Three Things Therapists Do

woman-thinkingThere is a funny meme that one can look up by going to Google Image Search and typing in “what people think therapists do”.  I can tell you that I do relate to a lot of these.  The “what people think” meme is one of my favourites because it concerns my one of my favourite subjects: empathy.  Agree or disagree with what some people put in these memes it nonetheless challenges one to think about how differently people see the same thing.  I have worked as a therapist/mentor/behaviourist for several years now and I’ve picked up that few people understand what a therapist does and why these things are important.  This list of three functions of a therapist is what I consider to be the most important things that I do as a therapist.  Keep in mind that other therapists would possibly disagree and that maybe their approach suits their clients.  This list is ordered by the importance I place on them; here are the three things I believe therapists should do:

1. Validate emotions

2. Challenge beliefs

3. Give advice

Validate Emotions

Emotional Validation is a huge topic deserving of a book in itself and so I am not going to do this topic justice in these couple of paragraphs.  In my opinion it is the most valuable thing a therapist can offer their clients.  Being able to observe, identify, process, understand, and express emotions appropriately is probably the single most valuable life skill anyone could have for any purpose.  It is at the heart of mental health because being in touch with and understanding one’s feelings is functionally the same thing as having a firm sense of identity, self-value, and purpose in one’s existence.  The more respect we show our own feelings the more respect we show ourselves and other people and the more connected we feel with reality and with other people.  A great deal of mental anguish and bad decision making is the result of a deficit in a person’s capacity to process emotions efficiently and effectively.  At the risk of sounding flippant, but the number one psychological defence, i.e. denial, is basically a form of emotional constipation.

Emotional validation works by helping people to get in touch with their feelings, especially feelings they don’t know they experience, and to feel comfortable experiencing them and expressing them.  The process is complicated as it occurs on many different layers simultaneously (attending, listening, understanding, relating, normalising, supporting, etc…)

A simple example of emotional validation might be a person talking flatly about being abused by someone, sometimes they might be joking about it or expressing another false emotion.  A competent therapist will pick up on this and say something like, “I imagine you probably felt very hurt/afraid when that happened,” and the client who was previous emotionally flat or expressing a false emotion experiences a sudden surge of feeling as they come in contact with an emotion they probably didn’t know they had or didn’t feel safe enough to acknowledge.  Repeat this enough times and a person who is struggling to process their emotions starts to learn how to identify, label, handle, and express those emotions much better.  Emotional validation for other people is not an easy task, it does require much empathy and detective work at times.  Clients surprise me sometimes by feeling joy or anger in unexpected situations.  If a therapist gets the emotion wrong then it doesn’t work; it’s not an easy job for a therapist to do and like everyone else we have our slip ups at work and need to just keep working at it until we succeed.  This is where being an emotional detective becomes valuable.

What I think is essential is that whatever the client is feeling, it is important to validate that feeling in some way.  Feelings are in a way always right and what causes more distress to people is being told directly or indirectly that their feelings are wrong, immoral, or broken.  This can be a hard concept though for many people in the client’s chair to grasp but hopefully, they will eventually reach that point and they won’t need a therapist anymore as they can validate their own feelings.

Challenge Beliefs

In stark contrast to emotions where one approaches them as always being right, beliefs are treated entirely differently.  Beliefs are much more complicated elements of a person’s inner world, what we typically call ‘thoughts’ to distinguish them from emotions.  Like all complicated things, they’re far more likely to go wrong.  While honouring feelings, and being attentive to them is a good thing, holding steadfast onto beliefs is an entirely different matter; one doesn’t want to be too attached to most beliefs.  For example one might have a belief that whenever a person makes a mistake they ought to be punished.  Since people are not perfect, this often leads to a habit of masochism: I did something wrong, punishments are meted out to those who do wrong things, therefore I should be punished.  This habit of undermining, limiting, and attacking oneself only exists because of the belief that punishment is necessary for a person to correct their mistakes.  However, punishment is generally not helpful at all, and certainly not necessary since consequences are a natural inhibition against doing the wrong thing.  However, how many people can distinguish between punishments and consequences?  Less so in relationships than they can in a technical field.

This is where being a philosophical therapist is so valuable.  Philosophy is a process for testing beliefs to see if they are indeed rational.  My interest in philosophy in a therapeutic setting is focussed on grammar and classical education.  In the classical education system a person would complete a series of subjects collectively called the Trivium.  These subject were: grammar, logic, and rhetoric, which can be expressed more simply as: knowledge, understanding, and communication.  By challenging the beliefs of my clients I’m actually helping them to learn and strengthen their Trivium.  By doing so a therapist is helping a person develop the confidence to think clearly, for themselves, and to take responsibility for their decisions.

Give Advice

It seems to me, based on people that I’ve talked to, that this is what most people think of as being the primary role of a therapist.  I don’t believe this is true.  I actually think advice is probably the least helpful thing a therapist can give, unless that advice is helpful in the reinforcement of the first two things a therapist does.  Most advice I tend to give relates to insights into how emotions work, the things to look for in a relationship, differences between how men and women generally approach situations, ways to help see another person’s perspective, and better strategies for communicating with other people.  All these things are valuable, but until a person is comfortable with their feelings and capable of thinking clearly advice is of little use if any.

For example, a woman might nag her husband to do chores.  I could give her some ‘helpful’ advice: don’t nag her husband.  However, that is pointless advice because very few people enjoy nagging other people so she probably figured that one out herself, and it doesn’t address why she is nagging at him in the first place.  Other examples include advising people not to take drugs or to stop yelling at people when they’re angry.  None of this advice is actually helpful because in all these examples the problem is lack of emotional awareness and/or clear thinking.  It would be far better to spend my therapy sessions focussing on helping these people be in touch with their feelings and thoughts than to tell them patronising advice like: don’t nag, don’t take drugs, and don’t yell.  If someone tells you that they are scared they might kill themselves, would you ever say to them, “Well, just don’t kill yourself then!”?

Advice that is helpful is usually things like: explaining how boundaries work, the different sexual pressures men and women face, how to better cope in a relationship with a traumatised person, a way of reframing a painful experience into something positive and so on.  These pieces of advice are intimately connected with the first two roles a therapist has and explaining them is typically helpful in reinforcing the lessons of “validate your own emotions” and “challenge your own beliefs.” Since such advice is more in aid of the first two roles I don’t have any expectations for my clients to actually follow my advice.  I don’t personally care if my clients don’t do anything I suggest.  I am happy of course if they think about my advice and that this advice inspires them to be more creative, deeper, and responsible in their decision making – that’s a sure sign to me that I am giving them the value they are paying me for.

I have a little mantra just to help remember these three things:

The Philosophical Therapist’s Mantra

Emotions are always right,

Beliefs are almost always wrong,

Advice never needs to be followed.

After reading this article, I’m hoping that it clears up some of the mystery behind what a therapist does, or is supposed to do.  Although, not all therapists are the same, I know of some who emphasise challenging beliefs and don’t take emotional validation that seriously, while others are heavily into emotional validation.  I tend to see those therapists as being more specialists in these skill sets which can certainly be helpful for people seeking extra help in those areas.  Therapists who only give advice are, I believe, more a creation of Hollywood screenwriters because therapists on TV shows are often terrible depictions of what real life therapists are actually like or what they do.  However, I do frequently cringe at some of the horror stories I hear about bad therapists.    Which I think is unavoidable because the task of emotional validation is complex and subtle even though it has an excellent track record in helping people to heal their psychological injuries.

I would be curious to hear any feedback from my readers about what things they value from a therapist that I haven’t mentioned.  Also, I am interested to know of any bad experiences people have had with therapists.  An article about what a therapist should never do is something I would like to write in the future so some good anecdotes to share would be much appreciated!

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