Dear Therapist:
I enjoy your column every week. I appreciate how each of you have your own style and way of seeing things. I was wondering if you could each share your opinion on what you think is most misunderstood about therapy. How would you clarify and reframe it for those who may be considering therapy?
Response:
Of course, as you said, all therapists have different styles and perspectives. (Thus, our responses to this question will likely differ.) But differences in style and perspective can be extrapolated to all human beings. It also relates to all therapist-client relationships.
One misconception that many people (and even some therapists) have is that the therapist is the architect of change. They believe that the “patient” has a problem and the “doctor” is there to fix the problem. This perspective dates back to the early conceptualization of therapeutic intervention, which in turn has roots in conventional medicine.
Actually, therapists are not here to "fix" people. In fact, it is my belief that therapists are not even generally here to introduce entirely novel concepts. I believe that most ideas that therapists help their clients to recognize and address have already been conceptualized by the clients. Sometimes, these concepts are largely theoretical; sometimes they are applied to others, but not themselves. Typically, the client does not need to be taught how to think or feel; they simply need help tapping in to their own beliefs, thoughts, and feelings that can help them to grow.
For the most part, our issues are due to automatic thought, instinctive belief, unexamined emotion, and behavior. These four aspects form a cycle that is reciprocal in nature; they affect, and are affected by, one another. We are perfectly capable of acknowledging, addressing, and changing all of these aspects, but we get stuck in patterns of emotion-thought-belief-behavior. We may feel something (perhaps a triggered childhood emotion), which causes us to think that we are not good enough. This causes us to reinforce a more general, deeply entrenched, belief that we are worthless. We therefore retreat, avoid, or otherwise shield ourselves from harm, which deepens our sense of isolation and difference—ultimately reinforcing the very negative emotion that started the cycle.
It’s not that we don’t technically have the tools to recognize and challenge our emotions, thoughts, beliefs, and behaviors. We are simply stuck in our patterns. We also have those pesky unconscious childhood-based defense mechanisms whispering in our ear, warning us against opening a can of worms.
The therapist’s job is not to “fix” their client’s “warped” or “bad” emotions, thoughts, beliefs, and actions. Rather, the therapist is there to help the client to draw on their innate abilities and to acknowledge and address unconscious (or conscious) obstacles.
One effect of the belief that therapy is there to “fix” the client is another common misconception. If I believe that therapy is the “fix,” that must mean that I am “broken.” For people who already don’t feel very good about themselves, needing therapy can be a powerful reinforcement of their negative sense of self. Thus, it is the therapist’s fundamental and crucial responsibility to help their clients understand the nature of therapy. This includes the recognition that they—the clients—are the architects of their own change, and that the therapist is simply there to help guide them in their journeys.
-Yehuda Lieberman, LCSW
psychotherapist in private practice
Woodmere, NY
adjunct professor at Touro University
Graduate School of Social Work
author of Self-Esteem: A Primer
www.ylcsw.com / 516-218-4200
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