Why You Want “More” From Your Therapist (and Why He Can’t Give It)

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You think of your therapist as a special person, at least some of you do. His kindness and attention can not only generate gratitude, but affection. You are aware of his boundaries and you can be frustrated by a professional stance limiting the kind of contact you’d like: a favored position, not someone put into a time slot with a financial transaction attached.  Perhaps, however, there is more to this than an ethical code. Why might his viewpoint as a therapist make what you want difficult to obtain? And, no, I’m not talking about sex.

Consider the role you play and the role he plays. You are likely talking about emotionally charged issues. Your feelings are front and center. His are not. Indeed, he is thinking about what you are feeling and doing.

You come to the clinician because of problems on which you are intensely focused. Thus, you are internally directed to your issues. The counselor, on the other hand, is not attending to his concerns, but to yours. He is looking outward, you are looking inward.

The counselor is not exposed. While you can find out some things about him, the treatment is not about him. You do not keep his secrets, but he wants to keep yours. You are encouraged to open yourself in order to heal. He is closed, assuming a relative position of safety and authority no matter how much he tries to be gentle and helpful.

Your session is of singular importance to you. It is one of many sessions for him, focused on you and a full complement of other patients. That makes him more important to you than you are to him. It does not mean he is indifferent to you. The doctor may well have tender feelings for you and enjoy your company, care genuinely, and approach you somewhat differently from the way he approaches others. Still, he is your only therapist, while you are not his only patient.

The counselor spends a limited time with you. He will then meet with someone else and switch his concern to the newly arrived individual. In a sense, however much he is concentrating on you while you are with him, he must develop an ability not only to be “in the moment” with you, but switch to another person after a brief interval. You do not switch. When you leave, your concern is still on yourself and the relationship with the therapist. A mental health professional is like an athlete in this way. After the game is over, he quickly puts the contest behind him so he is able to bring all his skill and attention to the next game.

To the extent that the therapist makes himself a blank slate and reveals little about his life, it is thought you will play out your emotional issues in the form of transference: experiencing him, to some degree, as similar to an important person or persons in your life, especially if your parental relationships are unresolved. Your transference toward him provides important material which he will help you work through. In doing so, you cut the trip wires of the past that continue to harm you in the present.

The counselor, of course, can also have countertransference toward you: experiencing you and reacting to you as if you are someone about whom he has unresolved feelings. However, to the extent he gets to understand the intimate details of your life, he is likely to be less prone to such emotions than you are in response to him. You are not a blank slate to the therapist. Thus, his likelihood of projecting his issues on you is at least a bit less probable.

Now let’s switch focus. Imagine what therapy would be like if these conditions were not typical of a therapeutic interaction. In which case:

• The therapist would reveal as many of his issues as you do of yours.
• He would be focused on himself as much as on you.
• He would have less control over his emotions in session.
• You might come to know disqualifying things about him.
• The counselor might break down in session when you are overwrought or because of his own life problems outside of the office.
• Consolation from you may well be required to stabilize him.
• When you are in session he could be preoccupied with the last patient he saw before you.
• Your relationship to him would approximate the kinds of contact you have with friends and co-workers.

I wrote this essay for the purpose of helping you understand a therapist’s perspective, his limitations, and his boundaries. Without those walls, little benefit comes from treatment. This is not to say your therapist doesn’t care about you. It is to say his care must remain within limits. In the absence of those limits, no matter how much you believe you’d like something more, counseling leads to something less.

Sometimes in life we do not know what is best for us. Then we are lucky — very, very lucky — that our wishes are not granted.

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The photo of the 45 rpm disc was sourced from Wikimedia Commons.