Do Therapists Really Have More "Power" Than Their Clients?

The following discussion applies to adults in therapeutic relationships with qualified therapists. For obvious reasons, it does not usually apply to minors.

Many adults in therapy bestow great power onto their therapists. This often results in the perception of a power differential in the relationship such that the therapist is seen as having more psychological strength, control, and leverage than they do.

The reality is, however, that while a therapist might have more specific training, particular knowledge, and certain skills, the client has most of the actual power.

For instance, the client has the ability to speak freely of his/her therapy and/or therapist while the therapist must uphold strict, privacy and confidentiality. In addition, in essence, the client is the therapist's employer. A client can "fire" a therapist at any time for any reason — no ifs, ands, or buts — whereas a therapist can't ethically abandon a client without making an effort to transition the therapy to another provider. Thus the client is the therapist's employer and technically his or her "boss," is not limited by HIPAA and privacy regulations, and can terminate therapy at any time for any reason.

Interestingly, some people take comfort in the perception that their therapists have some special mental might or psychological power like a benevolent parent has over a child. But the fact is therapists are not endowed with any special powers and abilities that make them better or "more" than other ordinary people with specific educations and (let's hope!) adequate credentials.

This frequent misperception of the imbalance of power in therapy most likely arises from the dogma of Freudian and psychoanalytic psychotherapy wherein "transference" is given a great deal of emphasis. (In brief, "transference" is the displacement and redirection of feelings usually arising in childhood, and most often held for one's parents, onto one's therapist).

Unfortunately, because some people suffer from issues related to excessive dependency and have deep-seated rejection and abandonment anxiety, they are ripe for exploitation if they end up under the care of unethical (if not criminal) clinicians.

In these cases, because the client is willing to relinquish his/her power to the therapist, a true imbalance can occur and clients can be significantly harmed. (Lest I come across as "blaming the victim," let me be clear that there are some cases wherein a vulnerable client who has little or no experience with therapy can suffer grievous boundary violations without "willingly" relinquishing power.) But in the vast majority of therapeutic relationships, which should rest on a solid foundation of mutual trust and respect, a level playing field of shared power exists.

While transferential processes might be considered crucial in traditional psychotherapy, in CBT they are usually seen as interesting quasi-phenomena rather than material to be "analyzed" as if doing so would advance the therapy. Indeed, in CBT, a therapist is best seen as a teacher, coach, confidant, ally, and advisor who exists on the same equal footing as his/her clients. Therapists don't have psychological X-ray vision, they are not mind-readers, and if one claims to know what's in your unconscious... it's probably because he or she put it there!

Moreover, this reality of a balance of power doesn't apply only to therapeutic relationships. It applies equally to one's relationship with a medical doctor, plumber, hairdresser, lawyer, and friend. This is because there are no truly psychologically mightier or superior people. There are only people with various educations, skills, abilities, knowledge bases, social/political positions, and degrees of wealth. But no one (in the world of adult relationships) has any intrinsic superiority or psychological power over anyone else. Sadly, however, as mentioned above, people often relinquish their power to others, including their therapists, which is often a productive focus of therapy, but not in a psychoanalytic sense.

Of course, it could be argued that the massive imbalance of wealth on this planet is a huge power disparity because with money comes a certain power of influence. And while this is true, having less money than your neighbors doesn't make you any less of a person than they are, nor them any better than you. It simply means they have a few more choices available to them that you can't afford. Thus, many people may have more wealth than you do but that doesn't mean they have more worth than you do.

So, bringing it full circle, don't believe for a minute that your therapist has more power in the relationship than you. Realistically, you are just two people with different skill sets working collaboratively to achieve therapeutic goals.

It is important to note, however, that the nature of therapeutic relationships does often involve an imbalance of intimate sharing. This arises from the therapist often learning the client's deepest secrets while the client usually knows only superficial facts about the therapist.

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This can create a great sense of transparency and even vulnerability on the client's part that doesn't necessarily have to do with an imbalance of power, per se, but rather a personal information disparity.

Nevertheless, this can be thought of as similar to a physician having a greater understanding of a patient's medical issues than the patient has about the physician's, or an attorney knowing intimate details about a client's life circumstances that the client doesn't know about the attorney.

Still, the fact remains that despite informational and personal knowledge imbalances, the playing field of interpersonal power remains objectively level.

Remember: Think well, Act well, feel well, be well!

Copyright 2015 Clifford N. Lazarus, Ph.D.

This post is for informational purposes only. It is not intended to be a substitute for help from a qualified health professional. The advertisements in this post do not necessarily reflect my opinions nor are they endorsed by me.

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