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Do Therapists Live Vicariously Through Their Clients?

Intimately engaging with therapy clients' pain can help them heal.

Essentially, empathy, compassion, and understanding are learned behaviors. Sure, we may be pre-programmed to respond to others with concern--its propensity residing deep in our genes. But what serves to activate such solicitude, mature it, even "complexify" it, is our environment. And the profession of psychotherapy is optimally suited to help therapists develop levels of fellow-feeling considerably higher than what might be the norm.

Consider the fact that a crucial factor in effective therapy is listening well--demonstrating the ability to detect the psycho-logic behind a seemingly incoherent narrative, pick up on the slightest of hints, and react to subtle alterations in tone, shading, and mood. All these learned skills involve attending acutely to what the client is saying. And making every effort not only to accurately interpret the various ramifications of what's being shared but, with an open heart, to successfully identify with the emotions embedded in the client's experience. This capability takes training, sensitivity, and imagination. And, too, a certain amount of courage. For frequently it's not terribly pleasant to be with a client--"up close and personal"--when he or she is divulging something chilling, repulsive, or ethically repugnant.

I can't begin to count the times I had to press myself to follow a client into a dark, scary place that threatened to make my hair stand on end, my body shiver, or my gut send out alarm signals of nausea. To determinedly stay with clients when they're trying to dislodge some horrific memory tightly stuck in their psyche isn't something that comes naturally for me. In fact, I think almost all of us feel impelled to detach emotionally when another's expression of inner turmoil begins to make us uneasy.

So it's only in holding back and, instead, vicariously experiencing--or personally "clothing myself in"--their personal drama that I'm able to assist them in navigating their difficult journey toward healing. It's in my very willingness to accompany them every nervous step of the way that helps assuage the loneliness of the mental/emotional hurt that's prevented them from evolving in more advantageous ways.

And in existentially joining them in their efforts to make peace with their past, I evolve, too. As I assist them in developing what ultimately will be a more positive self-image and greater self-acceptance, my own consciousness expands. Fully participating in their self-work, vicariously "inserting" myself into their life story, can't but facilitate both my personal and professional growth. And with such heightened awareness, I have at my disposal that much more empathy, compassion, and understanding to extend to others. Moreover, it's only through having intimately engaged with clients' efforts to resolve old conflicts and impasses that I can gain what (in the trade) is referred to as "clinical wisdom."

As an example of what I'm trying to illuminate here, I might mention a physician I once saw that told me about a childhood event that had terribly humiliated him. Sensitive to what was taking place in my body as I listened to--and sought to identify with--his repellent descriptions, I tentatively suggested to him just where I thought he might, physiologically, still be experiencing this old degradation. And he literally stared at me in disbelief, asking me how I could possibly know something so private, so uniquely personal. Was I psychic?! In response, I simply shared with him that I was imagining myself in this abhorrent situation and, spontaneously, that's what came up for me. Realizing that (in "real time") I was able to mirror his experience, he felt many things: gratitude, relief, appreciation--and a tremendous sense of validation clearly (and painfully) missing at the time the incident happened. What he'd endured so many years earlier felt much lighter now that it was a "shared" experience.

In sum, I can think of nothing more important for a therapist than becoming ever more attuned to what their clients have gone through . . . and then communicating to them how such oppressive experiences may likely have affected them. As a direct result of so many times "re-living" my clients' experiences--inside my own skin, as it were--this is the "gift" I have to offer them And I consider my open-heartedly identifying with the negative experiences that left them feeling angry, fearful, hurt, or alienated from others as helping to provide a bridge back to their feeling normal and related--vitally related--to the human community.

All clients want, and sometimes desperately need, to feel understood--and on as many levels as possible. Being able to vicariously interject myself into their particular situation may, more than anything else, be what enables me to fulfill this core therapeutic function. Ideally, what then occurs is that clients feel "grasped" not simply on a mental or intellectual plane, but emotionally and physically as well. And once they can experience this corrective, supportive alignment--the earlier lack of which made them feel fundamentally defective or different--they can begin to "re-align" with others. They can even begin to recognize that their past disturbances actually bind them to the rest of humanity. For their adversities and afflictions--whatever they were--aren't really that different from what, at one time or another, almost all of us have had to bear.


Note: This piece complements a two-part post I wrote earlier for Psychologytoday.com. Entitled "The Past: Don't Dwell on It, Revision It!" here are the links for Parts 1 and 2.

© 2011 Leon F. Seltzer, Ph.D. All Rights Reserved

---I invite readers to follow my psychological and philosophical musings on Twitter.

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