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I’ve Never Cured Anybody: How Change Happens in Psychotherapy

(3 minute read)

I’ve never cured anyone.

It’s a funny thing for a psychotherapist to admit, but it’s true. That’s not to say that my clients don’t get better — the majority of them get much better — but it’s not because I waved my magic therapist wand and fixed the person. I may have asked the right questions, or shown interest in some important part of their life, or had a few suggestions of things they could try, but at the end of the day it was the client who made the changes they had to make. Here’s the perfect example of a client who did just that — and in just one session:

Pat had struggled for years with her argumentative and combative elderly mother. Whatever Pat suggested, her mother would shoot down. Her mother would make impossible demands: fire the maid, move house, take her on a vacation somewhere tomorrow. Pat found herself engaged in shouting matches, then feeling terribly guilty later. This had been going on for years and Pat found herself becoming as sad, irritable and irrational as her mother. “I think I’m turning into her” she said tensely. During our first session, I simply listened, asked some clarifying questions and told Pat that it was clear she was having a rough time.

A week later Pat returned, looking like a different person. “The fights are over” she announced happily. “I decided to stop contradicting my mother. Now I just repeat back to her what she’d said, no matter how unreasonable. She tells me she wants to fire the maid today and I say ‘OK, you would really like to fire the maid now.’ And then my mother says ‘But if we do that, it’ll take months to get another one, and maybe she’ll be even worse than this one.’ I repeat that back to her and pretty soon she’s convinced herself that it doesn’t make sense to fire the maid. Problem solved.”

Pat’s solution worked brilliantly. And the important thing was that it was her solution. Other than listen, ask a few questions and empathize, I did nothing. Having struggled with the problem for years, all she needed was someone to truly listen to her. Feeling heard and understood enabled her to step back, stop thinking about anger and start considering solutions.

Some people think that going to see a psychotherapist means exposing themselves to the searching gaze of a well trained professional, someone who will ferret out the blackness that they secretly fear lies at their very core. They believe that psychotherapists are experts in seeing through people.

Perhaps some therapists will tell you what you are “really” thinking or feeling and act as if they are an expert on you. If you have the misfortune to come across one of these individuals, you might want to think about switching therapists. Even if they happen to be right, their insight isn’t going to help unless you’ve come to the same conclusion yourself.

The research shows that the majority of people solve their problems themselves. Over time they stop drinking, recover from depression or manage their anxiety. They are experts on themselves, and use that expertise to change their lives.

But sometimes people get stuck. They can’t figure out how to change themselves. Or the pain they’re in and the time it will take to change on their own is more than they’re willing to bear. They speak to a therapist because they feel they’re lost in a forest, unable to find the path out.

It is my job to help my clients find their path out of that forest. I don’t find the path for them; instead, I’ll shine a light in the various places where I think that path might be, and it is up to my client to choose where to walk.

What does that mean in practice? It might be as simple as just listening — that’s all Pat needed to find her path out of the conflict with her mother. Sometimes it’s letting a client know that their feelings are normal and that they’re nowhere near as awful as they believe. It can also involve suggesting different interpretations for what they’re feeling; for example, that their anger might hide hurt, or that a fear of rejection could underlie their need to accommodate others. Often it’s a joint quest for different ways of thinking and behaving that can make them feel happier. And sometimes it’s a reminder of the strengths that they have.

When my clients thank me for all I’ve done for them, I tell them I haven’t done anything other than shine a light — they had to see the path and walk it themselves.

Because, in truth, I have never cured anybody.


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