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What Your Therapist (or Patient) May Be Thinking

Intimate, insightful reveals from 12 therapists and 22 patients

Source: Ambro/

Whether you are the therapist or patient, it is impossible to have the perspective of an inscrutable therapist or as a therapist to understand a patient fully, particularly if that patient avoids or fights the truth.

Through a series of experiments, findings recently published in Psychological Science show that “We tend to believe that people telegraph how they're feeling through facial expressions and body language and we only need to watch them to know what they're experiencing--but new research shows we'd get a much better idea if we put ourselves in their shoes instead.”

A highly unlikely circumstance when patients want to “know” their therapists or vice versa. Your best shot at understanding therapists and patients comes in the book, How Does That Make You Feel? True Confessions from Both Sides of the Couch. It is an arresting, tell-all collection of essays edited by therapist Sherry Amatenstein that pokes into therapy’s many mysteries and the diverse characters who provide and receive them. The storytellers, some bestselling authors, are brutally honest—brave in using their real names; their accounts reveal eye-opening insights and intimate details.

Therapists' essays, offering unique perspectives, permit you to climb into their heads and understand just how vulnerable and human they are. An interchange between a therapist and patient underscores that point, one we often forget. Kate Walter, who felt betrayed by her therapist whom Kate believed was a lesbian, noted, “How can I trust anybody if even my shrink was sexually confused?” Another therapist responded, “You put her on a pedestal as an expert…but she is just a person.”

Therapists Open Up

Courtesy of the Publisher
Source: Courtesy of the Publisher

Beth Sloan (the only therapist who did not use her real name for obvious reasons) didn’t find her extremely narcissistic patient, Marcelle, even likable. Beth admits her weakness: “A few months later, Marcelle terminates therapy…I put up no resistance, rather feeling a sense of joy that I won’t ever have to see her again. Marcelle taught me that the best thing I can do for myself is avoid narcissists and bullies.” Beth refers “them to therapists who have stronger emotional constitutions than mine.”

Most therapists have been schooled to reveal as little as possible about themselves and for some their training presents a predicament. Binnie Klein, a therapist and radio show host in a small New England town, knows that her on-air weekly music and interview show draws the attention of her more psychoanalytically oriented peers. In her words: “I’ve worked with this issue of having a public life outside therapy for multiple decades and decided long ago that radio was too important a part of my creative life to give up…I believe as therapists we can work successfully in the postmodern age with new theory-bases and approaches to the increasingly more public aspects of our identities.”

Similarly, Juli Fraga, who after a heartbreaking description of her relationship with one of her patients who died, changed her attitude about expressing her emotions with other patients. She offers these examples: “…when a woman’s baby was stillborn, we cried together as she grieved. When patients struggle with infertility finally become pregnant, we shed tears of joy. Crying has become an emotional cord between my patients and me, communicating an understanding that words cannot.”

As different therapists “speak,” we learn more about their own conflicts and problems, depression and anxieties, insecurities and a host of foibles they show or hide. In equal measure, patients have their say too.

Patients Speak Out

From living in a therapist’s apartment rent-free to standing up against the therapist who wants to befriend you (read: have sex with you), the patient-writers are shamelessly forthcoming. Ever contemplated what’s going on in your therapist’s head? Wondered if you were putting him to sleep? Or leave a session asking yourself if your therapist “crossed the line?”

At age 16, Estelle Erasmus’s parents put her in therapy. Ron, her 45-year-old, married therapist, was totally inappropriate, asking her if she thought about him when she masturbated or if he turned her on. In her essay, “Therapy Undercover: Satin Sheets and Sex Talk,” she explains what she learned and how she benefited from having a pervert as a therapist.

It happens that a therapist just doesn’t “get” you, her perspective is the polar opposite of yours. That was the situation for Laura Bogart whose therapist “shut her mind around an idea of hearth and home that might have seemed organic and healthy to her, but tasted like bad medicine to me…She sat with her feet tucked under her, but now this familiar position had a kind of malevolent insouciance: what could this (naturally) thin woman ever understand what it was to lose weight…Her stances about love and hope and health for a fat woman are the targets I load my bow against.”

Among others, Beverly Donofrio discuss her encounters with a series of therapists and offers ten points of sound advice for patients and Dennis Palumbo discloses his journey from successful Hollywood screenwriter to psychotherapist.

An Enigmatic Relationship

How Does That Make You Feel? strips bare that puzzling relationship allowing a better understanding of the therapy process, different types of therapists and myriad ways their patients relate to, learn from, or leave the person in whom they entrust their fears, secrets, and problems.

In Harper Lee’s To Kill a Mockingbird, Atticus Finch said to his daughter, Scout, “You never really understand a person until you consider things from his point of view. . . Until you climb into his skin and walk around in it.” In its totality, this book is about as close as you will get to being in therapists' and patients’ shoes and walking around in them.

Searching for a therapist? Read intriguing findings to ease your search.


Amatenstein, Sherry. How Does That Make You Feel? True Confessions from Both Sides of the Therapy Couch. Berkeley, CA: Seal Press/Perseus Books, 2016.

Haotian Zhou, Elizabeth A. Majka, Nicholas Epley. Inferring Perspective Versus Getting Perspective. Psychological Science, March, 2017; 095679761668712 DOI: 10.1177/0956797616687124

Miller, Kenneth E. Miller. What Are the Essential Qualities of Effective Therapists? Intriguing findings can ease the search for a skilled helper. Psychology Today, March 5, 2017.

Copyright @2017 by Susan Newman

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