The role of a therapist is in my opinion, quite simple. To provide a safe, comfortable and confidential environment, both physical and emotional, within which a person may explore personal issues that they feel has a limiting effect upon their happiness or well-being. By addressing them, they will achieve a positive and beneficial outcome in their life.
In providing this environment, the therapist will become party to the deepest and in some cases, the most emotionally disturbing events an individual may experience providing of course that congruence and rapport exists.
In experiencing these events and traumas in the therapeutic relationship, the therapist is liable to be affected in some way. Whilst this may be something that the therapist can ultimately 'handle' as part of his or her work, there is always the possibility that in relating an experience to the therapist, the client will emotionally or psychologically affect the therapist.
For example, a client who is in therapy to address issues around a divorce is more likely to experience an empathic relationship with the therapist if the therapist has addressed their experience of divorce. In the same way, an adult dealing with childhood abuse is more likely to fail in their therapy if the therapist was abused and still has not been able to resolve the impact their own experience of abuse had.
Therapy is not an ordinary social exchange between individuals, it is quite different. One of the characteristics of therapy is transference; where the patient begins transfer the feelings that emerge in therapy to the therapist. The patient may come to like or dislike the therapist. In psychoanalytic therapy, such transference is expected and can be used as an indicator as a sign of progress on the part of the client.
In understanding the work of therapists, it is first important to appreciate the role counter-transference plays in therapy.
Counter-transference is when the therapist, during the course of therapy, develops positive or negative feelings toward the patient. This is also a normal and expected process during therapy. However, therapists must not act on such feelings. To act on them is unethical.
A deepening of our understanding of transference and counter-transference and concentrating on the most primitive aspects of the relationship on the part of both patient and analyst is one of the keys to success as a therapist.
Irma Brenman Pick captures this wonderfully. "Constant projecting by the patient into the analyst is the essence of analysis". Pick (1985).
She goes on to say, "The client does not just project into an analyst, but instead patients are quite skilled in projecting into particular aspects of the analyst...the wish to be a mother, the wish to be all-knowing or to deny unpleasant knowledge, into the analyst's instinctual sadism, or into his defences against it. And above all, he projects into the analyst's guilt, or into the analyst's internal objects. Thus, patients touch off in the analyst, deep issues and anxieties related to the need to be loved and the fear of catastrophic consequences in the face of defects, i.e. primitive or persecutory anxiety".
In conclusion, she says, "Of course in these situations the patient massively projects parts of the self and internal objects into the analyst; such patients also arouse in the analyst feelings of being helpless and at the mercy of vengeful exploitative behaviour whilst the patient indulges in imperviousness to the analyst's needs. The task of experiencing and bearing these feelings whilst at the same time not becoming alienated from those parts of the patient that are genuinely defective and in need of support is a considerable one".
Thus, the therapist who has addressed aspects of his or her life which he or she may come into contact with during therapy and which are no longer issues that cause emotional or psychological distress will be better equipped to empathise with the client whilst remaining neutral as to the effect of them upon him or her.
Pick I B (1985). "Working
through in the counter-transference". International Journal
of Psychoanalysis 66:157-66; reprinted in Spillius (1988). Vol. 2, p
34-47 About the author:
About the author:Article written by Gordon Pownall, MSc DCAH MAACT Dip Couns MAGC MIMgt is a Hypnoanalyst in private practice in Huntingdon, Cambridgeshire and in Finchley, North London, (01480 454254 / 07740 305460). His therapeutic work with children and adults is complemented by his work as a trainer on the faculty of ICET, London. He is currently writing his first book and is nearing completion of his PhD in Applied Psychotherapy.
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