A Psychotherapist Goes To Therapy — And Gets A Taste Of Her Own Medicine

This is a link to "Fresh Air" with Terry Gross.  If you would like to get a stronger sense of therapy, you might find this episode useful and enjoyable:  https://www.npr.org/sections/health-shots/2019/03/28/707561940/a-psychotherapist-goes-to-therapy-and-gets-a-taste-of-her-own-medicine

Guess what? I’m going to give you some advice. Here’s what I think you should do:

1. Buy a place now.

2. Go on the date.

But wait — before you take that advice, let me give you one last piece of advice: Please don’t take my advice. Because if you do, you’re likely to end up as disappointed with me as you were with your parents. My advice — like your parents’ or even your therapist’s (were she to give it) — may be well-meaning, but it won’t help you in the ways that you hope.

For one, despite my good intentions, whatever I suggest will be mediated by my own biases and life experiences. So while I took your living situation into account, it’s also true that I advised you to buy a place partly because I bought my first home in my 30s and in hindsight I wish I’d bought earlier. In other words, my advice was clouded by my personal beliefs about real-estate appreciation. Likewise, I suggested that you go on the date because if it were me — if I were almost 30 and really liked a guy and wasn’t close to a woman who briefly dated him over a year ago — I’d go on the date. But you might have different ideas, values, and tolerance for any potential fallout. What might be a good idea for me might be a disaster for you. And by giving you advice, I might be projecting my own values and beliefs about the world onto you, rather than helping you to gain a stronger sense of your own.

There’s always going to be a gap between what the therapist might advise, and what’s best for the patient. A therapist might see a couple and think they should divorce, but some people prefer to be in a highly conflictual marriage than to be alone, no matter how much the therapist might personally champion being alone for a time over a highly conflictual marriage where one partner refuses to change. Our patients’ lives are theirs to live, not ours.

Our patients’ lives are theirs to live, not ours.

Even so, you’re not alone in wanting your therapist to tell you what to do. I’m asked all the time questions like which job a person should take, whether they should have another kid or freeze their eggs, and whether they should go to their chaotic family’s house for the holidays or do something more pleasant instead. And when I don’t meet that desire, it can feel like I’m sadistically withholding “the answer” that, in their view, I can easily provide and that will solve their pressing problem.

One of the surprises of becoming a therapist has been how often people want to be told exactly what to do, as if I have the “right answer” — or as if “right” or “wrong” answers exist for the bulk of choices we make in our daily lives. Taped up over my desk is the word ultracrepidarianism, which means “the habit of giving opinions and advice on matters outside of one’s knowledge or competence.” As a therapist, I’m trained to understand people and help them sort out what they want to do, but I can’t make their life choices for them. I’m not a real-estate specialist, career counselor or, most important, soothsayer. Part of what people want from my advice is relief from uncertainty — if my therapist says X, I don’t have to sit with my anxiety around ambiguity. But one thing that’s certain about life is its uncertainty, and the inability to tolerate the uncertainty of what will happen if they decide X or Y or Z leaves people trapped in indecision. Learning to slow down and reflect on their choices and anticipate the potential consequences of their actions helps to decrease their anxiety in the long-term. Taking a therapist’s advice alleviates anxiety in the moment, but it won’t last.

Early in my training, I felt tremendous pressure to give advice of the benign (or so I thought) sort, until I realized that people resent being told what to do. Yes, they may ask — repeatedly, relentlessly — but after you actually tell them, their initial relief is often replaced by resentment. This happens even if things go swimmingly, because ultimately humans want to have agency over their lives, which is why children spend their childhoods begging to make their own decisions rather than have them made for them.

But if you were a certain kind of child, a child like you, NAFM, a child who had to make decisions for yourself before you were ready — either because nobody offered, or you couldn’t trust the advice you got — decision-making and the agency that comes with it may feel crippling. Instead of asking for more freedom on the way to adulthood, this type of child will likely grow up and plead to have that freedom taken away.

So you ask your therapist: Should I do this? Should I do that? C’mon, just tell me: What would you do?

Behind these questions lies the assumption that your therapist is a more competent human being than you are. The thinking goes: Who am I to make the important decisions in my own life? Am I really qualified for this? Your therapist, on the other hand, is believed to be the expert, the surrogate parent, the One Who Knows Best. And you are the child in the adult body who fantasizes about how nice it would feel to abdicate all of your responsibility and let a capable adult do the heavy lifting of making hard choices. Even if it goes badly, having somebody else decide seems safer. What a relief to be able to blame someone else for a wrong decision, so that the pain of a bad outcome isn’t amplified by having been the one to create the “mistake” in the first place. (And thus think: Oh, God, I’m just like my parents — I make terrible decisions!)

That’s a deceptive kind of protection, though, because your therapist’s advice will actually make you feel angry and unsafe. You may beg, plead, and cajole until your therapist, at 5 p.m. on a Friday, is so worn down that despite herself, she offers the advice you want. And your first reaction might be elation! Finally! Initially, you might feel supported and taken care of in a way you didn’t with your parents.

But what might you do with this nugget, this actual therapist-given, expert-approved, and longed-for gift of concrete advice? Despite getting exactly what you asked for, you might not do it. You might procrastinate, coming up with all sorts of reasons why you haven’t gotten around to it yet. And then you’ll feel bad for not doing it. And you’ll start to think, I feel bad because my therapist made me feel bad by trying to tell me what to do. How dare she! I’m not doing this, dammit, just because she told me so. Who is she to boss me around? And you’ll sit on her couch every Friday at five, not telling her that you didn’t do the thing she suggested, because you resent her for intruding on your voice, for making you feel like your own opinion doesn’t matter; and on top of that you’ll be consumed by the shame you feel for displeasing her by not doing the thing she wants — which is what this whole interaction will have gotten twisted into in your mind, even though the ostensible point of her giving the advice was to please you, not her. In the end, nobody’s happy.

That’s why getting advice is not the solution to your problems, NAFM. Underlying all this hand-wringing about what to do with your apartment and the guy who asked you out and the dozens of other pieces of advice you may have pushed for is your therapist’s hope that you will leave her. Not now, but when you’re ready, and her goal in each and every session is to help you get ready. From Day One, we are thinking about how to get our patients to leave us, not because we don’t care, but because we do. We don’t want you to struggle so much. We want you to learn to trust yourself. We want you to stop asking us to play God with your life because we are not gods. We are mortals who do our best to understand our patterns and tendencies, our pain and our yearnings, so that we can take responsibility for our lives. And we want you to do the same.

We all wage this internal battle to some degree: Child or adult? Safety or freedom? And no matter where we fall on those continuums, ultimately, every decision we make is based around two things: fear and love. Sometimes fear wins, and sometimes love does, and sometimes it’s wise to listen to the fear, other times to the love. If there’s one thing your therapist is trying to show you, it’s how to tell the two apart. And she’s showing you by asking you to practice listening to yourself so that you can use those feelings like a compass to point yourself in the best possible direction.

Therapists may not give advice, but we do give guidance. And if there’s one thing your therapist knows, it’s that the most powerful truths — the ones people take the most seriously — are those they come to on their own.

 

Looking to get more from life?  This video can help:

There is a changing trend in therapy.  Time was a client entering therapy could expect, and perhaps fear, a long stay.  I think being trapped in therapy  was dreaded by many and kept some from going to therapy despite a need for help.

 

Today the field of therapy has accepted  a reality that many come to therapy because they are experiencing a problem that they need help with, yet are not wanting a long term excavation of their psyche.

 

I believe that this is a positive change and have seen a change in my practice.  Many come in times of need, ending when things are working better, and return months or years later when another need arises.

 

That said, I think that something of value may have been lost in this process, like the baby with the bath water.               

How many of us are content with who we are?  Maybe we aren't  having the relationships we want, or the career success.  These problems sometimes require deeper reflection and the courage to own areas of difficulty.  Why did someone else get the promotion?  Why do the girls I want always seem to fall for someone else?

                        

We wrestle with ourselves.  Therapy can help.