Turning the therapeutic tables

On the way out the door, a client starts grilling me:

“Do you have kids? Are you married?”
“No, not yet. We’ll get there one day.”
“But you’re still young. How old are you?”
“I’m old already. I’m 38.”
“Oh well, you live your life the way you want,” she says, delivered with an airy flourish.
Oh great, I think. Another patient who thinks I’m gay.

Remembering this exchange today, I can’t help chuckling at my client’s curiosity. And it also gets me thinking about psychology and power. I often think that psychologists love being the ones asking the questions rather than receiving them. One psychologist I knew always answered a question with another one. [A handy tip: So what makes you think that?] It’s not so great when we’re on the receiving end of prying. Put another way, we like to be the ones wielding the power, putting the patient under the microscope and analysis. Analysis after all comes from the Greek work “analyein” which means “to break up”. The dictionary gives as one definition: “The abstract separation of a whole into its constituent parts in order to study the parts and their relations.”

She loves me then she loves me not.

He loves me then he loves me not.

So what do we (as therapists) do when it is the client who wants to break us up into little bits and to study our parts and relations? 😉 Well, we tend to become a bit defensive. We devise useful ways of deflecting the question such as: “We can talk about me if you like, but I’m wondering what that’s about for you. Are you wondering if you can trust me, if I will understand where you’re coming from?”

No, I was just curious.
What were you thinking?
No, I just wanted to know. You don’t have to answer the question if you don’t want to.

I envisage the conversation going round and round until the therapist answers or deflects the question successfully. In my own therapy, I have found it liberating to be able to discuss my reservations about the therapeutic relationship. Having inside knowledge about the process helps but also hinders here since I know it’s a bit of a game on my part. Trying to outsmart my therapist by making shrewd interpretations. I am quite restrained in telling my current shrink why it’s just not working for me and the poor man has to sit through at least another three sessions of this before I break up with him. He is at least getting a decent fee for it but it is also a bit disconcerting sitting there and talking about how he just doesn’t quite “get” me.

Most South African men I know are just not that sensitive, I tell him, so you’re starting from a difficult position. I also have a natural suspicion of doctors and therapists since I’ve been exploited in the past. (Litlove’s hospital experience also springs to mind as a good example of how medical practitioners can, perhaps unknowingly, be insensitive.) But part of me also wants to hang in there for a bit. If a lot of these feelings arise from my own projections (of previous insensitive males), then can I change the projections by working on them?

Lastly, if there are any clients out there who are wondering if they should confront their shrinks with their reservations, my advice is: Absolutely! Talking about the therapeutic relationship can be wonderfully liberating if it’s done in a helpful way.

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8 Responses to Turning the therapeutic tables

  1. Emily says:

    For me, it’s just disconcerting not knowing even basic facts about someone — even a therapist. It feels rude.

  2. Novalis says:

    Yes, I think patients (and many of us have been on both sides of the process) ask those sorts of questions for very different reasons. Sometimes it is, as was said, primarily out of politeness, sometimes (in the case of socially isolated people) out of an honest hunger for natural human relatedness, and of course, in some cases it really is a defensive attempt to “turn the tables” or distract from the process.

    In my opinion patients have a right to know some basic information about therapists: their training (of course), but also their geographical background, whether they are married or have children, and in some cases, their general religious and political outlooks. All of these are life experiences or value systems that may influence therapeutic process in subtle ways. Anything more specific than these may be prying, or unwise self-disclosure.

  3. openpalm says:

    I ask my therapist about her and my son’s therapist about him because I *like* them.

  4. Pete says:

    Emily – You’re right of course. I think now that therapy is becoming less fashionable, people are not so hung up on therapists anonymity.

    Novalis – Very true. All of those have a bearing on the therapist-patient fit. Thanks for putting it so clearly.

    Openpalm – That’s as good a reason as any! I think if we’re curious we should ask (unless politeness suggests otherwise). Sometimes it’s hard to know where the limits are though.

  5. Litlove says:

    My therapist is frighteningly rigorous about not letting me know the least detail of his life. This is, I think, in part because he knows I would try and please him and make him share the analytical spotlight, thus distracting attention from me. I understand the reasons, but sometimes the inequality of the arrangement gets to me.

  6. Pete says:

    Litlove – sounds frustrating but maybe ultimately helpful. I guess that’s their job – not letting us wriggle out of confronting stuff. But sometimes it would just be nice to have a more friendly chat I think. (Of course that’s my own stuff ….)

  7. Natalian says:

    I have enjoyed reading this post and the comments. I have written and deleted my comment about three times as I seem to be in a bit of a grey area with how I feel. On one level I think a therapist should be distant allowing the patient to focus on their issues and also that once the process has run its course that the patient is able to leave without feeling a sense of loss due the the relationship ending. Then again as the patient you need to feel comfortable with your therapist and surely this is achieved with a bit of a friendly chat? I suppose there are boundries which patients need to accept if they are to enter the theraputic process?

  8. Alexander Dukette says:

    Thank you so much, I’m currently starting therapy for the first time, and honestly this has helped me understand the relationship between my soon to be therapist and I. I was worried that I’d be afraid of opening up to Somone who I know nothing about. This has been very insightful, thank you

    Sincerely
    Alexander Dukette ( (age 15 )

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