Dear Therapist:

I am a 19-year-old...I have tremendous emotional difficulties: anxiety, panic attacks, obsessive looping, and depression. I also struggle with trauma and an unhealthy childhood. While I was skeptical of therapy, I decided to give it a try. I saw a highly recommended therapist for 8 months and found it to be a disappointing experience.  While it helped me gain clarity about myself and a brilliant understanding of mindfulness, I felt like something basic was not addressed and am wondering if my experience is typical. 

I feel what I need is empathy and validation, not suggestions, insights, concepts, and modalities. Is this a therapist's job? Do I need a special type of therapist? Can a therapist just sit and be silent and feel bad for my unreal suffering and not act as if they know everything because they have a degree and experience?

 

Response:

Clearly, people have differing personalities, insecurities, issues and needs. Just as different therapy clients may require different approaches due to their specific thoughts and feelings, therapists vary in their issues, needs, and personalities. In a perfect world, all therapists would leave their problems and other personal feelings completely behind when entering a therapy session. In reality, however, this is impossible. As therapists, we’re supposed to strive to do this to the extent possible. This entails introspection, self-awareness, and recognition of our triggers and needs.

I’m glad that you were able to make some gains in therapy, but you identified a key issue within your therapeutic relationship. Your sense that the therapist appeared to be condescending is probably to a large degree related to their self-identity. When someone feels that they need to be self-aggrandizing, this usually points to a deficit in their self-esteem.

People who have trouble feeling good about themselves as based on their intrinsic qualities will look to external factors to boost their self-image. This often causes us to identify ourselves—to some extent—as based on our professions, possessions, and other external things. We all know lawyers who are always in lawyer mode, wealthy people who need to constantly remind others of their wealth, and others who largely define themselves as based on their professions, capabilities, or possessions.

Therapists are not immune to this need. This is the underlying reason that, as therapists, we need to be as self-aware as possible. This helps us to focus on the client in the most beneficial manner possible.

A therapist may be highly recommended for various reasons. For some, a therapist who has a good grasp of modalities and treatment protocols can do a world of good despite their need to feel superior. For many, however, this can only go so far. You recognize your need for a therapist who can help you without giving you the sense that they are the THERAPIST. I assure you that there are excellent therapists who combine the best of both worlds.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317