When Being a Therapist Means Saying You are Sorry

We all try to understand people. Counselors and personality experts use formal systems for the job. The therapist begins with lists of human characteristics, a bit like a Chinese menu – beef, chicken, pork. If you fall into one column or another, you are given the name at the top. Not fish or fowl, but introvert, extrovert, narcissist, schizophrenic, etc.

These systems all tend to put people into a box they fit imperfectly. We therefore add other words as qualifiers to make the label more precise. Kind of like saying a person is not merely “tall,” but “muscular,” or “slender” or also has “a winning smile.” Still, they are all generalizations and even the one with the dazzling teeth isn’t grinning all the time.

Our boxes are not made of corrugated cardboard or wood. They come from knowledge and experience, imagination and instinct. Without using them to “place” every person we meet, we’d be like small children, unable to make sense of people, neither responsive to their needs nor capable of securing our own.

On occasion the categorization strategies don’t come close to making the human world comprehensible. Not all labeled people and their motives are well-captured by name tags. They are more complex. Those individuals don’t quite think the way we do or feel the way we do, making our comprehension of their nature harder to achieve. Our effort at understanding another, too often based on how our own minds work (or we think they work) can fail. Therapists share this experience of failure with everyone else. Less often, we hope.

I’ve met only a few unique people in my life despite having more in-depth human encounters than most. These few burst any categories in which we place them. Usually, however, the boxes work well-enough or better. Indeed, many times they are spot-on.

Everyone outside the doctor’s office, however, is at risk of resorting to stereotypical, pejorative labels, condemning those who are different because they don’t understand them. The labeled crate becomes a confinement of accusation and punishment. Look around: nationalists of all countries transforming races and religions and different national groups into imagined monsters.

It makes the world less scary to do this. Life is simplified into one pile of good people and one pile of evil people. The individual doing the sorting is never in the evil stack.

Being a therapist means you must be humble and open to those who can be difficult to categorize and sometimes, just plain difficult. If you are over-matched by the task of grasping and managing the therapeutic relationship, maybe you should make a referral from the start. Usually, however, you don’t realize your understanding is flawed for a while. By then a referral will not be simple. No matter the desire to do good by the patient, your rejection is likely to sting or devastate. The client came to you for repair and you made him worse.

Some counselors will keep the same box and keep using their failed understanding to treat the person. Some try to jam the client’s body into a differently labeled container and still treat him, even when box #2 doesn’t work either. Most will try to learn more, be humble, and look for a right-sized carton or no box at all until things are clearer. None of these tacks is sure-fire, but I favored the last one when I was in practice, often with the help of a personality test.

The therapist in all such situations confronts his own limitations. He needs modesty before he can achieve mastery. He needs to acknowledge his errors. He needs to figure out what is best for the patient while keeping his brain from exploding a little from the frustration and the fear he won’t be able to handle things.

Not all of us can do this in therapy or in life, and no one does it all the time with those for whom we care and those we care about.

If you’ve read the black on white scribblings I seem to endlessly produce (to my own astonishment) you know I don’t offer too many simple answers. Like you, I keep trying to understand this thing called life that appears so simple on the surface and no one ever fully gets right.

Life is a squirmy creature. You believe she is in your grasp and one second later she wriggles away. You think you are the master of yourself until your lack of mastery can’t be ignored. People don’t fit into a carton, and life – of all things – oozes and leaps and bumps against any enclosure we attempt to put it in.

Our boxes, as essential as they are, can injure people around us and limit our own understanding: understanding of the complexities of our fellow-man and our ability to be understanding, comforting, and kind.

The irony is that our use of boxes puts us in a box, too.

The moral of this story is to acknowledge the artificiality of labeled cartons and know they are also needed to get through the day. And then, perhaps, drink a glass of wine and accept the universe as it is.

No wonder religious faith is so appealing. The idea of “giving control over” to a benign, all-powerful, all-knowing being is consoling for those who can. For others, myself included, the wine will have to do. And tomorrow you will find me, not at a wine bar again, but back at repairing and enlarging my boxes, fashioning some new ones perhaps, trying to make them work as well as they can.

To be our own best selves, therapists or not, at some point we awaken to the guidance so easy for every one of us to forget.

Each box should be labeled “Handle with Care.”

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The top photo is called Box Loading and is the work of Surya Prekash, S.A. The second image features U.S. Troops Surrounded by Holiday Mail during World War II, ca 1944. It comes from the Smithsonian Institution. Both are sourced from Wikimedia Commons.