Therapists Are Human Too!
February 17th, 2009 |
A GoodTherapy.org Featured Column written by Greg Madison, PhD
Click here to contact Greg and/or see his GoodTherapy.org Profile
At times I can be didactic and preachy with clients. I fall into believing that I have some special knowledge about life. I believe that I’m expected to pass along little gems of wisdom in sessions as if I know what life is really about. My client and I collude in forgetting that this is my first life too, what do I know? Outside the consulting room I am not always so wise. I can lose my soft-spoken reflective stance and be as reactive and unreasonable as the next person. I would say it’s worse for therapists when this happens – we have the extra layer of shame that comes from feeling we should know better. What if a client saw me arguing with the bank teller, pushing my way onto a crowded train…
Who do you have to be to be a therapist?
I am coming to the realisation that some of the most significant and poignant moments in therapy are not really about the content of the discussion. Not really about behaviour change or unravelling the past. In fact, in a sense, not really about the client’s trouble at all. In the deepest moments of therapy I am freed by my client and my client is freed by me.
Leo, a 33 year old Finnish solicitor, was referred to me for anxiety and mild depression, the mainstays of modern therapy. His lack of eye contact during his previous CBT treatment earned him a tentative Asperger’s diagnosis. The referral letters from his psychiatrist and previous psychologist read like lab reports on a strange species. Leo is very sensitive and would have been hurt and angry if he saw those letters. I don’t blame him, so much of our language as so-called mental health professionals pretends that we are somehow superior to the client.
In our first meeting Leo was furtive and a bit suspicious so we spent time talking about what it was like to be together. He was despondent about therapy and quizzed me about my approach. I said I wanted to work from his own experience and understanding and I said a bit about Focusing, a form of self-awareness that a friend of his had found helpful. I encouraged him to ask me about what I thought and felt about him and over the first few sessions we gradually developed an honest and respectful rapport. I felt very accepting towards him and I told him so. We had moments of warmth and he eventually thawed as he came to really believe that I wouldn’t reject any part of him, even those aspects of himself that he continued to condemn as shameful and wrong.
In our twelfth session we decided to review our work. I felt it was really important to hear from Leo what he felt was useful in our meetings. He had certainly changed. His relationship with his boyfriend had become much more communicative, his behaviour at work had become more caring, and he had found a way of standing up to his father without losing his temper. As we reviewed his progress, Leo held out his hands to show me that he no longer bit his fingernails. I could see that the rough nails and bloody fingertips had healed into soft smooth flesh with trimmed nails. He smiled broadly. I smiled back, ‘Good for you. You seem very proud of that Leo’. He began to laugh, obviously delighted with the change. ‘What helped you to stop biting them?’ I asked. Leo took notes after our sessions so I was pretty sure he’d have a hypothesis about why this stubborn habit finally changed. ‘Well’, he said thoughtfully, ‘You remember that session when we really talked about this habit of biting my fingers?’ I nodded. ‘Three things happened there that helped me. You helped me talk about what it meant to me, that I was ashamed of my fingers because they showed people how anxious I felt and they would know I’m not like them. Then we talked about substituting a different behaviour that wouldn’t be so visible. Those two things helped a lot. I started to tap my fingers together instead of bite them and that helped me for a while. It was less noticeable and I felt less embarrassed. Now I hardly ever do that anymore either. But you know, the most helpful thing was that you showed me how you chew your lip, you were even doing it in the session. You said many people have a kind of thing they do when they are concentrating and you did too. That helped the most. I felt less weird about it and it was easier to stop. I felt it was Ok, biting my fingers didn’t make me different and wrong’.
I was surprised by Leo’s response. I repeated it back to him to make sure I’d understood. He said it again, ‘Yes, the most important thing in these sessions is the constant acceptance you show me, no matter how awful I think I am. I really believe you now’. We stared at each other. ‘You’re looking right at me Leo’. He smiled. I said ‘You know it feels like we can really accept each other’. Leo had allowed me to be myself. By accepting me with my own foibles he had freed me from having to be an expert on life, he’d allowed me to drop the role of mental health professional. He could have rejected me and my lip biting but he accepted me as the slightly anxious person I am and I could bear him seeing me like that. We had both overcome the trance of withdrawing from each other into pretending and hiding in order to belong.
We finished our contract three months ago and I continue to reflect on my time with Leo. By accepting each other we created a healing connection. We overcame the anxiety that kept us isolated in our separate selves, silently believing that we cannot be real and be accepted at the same time. Seen from this perspective therapy is the bridge that spans our isolation from one another. It is a place to welcome humanity, one by one, back into a community of belonging. A place where the vulnerable ‘I’ of separation becomes a ‘we’. Therapy is not a treatment any more than marriage, friendship, motherhood and fatherhood are treatments. I am coming to believe that therapy, when it works, is mutual redemption of the lonely ‘I’. Perhaps implicit in each phobia, trauma, addiction and compulsion, depression and anxiety, is the loss of our human belonging. But it isn’t that we as therapists are whole perfect beings sharing our wisdom about acceptance. We also seek connection and redemption from our own human exile and isolation. Otherwise how could we be helpful? It is only those who need redemption who can offer it. After all, wasn’t it that need to connect that motivated us to become therapists in the first place? And isn’t it in the consulting room that many of us allow ourselves a depth of vulnerability and courage that we seldom achieve in our daily lives?
(this account is based on actual client work but is heavily disguised)
©Copyright 2009 by Greg Madison, PhD. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Greg and/or see her GoodTherapy.org Profile
14 comments so far
As a client, the most valuable, transforming therapy sessions I have experienced have been those when my therapist has had the courage to share some aspect of their life which was a learning experience for them – as a teaching opportunity for me, or has admitted not knowing the answer or the best way to proceed. These occasions – where I have been trusted enough to be allowed to see a little way beyond the therapist as professional towards the therapist as person, have been watershed moments, allowing me to lower barriers, trust a little more, see a little further into myself, test responses without fear of recrimination & hurt, feel less isolated & alone. They have been an experience of a real world situation within the safety of the session, and as such very empowering. I commend you & all others who use this approach in their practices for your courage in doing so, because it changes your clients lives for the better. And that is a wonderful gift to receive.
Dear Greg,
I can’t tell you how much I enjoyed your article. It is a wonderful reminder of how the authentic human relationship is truly the vehicle of healing. I hope too that it will encourage other therapists who hide behind a veil of professionalism, hierarchy, or whatever it may be, to get real… Thank you for your transparency….I bite my lip too, among other human behaviors :) Noah
I could never repay my therapist Val for all of the hard work and effort that she put in for me. I came in one tough and hardened cookie and she really had to work hard with me to make me see that I am special and have gifts and worth to offer to others. How can I ever give her back all that she has given to me? It makes me feel good to read this and to know that in the end I may have been able to give her a little something too and I like feeling that.
Finding a therapist you can really connect with is hard, and I guess that now I see that it can be hard for them to connect with clients too.
As a therapist I totally agree with what you are saying. We are all human and bring our own baggage to the consulting room.
You might be interested in my new novel: :Shrink: Odyssey of a Therapist” which depicts the therapeutic interaction of a therapist with a patient who reveals a psychopathic personality. Moral, ethical, and personal issues of both parties are revealed. Shrink is available from Amazon and Barnes Noble.
There is a downside too when therapists can get too involved with patients and cross thos moral lines.
That is despicable when I hear about things like that happening. Therapists are being given a bad rap because of the actions of a few but those are the ones you always hear about. There are many many more who have dedicated their lives to helping others, and of course they get involved in their patients lives- they care about them and what happens to them. That is the definition of being compassionate right, which is what I would assume all of us want from a therapist? Being a therapist has to be difficult work- you hear about the problems of others all day long. When do you get a chance to decompress and deal with your own?
I loved this article as I related it to something that happened between me and my child recently. I believe we carry this air of perfection around us even in our role as parents. We love to portray ourselves as extremely responsible, morally correct and the last word in etiquette . I find myself constantly correcting my child as he grows and one day he turned around and corrected me for being rude with my mum. I realised that the moment I accepted I was wrong and confessed that I shouldnt have said what I said, I felt no built-up stress and in doing so I had showed my child that noone is perfect. You dont have to be but you can aspire to be a better person everyday.
My cousin lost his life being a counsellor in a school in a very bad neighbourhood. He found a drug peddler who was causing a lot of havoc in the student community. I think there are examples of dedication that definitely outweigh the “I am here for the money” kinds.
I am so glad that someone spoke for the therapists. I am one and I think we all come under constant criticism not to mention legal harassment.
Great article. I personally am glad to see therapist getting involved with people, as long as its on a professional basis… people need someone they can confide in and feel comfortable with.
I have to agree with Fran… we can’t judge a therapist by some of the ones who lose their moral values… There are some really good therapist out there willing to help and not just for the money, but for the satisfaction of actually really helping someone.
I’m sure there are many therapist out there who have their own way of dealing and helping clients. I see nothing wrong with giving personal examples of themselves, but as long as it is professional and in good taste and doesn’t offend the client
We lose everything when we forget the most basic of things – we were humans before we became therapists. Many therapists use the therapeutic boundary as a way to keep themselves at a distance. This is a disservice to both as neither gets to experience the healing of a real relationship – one that has openings for both the therapist’s and the client’s flaws, failures and quirkiness. I don’t know about other therapists but I just want to be me– not god or magical, just me– compassionate, nurturing and open to whatever experiences my clients bring me.