If Therapists Have Problems, How Can They Help?


I’ve never met anyone without problems, in or out of therapy. Some are more serene, optimistic, or luckier, but no one escapes the downside of life: frustration, heartbreak, and aging. What then, despite those troubles, enables such a person — aka your therapist — to help?

Part of his capacity to relate to you is the very fact that he can’t escape either. The counselor and you are members of the same species, no matter how different in significant details. Basic experiences are common to each of you: learning, making a living, finding love, communicating in words, inhabiting a fragile body, losing people, and facing your own demise.

He is also damaged, if not necessarily as severely as you; and ideally, not suffering acutely in the moment he treats you. Yes, there is a point beyond which the one treating needs treatment before he can assist others. Perhaps his own demons are triggered by what you say or do, even how you look. Maybe he will be unreliable or poorly trained, using outmoded theories or failing to keep up with “what works.” A counselor can also be overwhelmed by his own life circumstances and lack the energy to help while he is trying to stay afloat himself.

These concerns excepted, you will still be dealing with a flawed person. Best if he is not also either too young or too old. A youthful counselor is inexperienced by definition. He brings enthusiasm, boundless effort, and (we hope) knowledge of the latest research, but hasn’t spent enough time in the trenches. Still, he must learn his craft somewhere.

Caution also applies to seasoned doctors who just go through the motions or have run out of gas. Too often they are tied to routine ways of thinking and are no longer “alive” to what it means to be in the springtime of life. They, too, should be avoided, perhaps even more than earnest young people who will, at least, invest themselves in you.

Part of my hesitation in recommending young therapists, however, has nothing to do with their limited patient contact. Rather, most have not been hurt enough. To be adequate to treat, life must have its way with us for a time. We need to find out who we are and what life is. Ideally, counselors also need a body beginning to show signs it won’t last forever — to be informed of their own mortality. A future therapist should be humbled by life and find a way to come back for more. His rebound approximates the journey you hope to make yourself, the one on which he will accompany you.

Consider the kinds of preliminary encounters the legendary conductor Bruno Walter thought necessary for making music. Imagine how his opinion applies to a therapist’s need for life experience. The language is fulsome, characteristic of the time he was born (1876), but the message transcends it:

“He who has not experienced the stormy sea with a feeling heart will fail to find the elemental force of expression essential for the Overture of Wagner’s Flying Dutchman … Beethoven’s Scene by the Brook (from the Pastoral Symphony) will sound empty unless the conductor’s own delight in a purling brook and a smiling landscape is joined to the musical soulfulness of (his) interpretation … (And) he who is a stranger to ecstasy cannot convincingly conduct Wagner’s Tristan and Isolde.”

Simply put, should you visit a shrink who lacks the education acquired by passing through times both rough and wonderful? Read Homer’s Odyssey and ask yourself how the hero, Odysseus, might have been changed by a 10-year war at Troy, returning home by sea, fighting the Cyclops, and the additional 10-years required to find his way back? Few therapists experience anything close to this, but do learn a few things down a less remarkable path.ulises

A shrink should be like The Velveteen Rabbit, who only became “real” by being worn from use and transformed by love.

Therapists and non-therapists alike are survivors. Indeed, we are all the offspring of shipwrecked fellow men who endured. A shrink without personal acquaintance with travail and romance would be like a Martian trying to understand mankind. Yes, your doc has his own “stuff.” Would you prefer a virgin psychologist, untouched by life as well as sex?

Yet, he must also be different than his patients. A professional combines his training and experience to form an understanding of the “full catastrophe*” of existence. His daily practice allows refinement of the technique required to aid others. Thus, a seasoned counselor’s personal hardships and learning meld with the experience of helping patients (from whom he also learns, especially by making the mistakes novices usually do).

The practitioner ought to know more than you do about the healing art. Moreover, he is useful because he is NOT tied to you at the deepest level. A therapeutic perspective is essential: the dilemmas of your life are yours, not his, nor those of his loved ones. He can keep his head because of this, even though he does come to care about you as a particular person with increasing contact. Therapeutic distance permits him to remain calm and thoughtful in the presence of your pain.

Perhaps, too, the shrink has been luckier than you, without which he could not lend you his hope. He knows good things can happen and the darkness is followed by the dawn, at least much of the time. You are better off for his self-assurance and clarity of mind. They enable him to see the dimly lit road out of the woods. You would not wish him to be looking for the breadcrumbs left by Hansel and Gretel.

None of this is to suggest the counselor is some sort of god. Rather, he is the master of a limited situation — the small chamber in which he does his work. He is also an illusionist, of sorts. If you observed him unshaven, in his underwear, without the mirrors and smoke, arguing with his mate, worried about his kids, upset because the newspaper delivery service keeps leaving him the Tribune instead of the New York Times, then you might think less of him.

The illusion is a necessary one. You overgeneralize and come to believe that he is a wizard everywhere and all the time. He doesn’t stop you, as if he could. You need to believe.

So, dear reader, we therapists are quite mortal. We’ve got our own issues and the bruises sustained on our part-way-completed expedition through life. If we are any good, then we are observant and sensitive. We’ve seen the world’s unfairness. Judgment is set aside for the most part. We are each, as Seinfeld’s George Costanza used to say, “master of our domain,” although in a rather different context than George intended.

Some of our imperfections enable us to help. When we have too many? That’s another story.

*The facetious phrase, “full catastrophe,” comes from the 1964 movie Zorba the Greek. It has become associated with the book Full Catastrophe Living by John Kabat-Zinn.

The first image comes from the 1954 movie Ulysses (the Roman name for Odysseus). The ship is a model, not a full-sized boat. An illusion, yes? The movie poster is from the same film. The title role was played by Kirk Douglas. Anthony Quinn portrayed “Zorba” in the 1964 movie and took a supporting role in Ulysses.

How Therapists Fool Themselves

Snowball therapy

The above photo of Kyle Young’s album “Snowball Therapy” is not meant to suggest anything negative about his music. Unfortunately, however, there are probably a few therapists who are using forms of “therapy” that are nearly as preposterous as that name implies.

The fallibilities of therapists could probably fill several books. I will not win much applause from colleagues by telling you how therapists sometimes fool themselves. The list below does not apply to all healers, but the self-deceptions are more common than one would wish. Here are a few of the ways that counselors sometimes lack a realistic appraisal of themselves and their work:

1. “I’m not doing this for the money.” While almost all therapists come to the profession in order to do some “good,” most also have to make a living like everyone else. Quite a few will discount their fees for certain patients, but most set some number as the very bottom-line that is acceptable compensation, meaning that clients without medical insurance coverage or a heavy wallet go without.

Those practitioners who do lots of marketing and employ other therapists clearly are mindful of the potential for profit. All this is fine, but it also means that there is more than one reason that therapists do the work; and that for some, money is of equal or greater importance than the work itself. Keep in mind the old joke about the MD who is asked about his specialty. His answer is: “My specialty is diseases of the rich.”

2. “I can treat almost any diagnosis.” There are too many different ways a life can go wrong and too many areas of skill and knowledge required to help put things right. No one has seen them all and knows them all, but some think they do. If your counselor claims omniscience or anything close, run — run fast!

Watch out for a therapist who thinks of himself as some sort of therapeutic comic book hero.

Watch out for a therapist who thinks of himself as some sort of therapeutic comic book hero.

3. There is no research supporting what I do, but I know it works.” Some therapists go so far as to write books about their style of treatment despite a lack of research support. They claim that their experience justifies their approach, citing anecdotal evidence which no scientist would take seriously. They ignore the fact that empirically validated treatments exist for conditions like Obsessive Compulsive Disorder (OCD) and Social Anxiety Disorder, to name only two.

In effect, these healers practice the rough equivalent of using an unproven folk-remedy to cure cancer. They tend not to read scientific journals that publish rigorously designed, peer-reviewed articles, dismissing them as too “academic and impractical,” and may not even have the training to adequately understand such research reports. Good luck if you are the patient of one of these people.

4. “We need to continue; you aren’t where you need to be yet.” Several potential problems are found here, even though it might be true that the patient could benefit from something more. First comes the question of why therapy hasn’t already accomplished what it needs to do. The therapist may have taken this person as far as he is now capable of going, regardless of who might treat him; or else lacks the skills needed to take him further. Is the healer’s desire to extend therapy motivated by money? What is the treatment plan to get the person to the finish line and is the patient prepared to make the effort and pay with his time and hard-won dollars?

The truth is that we humans are never perfected in all the things that could make our lives better, yet most of us continue without lifelong therapy. The decision to end must come sometime.

5. “My personal issues haven’t compromised my ability to do therapy.” I have known (or known about) therapists who treated obesity despite their own considerable overweight, who treated addiction despite themselves smoking two or more packs of cigarettes a day, and who were cheating on their spouses (sometimes with patients). I’ve heard of therapists practicing with their own untreated (and perhaps undiagnosed) Attention Deficit Hyperactivity Disorder (ADHD); others with undiagnosed or untreated Bipolar Disorder.

The list of human weaknesses in therapists is not much different from the list you will find in non-therapists. Having problems at home, as therapists sometimes do, can be enormously distracting, to say the least. The more chaotic and disturbed is the healer’s life, the less effectively can he help anyone.

6. “My values don’t influence my ability to do therapy.” I’ve known therapists who were very religious, going so far as to encourage their patients to adopt a similar view; and atheist counselors who were troubled by patients who had strong religious beliefs. I’ve known those who can’t easily talk about death because they are terrified of it, a problem when dealing with someone who has mortality issues. Therapists must either refuse to see certain people, refer them to others, or heal themselves in order to practice honorably and well. Unfortunately, some practitioners deny their own limitations and the extent to which their own beliefs and issues can affect therapy.

Finally, the biggest self-deception of them all:

7. “My patients get better — I’m a good therapist.” Maybe not. Remember that most people come to therapy at a low point in their lives, perhaps even a crisis. Time passes, whether in therapy or out. Most of us tend to bounce back. As researchers know, the real question is whether the person you are treating would have done as well or better with a different treatment, without treatment; or with someone like a relative, a friend, or a clergyman who did little more than listening and hand-holding.

A few therapists forget the admonition made to physicians: “First do no harm.” Indeed, there are counselors who believe they are doing just fine, but who have failed to diagnose the difference between Bipolar (Manic-Depressive) Disorder and other varieties of depression; or missed recognizing that a patient has partially compensated for his non-hyperactive problems of attention and concentration by dint of intellect and effort, and thereby effectively disguised his need for medication.

Those diagnostic failures virtually guarantee frustration and discouragement in the patient, who then has one more life disappointment to add to a long list; and who might never return to therapy with a genuinely competent therapist. The “doc,” meanwhile blames the client (or the severity of the patient’s problems) instead of his own incorrect evaluation.

Part of the dilemma for prospective patients is that most don’t investigate therapeutic options years in advance of the decision to seek help, nor can they reasonably be expected to. Indeed, they usually spend much less time researching potential treatments than they do when investigating which car to buy. Rather, clients typically come to therapy at life’s low ebb, review the list of people who accept their insurance, and look upon the therapist as a licensed authority who will surely have all the answers. Yes, we are licensed, but that doesn’t guarantee our competence any more than it does for cosmetologists, physicians, cemetery managers, real-estate agents, or barbers, all of whom need to be licensed in the State of Illinois.

There is nothing better than knowing what you are getting into and with whom, even if you are out of gas; especially if you are out of gas. Get recommendations from your friends or your MD if you can. Early on, find out what your diagnosis is and do research on the web concerning empirically validated treatments for that condition.

Therapists generally mean well and some are really terrific. Literally, life-savers. But, like any other group, we are subject to our own self-deceptions. A few counselors should be placed on a pedestal, a few underneath one.

Advocate for yourself.

You may find the following related post of interest: When Helping Hurts: Therapists Who Need Therapy.

The top photo is from Kyle Young’s fourth album. The second image is of “Retman,” an actual therapeutic comic book hero. The first three initials, R.E.T., stand for Rational Emotive Therapy. The cartoon is the work of Razvantonescu, International Institute for Advanced Studies of Psychotherapy and Mental Health. Both works are sourced from Wikimedia Commons.