by Philip J. Rosenbaum, Ph.D.
People often ask why they should talk to a therapist when they could just talk to a friend.
Answer: In addition to creating a safe, confidential and non-judgmental space, therapists form a unique relationship with their clients.
The therapist-client relationship is central to helping people learn how to change their problematic behaviors. Therapists engage with their clients’ lives without becoming a daily part of it. Well-defined boundaries allow therapists the perspective from which to observe behaviors that friends who are involved in a client’s life may be too close to see.
From their unique perspective, therapists have two data points from which to understand their clients:
Behavior Patterns Outside Therapy Also Happen in Therapy
Attentive to the routine ways clients behave in their daily relationships, therapists listen between the lines for repetitions of patterns. They also keep an eye out for how those patterns may be recreated in the therapy relationship. When this happens in vivo, therapist and client are able to directly address the issue.
"Lauren," a young female client, recently told me about a painful experience she had while out with a friend at a bar. She felt out of place, like she didn't fit in. “What was worse,” she said, “was that my friend didn’t even seem to notice.” Lauren was angry that her friend could be so oblivious to her needs. Knowing that she has a tendency to not speak her mind, I asked if she had told her friend how she felt. Lauren responded that she had not; she felt her friend should have just known. Lauren’s pattern is to suffer in silence and then become resentful.
I found myself wondering aloud if she ever felt a similar discomfort when she came to see me. As it turns out, Lauren said that coming to see me was very difficult for her—but she had not felt able to tell me until I asked.
Talking about her discomfort in therapy was relieving for Lauren. She could see how she had been putting on a brave face her whole life. She worried that people would be burdened if she told them how she really felt. In addition, she could see how it was problematic that she resented it when others didn’t seem to notice her pain.
Behavior Patterns in Therapy Also Happen Outside
Sometimes behavior patterns become apparent in the therapy relationship before they can be identified as a pattern in the client’s life.
"Frank" is in his late 20s. He expresses his opinions in ways that imply that his view is the obvious and correct one. He typically ends his statements with, “isn’t this true?” At times, I would find myself feeling pulled to agree with him, even when I didn’t.
The first time I disagreed with him, Frank became angry. He said that I was not supportive and that he would probably be better off with a different therapist. He threatened to end the therapy. I told Frank that it felt to me like there was a part of him that was demanding and controlling—it was his way or the highway. Frank became quiet and slowly admitted how important it was to have my approval and agreement. As we examined our interaction, Frank speculated that he may have driven away friends with his aggressive demands for agreement, a behavior which hid his vulnerability.
Frank had repeated what he does with other people in his life in his relationship with me. Up until that time, his friends had not been able to communicate the effects of this to him. Indeed, they were more likely afraid of him due to his coercive and aggressive manner. Our discussion helped him learn something about himself that he would have otherwise avoided knowing.
Involved, But Not Too Involved
Clients often come to therapy in distress but without awareness of the behaviors and interactions which are causing them pain. Listening closely to clients' stories while interacting with them, therapists are able to help people identify maladaptive patterns of behavior.
This is the first step towards change and growth.
Philip J. Rosenbaum, Ph.D., is a clinical psychologist, psychoanalyst and is the Director of Counseling and Psychological Services (CAPS) at Haverford College. He received his psychoanalytic training at the William Alanson White Institute. He is co-editor of the Journal of College Student Psychotherapy and editor of the recently published book Making Our Ideas Clear: Pragmatism and Psychoanalysis. He is also in private practice in Philadelphia. More information can be found at his webpage: www.philiprosenbaumphd.com