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Relationships
The Many Hats of the Psychotherapist
The Many Hats of the Psychotherapist
Posted May 14, 2008
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.
