Trust in Me: In Defense of the Therapeutic Relationship

Two women sitting and talking togetherTherapy is about trust: Trust in the process, in the relationship, in the person, in the cure. It is easily lost, and hard to win back.

I had coffee the other day with a friend who is actively searching for a therapist. She’s a believer in the process and has seen 12 so far, each for two sessions. And yet, she still hasn’t found someone that she can work with. She’s still looking, though, because she is a believer.

But my mum isn’t. She’s lost faith in the process. She’s an atheist, in the context of therapy. I’ve struggled to understand this. I’ve had good experiences and great therapists, but in a way, it’s like love affairs: If you have been loved well, then you are more likely to love well in return. If your heart has been broken, then you actively withdraw from the possibilities that love presents. And my mum has been hurt.

Seven years ago, when my mum first started struggling with depression and anxiety, and when I lived close enough to get home, I accompanied her on some of her first forays into therapy. I drove her around to therapists’ offices for appointments that dad had booked through the Internet. And it is two of these early experiments with therapy that come to mind when I’m trying to figure out why I can’t get her to go and see someone again.

Mum’s First Foray
The first was with a Cognitive Behavioral Therapist in Stoke, an industrial town in the North of England. I remember that we sat on a frosted bench, outside a detached house that had been converted into offices, waiting for our appointment. It was winter; there was no reception, no waiting room. My mum was distraught. I held her hand in mine, for warmth and comfort. When called for the therapy hour, we walked in together (mum had asked me to go in with her).

It was an odd situation. Mum had never been in this kind of relationship, a therapeutic one; for 50-or-so years she had never understood or thought much of therapy. But here she was, finding herself with a strange woman who was asking her to rate on a scale of one to 10 how bad she felt.

“One hundred.”

“No, within the scale, is that ten?”

“Twenty.”

She demonstrated resolute difficulty and unwillingness to do the exercises, to get them right — to perform the role of the good patient. But also, my mum’s mind doesn’t work this way; she was unable to grasp the connection between these exercises and her condition, our situation.

Sitting in the therapy room with her, I listened to her frustration that the therapist couldn’t grasp what she was going through. The therapist couldn’t understand that my mum believed this was the worst that it would ever get (though we now know that’s not true and, at that stage, she was probably around six out of 10 on her own distress scale).

The miracle cure, of course, doesn’t come that hour. My mum comes out, saying, “That was a waste of time. How did that help? I’m not bloody going back there.” I tell her it takes time. She doesn’t understand and wants it fixed. “Forty pounds down the drain,” she says.

The Second Saga
This time it’s at a swish private clinic, in the more chic town of Altrincham with a therapist my parents have seen once before. My dad had to go to work; life doesn’t stop for everyone when one person’s does.

I drive this 40-minute journey, trapped on the motorway with my mum, who is raving. I start to disconnect from this version of my mum. I even get angry with her. I say those words you shouldn’t say: “Pull yourself together. You can try harder. You are not listening to me.” The script that we’ve lived with has begun. Mum says, “I’ve been a good girl. How can I live with this thing in my head? It’s like an engine.”

We arrive at a building that feels like a residential home. There’s a waiting room at the bottom of a staircase, between a dining room and the reception. It feels like we are in transition. There’s one other pair: a young man and his mother. We try not to make eye contact. He seems to be the one that’s sick, and not her, but who can tell? It’s quiet. No one speaks. It seems inappropriate to read the magazines on offer. This isn’t a dentist or doctor’s waiting room.

We’re called in and up a flight of stairs, through an anonymous corridor with many doors and no life. The therapist today costs 140 pounds per hour. Mum has mentioned that this therapist is a senior professional in the psychiatric ward at a local hospital. She’s already conscious that this woman is posh and educated. The therapist intimidates my mum, whose tirades stop when she enters the therapist’s room. Her polite upbringing kicks in and she realizes it is inappropriate to act with this woman the way she acts with us.

There’s something else going on, though: this therapist wasn’t actually that interested. She listens to what mum says, but it’s not empathic; she’s humouring her. Then, for my benefit this therapist runs through her resume.

“I’m not interested,” I tell her. “We’re here for my mum.” I start to get frustrated, as I listen to more of the words that I know won’t reach my mum. Why can’t she see who her patient is?

Then my mum mentions something about panic and anxiety. The therapist latches on to this: “I have something for that,” she says, and mentions something about a relaxing CD. She then spends five of our very precious 50 minutes trying to find it.

Eventually, I volunteer to go to the reception and collect a copy. I leave mum, walk downstairs, and collect the CD. I am told it will cost 20 pounds. I pay the money, go back upstairs, and hand the CD to the therapist. She says she’s never used this one before, but she’s sure it’s good.

You’re kidding, right? This is your advice – take a CD home and follow it on your own, and you’ll get better? I thought. How can she not see this woman who can barely dress herself? How can my mum possibly listen to a CD that the therapist has not even heard, and how can the therapist possibly recommend it?

We listen to it in the car on the way home. Before long I’ve turned it off, furious, but mum and I are also fighting again. Once more that day, we sit in traffic while mum replays how the tinnitus started.

Fear, Coping, and a Case for Trust
I’ve since learned that there were other therapists, like you hear rumors of love affairs. There were many of them. We did find one wonderful therapist, who saw mum for a while in San Francisco when she visited. But long distance relationships don’t last — even therapeutic ones.

She’s been burned, badly. And so have we, her family members. I understand her ambivalence about allowing therapists near her. I share that too. She feels so fragile. Will they make her unravel?

While we’ve reached some kind of equilibrium now and we’re coping and can manage, sometimes we wonder, why pick at the wound? Why break the leg again? Even if it heals badly, at least you can still stand, even if you can’t walk. And when mum is in crisis, when she can’t function, we wonder, what’s the point? Can therapy even get through to her?

But I firmly believe, too, that she needs therapy, and that if any relationship could bring her fractured mind and self back together, it is the therapeutic one… If only she can learn how to trust again, and if only we can, too.

A Brit based in northern California, Claire Hodgson is a writer and curator, and the founder of Joe’s Daughter (joesdaughter.org).

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 11 comments
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  • carl

    carl

    May 31st, 2013 at 9:40 PM

    sorry about the bad experiences that your mom had with therapy.wasnt sure of therapy effectiveness myself but when I did go in due to an abnormal level of anxiety it certainly did help.saw a therapist for about three months and things are much better now.

    true that not everybody will have the same outcome but therapy can and will help.happy to see that you still believe in the power if therapy and I hope your mom finds a therapist that is able to help her.all the very best to her.

  • rena

    rena

    June 1st, 2013 at 4:38 AM

    I don’t know if this is the case, but I know that there are some people who are constantly making excuses why they can’t relate to this person or another. One talks too much, one not enough, too cold in the office, too hot, on and on and on. There will always be something and after a while it starts to feel like one long excuse after another. It’s not that they don’t think that they want to heal because I think that most people deep inside really do want that freedom that healing will bring them. But I think that there is naother part in some of them who are afraid of the process, afraid of what will come up and come out if they really begin to work with and trust one without question. I think that for a lot of people this is the thing that has to be addressed first befoe they have any hope for moving forward.

  • Mark

    Mark

    June 1st, 2013 at 10:40 PM

    Trust in therapy has to be the first step in gaining anything out of it.Because unless you believe and trust in its effectiveness you are not going to be able to gain.No matter how good a therapist you meet or how great his techniques are unless you truly believe it will help you it will not.

  • Reid B

    Reid B

    June 2nd, 2013 at 5:35 AM

    It was such a relief to me when I finally found my right therapist. I had been to so many for a couple of sessions and never really felt like I could find someone that would understand everything that I was feeling until I found my current therapist.

    She has really been my lifesaver. gotten me finally safe to shore, and I could NEVER thank her enough for everything that she has done for me. I really don’t know where I would be at this point in my life without her.

  • Mary S

    Mary S

    June 2nd, 2013 at 3:40 PM

    What seems to be missing in the comments (not the original post) here is that the therapist needs to *earn* the client’s trust, and needs to be *worthy* of the client’s trust. I made the mistake of trusting therapists when the trust wasn’t warranted. I would tell myself that I wasn’t giving them a chance, that I needed to try harder, to be more tolerant, more trusting, etc. (which they, by the way, encouraged). But, looking back, my doubts were indeed well-founded. So much about therapy didn’t make sense to me – and trying to trust despite my doubts harmed more than helped. The therapists’ world view seemed so different from mine, and therapy seemed so divorced from my everyday experience. I just couldn’t convince myself that the emperor was really wearing clothes. I wish I had trusted my judgment more – but part of what I went to therapy for was to learn to trust my own judgment more, to be less easily swayed by others. Catch 22.

    So my take is: Therapists need to recognize that people are tremendously diverse; that just because the therapist may feel that they have empathy for a client doesn’t mean that the empathy is accurate; the therapist may be seeing a creature of their imagination, rather than the real client. Practitioners need to realize that one size does not fit all, and that client-therapist rapport is important. It is not the client’s responsibility to trust; it is the therapist’s responsibility to earn and be worthy of trust.

  • brittany

    brittany

    June 2nd, 2013 at 10:49 PM

    opening up to anybody can be scary at first. especially for some of us it can be a nightmare come true. and after having had bad experiences like your mother did, I dont think I would ever be able to trust therapy anytime again and would run away from any mention of it.

    being in therapy is a vulnerable position in itself. being treated this way would put a certain full stop to anything like that ever again.

  • NONYMOUS

    NONYMOUS

    June 3rd, 2013 at 6:17 PM

    i am not a peson who beleive or would let a therapist near me at all. I trusted god after the damage done to bme by drs i was taken to when i was not even sick or depressed or complain. i was a fragile person and had to be close to god. No one but god , had the interest oa abilty to heal that . i was a extreme munchausen by proxy by drs.. and i got to live a new life. i recal how sick i got being taken to these people ho did not care what i said and most of them were sick. I did not find one person who was basic enought to realize what was going on before they almost make me killmyself. i did not give in , and went with god and he took me to high happy places..

  • Raine

    Raine

    June 4th, 2013 at 3:54 AM

    If you are not willing to allow some of those defenses to fall away then there is no reason to see a therapist at all. Why go if you aren’t going to allow them in to get to know you and understand you?

  • Discussant

    Discussant

    June 10th, 2013 at 1:36 PM

    Trust has to be earned. Many therapists become therapists because they were unsuccessful in maintaining trusting relationships in their personal lives, and a professional role in which “trust” is commanded rather than earned may seem like a good substitute for them. These are the last people we should put faith in. It’s important for consumers to judge carefully, and choose safer alternatives if possible.

  • resharpen

    resharpen

    June 12th, 2013 at 12:58 PM

    Discussant – I hear you, loud and clear! For an excellent blog on poor therapists:
    disequilibrium1.wordpress.com/
    Many of us have had terrible experiences with therapists, including myself. SOMETHING MUST BE DONE TO CHANGE THAT PROFESSION. My experiences have DO go into this field because of needs they have, many of which are unconscious.
    for instance, WHY would a therapist scream at her/his client??? Belittle them? Act superior to them? Literally bark orders at them, in telling them HOW to solve a problem? I have had therapists who have done what I have just described and more; as in the following: one spoke about her hatred of men, because her husband had cheated on her; A man told me, in a very ugly voice, that his wife was a JAP (Jewish American Princess), even tho I was Jewish, and his comment had NOTHING to do with what we were discussing; my first therapist exhibited all the symptoms of borderline personality disorder, and actually ‘accused’ me of ‘hogging’ all the therapy time for telling her MY problems (she told me that she needed time to tell me HER problems – btw – I was paying HER); another told me, very belligerantly that of course men didn’t like me because of the way I ‘acted’ – never explaining what that was, and never trying to help me ‘change’, etc.; several said NOTHING during entire sessions – when I asked one why she wouldn’t say anything she told me that I and my boyfriend (we had sought couples counseling) had ‘too many things’ going on – I told her that in my next life I would become a therapist & do exactly what she was doing – get paid big bucks for doing NOTHING; when I told a new therapist what I was coming to see her for, she responded ‘And THAT bothers you?!’ like I was nuts or something-she never helped me, and should have told me that from the start that she couldn’t. I am really sick & tired of this profession – I think many therapists are in it because: 1) they have a ‘belief’ that they MUST announce to everyone, like ‘men are all jerks”,; 2)Many are angry people who can take their anger out on their clients easily – clients are vulnerable, and desperately want help, and won’t fight back. 3) Many have mental problems themselves, and in a very bizarre way, think they can ‘work them out’ by doing therapy – a variant of this is they feel badly, but when doing therapy on others, are no longer focused on their problems, and so feel much better; 4) Many just want power, and go ‘nuts’ if challenged; 5) Many can’t get intimate with others, they are too scared, etc., BUT as we all have intimacy needs, they fulfill these needs by getting ‘intimate’ with their clients – after all, when we listen to someone’s deep feelings, we do feel closer to them. THis way the therapist gets intimacy without having to be vulnerable.
    Well, that’s about it. I think therapist’s sessions should be randomly ‘listened in on’ by supervisors. Otherwise, there is no way that anyone else really knows what’s going on – and can call them on it.

  • Sue

    Sue

    June 22nd, 2013 at 1:41 PM

    I find it one of therapy’s harmful mythologies that the client is asked to surrender her judgment and put herself ingenuously in the therapist’s masterful hands.

    There’s not a person alive scrubbed of all weaknesses, fears and blind spots. Given the power imbalance and abuse potential embedded in the therapy “performance” the possibility for harm might be more present than in an outside relationship.

    Isn’t it more realistic–and “healthy”–for therapists to stop asking clients to idealize and engage without the child-like awe?

    Does unconditional “trust” really prepare an adult for life? Or or is it more to serve the therapist’s ego and income?

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