We are vulnerable beings – particularly so when stepping over the threshold of a consulting room, to confide that – despite our shiny shoes and recent promotions, things are not so okay.
As a therapist myself, I’ve been on both sides of the couch. I’ve struggled with bad therapy and therapists, and grown with the excellent ones. “Bad” may seem a strong qualifier; certainly most therapists don’t think of themselves this way, nor intend to harm. But because of the nature of the work – psychic surgery – “bad” leaves scars – the leaky, tortured sort that still ache twenty years later. However, there are messy, difficult sessions in excellent psychotherapy.
How can you know the difference? When is feeling terrible justifiable – a natural though painful part of getting better – and when is it a mangled operation?
Here are some frequent examples of “unhelpful help”:
As a young clinician, I was intimidated; I had to speak in public, introduce myself to strangers, and try to seem expert – at age25. My then-therapist’s response: “oh, you’re scared to act, just like your mother.” So what’s wrong with this answer?
This stifling oversimplification (that came from the therapist’s mind, not mine), blocked any potential thought on my part. This is the caricature of therapy – whatever ails comes from your parents, (which we all know anyway). No surprise that this left me feeling guilty, helpless, and angry for “being like my mother”, as well as clueless… what could I really do with this information? Like most patients inexperienced in the ways of therapy, I blamed myself, and tried harder to “not be scared to act.”
A therapist I had in college told me to clean my dorm room, sit down, and study. While this can seem logical (why not?) this is not psychotherapy. He would get annoyed at my behavior, my sometimes poor grades; I felt, again, guilty, demoralized and shamed. With him, any deeper discussion about my disorganization and its meaning was impossible.
Silence can be a double-edged sword. Used well, it’s a relief; therapy isn’t a conversation between girlfriends, after all. Silence at the wrong times, or too much of it, can feel like abandonment.
I felt very competitive with my therapist in my twenties. She was in her early thirties. Sometimes I’d say, “You are prettier, better educated – I’ll never have what you have”… her answer… silence. This was excruciating, and seemed to confirm what I said; I really wasn’t going anywhere, she didn’t disagree.
Silence soothes when accompanied by a compassionate presence. Sometimes silence is the perfect response to strong feelings. “Bad” silence doesn’t share this quality: it’s the uncomfortable, awkward silence of acquaintances accidentally revealing something too intimate, too intense. Both parties back off, and change the subject – which is what I did after the above episode.
This is fragile territory; a delicate network of nerves requires a skillful, graceful, and unhurried surgeon. If you sense that certain issues are too “hot” for discussion, and think it’s your fault that she “can’t handle you”, you may blame yourself for the clinician’s limitations. You will hide things – not only to avoid feeling judged, but also to not lose the relationship. You have after all invested your therapist with time, money, even affection.
It’s essential to discuss this. The relationship with your therapist behaves like a snapshot of other bonds in your life. If you cannot talk about certain things for whatever reason, it may be time to go.
Finally, if a professional shares a lot of personal examples, using her life as a model, this isn’t psychotherapy. She isn’t a guru; this isn’t about her. Therapy is about becoming more yourself, not your therapist.
Good therapy can (and will) sometimes feel bad…
Sometimes sessions are boring, angry, annoying, or very sad; but the therapist won’t respond directly to the content of your words. Instead, she hears their underlying meaning.
Saying, for example, “you are successful, but not me” shouldn’t bring silence, but an invitation to explore implicit performance fears, competitiveness, and shame.
Roadblocks and obstacles ought to be treated with curiosity and respect – they are there for a reason. Otherwise, they wouldn’t be…! A recurrent behavior or way of thinking always exists for a reason – however “illogical” or self-defeating. The unconscious mind loves repetition (Freud called this the “Repetition Compulsion”).
Good therapy doesn’t always feel good. Anger and misunderstandings happen in all relationships. Can you voice discontent, without fear of retaliation? Can you even say dumb, ridiculous, childish things – because they seem true – at least at that moment in your session?
A kind, discerning therapist can survive all you need to say. Safety, candor, and keen listening are the bedrock of a skillful process, and ultimately, healing.