Thoughts From The Couch – On being real

It has taken decades for me to develop my own style and become the therapist I am today. I remember starting out with all the fears of a green therapist, wondering whether I was good enough, what my clients would think of me and above all, whether I would be liked. I had received explicit instructions from tutors that if I was to work from home or an office, it should have no reflection of who I was as a person. I remember a colleague saying to me that I would be advised to change the way I dressed as ‘it was too colourful and flamboyant.’ It was a confusing time, but I was clear that just fulfilling a role, and or being a carbon copy of other therapists was not going to support me in being the therapist I wanted to be. The demand to be false, which never goes away, is something I leave outside of my therapy room.

Today I still hold true to what felt important back then, that I bring my real self to the therapy room so as not to become stiff and unnatural. I see my job as a secure base to be a different sort of anchor that my clients have had before, and that in offering my client aspects of my authentic self, a trusting relationship can develop, for some, for the first time. For the most part, I am quietly confident in the knowledge that I am trustworthy, honest, compassionate and loving. In my view, in order to be able to benefit from the full therapeutic alliance that develops between myself and my client, I need to be able to hold both the professional and personal facets of who I am. I have incorporated my own self-development and self-awareness into my way of working, and although I have a toolbox to draw on, above all, I bring myself. After all, how can I encourage my client to be themselves if I am not willing to do the same?

The ‘blank screen’ therapist is a myth. No matter how hard I might try, it is impossible not to reveal myself in the same way my clients reveal parts of themselves, within the first few moments of our meeting. Whether on screen or in the room, I self-disclose the minute a client meets me. The way we speak, dress to whether or not we wear a wedding ring. Our gender, age, tone of voice, accent, gives our clients an imaginable insight into who we are. When we work from home there are extensive self disclosures, such as financial status, clues about family and pets, possible hobbies and habits. Informing clients about time away from the office or a forthcoming holiday are also self disclosures that are unavoidable. In addition, as a result of spending so much time together, our clients get to know us well. Like a child who watches her mothers face to get a sense of mood or reaction, clients look and listen for similar signs from me, and there are many. I have learnt over the years that there are times I give away more about myself than I realise, and that is before I have even said anything. So, with that in mind, there is no point in trying to hide.

As a therapist, I am deeply sensitive and intuitive. I seek to create a connection with my clients whereby we can be real with each other. To be real does not mean that I have to answer or appease all or any of my clients questions or demands. However, I will be clear and direct with them, adhering to the code of ethics I work within. Many of my clients have little or no experience of feeling that important figures in their lives have really seen and understood them, and so my being real and honest allows for an authentic exchange of thoughts and feelings. I use transference and counter transference as a way of exploring my clients subtle emotional tendencies. By doing that, it allows me to use my own process as a valuable compass in exploring my clients tender spots. Depending on the length and strength of the therapeutic relationship, there are times when I deliberately choose to self-disclose by either self involving, whereby I share with my clients my personal reactions to them, and what occurs during our sessions or self revealing, by disclosing information about myself.

There are many differing thoughts around self-disclosure. I hear colleagues talk about self-disclosure in binary terms; you either do or you don’t. As I see it, it is not a question as to whether or not I should self-disclose, but more when should I self-disclose. In my experience, there have been many times when my self-disclosing has been beneficial to my client, and the therapeutic relationship. I am mindful of the when, why and how, as I don’t want my disclosure to have them feel they need to be concerned about me or burden them in any way.

For many clients, what happens in the therapy room acts as a microcosm of their relationships in the world. Very often, a client will respond or react towards me in a similar way they do with others in their lives.The client who can push the boundaries constantly, despite being asked not to. The client who becomes angry when I don’t behave in the way she wants. The client who reacts as if they have been attacked when they were only asked a question. The client who appears to use a barrage of words as a way of keeping distance. The client whose words and actions are not congruent. In the therapy room, all behaviours and ways of being are noticed, and there is the opportunity for me to explore, challenge, notice such behaviours, the impact on me and, being mindful, share that with my client. Not always comfortable or well received, but rarely has it happened that the awareness has not, in someway, facilitated change.

So often, clients come and share stories of tragic and traumatic events disconnected from themselves and their feelings. Through turning my awareness to my body and in turn my clients, I can gain valuable information about what might be happening in the moment with my client that she might or might not be in touch with. I can utilise this information to develop an awareness that complements the therapy. By sharing my feelings, it can be a useful way for my client to become aware of how detached she has grown from hers. 

Above all, I want my clients to see me as human. I don’t claim to have my life sorted, have all the answers or not to have made mistakes, that I have had to learn to live with. “Even if it is initially useful for clients to idealise their therapists, we must help them and ourselves to see a separate reality. Modelling takes the form of presenting not only an ideal to strive for but also a real, live person who is flawed, genuine, and sincere. Occasionally, the therapist can use self-disclosure to close the psychological distance between herself and the client. Such sharing can often lead to increased feelings of mutual identification, as well as build great intimacy and authenticity, many clients are greatly relieved to learn that their therapists have been the victims of the same self-defeating behaviours that they are now trying to overcome “ (Kottler. 2017:22)

As part of self-revealing, there are times that I choose to disclose the impact of what I have heard with my client. A moment when my client looks deeply into me, searching for some form of lifeline to understanding, calling for me to share my similar, or relevant, experiences, that allows her to see that survival is possible. I have learnt over the years that by revealing relevant personal information in an appropriate, controlled way, can have a powerful impact on my clients willingness to take risks. By sharing the feelings that emerge when my client discloses can be profound. When sitting with clients as they express their deeply held experiences, secrets and emotions, whatever they may be, and remaining open is not always easy. But by doing so, and acknowledging how it impacts me, they can sense that I too have experience of the powerful, gut wrenching feelings that can, at times, cause us to question life. At that moment they feel validated.

As a therapist, I hear things that are deeply challenging and, at times, can sense things that are invisible to others. I see my gift to my clients is to model what it is to be human, authentic and imperfect. I believe this allows for moments whereby my client and I can sit, without needing to say anything, reaping the benefit of the rare and precious intimacy we have created together, built on the foundation of being real.

Kottler, J.A (2017). On Being a Therapist. New York: Oxford University Press

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