Sometimes your patient cannot get enough of you. He might love you or want friendship. He could wish for continuing advice beyond therapy’s end; or desire you as a stand-in parent available for the long haul. Often he doesn’t understand his motivation. The “draw” of the doctor is felt, but not easily articulated. Perhaps the longing for closeness and security are enough to explain it.*
The preoccupation might take the form of attempting to get a glimpse of him: a pattern of observation from a distance, undetected — as he enters his office, for example. Checking him out on the internet is another possibility. Perhaps not even that. The simple act of spending more time thinking about your ex-therapist post-counseling than you logged in face-to-face is what I’m talking about.
Is the counselor injured by cyberspace scrutiny or residence in the patient’s head? No. How am I harmed if someone reads a journal article I wrote, watches a speech I gave, views a blog post, or wonders about me? I don’t go sleepless with any fear of privacy invasion. I tremble not because of a potential encounter we might have at Starbucks.
Freud expected his couch-candidates to develop strong feelings about him. He thought these emotions were unconsciously transferred to him from people like mom or dad and therefore called the phenomenon “transference.” By working through the intense attachment to him, Dr. Freud believed the patient would overcome his unresolved early-life injuries. Once accomplished, the therapist again became the shrink, not a stand-in for anyone else. Freud understood it was not he who lived in the mind of his analysand, but an idealized (or diminished) version of himself.
All therapists realize that patients often benefit from closeness. Each of us needs to believe we matter. When such knowledge has been absent, treatment can foster an improved sense of value. The doc’s caring, intelligence, close attention, and understanding help repair earlier relationship injuries. Not surprisingly, a lengthy course of psychotherapy commonly produces at least a bit of attachment to the shrink.
On the other hand, there is a problem if the patient experiences continuing, daily, affect-laden preoccupation with the doc and his life. I’m ruling out the occasional cyber search most of us do. Old friends, lovers, and movie stars are fair game. An impromptu internet investigation is an innocent way to pass a few minutes.
Past counselors can so fill the space in the client’s head as to squeeze out his effort to find satisfying human contact in the non-virtual world. The internet realm is safer and the therapist is “known,” perhaps part of the reason he is chosen over the unreliable community of touchable humanity.
The preoccupation can be excruciating. Yet the sufferer’s relationship history is worse. Thus, the limitations of an out-of-reach therapist are benign in comparison.
It is useful to imagine a shrink as akin to a transitional object for some of his clients. Think of how an inanimate security blanket helps a child soothe himself when his caretaker is absent. Indeed, a counselor might even give a worried adult patient a stuffed animal to help him manage the doctor’s anticipated vacation.
To continue the analogy, the therapist tries to comfort the client and enable his development of emotional self-care skills. The patient will ideally attempt relationships after therapy, but generate these on his own with less sense of either fear or desperate neediness. The goal of psychotherapy is self-sufficiency and “wholeness” for patients, even in those life moments where satisfying intimacy might be absent.
The problem with an unending preoccupation with the memory of the therapist is, to an extent, not different from the continuing “presence” of a deceased or estranged parent, friend, or lover. Even to the degree that these people played an important role in his life, one must “get over” them and their absence. A mourning process is required, not perpetual attention to a shadow version of them in public space — the footprints they left (or continue to leave) in the real world.
Counselors and patients, from the first day of treatment, need to understand the contact between them will be temporary, however life changing. Many clients, nonetheless, cannot conceive of the extent to which their attachment may intensify. Even were they told in a detailed and emphatic fashion, they would be unconvinced.
Treatment is intended to be a stepping stone to “living,” not a substitute for it. Patients are only fully alive when they’ve taken the hard and courageous learning they wrested from the consulting room on the road. The highway of existence is pothole filled. The journey risks disaster, but offers the possibility of achievement, self-worth, and intimacy not available if you are too focused on a one-sided, unreciprocated experience of watching and longing for what cannot be; and therefore not making the best use of your human qualities in the limited time we have on the planet.
In some sense, all relationships — not just the doctor/patient variety — are temporary. We grow apart, friends move away, death intervenes, and our heart breaks over the losses. This is in our nature, a portion of the human saga. Persistent attachment to a therapist is not the patient’s “fault.” Unfortunately, it can take the form of a ball and chain, restricting his growth. Perhaps a better metaphor is to say the client is haunted by the vaporous remains of a too significant “other.”
Unless he turns to a different counselor, the patient must shed the ghost of his therapist by himself. A warm spot inside for someone who meant much is one thing. An internal cauldron is quite another. You will find no exorcist to make the bubbles disappear.
The first step in solving the problem is to recognize it. Then remember why you sought help in the first place. Surely, it was for reasons other than becoming closer to a professional, reasons you can honor by freeing yourself from the abiding distraction his recollection produces. Next, pursue new activities and connections while simultaneously leaving the therapist’s shadow to mind itself. Grieving is in the mix throughout.
As much heartache as may be involved, the door leading to fresh possibilities requires this challenging set of steps.
But then, you’ve faced obstacles before. Indeed, I’ll bet nothing about your recovery has been easy.
The top image is called Female Spirit on a Street by Bonnybbx. The photo that follows is called Fog-Pocalypse by Zach Dischner. Both are sourced from Wikimedia Commons.
*This post was prompted by reading Staying Connected to My Therapist and Trying to be Kind to Myself.