Why Your Therapist Will Say the Wrong Thing

What follows might not be what you want to hear. Therapists don’t talk about it publicly. I hope, however, this gets you thinking about your counselor’s aims, what you might want him to do, and what is reasonable to expect of her or him in the effort to be the best possible healer.

Girl in Therapy recently wrote a post called How Your Therapist Signs Their Emails, reblogged by Life in a Bind with an insightful preface. The gist is captured here:

This thing, let’s call it a pet hate, is email sign-offs. You know the thing people write just before their name? And more specifically, the way my therapist signs off on an email or text.

She “hates” such closings as “kind regards” and “best wishes.” The blogger wants something different from her therapist than the equivalent of “a warmed-up, just vomited fur ball that I’ve stood on in bare feet in the middle of the night.” She is both funny and serious. Sirena (her name) desires the parting portion of a missive to acknowledge the intimacy and importance of the relationship. At least, that’s how her plea sounds to me.

Quite understandable and, based on comments to the two bloggers I mentioned, she has lots of company. The easy “solution” for a shrink called out on this point is to be more creative. Fashioning personal words is simple enough. We can all do with some small tenderness. A thoughtful parting sentiment touches the heart.

The target I want to address, however, is a problem reaching beyond text farewells. Sirena’s concerns lead to the general issue of a therapist’s delicacy in communicating with his client vs. the use of words that cut or fall flat, whether in session or in an email.

The counselor has lots going on in his head, as I wrote in What is Your Therapist Thinking?  He needs to weigh his words and avoid frank episodes of insensitivity. And yet, there are reasons he sometimes misses the mark.

Here’s why: at the same time he is trying to help you he must not be preoccupied with a paralyzing, word-by-word self-analysis of his language. Were he to do everything in his power not to injure you (by an oh-so-careful self-scrutiny) he would risk hurting you by missing a different portion of the overall picture with which you present him. Once bereft of needed spontaneity — a slow, studied, halting treatment would be a bitter masquerade for a proper talking cure.

Self-consciousness psychotherapy by the person guiding it is useless. Your doc couldn’t do his job — the job you want him to do, the job he is trying to do — with this restriction.

Think of a surgeon terrified by a possible slip of the scalpel while he is guiding the knife. Were I his patient I wouldn’t expect ignorance of the worst medical errors, but I’d much prefer him to be “in the zone,” not fraught with the potential for a literally paralyzing surgical mistake. A doctor characterized by calm, focused attention, and control is the person I’d want. This is the reason surgeons don’t operate on their own children. This is why your counselor’s concern for you might, on occasion, seem callous or inattentive. If he were your parent and therapist — both — he’d be an emotional wreck and you’d be the worse for it.

A  counselor cannot be equally burdened by the anticipated impact of his every word and simultaneously dialed-in to all the other important events happening in session. Put differently, if the surgeon or the therapist is too self-conscious he will not leave you unscathed (pun intended) by an injury much worse than an occasional, temporary hurt feeling caused by an ill-chosen expression.

I am not saying he wants to harm you. Indeed, words matter, as does your safety, but I hope you do not put his office on surveillance by the word police. His care of you and for you cannot be like holding a priceless antique Chinese porcelain doll. If the shrink must maintain perpetual alert over possible injury, he risks infantilizing you.

We all deal with a similar challenge. How much protection should we render in conversation with our friend or neighbor? Can we expect a dinner companion to acknowledge his own tendency to misinterpret or over-think what we’ve  said? Are we alone to blame for misunderstandings?

Most patients make lots of allowance for an occasional undiplomatic comment, to their credit. Were the doctor’s office a place where nothing painful between the shrink and his client occurred, no patient could return to the world ready to thrive. The first step out the door would be like the shock of a newborn’s exit from the womb.

In summary, I’ve tried to explain the following:

1. The therapist mustn’t steal the patient’s initiative and responsibility for owning his own part in the relationship with a counselor. Yes, sometimes a problem is all the healer’s fault, but not always.
2. Part of growing, in and out of the treatment room, is learning what’s important, what are the little things, who is your friend (however imperfect), who the enemy, which issues will be resolved if you work at them, and those requiring only patience and time. We all need to do this. I am not immune from the obligation of trying to sift through the events of life and attempting to put everything in the proper cubby-hole, working on a few things that are my issues, setting others aside, ignoring some slights and addressing others.
3. Whatever your work is, you can paralyze yourself (like the the surgeon I mentioned) by a too constant internal look, especially while you are in the act of performing that work. Remember, even if the therapist utters an ill-considered phrase from time-to-time, in the long run the most important things eventually get addressed by a good practitioner.
4. If his words bother you, raise the alarm, especially when this is a continuing pattern. What seems obvious to you might not be clear to him. He should want to know of errors and improve himself. Be prepared, however, that whatever you say is potential grist for the treatment mill. Sometimes the issue is his, sometimes yours, and often you are co-owners. The percentages depend on you, him, and your interaction together.

These opinions are mine alone, though I’d guess I’m not the only therapist holding such beliefs.

Hope this helped.

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The top image is called Miedo-jeno by RayNata. The photo is Adolescent Sad Girl by stars alive. Each of these is sourced from Wikimedia Commons.