7 Ways Therapists Get in the Way of Therapy

A yellow diamond sign in front of a blue sky. The sign reads "Challenges ahead" and has a silhouette leaping over a hurdleWe evaluate. That’s what we do. We ask question after question after question, and when we’re not asking questions, we’re noting answers to questions we haven’t asked. We’re so curious, professionally curious. It’s a trained curiosity, and if we’re not careful, a habitual curiosity, a distractive curiosity, a harmful curiosity.

Psychologist James Hillman (1967) warned: “Curiosity awakens curiosity in the other. He then begins to look at himself as an object, to judge himself good or bad, to find faults and place blame for these faults, to develop more superego and ego at the expense of simple awareness, to see himself as a case with a label from the textbook, to consider himself as a problem rather than to feel himself as a soul.”

There is often a contradiction between my image of a person in therapy through their self-assessment of their issue and my actual experience of the person. There is also a vast gulf between the diagnosable issues as seen through the lens of psychological expertise and the essence, identity, strengths, and hopes of the person before me.

Therefore, I must cultivate space to come to know the whole person. This begs the question of what “knowing the whole person” entails. But let’s be clear: trained curiosity and assessment are not the soul of psychological change. Therapists mean well, but I know at times even I have strayed outside the bounds of helpfulness. Here are seven ways therapists sometimes irritate people in therapy and get in the way of therapy:

1. Interrogating

When people come into session in the midst of an emotional storm, the last thing they need is to be inundated with endless questions on the basis of an agenda that is likely intended more to fulfill organizational protocols than to promote a foundation of therapeutic empathy and rapport.

Questioning always runs the risk of interrogation. The details learned about people’s lives ever tempt helping professionals toward distraction. There is a distinct difference between a personality and a person, a diagnosis and a destiny. It is our responsibility to stir hope and catalyze strengths rather than to stew history and analyze at length.

2. Pathologizing

The concept of “mental disorder” is rigid and misleading. In short, diagnosis is description, and by and large, mental health diagnosis provides description of “software” issues rather than “hardware,” so to speak. It’s a language of understanding what type of struggle a person is experiencing. When therapists refer to people by these diagnostic labels, we overgeneralize a person’s experience and distance ourselves from a critical resource: the powerful, complex, and fluid process of therapeutic understanding, the power center of effective therapy.

It is our responsibility to stir hope and catalyze strengths rather than to stew history and analyze at length.

One of my professors, Bill Collins, taught me “pathology” is a dangerous categorization of a person’s experience. He contrasted “providing treatment to people” with “puzzling through a process with someone.” He told of one friend whose father, growing up, would never let him finish anything without taking over. His friend would, as his father asked, begin to screw in a nail with a screwdriver, and before he could finish, his father would grab it from him and say, “Oh, just give me that.” Those kinds of experiences, he noted, leave long-lasting impressions on a person in regard to self-worth and competencies. Bill said we are to “help others to unpack their conclusions about who they are.”

3. Shaming

We ever risk a false sense of expertise about people’s lives against the backdrop of anxiety about our own. If we’re not careful, we may find ourselves reinforcing the tyranny of the perceived should. Should is shame’s accomplice, and therapists must take care not to aid and abet them.

4. Sympathizing

Researcher Brené Brown (2010) rightfully proclaimed, “Empathy fuels connection, while sympathy drives disconnection.” Saying you understand is unhelpful and probably not true. And let’s be honest—it’s usually a ploy to rush people out of their emotionalism, which sends the message, “I really don’t care enough to walk with you through your suffering.”

5. Lecturing

Psychologist and psychotherapy researcher Les Greenberg (2002) wrote, “Darwin, on jumping back from the strike of a glassed-in snake, having approached it with determination not to start back, noted that his will and reason were powerless against even the imagination of a danger that he had never even experienced. Reason is seldom sufficient to change automatic emergency-based emotional responses.”

With a surge in cognitive therapies, there has been a surge in their wrongful implementation, with many therapists engaging in power struggles to convince people of faulty beliefs in order for new, more positive truths to simply work some magic ripple effect into their lives.

As an emotion-focused therapist, I have been prone to, for instance, encourage couples to engage in safer, softer, and more emotionally responsive interactions, yet when I have stood on my own soapbox, encouraging them to do so out of pace with their own readiness, I have violated my own guidance. Miller (1986) observed that people will “persist in an action when they perceive that they have personally chosen to do so.”

6. Babbling

Silence can provoke anxiety, even for therapists, who think they should surely be redirecting, conjecturing, advising. I find myself observing people in therapy watch me watch them watching me watch them. And I have found a power in it. Like a Rorschach ink blot, presence has power in and of itself to nudge a person’s anxiety so it presents and speaks up for itself.

Another of my mentors, Blanche Douglas (2015), wrote: “There was a method in Freud’s madness when he prescribed the analyst be as undefined as possible, not disclosing details about his life and sitting behind the patient out of sight, saying little. This forced the patient to make meaning out of an ambiguous situation, and the only way he could do this was by recourse to his own experiences.”

7. Methodologizing

If a psychotherapist is lifeless or their technique too technical, their efforts to help may be worthless. Therapy, in this case, is not a relationship but a poor excuse for scientific experimentation. The mechanisms of some psychotherapies undermine their therapeutic value. When we fixate on therapeutic modality, we run great risk of missing prime opportunities to interject the most valuable therapeutic tool we have to offer—ourselves.

Additional reading: The Elements of Good Therapy.

References:

  1. Brown, B. (Speaker). (2010). Brené Brown: The power of vulnerability [Video file]. Retrieved from https://www.ted.com/talks/brene_brown_on_vulnerability?language=en
  2. Douglas, B.D. (2015). Therapeutic space and the creation of meaning. Context. Warrington, England, United Kingdom: Association for Family Therapy and Systemic Practice. [Edited by Edwards, B.G.]
  3. Greenberg, L.S. (2002). Emotion-focused therapy: Coaching clients to work through their feelings. Washington, DC: American Psychological Association.
  4. Hillman, J. (1967). Insearch: Psychology and religion. New York, NY: Charles Scribner’s Sons.
  5. Miller, W.R. (1986). Increasing motivation for change. In W.R. Miller & N.H. Heather (Eds.), Addictive behaviors: Processes of change. New York, NY: Plenum.

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  • 21 comments
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  • Lucille

    Lucille

    August 17th, 2016 at 7:39 AM

    These would not be the norm for most therapists I wouldn’t think?

  • Zoe

    Zoe

    August 17th, 2016 at 10:38 AM

    There is enough interrogation that I get in my life from my parents. I don’t need to have another person in my life who did that, so if that were the case and I felt badgered or pressured, the time would be right for me to move right on along to someone else.

  • Windy

    Windy

    August 17th, 2016 at 1:53 PM

    you know that any therapist with a grain of self respect would be mortified to think that there were patients who believed that their actions were holding them back

  • Matt

    Matt

    August 18th, 2016 at 9:02 AM

    I don’t like to be lectured to but I know that this could easily be misconstrued and if you already know that this is behavior you don’t like, then you may have a tendency to feel like someone is always doing this to you. I say you have to keep an open mind to it for at least a little while.

  • michael g

    michael g

    August 18th, 2016 at 1:55 PM

    nicely written. I especially like the Bill Collins quote on unpacking conclusions. Staying open in the unknown is courageous, for therapist and client!

  • William

    William

    August 19th, 2016 at 7:45 AM

    So many of these things when you first look at them seem like they would be so innocent and yet when you write out the explanation of why it’s bad, then yeah, I can see that.

  • lynette m.

    lynette m.

    August 20th, 2016 at 5:56 AM

    Most therapists take away our feelings, by interrupting, especially when we are crying, they literally Steal our feelings away, for their own, unresolved needs! Sad because most people are unaware of this damage.

  • Kerrie

    Kerrie

    August 22nd, 2016 at 8:39 PM

    Thank you Christy I agree No. 8 should be trying to fix it. Thank you also to lynette m. Lynette Thank you for reminding me about that. It’s good to your hear your honest opinions about your experience of counseling. I will try very hard to not make those mistakes. Thank you to the author for a thought provoking article.

  • Dana

    Dana

    August 21st, 2016 at 10:46 AM

    Brilliant! Should be manditory reading for grad school students!

  • Christy

    Christy

    August 22nd, 2016 at 9:31 AM

    #8…. Fixing.
    I hate it when I tell a therapist my woes and they try and fix it rather than recognize how frustrated, sad, etc, I am. For example, I have had a lifetime of sleep problems. I don’t need to hear “Well have you tried exercise?” or “You know, if you just tough it out and wake up early you will get into a routine.” Or when I was single years ago I was feeling lonely. A therapist started referencing “Sex and the City” characters and suggested I join a speed dating club. I know I’ll be OK and eventually meet someone lady. What I need right now is empathy, not dating advice!
    Great article.

  • Kaye

    Kaye

    August 22nd, 2016 at 11:26 AM

    They sometimes have to affix a label because that is what an insurance company will demand to have in order to pay. That does not mean that this is who a person is, but they have to in some way get used to it if they want to know what it is exactly that they are battling.

  • Lynda

    Lynda

    August 22nd, 2016 at 7:04 PM

    Great article…thanx

  • Gail

    Gail

    August 23rd, 2016 at 7:29 AM

    Great article – well written. You have explained so clearly my message to my clients “You have it within you, I’m here to catch it and help you process.” Without empathy and relationship we have nothing.

  • Jackie

    Jackie

    August 23rd, 2016 at 7:45 AM

    This article helps to keep us therapists in check. So simple and useful. Keep these great articles coming!

  • Mark B

    Mark B

    August 23rd, 2016 at 1:28 PM

    Our instinct as helpers sometimes causes us to reassure and explain when really all that is required is that we come alongside our clients and display empathy for their pain.

  • richard

    richard

    August 23rd, 2016 at 2:20 PM

    The good thing about a therapist though is that if you were to point out that they were doing one of these things, they should immediately be able to see that hey, you are right, and then they would change their approach with you.
    I mean, these are things that they should be helping you not to do in your own life so if you tell then that you feel like they are doing this or that it should be easy if they are a good therapist to recognize that what you are telling them is true.
    If they are committed to your care, then I think that they would then want to reevaluate the things that they are working on with you and hopefully try a different approach.

  • lynette

    lynette

    August 23rd, 2016 at 5:05 PM

    You missed my point? people DO not know their feelings are being stolen?

  • Marsha

    Marsha

    August 28th, 2016 at 7:27 PM

    Great reminders for both the seasoned therapist and the beginner. Curiosity should always be respectful and the focus should be what the client knows not what the therapist knows. Thank you for an excellent article = – )

  • Crow

    Crow

    September 2nd, 2016 at 11:18 PM

    I recently experienced therapist who lacked all curiosity. It was like being in the room with a dead person. When I mentioned this she suggested it was transference. I pointed out that if she behaved as badly as someone in my past then, of course, I’m going to feel similarly toward her. There was no empathy, no being attuned and no feeling “felt”. I chose to disclose something small but significant and she barely even acknowledged it with a mere clarifying question. I felt dirty & violated and very vulnerable. I could in no way trust this woman with anything more traumatic from my past. After 3 months of trying to establish some kind of therapeutic relationship, and failing entirely, I gave up and left. I won’t be back. In the UK NHS system we don’t get any choice about who we are paired up with. You have to try and force things. A person with developmental trauma/PTSD symptoms needs safety, stability, empathy and authenticity as a basic. I stated, during our last session, that I could not trust her and why. Her “solution” was to transfer me to group therapy with herself. Somehow she thought I would be better able to trust a whole group of complete strangers. I explained why I though this was not a good choice and she told me to “go and think about it”. I felt patronised and discarded and angry. Never again.

  • Olivia N

    Olivia N

    December 29th, 2016 at 3:06 PM

    I like your idea on finding a therapist that does not lecture. I would imagine that you would want to find a counselor that will understand the choices you make and not lecture you about them. My sister is looking for a therapist right now so she’ll have to find one that doesn’t lecture.

  • Susan Silver

    Susan Silver

    June 7th, 2017 at 6:23 AM

    One of the best articles I’ve read. Thank you

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