Mark Goulston M.D., F.A.P.A.

Just Listen

Is YOUR Psychotherapy Helping or Enabling You?

Maybe it's time to fire up or fire your psychotherapist

Posted Feb 18, 2013

Have you been seeing a psychotherapist for six months or more? If so, ask your most trusted, candid and in-your-corner friends, partners, family or coworkers what changes they have noticed regarding your attitude, communication and ability to handle stress. If they say they haven't noticed anything, it's time to either fire or fire up your psychotherapist.

One way to get the ball rolling to help your well-meaning psychotherapist to help you is to say to them: "When you say, 'uh-huh,' or 'I understand what you're feeling' or 'I can understand how you might feel that way,' you are not saying that you think I'm right or that you even believe what I am saying. You might even think that I am completely wrong and being oversensitive and overemotional. Is that true?"

An honest therapist will say it is. When a therapist says, "uh-huh," it usually means they are acknowledging what you are saying to them and prompting you to continue talking. When a therapist says, "I understand what you're feeling," they mean, that from your point of view (not their point of view of even a point of view they agree with), it does make sense that you are feeling the way you are feeling. It doesn't mean they agree with you or think you are correct or seeing things clearly or accurately.

If you then ask them why they haven't been clearer about that and they say something like, "Well you're so depressed or anxious or stressed or feel treated so poorly by others that I have attempted to be empathic to help you feel less alone," they are doing you no favors and are actually enabling you to stay stuck if you haven't made any noticeable (to others) change in six months.

If you don't believe you are stuck and all those trusted and candid friends, family, partners and co-workers haven't noticed anything different about you (and they are not oblivious regarding you), then you are stuck.

One of the reasons your psychotherapist doesn't confront you is that they may have the desire to empathize and help you feel less alone, because being alone in pain makes it worse and often turns it into suffering. Feeling less alone, on the other hand, often helps lessen the pain. However, too often you and they may be stuck in a "folie a deux," "don't ask, don't tell" collusion. If that is true and you haven't asked for clarification of their "uh-huh," "I understand how you feel," etc., they won't tell you.

Why? What is likely happening is that your therapist is conflict-avoidant (which is why many psychologists and psychiatrists chose that specialty), and believes (from their personal background) that confronting people rarely makes things better, usually makes things worse, and that when you do, people become upset and don't change anyway. In the vernacular of the trade, that is their "countertransference."

Now there is the possibility that maintenance and keeping you from backsliding into something much worse (and God only knows how much worse utter discouragement and despair can be) is not a bad or even unacceptable goal, but you need to be clear with your therapist that that is the goal they have in mind for you as opposed to your progressing past it.

So what is the purpose of psychotherapy? The purpose of psychotherapy is to stabilize your personality so that when your therapist or friends provide counseling or suggestions, you are able to act on them. Stabilizing your personality means being better able to "take the hit(s)" from life in terms of frustrating, upsetting, angering or frightening things that happen to everyone every day without becoming and acting frustrated, upset, angry or frightened.

One tip to try to help you stabilize your personality is that whenever something upsetting, frustrating, angering or frightening occurs, say to yourself (or hear in your mind, in the voice of someone who cares about you and wants the best for you), "Opportunity for poise, take a deep and slow breath, take the hit, take another deep and slow breath and exhale."

And now that you've calmed yourself, re-centered yourself and refocused yourself, my counsel to you is to go confront your psychotherapist in a poised and gracious way. You already have a lot of time and money invested and they didn't mean you any harm.

Other resources for "stabilizing your personality":

  • Mental Help Classified and Clarified
  • The Monkey is Off My Back - Relapse Prevention is Here


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