What Clients Don't Tell Their Therapists

... and what therapists can learn from that

I am in the fortunate position of speaking to many students of psychotherapy and counselling in my role as tutor and supervisor and I am always interested in their perspectives. What I have come to hear very often is how, as clients in therapy, these students often choose not to say the things that are foremost on their minds in their own therapy. This has been a real eye-opener.

The biggest deterrents are:

• The therapist will not like them if they disclose “bad” aspects of themselves
  If they say for example: “I really wanted to strangle my dog after he chewed my best shoes up.”
• The therapist will not deem them fit to be therapists if they show their true colours
  If they say for example: “I don’t feel at all sympathetic towards that person.”
• The therapist will think they are mad/not normal
  If they say for example: “I keep on thinking everyone is out to get me.”
• The therapist will be upset if they say anything that is remotely critical
  If they say for example: “I want to end the therapy or I was really devastated when you were late last week.”
• The therapist is not strong enough to hold their emotions
  If for example they were to break down in tears.
• The therapist will be overcome with emotion if they reveal upsetting details about situations they have encountered.
  If they say for example: “My father used to beat me very hard to the point I bled, even when my sister was dying in hospital.”
• The therapist will punish them somehow
  If they say for example: “I think you charge too much for sessions.”
• The therapist will not honour confidentiality
• The therapist will not be interested
• The therapist will not understand
  

From these several responses (and no doubt there are more), therapists have a lot to think about in their practice. Surely, therapists want their clients to have a freedom to express whatever it is that is going on for them so the dialogue can be rich, fruitful and uninhibited – out of which there will be an enhanced therapeutic benefit.

To respond to the possibility that in their work with clients there is much being suppressed, therapists firstly need to challenge themselves. Here is a sample of such challenges

• How judgemental am I really about what the client is saying?
• What is it I think I already know and understand about this client that prevents me from really listening to what is being said?
• How robust am I really when certain topics are raised?
• Do I feel protective about this client and feel inclined to rescue them from situations by pacifying and advice giving, instead of really staying with what is being said?
• How immersed am I in this client’s predicament? Am I fearful for them and, if so, does this get in the way?
• Am I really able to work with this client?
• Do feel unconfident even fearful when I meet this client? Do I really work through this in supervision and therapy?
• Am I avoidant in the room because I am scared to take a risk in the work? Courage is one of the personal attributes we need as therapists.
• How do I come across? How does the client see me? Have I worked with this relational dimension in the work and, if not, why not?
• Am I bored by my client and if so how do I make sense of this: is it about me or is there something interesting to explore in our dynamic or is it an intolerance on my part?
• What are my expectations of my client? Do they get in the way of real dialogue?
• What are my expectations of myself as therapist? Do they get in the way of real dialogue?
  What are my expectations of therapy? Are they realistic?
• Can I tolerate uncomfortable situations in the therapy room?
• Do I feel quite persecutory when a client is being negative towards me?
• Do I ever ask myself, “What isn’t the client telling me? Why not? How can I encourage and be more invitational so that our conversations might be more open and fluid?”
  Am I so caught up in being “a therapist” that I come to objectify myself in this role and the client in their role of being “client”, rather than fellow human being?

When Nietzsche said “physician heal thyself”, he showed great wisdom; for it is only when we can admit our biases and weaknesses that we can with integrity meet a client, another person like us, in their personal explorations in the therapy room.

And the next interesting question is “As a therapist, how comfortable am I engaging in these self-searching questions with my own supervisor?”

Interesting dilemma – will probably reveal much.