De-Pedestalizing the Therapist and Calibrating Expectations for Actual Llife-Changing Work in Therapy
De-pedestalizing the Therapist and Calibrating Expectations for ActualLlife-Changing Work in Therapy
By: Lexie Beckstrand, LPC
(Estimated read time: 5-8 minutes)
A couple of weeks back, I was sitting for a morning telehealth appointment with one of my virtual clients. About halfway through our session, my client interrupted his own line of thought, suddenly remembering something. “I’ve been meaning to ask this question,” he paused, looking somewhat uncomfortable. He adjusted in his chair and pressed the cushioned speakers of his noise-canceling headphones more firmly against his ears. Looking at his hands, he continued: “Is there something I should be doing, I mean, in-between sessions, to get the most out of this? I just want to make sure I’m doing it…right”, he concluded, evincing a mix of doubt and earnest curiosity when he glanced back at me for my response.
In total therapist-mode, a list of questions dutifully materialized in my mind: What brought that to your attention at this moment? What do you think you should be doing differently between our sessions? What exactly do you mean by “right”? What did you feel when you asked me that just now?
This client’s question (and other clients’ queries like it) are not an uncommon part of the therapy process. The replies that auto-populated for me in ‘therapist-mode’ could all have led to helpful exploration of the client’s experience, and another therapist might not have bypassed those perfectly acceptable questions. However, as a flawed human, I am aware that I tend to look for signs that someone might be unhappy or displeased with something I’ve done. The client’s word choice (getting the most out of this), coupled with my own vigilance about not wanting to let someone down, led to this reflection from me: “I might be off-base, but in your question, I’m hearing you’re feeling uncertain about how our therapy may or may not be meeting your expectations.”
Come with me for a peek behind the curtain, just for a moment: therapists are trained to manage a few competing experiences while sitting with a client. We are tasked first and foremost with active listening, which means listening to understand. At the same time, we need to note the nonverbal information a client gives us in session: affect, presentation, speech, and behavior. We should also be mindful of how the client might be making us feel, and whether their behavior evokes any defensive reaction in us. We then try to offer the kind of response that shows we understand what the client is saying, but also further encourages the client’s self-exploration: ideally, accounting for the possibility that our own traumas, values, or even any distractions in the room with us might filter our responses in some way. I have, for example, previously asked to pause a session to use the bathroom when I didn’t get the anticipated break between sessions. Trying to listen attentively while holding one’s bladder is not the best recipe for success.
This client was still fairly new to my caseload, but from my vantage point, the work was going well. While still getting to know each other, we’d already identified several standout patterns in the client’s thought processes. The client was opening up to me about things he’d not shared with anyone else. We’d covered a couple of basic CBT interventions, especially directly challenging some of the client’s catastrophizing tendencies. Even so, my client confirmed that I had been more or less correct in my reflection. He went on to share that, while he liked talking with me and found it useful, he had hoped there was something about the process that had not yet become obvious to him. He wondered: was there a list we were moving through, a series of steps that once we got to the end of, he’d have ‘done it’? Was I, the therapist, hanging on to some part of the process that would eventually empower him to change?
I realized it was a good moment to recalibrate the client’s expectations of therapy and the role of a therapist. Even with my own discomfort, I was grateful to my client for being able to name the nagging sensation that he was missing something. His ability to tell me not only gave us an opportunity to re-center our work but also helped us identify another of his patterns for further exploration: the sense that he’s generally missing out on something that other people seem to have figured out.
I want to identify and celebrate what therapy is and what it is not. Beginning the process with realistic expectations is critical for achieving actual life-changing results.
What therapy and your therapist are NOT:
A quick fix: Just like learning a new language, therapy takes time, patience, practice, and intention. Consider the difference between learning your native language and learning a foreign language. You probably don’t remember learning your native language. It’s implicit, natural. You onboard it through repeated exposure at an age when your brain is like a sponge, much the same way you might download many of your worldviews, values, and thought patterns from early experiences: often without full awareness or intention. In the same way you might need to dedicate an awful lot of conscious effort and rigor to learning Mandarin or Arabic, you can expect a similar effort when it comes to addressing some of your innate material, that is to say, what you think, feel, and believe. Welcome the effort. Time will pass, whether or not you choose to do the work to improve your lived experience.
A silver bullet: Going to therapy once a week (hell, even twice a week) won’t materially change anything, not by itself. This conviction among long-time therapy-goers is actually fairly insidious, and needs to be dispelled. Some people weaponize the fact that they go to therapy, letting it be the authority by which they tell others how to live, or by granting themselves permission to bypass actual change. Attending therapy doesn’t automatically equal earnest introspection or updated behavior. At Forge & Form, we aim to hold clients to task: that is, we won’t continue to engage clients who are not willing to do the work. A common refrain among therapists is that real change work actually happens in-between the sessions. If something in your life needs to be different, the power (almost always) rests solely with you.
Inherently pathologizing: Diagnoses exist and can be immensely useful, but they are not necessarily the primary focus for many practitioners in private practice. It is critical that a client who meets the criteria for a mental health diagnosis in the DSM-5 receives the appropriate assessment, diagnosis, and follow-on care, just as someone with a physical medical condition would require the same. However, many people who come to therapy attend without meeting full criteria for any one diagnosis. In the same way, going to the dentist for a checkup and cleaning doesn’t automatically mean you have a root canal; mental health care can and should be preventative, proactive, and routine.
Better than you, or infallible: Many clients can’t help but pedestalize their therapists. It makes sense. The therapist is not asked to be vulnerable or raw during the therapy hour, the way clients are expected to be. Most therapists are incredibly conscious and intentional about what they share about themselves, if they choose to share at all. This bent towards ‘blank slate’ is a largely necessary part of the process, but it can leave a canvas for clients to project a fantasy human, one who knows more, doesn’t lose their temper, is unconditionally patient, doesn’t get sick, hasn’t experienced loss, doesn’t have problems, and cannot disappoint. The therapist is the professional in the room, but think about it: is anyone really more of an expert on you than you are? The therapist’s usefulness is necessarily tied to having an outside perspective, not to being someone who can read your mind, decide what kind of person you are, or dictate your future. Therapists are people. We are capable of lying, cheating, erring, and causing harm. Therapists are not sans-struggle. They are trained in helping you identify, understand, and address the struggles you experience.
On that note, even inside the therapy space, your therapist is not infallible. We can misstep, goof up our schedules, get distracted, get the meaning wrong, and offer advice that was never meant to be offered. The cool thing about therapists is that we’re trained for repair. We anticipate moments of wrong-footing with our clients. What counts is not the mistakes themselves, but how we model accountability, sit with discomfort, and address the client’s needs moving forward.
What therapy and your therapist can be:
A trusted, collaborative relationship: Research on psychotherapy outcomes has long shown that the best indicator of a successful therapy experience is a strong therapeutic alliance, meaning the therapist and client share a strong sense of mutual trust and collaboration. While building rapport and safety can take time, the therapeutic alliance can provide space for clients to explore their minds unapologetically and honestly, laying the groundwork for deeper understanding and future change.
A series of corrective emotional experiences: Some of the first skills new therapists learn include asking open-ended questions, reflecting meaning, extending empathy, and identifying feelings without criticizing or offering judgment. These are vehicles to corrective experiences for many clients. For example: if a client had a violent, outburst-prone father who exploded whenever the client expressed a big feeling, the client might’ve learned to minimize their own emotional expression and even their own needs in order to avoid their punitive parent. If in therapy, that same client becomes angry or expresses frustration with the therapist, the therapist has an opportunity to provide a corrective experience by normalizing the feeling (maybe even celebrating the feeling, if it’s difficult for the client to emote) and by offering curiosity and engagement rather than punishment. Over time, these corrective experiences teach the client that a pattern they subconsciously held for self-protection (such as minimizing anger or grief) can be dropped or altered.
Deeply challenging: In addition to basic skills that center on empathy and understanding, a therapist can and should provide intentionally deployed challenges. They may encourage their clients to really stop and experience an uncomfortable emotion, rather than talk their way through it. A therapist might sit in silence for long stretches, handing responsibility for the session's direction back to the client. A good therapist will almost certainly stop a client from spending the bulk of the session in superficial territory, like relaying some other person’s drama or detailing their weekend plans. A therapist might also encourage the client to consider different perspectives and challenge their own ingrained thought patterns. A therapist might ask a client to stop and regulate with them, including pausing for deep breathing. Crucially, a therapist might reflect something back to the client that the client doesn’t want to hear. That work is not easy. It requires open-mindedness and a willingness to sit in discomfort.
An accountability partner: While your therapist can’t do the work that brings about the changes for you, they can hold you accountable. Sometimes this means checking in on your goals, asking you to reflect on the therapy process, and offering encouragement and celebration for real changes made outside of session.
A holding space: Not every therapy session guarantees a mind-blowing insight. Sometimes the value of the therapy hour is the consistency, the safety, and the offer to be heard and understood.
What are your Expectations about Therapy?
If you’re interested in beginning therapy, or if you’re feeling stuck or stymied by the process, get curious about your expectations. Ask yourself whether there are places where you may need to adjust your expectations to meet the moment with realistic vision and intentionality in the pursuit of real, life-changing work.