I’ve experienced this myself and have observed it in friends too (though obviously I can’t know for sure). And it makes me want to SCREAM < why do you say that? Can you elaborate?
I could honestly say so much about this because I’ve experienced these situations myself and seen hints of similar dynamics between friends and their therapists. I’ll try to speak to my own experience though because obviously I can’t say with certainty what’s going on for someone else.
But basically, just everything that was said in the post. The person I quoted is a really renowned psychologist and psychoanalyst and the way he talks about therapy and its purpose has been so clarifying and helpful to me. I’ve had many therapeutic relationships in the past go very wrong and because of that, it’s become a huge interest of mine just like… understanding the countertransference/transference dynamics that get played out in the therapeutic relationship as a result of the patient’s and therapist’s own schemas/orientations/pathologies.
I think it’s tricky because there’s so much nuance and it’s hard to speak about things without overgeneralizing, but basically the therapy relationship, while concrete in some respects, is also symbolic. I don’t know how to say this in quite the right way, but a therapeutic relationship is obviously “real” in that it’s between two humans who care about each other and the compassion is real and all of that. But at the same time, it’s largely symbolic, in that the patient projects onto the therapist their own relational schemas and past trauma and difficulties (transference), and then this transference is actually a vehicle for psychotherapy to occur. So it’s not the same as a friendship or a romantic partnership or a mentorship, because the transference is actually the point – like it’s not a bad thing, it’s actually what allows therapy to happen because it tells the therapist about patterns in the patient’s life and the job of the therapist is to analyze that transference, observe their own countertransference reaction (how they respond as a result of what the patient has ‘projected’ onto them), and then use that entire thing as a vehicle for the patient to understand themselves more clearly and the dynamics they recreate).
I think so often clients/patients start to treat the relationship like it’s purely concrete and get really stuck in the relationship itself rather than bringing these themes into their actual life and their real mutual relationships. And I can say this from experience becauseI’ve had therapeutic relationships where there was so much care and support and empathy, and I felt soooo connected to the provider and really loved the therapist and knew she loved me, and blah blah. And it was all very real, but at the end of the day her love wasn’t curative… it was never going to be because the role of a therapist is not just that. There were so many points when I was like, “Oh I feel so connected to this therapist and she cares so much” but I was still doing really really poorly. So something about the dynamic wasn’t working. Because while our relationship itself was rich and meaningful, nothing in my LIFE was changing. (So basically the therapist and I got stuck in the concreteness of the relationship, rather than expanding and zooming out and interfacing with the symbolism and what was getting recreated and then using that to transform my life and change the way I interacted in the world.)
Basically what I’m saying is all that love and care and empathy wasn’t enough. Like… that alone is not therapy. You can get love and care and empathy from so many people. And I myself have (unconsciously) used therapy almost as a substitute for getting that love/care elsewhere, and I know others do the same. It’s kind of inevitable because on the surface, you have what seems to be this perfect one-sided relationship since the focus is supposed to be on the patient, and giving the patient the care that they need (I mean care as in treatment). And that’s how it should be, because the therapist shouldn’t be using the patient to gratify their own desires, obviously (even though some do without realizing it). Anyway, that is the point and that in and of itself (the one-sidedness) IS the therapeutic relationship and is exactly why it is symbolic and not concrete because the goal of psychotherapy isn’t mutuality. And of course the therapist has feelings because they are a person, so those get explored but only to the extent that they impact the patients’ care and ONLY if it’s beneficial to that care. And everything else, is what the therapist explores in their own therapy (hopefully).
And it’s tough to be stuck in this trap of having murky boundaries and the relationship going from purely concrete to symbolic… then to both etc. It’s also difficult to discuss without making it sound like you’re minimizing the care present (because it is real for both parties!!)
And it’s just tough to see people who have been in therapy for fucking ever with a therapist they love so much and who loves them and blah blah but I’m like wait….. You’re literally still doing so badly, so it’s probably time to evaluate what is going on….. Like therapy is not supposed to last FOREVER. And if you’ve seen the same therapist for SO long and made really minimal progress something does need to be looked at.
It’s also tricky because trauma is hard and some conditions take a long time to treat and progress is definitely slow and difficult and you need to build trust etc., so of course it won’t be quick. Like all of that is absolutely true, BUT at some point, I do think you need to take a look at the relationship and be like, “Okay what is the PURPOSE of our work together.”
I think it’s really easy for attachment to happen on both ends (which isn’t bad, obviously it’s important and normal and human and good for the therapy!). But I think the client AND the therapist can get into these patterns where they forget that… there is a purpose to the work… like a goal they are both orienting toward that isn’t just… to make someone feel loved and good. Like it truly is for change to happen.
I think it’s hard when you get comfortable with someone to have that relationship become like a default in your mind. Like the idea of staying with the same therapist for a super long time and they see you grow up and all of that is appealing and safe. And I’m not judging that, like people can do whatever they want. And maybe that can work for some people, but if I’m being entirely honest, I’ve never seen it work. When the therapeutic relationship becomes this drawn out extended thing where for years and years the therapist stays the patient’s only source of support and there are no shifts toward someone in the patient’s real life taking that place, progress is limited. I mean like… of course it is because healthy relationships are fulfilling on both ends — to give and receive love and support, the mutuality of it is what makes it fulfilling and by definition you can’t have that to the fullest extent within the boundaries of a therapy relationship (because of the fact that it’s supposed to be one sided, focused on enhancing the wellbeing of one party). And if it starts to shift to that (become a truly mutual thing) then it is again, by definition, no longer therapy.
And I absolutely don’t ~blame~ the client/patient, because at the end of the day it’s 100% the therapist’s responsibility to maintain the frame of the treatment and keep both parties on track and manage their own countertransference reactions as well. And I’m also not necessarily ~blaming~ the therapist. Like it’s natural to love your patients (I honestly still don’t like when therapists use that word and after having therapists cross boundaries with me, if my current one was like, “I love you” I’d be super disturbed)… but anyway, natural to really care about your patients and nothing wrong with that, but you have to also ask yourself whether you’re really serving your client. And if they’re still so stuck even if you love them… you do have to ask what’s in the best interest of the client
And I think a lot of times therapists don’t want to admit that it obviously feels good to be admired and loved by your patient. And I think they can get comfortable in that role (kind of like the ~shadow~ part of why people get into this work) and if you’re not keeping it in check, I think things really go south.
Anyway, I could talk forever about this because I’ve read literally so many books on this topic and also had so much personal experience with it. But I guess I’ll end with the fact that with any other medical professional, if you were not getting better, you would find another provider. You wouldn’t stay with the same provider if after years you were not seeing improvement. And again, I absolutely understand that trauma is tough to deal with and that building trust takes time, and it’s obviously slower than going and getting a quick surgery, but even with all of that, there should be movement and if there’s not, then something should change.
And therapy is unique because you have both people’s psychologies intertwining in this little dance and what is symbolic becomes super concrete and then neither party wants to leave or admit that it’s not serving its purpose and that although they feel good and nice and connected that is at the core not what therapy is for (at least it can’t *only* be that)
I edited this because it was wordy and confusing and had a lot of typos, so if you had to struggle through the first iteration, I apologize lol
