Making Friends with Your Discomfort
August 14, 2017
When I teach other therapists, whether in school or in practicum, I stress that much of what goes on in therapy not only isn’t taught in school or during training, but also that it *can’t* be taught because the learning is experiential. (Ironic that I say this while conducting a training.) I think that this experience is common across many of our relational activities. You can read all of the books on marriage, parenting, and grief that you want and none of them will fully prepare you for the experience of those things once they happen. A therapist’s relationship with discomfort is one of these important experiences.
Someone told me about another therapist that they knew who said, “I don’t need to worry about transference and countertransference, I do CBT!” This is wishful thinking and I respectfully disagree. Whatever your theoretical orientation, you are, first and foremost, a person in the room with one or more other persons. In physics, the observer effect postulates that the simple act of observing or measuring something has an effect on that something. I believe that the same applies to therapeutic relationships. Your very presence has an influence before you say a word. You are in the therapeutic field and accepting that is important.
There may be an expectation that a therapist is calm, cool, and collected as well as fully grounded all of the time. Good luck with that! I am happy to say that no therapist that I know has been permanently harmed by being uncomfortable though some do all they can to avoid the experience. One of my mantras is: “Life is uncomfortable. You can be less uncomfortable now on your terms or more uncomfortable later on someone else’s terms.” This statement has generally had a positive — if sometimes groan invoking — effect on people. Once you accept that life is uncomfortable, the idea that you may have some agency over that discomfort may appeal.
How does this affect clients? With relationships, it can be someone wanting to buy some expensive widget and fearing what their partner will think. It can be, in an open relationship, interest in someone new and not knowing how their partner will react. It can be big life decisions — partnering more formally, buying a home, having children, moving somewhere new. With individuals, sometimes people are not fully honest with themselves. This can lead to experiences of denial, avoidance, and, in extreme cases, delusion. Being honest with yourself sooner rather than later may make that experience not easy but easier.
How does this affect the therapist? If there is conflict over the new expensive widget or new dating interest, it may be tense in the room. If the therapist does not deal well with conflict, this may be challenging. There is often a balance between soothing the clients and watching what plays out in the conflict. And ire may be directed at the therapist. If it is a big life decision, it may seem impossible to reconcile two opposing desires. This can bring up feelings of inadequacy or incompetence in the therapist. It can also be that the client brings in something that the therapist is wrestling with in their own life. Let’s touch on each of these in turn.
Dealing with Conflict
Clients have said things like, “We never fought before therapy and since we have come here we fight all the time!” or “We only fight while we are in therapy!” and in some cases one or both partners have blamed me. When a couple comes in and says, “We don’t fight and we never have,” my first internal reaction is “Oh boy, let me prepare for an explosion.” I expect there to be a least a little friction, a little disagreement in most relationships.
If you consider the presenting issue the tip of the iceberg, coming to therapy may reveal the rest. And clients can be scared, angry, or confused by this and may lash out at the therapist. When this happens, I usually take a slow breath and try to first relate to the feeling state of the client. In reality, most often I don’t think that the clients is angry at *me* though I am a convenient target for their anger. A couple may be angry at each other or at themselves. My goal is to shed light on that potential self-directed anger while not identifying with the anger that they project on to me. If they are genuinely angry at me, that’s an opportunity to work through that anger. I believe part of my job is to hold that anger without taking it on. If you don’t like conflict, you may not want to work with couples or families. For me, it makes things easier because very often things become more out in the open much more quickly.
Dealing with Feelings of Inadequacy or Incompetence
This one can be fraught, especially for new therapists. Remember that most likely your client has been sitting with their issue for a long time, they have thought about it, they believe they know it well, and they may want you to solve the issue for them since they have not been successful in doing that on their own. And there’s the rub: it is not the therapist’s job to solve the client’s issue. We (usually) don’t give advice and we (usually) don’t express personal options. If you can fully internalize this, it can help. Solving the client’s problem is not your responsibility. You may be there to help, to mediate, to model and teach communication, to give exercises to improve a whole host of things, but, in the end, it is up to the client to deal with their issue. When I was an EMT, the instructors taught us that EMTs (or nurses or doctors or doulas) don’t deliver babies, mothers deliver babies and we are there to assist in the process.
All that being said, you do want to help your client help themselves. When in doubt, get consultation or supervision and, in a broader sense, get more training and experience under your belt. For me, the real learning as a therapist started when that first person sat down in front of me. I have been learning ever since and I hope to continue until I retire. Most of learning is experience and I think that learning from the experience of others — and that is how I view good consultation, supervision, and training — is a valuable part of that.
Dealing with Facing Your Own Issues
Jung is purported to have said something like, “You get the patients you need.” To be candid, it happens to me all the time. I sit with a new client and in the back of my mind I say, “Am I looking in a mirror?” as the client brings up an issue that I currently face. And often, I am still in the midst of tending to that issue. Rather than say to myself, “How can I help this client when I can’t help myself?” I see this phenomenon as a gift for me, a chance to look at my own issue in a new way in *my* therapy.
You are in therapy, aren’t you? I hope so, because I think it is one of the necessary parts of being a therapist, doing your own work. I have heard many people say that they become therapists to help other people. Somewhat fewer say that they become therapists to know themselves better. I fall into the latter category. While I enjoy helping other people, I really enjoy better knowing myself. Mind you, not at the client’s expense. Their therapy is about them, not me. When something makes me uncomfortable in the room, it is a clear sign to get consultation or bring it up in my own therapy. Only then does it become about me.
To close, I believe discomfort in its myriad form is valuable and not to be avoided despite that being the prevailing tendency. All feelings, all pain are information. They tell you something and discomfort is no exception. Make friends with your discomfort, take it out for some tea or coffee, find out what it is doing for you, learn from it, welcome it and experience it, and then it becomes a growth experience rather than a burden.
Joe Zarate-Sanderlin, MA, MFT, is a psychotherapist based in San Francisco, CA. He sees adult individuals, couples, and more than couples in private practice where he focuses on communication and relationships. He has expertise in the open relationship, queer, and BDSM communities. He can be reached at http://www.jzsmft.com, @jzsmft on Twitter, and https://www.facebook.com/jzsmft/ on Facebook.
Originally published at www.therapyden.com.