I debated a little bit before deciding to write today's post. In recent posts I've been writing about projection, the process where we see in others things that we are not able to see readily in ourselves. Last time I focused on how the client projects onto the therapist. In some ways, for most readers that's the most salient process and this column could have more relevance for therapists than the general population.
But it is from a place of egalitarianism that I chose to include this piece. There was a time in psychotherapy when the therapist was seen as all knowing and the client was a "patient". With the shift in attitudes and understanding (brought on in large part, I believe, by feminism with its inherently more relational stance) doctors of all stripes have been brought down to earth.
A deeper reason for my including this, however, is my belief that rather than detracting from the authority of the therapist, the recognition of how a therapist responds to and projects onto the client adds to the clinical repertoire, not detracts. When a therapist is willing to monitor his or her own reactions to the clients and rather than pretend they are not there, instead use them to better understand what's happening in the room, it deepens the process considerably.
A prerequisite to a therapist being able to do this is twofold: a) a therapist needs to have done a significant amount of work on him or herself (for this reason, personal therapy is a requirement of nearly all training programs for therapists), and b) a therapist needs to be comfortable looking at his or her own trigger points.
As a beginning therapist I struggled more with my reactions in the room, mostly because at first they were stronger and more confusing. I didn't have as clear a notion of where I left off as a person and began as a professional. So I simply didn't trust my reactions as much. Over time, as I've come to trust that the way I have internal reactions to clients is simply my body or my unconscious working as an instrument of perception. In accepting this, the reactions have become much more subtle and refined and are now invariably aids to help me help the client. If I feel a flash of anger, a moment of boredom, a strong attraction or some other reaction, I have learned to use it to help me understand what's happening in the room.
Is it perfectly honed? Nope. There are a few types of issues where I recognize my reactions are more about me than about the client and at this stage of my career I have decided since I haven't yet worked that piece out within myself, it's not fair for me to project it on the client and I refer the client out. For example, I will not work with sociopaths, people who are unable to empathize with another human being. For one thing, it requires that I be constantly on guard, and that's not how I want to be in my work. For another -- how should I put this delicately? I simply do not like people with this issue. It is not fair for me to pretend otherwise. Now I could make the point that my not liking them is me picking up on their incapacity to care about another human and responding in kind. Perhaps that's true and if I had sufficient motivation, I could martial this response into an effective way to work with sociopaths. But I'm not motivated enough to take this one, so I choose not to.
For me the bottom line, whether it's about ourselves as therapists or ourselves as clients, is we need to learn to accept ourselves as we are. The more we do that, the more we're able to see our projections for what they truly are: our own "stuff" projected out onto the world and the people around us.