Recognition of Therapist Impact

Sandy Springs Psychotherapy is set up as a clinic designed to teach individuals how to become their own healer and live their life to the fullest.  Given that this is what we believe and how we practice I thought it might be important to examine the therapeutic relationship and the impact that the therapist has on an individual.  It is important that we remain thoughtful, responsive caregivers not caretakers.  The following are some thoughts on therapist impact.

Don't react- Learn to respond:

The individuals we work with are sometimes very fearful and they occasionally tell us scary things.  It is imperative to understand that people are sometimes out of touch with themselves, especially during times of distress.  During those times they may rely on gathering knowledge about themselves based on the reactions they get from those around them.  They may mistakenly get in the habit of making assumptions about themselves based on how others are treating them- rather than taking a breath and realizing how they are treating themselves and the impact that has on their interactions with others.  The difficulty occurs when they begin to feel like their feelings are not valid because




they don't know them, and anything less than a big reaction from someone else leads them to believe that their feelings are not real.  The danger is that individuals can get caught in a cycle of increasingly self-destructive behavior while unconsciously seeking what they believe to be a validating reaction from the therapist.  The work then becomes focused on crisis intervention rather than increased self-awareness and healthy progress.

Role model non-reactive behavior:

Non-reactive does not mean dismissive.  Non- reactive means warm, thoughtful, and curious.

Teach the individual to respond to themselves without reacting:

These individuals often react to themselves by dismissing their feelings and reality.  Labels can be dangerous because they can lead to the dismissal of oneself.  I so often hear from individuals who feel out of control- "well I'm just a crazy borderline!"  To which I respond- "what would your response be to yourself if you were scared and confused and used those words to describe yourself vs. a label?  What would it be like to describe your feelings accurately and then respond to yourself in a soothing way vs. abbreviating your language and dismissing yourself with a label?"

The relationship heals:

All the techniques in the world won't work if a healthy relationship does not exist between you and yourself and you and the individual you are working with.

Expectations:

Of course the individual’s expectations about healing are paramount to their success.  However, the impact of the therapist’s expectations is also important.  It is important to recognize what you expect from the people you work with- if you expect them to be sick, they will live up to that expectation.  If you expect them to heal, they will.

Respect:

Maintain an awareness of your reactions as a person when you interact with an individual.  You need not act on your feelings or react to your feelings by judging them but it is important to remain aware of your internal responses.

Voicing the process:

Often individuals who are seeking help due to self-destructive behavior are mystified by the give and take in relationships.  They appear socially savvy on the surface- underneath they may be confused and scared and have little understanding or belief in the validity of labeling and voicing that process out loud.

Empowerment- yours and theirs:

Don’t be a victim to them; don’t let them be a victim for you. 

Managing your own anxiety as a therapist:

If the relationship is a healing healthy relationship then I have to be careful to empower the individual.  Sometimes individuals in the moment of distress do not want to be empowered.  Sometimes they unconsciously want me to hold the power and make them safe.  I can’t do that, and if I try to, they get sicker- so I explore that dynamic with them. 

Know the agenda- yours and theirs:

Sometimes individuals in distress don’t recognize that they actually do have an agenda.  They just want to follow mine and it’s not about my agenda. 

State what can and can not happen in therapy:

I can’t make you safe, keep you alive, take away your feelings, make you feel better, etc.  I know it sounds silly, but it is easy to forget that other people may not have participated in a therapeutic relationship.  Therapists are frequently and mistakenly believed to be powerful and have all the answers- we simply do not.  Remember, a core feature of the individual in distress is that- “others know what I need and have answers for me”. 

The individual is constantly locked in a battle with themselves of- “on the one hand I want somebody to regulate me, and on the other hand you better not try to regulate me because if you do I will panic and react to that regulation”.  Thus, it is our job to assist people in recognizing that they hold both sides of their dilemma.  By encouraging individuals to hold both sides of their dilemma we can begin to challenge them in their own self-awareness and recognize the choices they can make to regulate themselves.

- Anne Lewis Moore, PsyD