Posted by Adam on May 14, 2000, at 17:55:41
In reply to How Well Do You Know Your Therapist?, posted by Kay on May 12, 2000, at 15:47:06
> No, this isn't a quiz.
>
>
No, but it's a tough topic, and I know I'm probably going to catch some serious hell for what I'm about to say. This reflects my belief, however, and, to an extent, my experience.I for one will never enter the field of clinical psychology or psychiatry, even though I think I posess the mental faculties to do the job at least as adequately as some of my earlier providers. Issues of "transferrance", as someone mentioned above, are important. I think "transferrance," to use the term loosely, can go both ways.
The thought of sitting across from someone (as a therapist) who closely resembles me in their irrational emotional grief is something I'm not sure I could endure or ought to. I have had severely depressed friends and even significant-others in the past. I found I was, having read the self-help books and absorbed many of the platitudes my therapists doled out to me from the psycho-Pez dispenser (apologies to the "Frasier" writers), a very good ape of a shrink. They would lament, I would adopt my Sigmund persona, and the rest you can guess. They went away thinking I was most sage, I felt briefly like a savior, and neither of us took the advice that passed between us, or in any fundamental way believed any of it.
Call me crazy, but I think many a patient-doctor relationship in the field of psychology has essentially the same dynamic. Clinically depressed people, in a sincere effort to both help others and understand themselves, become therapists. They bring to their practice the benefit of intimate knowledge and true empathy, but also the burden of their own hopes and fears. They may not only project these onto theit patients, but, to an extent, want to bond with them as comisserators. I think the weight of this baggage can do serious dammage to the patient-therapist relationship, even when both are not aware of it at the time.
This is not to universally impugn the depressed or the depressed therapist, but I think that for a therapist to be truly effective they themselves must have or develop a safe distance from the heartache of mental illness, in the interests of the patient. Of course they should posess both empathy and sympathy, to the extent that they are caring human beings, and are moved within certain bounds to help their patients end their suffering. But that's where the line should be drawn. I think most of us know when that line is being crossed, and when it is, I think it is appropriate to end the relationship and move on. This will have two benefits, I am guessing: The patient can get the best care; the therapist must wrestle with the issues surrounding the end of the relationship and come to terms with them. If they can, they go on to be better therapists.
The best therapist I ever had was Charles Mansueto, PhD, who treated me for OCD (and in a limited way depression, since the two were so tightly interwoven). As far as I know, he never suffered from mental illness. He was still very kind, very insightful, personable, approachable, sincerely caring, and reasonably accomidating. He was most of all creative. I must admit I think he took a bit of playful delight in subjecting his poor patients to the inevitable discomforts of bahvioral therapy. I don't think there was a malicious bone in his body, he just saw some of the humor in it, and so did I, eventually. He knew, I think, that the more we squirmed the better the therapy was going, and saw progress in the struggle. I think I, in his shoes, would have felt this way with the rational part of myself, and would have simultaneously wanted to flee the room as fast as possible, or break down in tears. It would have shown. And that would help no one.
I thank the heavens for therapists like Dr. Mansueto, for his humanity,professionalism, and ingenuity. And the caring, as well as healthy, relationship I had with him. This sort of thing is what we need in our therapiststs. Don't just wish for it, demand it.
poster:Adam
thread:33299
URL: http://www.dr-bob.org/babble/20000508/msgs/33432.html