Does Your Therapist See You as a Person or as a Patient?

two men shaking handsGoogle defines the term “patient” as one who receives or is registered to receive medical treatment, and it lists the most common synonym for patient as “sick person,” with “invalid” not far behind. Also, Wikipedia, in its definition of patient, specifies that a “patient is most often ill or injured and in need of treatment …” In terms of etymology, the word patient originally meant “to suffer.”

It’s no coincidence that the other meaning of patient, the adjective, is defined by Merriam-Webster as “able to remain calm and not become annoyed when waiting for a long time or when dealing with problems or difficult people.” Historically, this is exactly what many medical patients were expected to do—to wait passively at the mercy of the all-powerful doctor and his or her orders, without questioning the doctor’s medical opinion.

Indeed, in the traditional medical model, healing and change does not come from within, as it does in psychotherapy, and the medical patient is dependent on the doctor’s intervention, which for the most part does not require insight or direction from the patient. In the medical model, the physician has the answers and responsibility.

Given the above definitions, the hierarchical relationship (or one-down dynamic) between physicians and their patients, and the influence of the medical model on the field of mental health, it’s no wonder there has been an “attitudinal carry-over” into the realm of psychotherapy. Unfortunately, there are mental health professionals who intentionally or inadvertently promote the one-down power differential between themselves and the people they work with, in subtle and not-so-subtle ways.

One unfortunate symptom of the one-down power differential are mental health providers who refer to the people they work with as patients. These practitioners either view the people they work with as somehow sick, invalid, and/or helpless, or they are oblivious to the meaning of the word patient. Whatever the case, inadvertent or not, these providers contribute to a number of damaging myths which further the stigmatization of psychotherapy.

I have reviewed these myths in the articles listed below and explained why their continued propagation is reason alone to stop the practice of viewing people in therapy as patients. However, it’s also important for therapists to stop viewing people in therapy as patients because it creates a barrier within the client-therapist relationship and renders the therapy far less effective than it would be with therapists who view the people they work with as people, not patients. The bottom line is that people in psychotherapy should not be viewed as or referred to as patients, and I will demonstrate why this attitude is so important for effective psychotherapy.

To argue this case, I have addressed the significant myths fueled by mental health providers who view the people they work with as patients. These myths lead to the devaluation of those who seek help and promote the idealization of helpers.

  1. The Devaluation of the Person in Therapy
  2. The Idealization of the Therapist
  3. Myth: The Therapist Has the Most Important Information
  4. Myth: The Therapist Is More Powerful than the Person In Therapy
  5. Myth: The Therapist Has It All Together
  6. Challenging the Myths that Stigmatize Psychotherapy

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  • Adrienne D.

    Adrienne D.

    July 24th, 2014 at 11:33 AM

    My therapist and I have known each other for a very long time and while we don’t have any kind of contact or relationship outside the confines of his office I know that he thinks of me as more than just a case. It must be tempting for therapists to look at the people with whom they work as nothing more than notes and stats, but I have a good one and he makes me feel like he truly does understand the issues that I am undergoing and he helps me work all of that out in a way that is comfortable to me. I don’t think that he would be able to do that or that I would feel that way if he only saw me as a patient file. I think that the good ones are always going to develop that kind of working relationship with their patients.

  • Alana

    Alana

    July 24th, 2014 at 4:27 PM

    I like my therapist and we really get each other but I don’t think that she sees me as anything more than another patient.

    I think that to be a good one they have to be able to separate their patients… and see them for what is wrong with them and not as a person that they would like to hang out with and stuff like that. That is when there gets to be real trouble, when those lines get kind of blurred it loses a bit of that professionalism that the relationship needs to maintain to be successful.

  • peyton

    peyton

    July 25th, 2014 at 4:11 AM

    I definitely think that until the therapist has the chance to get to know you as a person then they are going to be inclined to view you as a patient, to look at you and determine how the two of you will be able to best work together to work on your problems. I think that as stime goes by and you work with him or her more closely then they will come to see you as more than just a patient but I think that they are going to be just like the rest of us and will take the time to get to know you first.

  • Brandi Gruninger

    Brandi Gruninger

    July 25th, 2014 at 9:23 AM

    I could not agree more. At my clinic we refer to our clients: thus, reinforcing their empowerment and commitment to a voluntary process. We do not treat them – we guide them on their own journeys.

  • Carter T

    Carter T

    July 25th, 2014 at 2:35 PM

    This is all about building a foundation of trust and respect for one another… it will not happen overnight but there are some wonderful therapists who will manage to handle both aspects of that fragile patient/counselor relationship with much accomplishment.
    And the bottom line is that for me I don’t really care how they see me as long asd they see me as more than notes on a chart and as someone who has the capability to grow and learn from the experience.

  • Noah Rubinstein, LMFT, CEO GoodTherapy.org

    Noah Rubinstein, LMFT, CEO GoodTherapy.org

    July 26th, 2014 at 9:05 AM

    Please see that the people who come to therapy are not our clients. They are so much more than clients and should not be defined or referred to even as clients, IMHO. Even though they come to us seeking help, expertise, and even pay us for their time — they are not our clients. All 7 articles in the series explain why this is so, but to sum it up I will say that a person in therapy is their own therapist and their own client. A therapists job is to simply help facilitate the process of person becoming their own therapist, the process of remembering how to fully love and embrace oneself. It is not our power, wisdom, or expertise that enables this process — it is the one in therapy whose power and wisdom is accessed.

  • Manda

    Manda

    May 7th, 2020 at 10:13 PM

    Noah: if you don’t like “client” why did you refer to the “client-therapist relationship”?

    I mean, I know why you did. You have to call us *something*. For the sake of communication and clarity there needs to be a word you can use for those people who come to you for therapy, otherwise sentences get long and clunky. But if not patient or client, then what? Any word you choose will eventually gather meanings you don’t like, because that’s what happens to words for a stigmatised group.

  • Vern

    Vern

    July 26th, 2014 at 12:55 PM

    But always with your guidance so I think that it is unfair to assume that your expertise plays no role in encouraging their progress- I actually think that it is a huge part of the experience.

  • Hank f.

    Hank f.

    July 27th, 2014 at 5:05 AM

    I just want to feel better and work with someone whom I know cares about me and my experience.

  • Chris

    Chris

    July 28th, 2014 at 4:20 AM

    So how should the people who are seeing a therapist be referred to?
    My next appointment?
    I just don’t see anything derogatory about the term patient.

  • Alice

    Alice

    July 12th, 2019 at 10:09 AM

    Always been happy that my therapist uses the term patient instead of client, it’s not the fish market. Patient makes me feel more loved as a human being, “client” instantly makes me think about her fee and all those aspects.

  • Manda

    Manda

    May 7th, 2020 at 10:05 PM

    It depends on the context. I have a serious mental illness. I get treatment for my illness from healthcare providers, some of which is talking therapy of various kinds. I am the therapist’s patient. There’s nothing wrong with being a patient. As your patient, I am someone to whom you have responsibilities and obligations that are specific to the relationship between a person with an illness, the patient, and the person who is supposed to help them. There are vulnerabilities inherent to that relationship that aren’t present in other fields (say, interior design) where there’s a provider and a client. The word you use for me needs to remind you of the responsibilities you have towards me as a care provider. I think “patient” does that. The power differential exists whatever words you use, so I’d prefer you to use one that acknowledges that power differential, because it’s only by acknowledging it that the power differential can be used for good, and its dangers mitigated. Drives me nuts when providers try to convince me that in that room we’re equals in every way. We’re not, and I need you to remember the power you have, and be gentle and very, very careful with it.

    On the other hand, I’ve also had therapy for things unrelated to my mental illness. There, client may be more appropriate — I’m not ill, I’m buying a service.

    Additionally, I feel it depends on the role of the professional and the type of therapy. If I’m seeing a clinical psychologist or a psychiatrist, both of whom would easily come under “healthcare”, and they’re employed by a health service, then “patient” fits. If I’m seeing a relationship therapist privately for help with my marriage, it doesn’t, so much.

    The other issue is that I live in a country with socialised healthcare. When I get treatment for my mental illness through that service, I get whatever therapy I’m lucky enough to be given, in whatever modality somebody else has decided on, with a therapist I didn’t choose, within the context of a health service set up to prevent and treat illness, and I only get therapy because it’s been decided that I have an illness. Calling me a client in that situation — where I only get therapy because somebody else has decided I’m ill and need treatment, I didn’t get to choose, and I’m not the one paying — comes across a bit weird.

    But at least it’s not “service user”. Ugh.

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