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There is a vast gulf between diagnosable issues as seen through the lens of psychological expertise and the essence, identity, strengths, and hopes of a person before me. Psychotherapists mean well, but at times we all stray outside of the bounds of helpfulness. Here are seven ways psychotherapists get in the way of psychotherapy:
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 may 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.
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 emotional state, 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.
My former colleague, 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.
Conclusion
As a new therapist, I remember trying hard to demonstrate my own capacity for psychological insight—even though, I must confess for my wise professors’ sake, I was certainly not trained to be an egotistical show-off. Fortunately, somewhere along the way, I started to better understand and experience the disparity between knowing and being. All these years, I am still learning each day how to lean into the latter. There is something powerful in it, not just in the experience of the therapist but in the experience of the therapy.
The family therapy pioneer Lynn Hoffman, who sadly died in 2017, gave a language of values for sitting with clients—the non-expert position, relational responsibility, generous listening, one perspective is never enough.
If a therapist is not fully present as a warm, accepting, genuine, caring, and appropriately vulnerable person, the power center of therapy remains turned off. Whatever insight may come along the way, meaningful, sustainable change requires transformative experiencing. Analysis without encounter is nihilistic, all the apparatus of thought busily working in a vacuum. Only in the context of authentic relationship and therapeutic alliance can I grasp and catalyze the breadth and depth of formidable resources already existing within my clients.
This article originally appeared at Psychotherapy.net.
LinkedIn Image Credit: Photographee.eu/Shutterstock
References
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
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.]
Greenberg, L.S. (2002). Emotion-focused therapy: Coaching clients to work through their feelings. Washington, DC: American Psychological Association.
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.
