therapist in these circumstances. As much as I would love to have GoodTherapy.org investigate this, we don’t have the authority, resources, or the know-how to do so. However, we would take action and remove a therapist from our directory if he or she had been found responsible for unethical conduct by their licensing board. Please keep us informed as to changes ad updates. I hope we can support you and all of our therapists in a fair and objective way.
Most of all, I hope that you can care for the parts of you that, I imagine, may be feeling, in addition to scared, powerless in the face of injustice. It is terribly painful when power is misused. My deepest empathies to you for having apparently been a victim here.
Kindest Regards,
Noah Rubinstein, LMFT, LMHC
Executive Director
http://www.GoodTherapy.org