Therapy

Therapists in Therapy: What It Means for You

A recent study explores how therapists' own therapy influences their work

Posted Jan 27, 2020

The esteemed psychiatrist Irvin Yalom once reflected: Therapists need to have a long experience in personal therapy to see what it's like to be on the other side of the couch, and see what they find helpful or not helpful.”

So, how does a therapist’s own therapy influence their work with patients?

This question was the focus of a recent study conducted by Swedish psychologists Katarina Åstrand and Rolf Sandellout.  More specifically, they wanted to better understand how psychotherapists’ experience in personal therapy influenced their professional growth, with particular respect to gaining psychotherapeutic knowledge and skill.

To that end, Åstrand and Sandellout conducted semi-structured interviews with 10 psychodynamic psychotherapists. The participants had engaged in personal therapy, which is a mandatory component of training to become a therapist in Sweden (the minimum is 125 sessions).  The investigators then performed a thematic analysis of the participants’ responses.  The results generated three themes, each of which had sub-themes.  A summary of the findings is outlined below.

Theme 1: Shared Experience.

  • Experience as a patient. A therapist’s personal therapy provides a way to share in their patient’s experience in treatment and to feel reciprocity in therapeutic encounters. As one participant put it: “To this day when I meet patients, I can think, based on my own experiences, how it may be for the person who is there. It’s cool really, still today, I think so.”
  • Empathy and understanding.  Having firsthand experience with what’s difficult and painful as well as helpful can positively inform the therapist’s clinical work.  Personal therapy helps therapists recognize and identify with the patient’s therapeutic journey. One participant remarked: “Well, you get to think that there are some kind of common processes that we humans… need to get through in therapy to sort of coming to insight and feeling a bit better.”
  • Safety and responsibility. Personal therapy leads to greater confidence in one’s abilities as a clinician. It helps mitigate the uncertainty that often accompanies the work, and dispels the myths of how a therapist “should be.” One respondent asserted: “How would you dare to sit there and be a psychotherapist when you don’t know what it means to sit in the other chair? I would never dare, I think you have that responsibility”
  • Respect and humility. Personal therapy helps clinicians focus on what is common to human experiences and struggles, and negates us-and-them thinking and omnipotence.  It also underscores that self-exploration is an ongoing process — a revelation that makes the therapist duly humble in the face of patient’s challenges. One respondent averred, “If you think you know everything and have nothing more to learn, that you don’t need therapy yourself… then you have real problems.”

Theme 2: Personal Influence

  • Self Awareness.  Self-awareness is essential to being an effective therapist.  It helps delineate what the patient is bringing to the therapeutic encounter, and what originates from the therapist’s inner world. One participant stated: “When you don’t understand a patient, you simply have to go back to your own analysis and try to understand more about yourself. I’m responsible for working more with myself.”
  • Conviction.  Knowing that psychotherapy actually works encourages self-confidence in how one copes with problems.  The therapist can then gift this experience to the patient.  A respondent shared: “It has helped me and therefore I know it’s true, it works. Otherwise, I wouldn’t know. And that’s something you pass on to your patient. I think that’s really important. It creates a sense of security and calm in the patient knowing that you have… that you believe in this, know that this works.”
  • Sanctuary.  Personal therapy has been described as “a room for oneself” and a “place of recovery,” which the therapist can then provide for the patient. One respondent remarked: “You get the feeling that you are unique. Personal therapy gives you so much in that way. You are seen and you are good enough and all these things that you get to work with… I think that’s very important.”

Theme 3: Knowledge Integration

  • Theory.  Personal therapy deepens the therapist’s theoretical knowledge and promotes learning, understanding, and integration. It helps consolidate theory by connecting it with personal experience. As one participant put it: “You can’t learn just by reading, you have to feel it.”
  • Method and technique. Personal therapy makes the therapeutic process clearer and integrated, as the therapist can link their own experience to their clinical work.  One respondent opined  “… it was a way for me to take in what was said and connect to it in another way.”
  • The trade.  Personal therapy is a forum in which therapist’s can learn their craft. Being a patient offers direct experience with how different therapeutic interventions feel and work. One respondent said, “It’s difficult to have it transferred in any other way than by trying it out on your own…”
  • Role modeling. When learning one’s profession, it is vital to have a role model.  Thus, personal therapy provides a reference as to what being therapist is actually like, and to develop one’s own voice as a clinician.  One participant observed: “You notice things in the other person that feel right for you and you assimilate them and make them your own.”
  • Relations to the position as student.  In theory, personal therapy as a trainee is considered positive — but, in application it can be an overwhelming financial and emotional investment.  One respondent remarked, “In the most intensive study periods, clearly it was a lot of work.”
  • Linking the personal and the professional.  Personal therapy connects the personal with the professional.  It encourages the trainee to preserve and value their genuine and authentic self as they step into the role of psychotherapist. A participant reflected: “My professional self has settled down. Theory and practice have been integrated into me and I feel much more confident in my role… and my personal therapy is an important part of that.”