Psychology Today blogs

Psychotherapy Blogs  

The Many Hats of the Psychotherapist

We return to my fictional client Jane, who is discussing the significant relationships in her life.

"Well, there's my parents, but they don't really listen, they just tell me what to do. There's my brother and sister, but they're caught up in their own lives. I've got three or four close friends, but we seem to be drifting farther apart. And then there's you, but this doesn't count."

I believe that understanding our relationship takes top priority, as it is the foundation for all our work. I ask for her to clarify.

"This is your job. I pay you, and we only meet 50 minutes per week. You seem to care and everything, but it's not a real relationship."

I can't count how many times I've heard a client say that. I know what she means, though. We don't chat on the phone, see one another at block parties or exchange birthday cards. Our relationship has a particular structure and boundaries that set it apart from other relationships Jane might call "real." But I believe it is still very much a relationship; an intense, dynamic, powerful one at that. The question is not whether or not the relationship is real, but what kind of relationship it is.

The media doesn't help matters much. Depending on the movie or TV show, viewers may come to understand therapists as cold dictators, magical psychics, brainwashing manipulators, inept goofballs or secret lovers. The topic for a future blog, to be sure. But it's not all Hollywood's fault: I don't think our profession does a very good job of clearly defining the therapist's role either.

Therapy shares qualities with many other professions and relationships, yet none are a complete match. I'll do a little compare and contrast:

Physician: We go to physicians seeking the diagnosis and treatment of physical illness or injury. The physician is the authority, asking the questions and applying the treatments we passively receive. Clients do come to therapy for diagnosis and treatment, but the process requires much more collaboration. It's you and me working together on your problem, not me working on you.

Friend: Friends share experiences with one another and talk about anything from the deep and meaningful to the mundane. They feel mutual respect, provide support for one another and give advice. While communication, respect and support are at the heart of therapy, therapy includes one-way disclosure (discussed here), infrequent advice (discussed here) and does not typically involve shared experiences. You're not going to have your therapist over for this weekend's barbecue.

Teacher: Some people imagine therapy works like an individual tutoring session: "Today the topic is codependency, take good notes." There are times when therapists may teach certain theories or techniques (we call this "psychoeducation"), and some theoretical orientations do include giving homework like reading a book or writing a letter. Just like the comparison with the physician, however, therapy is much more collaborative than the classroom.

Psychic: The allure of the psychic stems from their ability to read minds and predict the future. Therapists study human behavior and may have a deep understanding of their client's lives, but they can't read minds.

Priest/Pastor/Rabbi/Shaman: You may choose to discuss spiritual issues in therapy or confess transgressions. You may even have epiphanies that feel like divine intervention. But therapists do not absolve sin and don't typically dispense moral advice.

Parents: Like a friend, a parent may listen and/or give advice. In some situations, the parents may even take steps to resolve their child's problem for them. Sometimes therapy does help fill in gaps or re-tool messages we heard in childhood, picking up where parenting left off. The aim of therapy is helping empower clients to face life's challenges on their own, not fostering the dependency of an early parent/child relationship.

Personal Trainer: This may be the closest match. People go to personal trainers with a goal - lose weight, get toned, drop a dress size, etc. The trainers work with you to develop a plan of action, stand next to you as you do the work, give encouragement, and revise the plan if obstacles arise. It's collaboration with distinct roles: both trainers and therapists use their knowledge and experience to guide the process, but you do the work and reap the benefits.

So where does that leave us? At times, the therapist's role can look similar to any of the above relationships. It can seem a little confusing. But like every other relationship in your life, each therapy relationship is unique. I encourage you to discuss your relationship with your therapist whenever you have questions about it. Together you can decide what kind of relationship works best to meet your needs.

 

Comments

a hat to add

Ryan: add another hat to the ring: a fellow-pilgrim (per Sheldon Kopp).

Pavel


Good point

Thanks Pavel. Kopp's - If You Meet the Budda on the Road, Kill Him! - is a classic.

The fellow pilgrim also reminds me of one of my literary/therapy heroes, Irvin Yalom, who speaks of "fellow travelers" in his book - The Gift of Therapy.


I have to ask....

If this book seems to reflect your view on how therapy 'should' work, then I have to ask... Whether traditional or modern, I'm asking for your take on this because it creates conflict in my mind about what I'm doing.
Keep in mind, I haven't read this book. Only an excerpt. What does it say? What are you saying? That man/woman is a theatrical mess and no one can teach him/her to get off the stage? That therapists should sit back and watch until the actor figures out the play is over and steps off? Is that fair to say? Is that fair to the actor?
I'm asking because I'm genuinely confused. I feel like I was fortunate enough to be introduced to a way of thinking that in many ways does make me feel like a student. And why not? I wasn't about to think this up on my own. This book almost feels as though it is poking fun at the seeking individual and mocks his ignorance.
I am being 'guided' through enlightenment. I wouldn't say 'taught' because I found this alternative by clumsily stumbling upon it. So upon asking, I was given books, or information to help me realize this study of bettering myself. But I would say my therapist is a great teacher and isn't so much a crutch but a invaluable tool who supplies lessons in which I can reference back.
So is this book you reference, frowning upon this? And if so, I'm just curious as to why. I only ask because I AM trying to make the most of my therapy, of my time, of my LIFE. So I want to make sure I'm doing it 'right'(for lack of better word).
I'd appreciate your thought or clarification on the subject.
Thanks in advance!


your comment

Thanks for your comment, C. I'm not totally clear about your question, but I'll take a shot at it anyway.

I mention two books in my comment above:

Yalom's "Gift of Therapy" (2002) is written to therapists and clients, encouraging both to be honest, open and unafraid to address issues in the here and now.

Sheldon Kopp's "If you meet the Buddha..." (1972) encourages clients to take psychotherapists off the pedistal of "guru" or "ideal bearers of final truths" (p. 11), and instead view them as very human fellow pilgrims. I assume this is the book you're asking about.

I personally am more of a Yalom-ian than a Kopp-ian, but I believe Kopp had an important message at a critical time. The late 60's and early 70's were booming times for psychotherapy, and many people were eager to hand over the reigns to their therapist to tell them who to be and how to act. Kopp challenged this trend by proposing that there was nothing magical about therapists, rather that they are guides who help us discover our own internal purpose and meaning.

Kopp would say the reading, teaching, guidance and lessons you are gaining is exactly what therapy is all about. He simply warns clients against becoming overly dependent on the therapist as the source for enlightenment. The tools learned in therapy help you 'better yourself', rather than waiting for a therapist to 'make you better.'

Thanks again for your thoughtful comment. I hope this helped.


thanks!

Ryan, that did help actually. I was genuinely confused about the message of the book and I can see where it can be easy to want to pass the buck to the guy who seems to have it altogther.

I was just curious about the message of the book and wondered if it would be beneficial to me at some point. I've done a lot of reading both online and off with a new drive.

I was only thrown off when I thought the message of that book (which made sense to me) clashed with the readings I'm doing now. But in your clarification, I feel better about it.

Thanks for taking the time to explain it to me!
C


Add comment

The content of this field is kept private and will not be shown publicly.

Blogger  

Find a Therapist
Choose the best match from
thousands of profiles.