In Psychotherapy: What is the Therapist’s Role?

I heard this story first in Gestalt Therapy Training, some 30 years ago: Snakes live in the forest. Their daily travels take them over rough stones, branches, and uneven ground. Every Spring the snake sheds her skin. The outer, older skin loosens and gets tugged at as the snake makes her way around her world. But the outer skin never leaves until the new, baby, inner skin gets tough enough to handle all the rough stuff the snake will be going over.

It’s never the therapist’s job to rip the skin off a snake.

Your therapist sees your vulnerability/your baby skin, that you probably don’t show in normal situations. I feel this is a privileged position and one that absolutely requires respect and compassion if I am to be of use.

Couple Counseling: What is the Most Common Problem?

Couples Therapy

The problems couples face are often caused by what is actually normal growth in their relationship. Couples grow through stages in a relationship, and when it happens that each partner is at a different stage, the result is often pain and confusion.  It is at these times that couples most often come to therapy, and it is often the biggest problem for couples. Couples therapy can help by guiding both partners to an understanding of what is going on between them and helping them both grow together.


I am certified by the Couples Institute in California in couples therapy. I use the Developmental Model of Couples Therapy to help many of my clients. This is an approach to relationship counseling and therapy developed in the 1980s by Ellyn Bader and Peter Pearson, of the Couples Institute in California.

This approach focuses on the development and growth of each partner individually in addition to the development and growth of the relationship. It identifies a number of stages in the evolution of every couple’s relationship. The first two stages of couple growth are Symbiosis and Differentiation.

Symbiosis – The Initial Stage

All couples start out here – feeling romantic, delighting in their newfound similarities, wanting to spend all their time together. This brings about important bonding, your becoming a couple.

Differentiation – The Second Stage

As time goes on, usually within the first two years, Differentiation begins: one person, or both, need to identify themselves as who they are as an individual person. Now is when you recognize that you have differences in feelings and thoughts than your partner, that you don’t always agree.  You may want to go out and explore their world, have time with old friends or start a new hobby.

When Stages Happen at Different Times

If this isn’t happening at the same for both people, the one not moving into this second stage often feels hurt or abandoned. “Why am I not enough for you anymore? Why can’t we be together all the time like we were when we were so happy?”  The resulting confusion, unhappiness, and stress is the most common time for couples to seek couple counseling.

A Real Problem Caused by Normal Growth

There’s that common problem I was talking about: the normal growth of one person moving to the second stage of the relationship while the other is still in the first stage. The person feeling left and hurt is in the first stage, Symbiosis, and the other has moved into the second stage, Differentiation. It would be so much easier if both people moved from the first stage to the next, but it often doesn’t always happen that way. So they show up in a therapist office, wondering what went “wrong.” Actually, nothing went wrong, they are growing as a couple, but unevenly.

Understanding What is Happening

Learning about these normal stages of growth helps enormously in understanding and normalizing what is happening for both people, and these are taught without judging either person.  There are lots of reasons why people go through these stages at different times, and that can be understood by looking at their relationships with their important childhood caregivers, usually their parents. For our purposes here, suffice it to say it is normal, but when one person is at one stage and the other moving into another, it’s a stressful time for the couple. There are more stages to normal couple growth which I can explain elsewhere.

Learning the Skills

In couple therapy, you both can learn the skills of the second stage: Differentiation.  These skills include you each acknowledging and stating your own feelings, needs, thoughts, and preferences even when they are not the same as your partner’s.  You learn you can maintain your own perspective and not attempt to change your partner’s to match your own. You can agree that as a couple you really are two different people. Being heard and being understood as a separate but still loved and accepted person is a wonderful experience, different than the first stage, but equally bonding.  It brings you two together in a new way, with new respect and clarity of who your partner really is and being seen as you really are. It can be exciting and enhance intimacy.

Of course, there can be conflict, and learning how to deal with conflict rather than being afraid to face it is another skill of living in an honest and vibrant relationship.

What does the therapist do in couple therapy?

  • Provide a safe environment where both people are able to speak  and be heard, and  where both sides come to  be understood and validated
  • Show how your backgrounds  (yes, your baggage) are being triggered and affecting the present, and what to do about it.
  • Help each person explore their feelings and thoughts without being blocked by taking their partners’ opinions. Learn to do this at home without the therapist being present.
  • Get clarity about what is going on so the couple can understand themselves and progress.
  • Discover patterns that are destructive or at least not productive.
  • Provide ideas about what to focus on between sessions.
  • Specific advice and guidance for your particular relationship

Re-parenting in Psychotherapy

I think therapists are re-parenting all the time they are in session with a client, and being keenly aware of that is part of using transference. Recognizing that transference is going on all the time in therapy allows the better therapists to be most effective. This is what is meant by “ It’s the relationship that heals,” not the particular therapeutic approach utilized.

It’s the therapists respect, interest, affection, effort put out to help; all of this and more is apparent to the client consciously or unconsciously. And all of this is saying “you are worthy, you are of great value as a person.” Your thoughts are interesting, your feelings matter, etc. etc. These messages are the ones the person should have gotten as a child are now being expressed by the therapist, overtly and not so overtly, verbally and non-verbally. That’s re- parenting. Knowing how to do this genuinely is an important therapeutic skill.

When I am meeting a client for the first time, I look to see what I label to myself as the “beauty” of this person. If I don’t see it right away, I consciously wait, because I know I will see it soon. If I can tell I am never going to like a person, for what ever reason, I don’t work with them. It happens very rarely. I know each person deserves to have their therapist like them and find them worthy.

How Do Therapists Stay Calm When the Client is So Very Angry at Them?

I think there are a couple of reasons. One is that we (us therapists) forgive ourselves for mistakes, and two, is that often we haven’t really done anything wrong at all and the client is angry because of misplaced transference. By the first I mean having confidence in the fact that we are 99 times out of 100 doing what is useful and if we make a mistake, we are OK with ourselves for not being perfect. The second one is about when the client is perceiving us as acting badly because they are seeing us as a family member who did act badly (transference), but we ( the therapist) actually hasn’t. Clearing that all up is called “working through negative transference” and it’s a very useful part of what can happen in therapy.

To explain further: If the client is having negative transference, they are seeing the therapist as harmful, as their parent or some important childhood figure was. They are then transferring the perception that this person is also going to harm them, onto the therapist. They are almost always transferring that onto other people in their lives also. So it’s great when it happens in therapy, and they get to realize that the therapist doesn’t mean them any harm when the therapist says “X” or looks at them “Y” – just like their mother ( or father or someone from childhood did). They may be completely right that the childhood person did intend harm and created harm, but the therapist isn’t doing that now. The therapist can explain what they meant by what they said or how they looked, or whatever.

That is so helpful to clarify. It clears up a lot of bad feelings this client may have been assigning to others in their world. It’s often hugely important.

The therapist recognizes, when the client is angry at them, if they’ve actually done something wrong and the client deserves an apology – and it’s very therapeutically useful to apologize and admit you were wrong at those times. The therapist also recognizes when the client is transferring motive, or whatever, to them and it’s not accurate, and listening respectfully and then explaining what they did intend, etc. is very powerful for the client to hear, and experience.

It takes skill and an understanding of transference to do this well with clients. It’s a perfectly OK way to use the therapist. It’s their job to help you make sense of what you experience and treat you with respect the whole way though

Do therapists ever get annoyed at or tired of their clients?

Yes, I think so.

The job of the therapist is to use yourself as an instrument, and be aware of how you ( your instrument) reacts. If you feel angry, irritated or bored with a client, very likely other people would also. So you use the information you’ve received, by your own reaction, in some manner that would be helpful to the client. The trick here is note your feelings to yourself, think about why the client is probably acting the way he is, and not express them as they are felt, for example – not speak angrily. The therapist’s job is to find a way to explain to the the client, so he can understand, how he is creating this reaction in another person without sounding critical. Then it’s the therapist’s job to help the client understand what is going on within himself.

Similarly, if, as therapist, you are “tiring” of your client, or getting bored, it is a signal (to me anyway) that the client is not being authentic, or is not going anywhere useful, i.e. being repetitive. This too can be communicated to the client without judgement and in a clarifying way to help the client in self awareness.

This takes skill, more than simple self control, because you as therapist have to know how to reach that particular client.

What you say may be experienced by the client as a confrontation but one that includes having the therapist’s arm around you, metaphorically.

Psychotherapy as a Spiritual Pursuit

I think it is everyone’s job, everyone’s spiritual job, to clean up the human mess your parents left you and not spread any more dysfunctional hurt around to any other people. So I think it is your job to do your own personal therapy so you don’t continue the mistakes your parents made with you – and I mean this not only with your own children, but first and primarily with your own children. Then with everyone you have contact with in your life.

Another way of saying the same  thing is that I think  it is everyone’s spiritual job to be the best version of themselves that they can be.  I don’t (at all ) mean doing this at every minute of every day, with a perfectionist pressure, but rather to become the best person you can be. That creates  another very competent, moral, high functioning person (in whatever way that is for you), so that you are making your personal best contribution to the world around you. You might  then be the best man in a construction crew – doing very good construction work and  being a good human being, kind, honest and decent, to those around you. Or perhaps you are a lawyer and could be unscrupulous and out to make the most money you can, or you could be  touching people’s lives, or a corporation’s life, with integrity that profits everyone involved. The world and all the people in it, need those of us who are in  the lucky enough position of having the money and time to indulge ourselves in personal growth – to do it.

I realize that doesn’t have to take the form of psychotherapy. But it is one path.

 

The Hard Truth about Couple Therapy

Taking your most recent fight to your couple therapist is probably one of the least likely ways to get much of anything from couple therapy. The therapist is not there to be a judge and decide who is right in your struggles. The therapist is there to teach you new skills so you can both get the relationship you want.

You need to set goals for what you want your relationship to be and learn the skills to get it there. So many people come in to a  couple session and want the therapist to “fix” their partner. In fact, you need to look at what needs changing in yourself, and if both partners  will do this, real growth and change can occur.  You need to be willing to look at yourself and what you learned about relationships and love from your family of origin and see how that is getting in your way in your current love relationship.  All of this takes time, dedication, a willingness to take risks, and often, frankly, a touch of humility.

If you are up for all of this, you could really improve your relationship.  There are very specific skills involved in improving an intimate relationship, and for some people they aren’t  easy to learn. You will grow personally in couple therapy much as you would if you were in individual therapy. If you are interested in how you contribute to the struggles you have with your partner,  you could  gain  a lot and grow a lot and have a much more loving , close and satisfying relationship –  through couple therapy.

Why you care so much about what your therapist thinks of you.

Because you are in transference with this therapist. That means, you experience the therapist as if he or she is a parent to you, and all of us want our parents to love and approve of us. Your therapist is a stand in parent to you.

In fact, “working in the transference” means to a savvy therapist , that giving their support, approval , validation, etc, is very healing to their clients. Therapists should know this and do this. I keenly remember how much it meant to me to have my therapist value and like me. I have said that her words were “mainlined directly to the two year old in me.” That was so very healing, and I never forgot it, so I do the same for my clients. I work in the transference, meaning everything I say and do with my clients is with the awareness that I am a stand in parent and have the opportunity to re-parent, to heal, the child within the grown up who is my client.

So what you are asking about is pretty much true for all psychotherapy clients, and the stronger the transference, normally, the stronger the need for a loving parent to give the child within the adult client the esteem building care they needed and can still profit from. I hope your therapist understands this. It is why so many people say that in therapy “ the relationship heals.”

I have other blogs about transference. You might be interested in this phenomena since it effects everyone in therapy.

Good luck to you. I hope you are getting what you deserve.

The Stages of Couple Growth

Couple relationships go through growing stages, and although this is a normal and healthy development, it can be painful to experience and  can sometimes make couples question if they should remain together. This is often why couples often come into therapy as they move through the stages, especially when one person is moving into a different stage than their partner is in.
Let’s look at stages of growth of all couples.

Stage 1 is called Symbiosis:  This is also known as  “The Honeymoon Period” – both people are swept up in  the excitement of their romance. “He (or she) has so much in common with me!” “Everything seems perfect”  and “We are so much alike!” Both are ecstatic with the  mutuality and perfection of the other, “How could anything go wrong?” It’s important to have some  time like this to establish your coupledom.

Stage 2 is called  Differentiating: After a while things happen  that show you are really two different people. Maybe you don’t really like watching  football, and that he has no interest in riding horses. She thinks you are “too” left leaning and liberal and you’ve been proud of that. It’s disappointing and hard to take for the one who wants to feel exactly alike and perfectly suited ( the one that is still symbiotic). It may feel liberating and factual for the differentiating  partner. Here indeed is trouble in paradise. As it happens, one partner  starts feeling restless or smothered. It seems like hanging out with old friends would be so nice.  Doing that sport, hobby (or whatever) that’s been neglected in spending so much of your time together – starts to look appealing.  This is a time when couples often show up in a therapist’s office.

Stage 3 is called Practicing: This is when the couple are both “trying out” being their separate selves while still being connected as a couple. They spend time apart doing separate things. They take the risk to  say they disagree and speak their differing opinions. At this time they are often dealing  with the risks and struggles of dealing with each other’s different needs and preferences , and it is a time of immense personal growth.

Stage 4 is called Rapprochement: This is when the couple is comfortable going back and forth, going away and coming together, returning to each other with ease and intimacy.  They come back to each other refreshed and happy to be connected deeply again.  Their trust is  secure in the other. The each are supporting the other’s self esteem.

Being able to see what stage your relationship is in can be reassuring and useful. Often one person is a little ahead of the other, and pulling their partner to come along with them.  When going  through these stages gets rough, couple therapy is often what is needed.

Good luck with each other! Love is a wonderful thing to cultivate at all it’s stages, and much too precious to neglect or loose.

How to get the Most out of Therapy

This article is going to list a number of suggestions about how to do your part of the work necessary to making your therapy a success.  My list will be more or less in order of what needs your attention, but after the numbers 1 through 3, you can determine the order of importance yourself.

  1. Decide if this therapist is a very good choice for you, or not. Notice if you feel comfortable with this therapist, if you “click” with her/his personality.  Don’t settle if you just don’t really like this person, or if you get the feeling she/he doesn’t much like you. Also ask yourself if  this person is a good choice for you in terms of knowledge, experience and competence in whatever  areas you need.  For example, if you know you are going to be doing trauma work, don’t let some young therapist “learn on” you.  If she/he hasn’t got trauma training and experience, look elsewhere.  If you think this therapist is a really good fit but later change your mind, reconsider the fit. Also look into my article about negative transference, which I won’t go into here, but is often why people leave their therapist when they would have gained more by staying.
  2. If one of these areas is weak, I recommend you keep looking for another therapist who can fill both requirements for trust building ( personality and knowledge).  You can, of course, go through the process of speaking your mind to the therapist and asking them to improve whatever it is you find them lacking, but this will likely only lead to the therapist’s growth, and not yours.  I don’t think it is a good idea to  bolster the therapist ( as you may have had to do with your parent(s)?)  Therapists  don’t get to learn on the job while you are paying for their help. You deserve to have a therapist who is ready to go with you, and to be the leader in the therapy.
  3. Once you’ve made your choice and are building trust, get engaged with your work. Getting engaged means thinking along with the therapist, answering questions thoughtfully , bringing up thoughts you have about yourself that pop into your mind, and  saying when you think the therapist is going in the wrong direction, or going somewhere you aren’t ready for, etc. etc. Engaging with your whole self, thoughts and feelings, and speaking of them so the therapist  knows for sure what your reaction is to whatever is going on, is probably the most helpful thing you can do to get the most out of your therapy.  Your thinking along with the therapist and saying what occurs to you makes for  two brains working instead of one. And your brain knows you!  I have clients who are interested with a passion about what’s going on in session and are deeply involved,  and others who honestly believe that if  they show up and listen, that’s all they have to do “to get better.”  There’s nothing further from the truth.
  4. The issue of trust is significant.  It may take you awhile to trust the therapist enough to speak up about what you are thinking, or cry when you feel tears, but if you aren’t ready and aren’t ready and this goes on for weeks, either bring this up or go find a different therapist. . Therapists are trained to tune in to their client’s and it’s their job to help you feel at ease by letting you know you that are interesting to him/her, and that you are accepted as you are. If you continue to feel less than comfortable with the therapist as a person, it could be the wrong therapist for you, or it could be something from your history that could be addressed successfully.
  5. Remember the therapist is hired help.  It’s the therapist’s job to reach you, whatever level of emotional intelligence you are at. The therapist needs to explain things so you understand. You don’t have to impress them, or not hurt their feelings, or be concerned how you express yourself. The therapist is supposed to come to you, where you are in every aspect, not the otherway around.