"Looking for a Therapist Who Looks for You"
What I am noticing more and more these days is that people who are in the business of treating mental health and addiction issues struggle to know how to do it. They don’t notice it in this way, rather their experience is that they are frustrated or disappointed in their clients. In situations where the client is unable to adjust or function in a way the therapist or professional deems acceptable, the therapist describes the client as “borderline” or “a problem.” The therapist describes this resistance as the client’s inability or unwillingness to improve or engage in therapy.
When you become frustrated or disappointed with a client (or other people for that matter), you have lost some contact with the Other. If you could really see them and connect to them, then you would not be frustrated because you would understand them. Attachment theory tells us that a person’s sense of wellbeing is the result of having a parent who provided an adequate container. An adequate container is the mind of the parent where the child experiences himself as welcomed and safe. If the parent was able to hold the child in her mind, that is, tolerate the child, then the child’s experience is that they are okay. When the parent’s limitations are expressed in disappointment, disgust, or anger, the child is likely to interpret this message as “I am not okay” and in order to manage this feeling of dread that comes when my parent is upset, I will learn to put away those things that seem to be upsetting.
We are human, however, so there is a way to communicate our inability to hold the child in our mind with compassion and patience without creating the need in the the child to develop a false self in order to survive. We can discuss our limitations. When we communicate our lack of capacity as such, we send an entirely different message. In this case the message is “you are bumping up against my limitations” rather than “you are a problem and need to learn how to behave.” This first message also requires a child to have to adjust and recognize the needs of others, while the latter message is internalized as “something is wrong with me.”
Therapy can be a reparative experience if the therapist is able to create this kind of holding container for the client. I wonder sometimes what therapists and professionals think therapy is when they share with me how the client is not able to meet their agenda. They develop a rich vocabulary for describing all the limitations of their clients without ever realizing that what they are asking their clients to do is to become someone more acceptable to them, the therapist—to demonstrate what the therapist needs them to do or be in order to qualify as acceptable.
When people ask me what to look for in a therapist, I simply say “look for a therapist who looks for you.” This is a person who is able to resonate with you even when that resonance asks them to consider their own limitations. Look for someone who has done enough of their own work that they are able to see and tolerate you. Look for someone who would welcome and even celebrate a discussion about how you are not getting the type of support and help from them or how angry and disappointed you are in them. If after such a disclosure they dismiss you by telling you “Well, I think this might be one of your issues…I think this is your depression or your addictive thinking talking.” Then you know you are working with a therapist who is trying to work through their own narcissistic wounds—with a therapist who requires their client’s admiration in order to feel okay.
Not too long ago I went to hear a lecture at a university. As the professor was sharing her ideas about attachment and regarding the client (child) with a positive regard, one student inserted, “Yes, but I am a cognitive behaviorist and the child can’t just go around upsetting things. She has to learn how to behave in society.” Very similarly, a therapist I was consulting with was sharing her ideas of a particular model and how the client was not responding. I began to share my ideas about attachment and resonance and she responded, “Well maybe that’s your way. Maybe that is just how you see it and I am more inclined towards Dialectical Behavioral Therapy.” In both of the above situations, my response was the same. It doesn’t matter what your theory is…if you are attached to your theory you may miss the client altogether. The idea of attachment is like an overlay. It is a sensibility through which we see the world and those in it. You can use ideas and tools and concepts from your theories, but if you don’t learn to see the client you will be employing your model at the expense of the client’s experience of well-being. The client needs to know you care and understand them and that your models are not more important than them. They need to experience that therapy is in the service of their needs, not yours.
Therapy is not for the therapist to be happy. Therapy is not for the therapist to proliferate his story and his version of the way things should be. Therapy ought not to serve the therapists need to be good—that is the need to be a good therapist. This need to be good will ask the client to make progress in such a way in order to provide evidence that the therapist is good at what she does. I don’t need my clients to “get better.” I don’t need them to accept some idea or notion of mine on the subject of mental health. The payment I receive from them is all that I require of them and the rest of the endeavor is about what they need. Of course no therapist can be unconditionally loving and never-endingly patient. So when a therapist does experience these limitations, they can make an apology or discuss these limitations with the client. They can do some self-care in order to return and be able to provide a better container for the client at a later time.
So the real problem is that professionals in the business of treating mental health and addiction often don’t know what they are doing. They don’t know their impatience and veiled judgments are about their limitations—not the clients. They are repeating the original wounds of childhood by acting in such a way to let the client know that something is wrong with them. What did the therapist think they were getting in to? Did they imagine that they would be treating people without wounds and symptoms? Did they embark on this career so that they could be a savior and a good person by imparting their gracious presence to others? For most, I think the honest answers to the questions above are “yes, that is exactly what they thought.” And then, hopefully, we go to our own therapy or found a mentor who could help us see what therapy really is. It is an experience, for the client, that provides an entirely different response from the Other. The new experience is that “I am okay” and that when people struggle with me, they are bumping up against their limitations, not mine.
Therapy is not a place where we go to be “called on our stuff” or to be confronted. There is no talent in that; there is no healing in that. When the therapist “nails the client” they are not providing them with the respect that their wounds and their defenses deserve. Therapy is not a place where we go to listen to difficult things, but rather a place we go to in order to share difficult things. During one session when I was struggling to talk about some things that I thought were shameful, my therapist illustrated this point by saying, “If you came in here and announced you were in love with a chicken, I would assume you would have a good reason and I would want to understand.” What a powerfully different experience than the one I had in my family growing up. My hunch is that most of our parents may not have had the capacity to respond with such curiosity.
The irony of all this business is that if you are not learning as much from your client as they are learning from you then you are doing it wrong. That is because real therapy asks the therapist to transform and surrender. This surrender must occur over and over again. It asks the therapist to feel and to work. It reminds the therapist of their wounds and of the real self. It is an honor and a gift to be able to listen to people share their wounds, their fears, their vulnerability with me. It is an honor to sit with people as they consider sharing their real-selves with me at the risk of receiving the same kind of rejection they received as a child.