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Witness to Pain: How Clients Impact Therapists


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Sometimes people ask me how I can stand to spend my days with people who are unhappy. “Doesn’t it bring you down?” they’ll say. “How can you listen to so many sad stories, and see your clients in such pain?” Part of the answer lies in the fact that I know my clients won’t be in pain forever, and that by coming to see me they’ve already chosen optimism and hope over despair. But the other part of the answer lies in how I relate to my clients.

Therapists generally relate to clients in one of three ways: Attached, Detached or Connected. If you’re in therapy (or considering therapy), you might do well to be aware of what relationship style your therapist has, because their style can help or hurt your therapy.

Attached

These therapists do indeed struggle to separate themselves from their clients’ pain. When a client is happy they feel happy, and when the client is sad, they are sad. Clients like them because they feel very close to them; they can see that their therapist "gets" them.

However, because the therapist experiences so many negative emotions, there are drawbacks to this style. Burnout is common, as the pain of being in the presence of so much sorrow can cause a therapist to flee the profession. Such therapists find the work draining, and are careful not to take on too many clients. They spend time and money on self care including long breaks, their own therapy, yoga, etc. Sometimes these professionals can be ineffective, particularly when a client’s problems hit a raw nerve of their own and they become overwhelmed with their own emotions.

Detached

The founder of psychotherapy, Sigmund Freud, recommended a detached attitude toward clients. The therapist stays above the fray, observing the client’s suffering with an objective eye. While that approach is debunked now, some — perhaps many — therapists still gravitate toward it. They provide their clients with diagnoses out of a medical manual; they remain emotionless, their faces a mask, as their client weeps their heart out; and their client feels that they’re being provided therapy out of a instruction manual.

Such therapists do not allow themselves to feel the highs and lows of their clients’ lives. They protect themselves from those emotions through distance. And by doing so, they lose the joy of this work, the wonder of truly connecting to another person. They also lose the most valuable tool they have into their clients’ lives — their own emotions. A therapist who does not feel during a session cannot truly empathize with their client. And if they cannot empathize, they cannot be sure to say the right thing, to pursue the right direction, to show the client that they have been truly heard and understood.

Detached therapists can still be very helpful, particularly in the short term. But over time, clients sense the distance, and this makes it more difficult for them to open up and to change.

Connected

The connected therapist feels what the client is feeling. However, there is always a part of the therapist that is calm and detached, observing those emotions, and objectively using that information to guide the session. A part of him or her is alongside the client inside their firestorm of despair, rage, pain and fear, yet the therapist’s core sense of self is unchanged regardless of what happens.

Feeling what the client is feeling is critical for the therapy. Does the client need to hear the therapist empathize, or offer a different perspective on their sadness? Or would words break the mood, and silence be the best move? Would showing sorrow help the client to know they’re understood, or would it make them feel guilty for making their therapist sad? Without being able to experience the client’s emotions, there is no way to answer these questions, and the dozens of others that come up in the course of a session.

At the same time that the therapist is experiencing the client’s emotions, it is also critical that the therapist core self be unaffected. Without that, it is impossible to keep the client’s interests first and foremost. It’s essential to feel, but it’s equally essential to think. While the therapist is sharing the client’s anger at their parent’s behavior he or she is also thinking “What other feelings are there besides anger, such as hurt, or a sense of abandonment? Where else in my client’s life does this happen? How is their relationship with their parents affecting the rest of their life? What should I say next that would be most helpful to my client?”

The connected therapist is like a see-saw: While the ends of that see-saw go up and down with the client, the center of the plank is fixed in place.

And so, when people ask me how I can stand to listen to unhappiness day after day, I tell them that as a Connected therapist, the sorrows of others do not weigh me down. Rather than being burdened by their pain, I feel that my clients have given me a great gift. They have done me honor by choosing to see me, and to let me into their lives, enabling me to understand them and share what they feel. Their willingness to do so infuses my own life with meaning and purpose, and for that I am not only not weighed down — I am eternally grateful.

Tim Hoffman 

M.A. Mental Health Counselling

Psychotherapy in Hong Kong

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