Why some therapists can be difficult clients

I have been reading the excellent new book from Stacey Millichamp entitled Transpersonal Dynamics; the Relational Field, Depth Work and the Unconscious and I have resonated with a lot of the material presented. A sign of a good therapy book, for me, is the rate and quality of these resonances to my own journey both at a personal and professional level. In the book Stacey outlines her theories of the psyche and sets out some useful frameworks for guiding psycho-spiritual development as well as offering a perspective on an integrative psychotherapeutic practice. I like her use of metaphors and particularly the use of the image of scaffolding which she explains can seek to act as a protector against wounded parts of the psyche.

I write here about her descriptions of how difficult some therapists can be as clients (see page 86 for reference). Stacey suggests watching a client in the consulting room for what they do rather than what they tell you what they do. A useful way of working is to ask clients to describe the events in their everyday lives rather than accepting their own analysis of those events.

Most therapists will have had to undergo their own personal therapy journey whilst meeting professional training course requirements. These requirements hopefully ensure that personal processing is sufficiently robust enough to help deal with personal blind spots when seeing clients, boosting their levels of self-awareness as well as helping to maintain a good self-care regime for practicing as a therapist. Some great thinkers have spoken in the past about the need for practitioners to be doing their own personal work. For instance, Freud wrote of the importance of personal therapy for therapists in training when he said: “But where and how is the poor wretch to acquire the ideal qualification which he will need in this profession? The answer is in an analysis of himself, with which his preparation for his future activity begins” (p. 246). Additionally, Norcross has spoken of the need to have attained a significant level of psychological maturation, adjustment and personal awareness in order to be able to help another person do the same.

Training therapists can be particularly troublesome in therapy. I wonder whether there is often an underlying resentment for some about having to be in personal therapy to satisfy the requirements of training courses. A form of training tax? Training course fees are increasingly inflated, after all. I sometimes speculate whether there is a sense of form filling or ticking boxes in order to meet course requirements when deep personal processing material is left unprocessed. The expression of anger can be one of the ways someone seeks to protect themselves against deeper self enquiry. The anger could be viewed as a defence or an ‘edge figure’ to protect against something unresolved in their past or from something which they don’t see as belonging to them. This can be when the trainee becomes critical of therapy processes or acts out in negative transference towards the therapist, blaming them for something they did wrong. I have witnessed training therapists leave their personal therapy when challenged or when they have met the required minimum number of therapy hours to satisfy course requirements. I have often wondered how unprocessed early material or wounding will impact on their future future work as a therapist.

Training therapists can often be super stubborn about taking risks and facing their fears or parts of themselves that they don’t like. They might be asking their own clients to extend themselves and to confront their fears but they themselves are reluctant to push themselves into their own uncomfortable areas. When challenged to converse in a different way in their personal therapy, such as in role reversal exercises or working with aspects of the multiple self, such individuals might become more resistant and retreat further into their own defensive system. When working with such individuals it can feel like they demarcate part of their psyche away from public view and it can feel like you are on the edge of their own walled and closed off city.

Furthermore, I have witnessed trainees in so-called personal development groups in training institutes worryingly lacking personal boundaries with their way of relating within the group. I wondered how they could conduct themselves in holding other people’s personal unconscious material later in their careers. Some individuals were not able to shut up and would be a source of constant irritation to other group participants such was the extent of their borderline symptoms. Their capacity for self-reflection seemed limited. The converse of this was also true when some course participants never opened their mouths and remained within their own silent bubble, leaving me wonder how much personal development had actually been manifested. From my own experience of undergoing training some course participants refused to engage in some aspects of the experiential work (for example non cognitive and somatic ways of working) claiming that such work was “not psychotherapy”. Others even opted to change the direction of their academic route to avoid leading a group such was their untreated fear of leading groups. (The successful assessment of some courses is that the trainee recruit and facilitate a small weekend group and write up the findings).

Ken Wilber helpfully described the concept of spiritual bypass when some clients engaged in certain therapeutic practices as a form of avoidance. They had not undertook their own personal psychological work and were still raging about some early material for which there was an open sore. Wilber’s idea on the expansion of consciousness and spiritual development and specifically pre trans fallacy might also be pertinent here. Wilber says that the pre and trans stages of development can be confused and that, and perhaps more specifically, the pre rational is elevated to spiritual status. I have met many people in the therapy community who claim to be serene yogi types and regular meditators who turn out to be furious when they are unsettled or challenged.

Fully qualified therapists presenting for personal therapy can also be ambivalent about engaging in personal therapy. They might not be seeking personal therapy to satisfy course requirements but that does not mean that they will be fully committed to the process. I have found that defences with therapists can be stronger than with other clients. This can be particularly so when addictive processes are present. The more versed in psychological terminology someone becomes, and the more analytical they are, the less able someone can potentially be to describe the nuts and bolts of their everyday life. They can tend to avoid feelings in the session and end up getting stuck in intellectual debate with themselves and with their therapist. They might put previous therapists on pedestals, question the way the therapist works and become overly opinionated about processes in the therapy. They essentially find it difficult to allow the therapist to be the therapist.

When with someone like this it is important to move away from debate and argument as best as you can and try to steer them towards ‘here and now’ feelings. Debating and arguing keeps them feeling safe and the focus off them. This might challenge their trust issues but if the therapeutic work is to become real and authentic then that is where the direction needs to be headed.

See also

Transpersonal Dynamics: The Relational Field, Depth Work and the Unconscious