Why Therapists (and Others) Don’t Always Understand

How often we hear someone say, “I understand.” How often we think, “I only wish it were so.” Beyond the imprecision of language, I want to consider 10 reasons why true comprehension – recognizing the other person as he is and in depth – is difficult.

  • The fog of appearances: We instantly react to the individual in front of us, even before he makes a sound. Beauty (including a lovely voice) or its absence rose with the dawn of man. Sometimes revealing, sometimes obscuring; sometimes enhancing, sometimes diminishing. Sometimes all of the above.
  • Stereotypes: Beyond what we take from the person’s facial symmetry, shape, and size, other factors can cloud deeper comprehension. Gender, age, race, religion, and nationality interfere with vision beneath the surface.
  • Secrets and history: Polite conversation sets boundaries around self-revelation. Many of us believe we have been misunderstood – judged to the point of harm – and hesitate to reveal much. Even in therapy this is an issue, though with time and growing trust, significant secrets are often divulged. Without exposure, the job of comprehending you is far harder.
  • Our limited access to important data: Think about what information you might need to understand someone else. No one can access to all three sources below:
  1. The individual is the only person who perceives his life from the inside. He does not, however, see himself from the outside and will be shocked the first time he hears a recording of his voice. His grasp of his own motivations cannot be assumed accurate and may not reflect the work of the unconscious. Similarly, he interprets his life without the benefit of external perspective; except whatever is received, understood, and accepted of the other’s body language, tone of voice, praise or criticism. Most of us would be unsettled to know what others say about us in private.
  2. Friends and acquaintances hear what the same individual says about himself, what he reports of life apart from the observer, as well as experiencing his behavior in real time. Even his intimates must contend with the fact that “a mask of him roams in his place through the hearts and heads of his friends.” (Nietzsche, Beyond Good and Evil).
  3. Finally, the therapist has the most limited exposure to the client in real life. Ideally, however, the patient is more open to the therapist than perhaps he has even been to himself. The counselor has the training to “figure out” who is facing him, and the opportunity to ask the most essential questions with some expectation of penetrating to answers not offered in the public world. He sees not from the inside and not only from the outside, but,  from closeup, below, and through.

  • How remarkable are you? Though I evaluated and/or treated well over 3000 people, I encountered only a handful who were unique. Such individuals represent an enormous challenge to one’s understanding.
  • Countertransference: We can have reactions to our patients that grow out of our own unfinished issues with persons of consequence who they resemble in appearance or personality. This is called countertransference. Objectivity and unbiased analysis flees the evaluator under those conditions.
  • The limits of our experience. One who hopes to grasp the essence of another will not have encountered the whole of humanity. If, for example, most of his contact is with like-minded people (let’s say small town residents of one religion) he will be at a disadvantage with those whose backgrounds are different. On the other hand, therapist and non-therapist alike can meet an individual with whom he is “in sync.” In that event, both might find friendship and sympathetic intuition effortless and uncanny.
  • The listener who wants to be right. Insecure counselors can be troubled, sometimes unconsciously, by their own uncertainty. They tend to find it more comforting to put people in a box than to recognize when someone doesn’t fit. The job of evaluator (not a judge) calls for two qualities not often mentioned. First, enough confidence to say to yourself, “I don’t understand yet.” Secondly, “I can do better and I’ll work until I get this right.” Therein they offer an odd combination of humility and security. From time to time the therapist must clean the slate and start over.
  • The observer’s own emotional wounds and defenses: Our personal wounds (we all have them) place a limit on the ability to absorb, accept, and seek the truth of all humanity. Indeed, who is to say there are not many truths. The best of us never fathom all we encounter.
  • The listener’s capacity and willingness to endure the other’s pain: Hearing personal stories, even with the therapeutic distance healers work hard to achieve, still creates vulnerability to the most poignant encounters. Too many such episodes close in time risk either overwhelming the counselor or making him callous. To understand the human condition one must recognize his limits.

Final thoughts. Treatment by someone who opened-wide your self-understanding can make you believe no one on the planet will ever know you so well. I’ve long believed that if you then allow yourself to take more real-life personal risks, other satisfying and close relationships are achievable. Nonetheless, the special nature of a therapy relationship may include a hard-to-duplicate quality of perception and acceptance “as you really are.” You then will want a friend or lover who is psychologically-minded, a patient and dedicated listener, and one who makes the effort to approximate what an expert analyst can manage. This might be a tall order.

Do remember this: you and the therapist might not have much in common beyond his comprehension and kindness. Interests, compatible temperaments, and world view count for a lot. He exists, as well, in a fantasy world of your creation: literally, too good to be true. Were the light-reflecting cellophane of illusion to come off the package, you’d find his unshaven, distracted, and ill-tempered alter-ego – occasionally.

Another thought. A psychologically profound understanding of your inner workings isn’t always essential for a happy relationship outside of the office. Love and acceptance, even without full knowledge of all your moving parts, can go a long way. Not even your counselor has a total grasp of himself or anyone else. That said, his success at his work doesn’t require perfection.

Anyone close is “out of this world.”

The first image is called Rorschach-like Inkblot by Irion. It is sourced from Wikimedia Commons. The painting that follows is Vassily Kandinsky’s Composition VI, 1913. Finally, just above, is Honore Daumier’s Couples Singers, as sourced from Wikiart.org/

New Year’s Thoughts on the Price of Friendship: Secrets You Must Keep Forever


When a friend tells you something in confidence you are always treading on thin ice — whether you know it or not. If the relationship is close, he needn’t even tell you to “please keep this a secret.” You just know it to be the honorable thing to do. But sometimes you find something out you not only wish you didn’t know, but also wish you could talk about because the information is so troubling to you — to the esteem in which you hold your friend.

Here is just such a story.

Let’s call her Eleanor.* I’d known her for many years going back to grad school and she was only a bit older than I. Never sex partners, but two people who shared many interests, shared a profession, and liked each other enormously. Indeed, Eleanor was known and admired by many people. Her patients and hospital staff who saw her in action almost uniformly thought of her as a kind and talented person. You don’t meet many people as good.

I knew Eleanor’s husband, though not nearly so long nor so well as my friend. His business involved international travel and he was perhaps five years older than she, about 40, when the incident in question occurred. My contacts with him were infrequent, but always pleasant. And Eleanor and I usually met in the hospital cafeteria (with his knowledge) early in the morning or sometimes for lunch elsewhere, at the point that we both practiced in nearby offices in the Oak Brook area. I don’t remember how it came up, but one day Eleanor told me a story that I wished I’d never heard.

It seems that she and her one and only husband had a period of separation that lasted perhaps eight months some years before. She still loved him during this period, she said, but the incompatibility of their work schedule and differences over having children were complicating things. They both wanted kids, but realized someone’s career was going to have to be sacrificed, at least for a significant time, and no one was volunteering for the job.

Now I should also tell you that both Eleanor and her husband were uncommonly attractive and vivacious. Eleanor was then in her mid-30s, as pretty as a Renoir painting, and many men found her desirable. So, perhaps not surprisingly, she had an affair that began during the separation. But that wasn’t the thing that troubled me. There was more.

During the separation, even while they received marital counseling, the affair continued, but Eleanor’s husband didn’t know. In fact, they did resolve their differences about careers and children, and about a year after the separation ended Eleanor had a baby. But, she told me that she couldn’t be precisely sure that it was her husband’s child and that the affair continued even for some time after the birth of her first child, about five years from the time it began. She never tried to explain why she continued it and when I asked, she said she really didn’t know why. It was a tale she’d never told anyone else and I was the sole holder of the secret.

I was troubled. I knew Eleanor to have turned down the advances of numerous men, powerful and handsome; bright and charismatic. She was thought by virtually everyone as a person of almost god-like integrity. But there it was, a story that couldn’t help but cause me to be uncomfortable around her husband and to keep my lips sealed on the countless occasions when people would almost fall to their knees in praise of her moral perfection and overall goodness. And although I continued to admire her, I must admit that I did think of her a bit differently from then on. Eleanor lived about another 20 years, and although I certainly tried (successfully I think) to keep it from disturbing our relationship, I’m still puzzled by her actions even now, nearly 10 years after her death.

I have long since given up trying to figure out why Eleanor continued the affair after her reconciliation with her husband. If I found out, it would almost certainly be the usual reasons one hears for such things. You can imagine them as well as I. But there are at least two questions I do continue to ask myself from time to time:

  • Why did she tell me?
  • What are the costs of friendship?

Well, I think most of us want some sort of relief when we admit to ourselves that we did something we shouldn’t have. I can only guess, but perhaps Eleanor saw me as some kind of confessor (in the Catholic Church sense, though I’m not Catholic and neither was she). To put it differently, perhaps she just didn’t want to live with her secret alone and needed someone else to hear it and not judge her badly or abandon her out of moral disapproval. And if that is so, then I’m pleased that I didn’t disappoint her and hope I gave her some solace just by accepting what I was told and maintaining the kind of relationship we’d always had. Maybe that is all she needed.

But confidants must keep the confidences with which they have been entrusted. And because all this troubled me, I was stuck with it. It is a little like a child’s game of tag when your friend touches you and you’re “it.” Only in those childhood games, whomever is “it” then runs to transfer the bad thing on to someone else by tagging that person. No, in this game, I was “it” for as long as we lived.

Even that’s not exactly correct. Because I still can’t talk about it with anyone who knew Eleanor even outside of her family (who now live in England): the countless patients and professionals and friends who admired her, the very people who might (because they knew her too) be most helpful to me in dealing with my questions about our now deceased friend.

Why not talk? Because to do that, I would be robbing them of the image that I once had of her and that they might still carry. I would be transferring (perhaps) my disappointment and puzzlement to them, damaging a precious memory of who she was. Of course I can’t be sure, but neither do I think it fair to take the risk, even if the harm to them might be non-existent or very small. No, I’m still “it,” and I’m probably going to be so for the rest of my days.

But then I say to myself, isn’t that what friends are for? Eleanor was a wonderful friend and a terrific person who did much good in the world and who I was so very lucky to know. She was sometimes my confidant too, always giving excellent advice and much-needed laughter, even if I never burdened her with any similar secret of my own, or had anything similar to divulge.

Friendship, like most things of value in life, has its costs. Doing the right thing by keeping her secret will not go down in history as a great moment, nor should it. It surely didn’t require me to throw my body over a live grenade to save my platoon, something I seriously doubt that I could ever do.

Many of you have done just what I did; and I’ll bet you didn’t get any parade in your honor or trophy to put on your wall. But you did suffer a bit  — just a little bit. Thus your reward, if you feel you received any, was completely internal. It had to do with being the kind of person you wished to be, the kind of person you aspired to be: an honorable woman or man.

I believe that we aren’t reminded nearly often enough that you only find out who you are when your actions cost you something. It can be money, reputation, or even your life; or something as small as holding your tongue and living with the unsettled feeling inside of you that can come from knowing something you wish you’d never heard.

By the way, happy new year, dear reader. May 2014 bring you all the best. And Eleanor, for what it is worth: I still love you, old friend.

I have changed “Eleanor’s” name as well as very many details of her life to make it impossible that she be identified. As they say on TV, the character I’ve created to stand for her resembles no one living or dead, at least as far as I can tell. The dilemma I’ve described, however, did involve a real person. The 1880 Renoir painting was uploaded to Wikipedia Commons by User: Hinonbey. It is called Mlle. Irene Cahen d’Anvers.