Learning “The Tricks of the Trade”: How a Therapist Gains Confidence

Therapists are born with the capacity to become confident but have only that possibility when they begin seeing patients as a part of their training. The trainees watch videos of their work, listen to changes in their voice, and observe their own body language, as well as a client’s movements, subtle changes of expression, and tone of voice. These budding psychologists receive guidance regarding when to speak, when to remain quiet, and whether a topic is ripe for attention or still too tender to touch.

Any and all of these considerations play a part in how the treatment process moves forward, if indeed it progresses at all.

Learning your craft is painstaking and painful. Your supervisors describe every weakness and strength. They should. The best of them challenge you to make yourself into what you must become to serve your clients. Your human flaws are dissected and examined. Left untreated, the new professional will inflict them onto and into the people he promised to care for.

It isn’t easy. It shouldn’t be easy. But it helps you become the best you can be, someone who is worthy of trust and an individual who accumulates wisdom if it is in you to learn what the human soul consists of — the light and the dark of it.

If you are as conscientious as you should be, you will take your failures and successes home at the start of your career. Yes, a counselor must learn to keep a therapeutic distance and protect himself from complete identification with the client’s suffering. Your best work cannot cause your own emotional collapse, but you must not be indifferent.

The whole enterprise of psychotherapy is a tightrope walk.

There are no shortcuts; if you are doing your job, you must keep up with the literature in your field of expertise. You are expected to be an expert, but that requires you to grow as the body of knowledge in your area grows. No one will pay you for this; no one will applaud this. It is your responsibility.

Funny, but one of the best comments on excellence in any field comes from a famous baseball pitcher, Vernon Law:

Some people are so busy
learning the tricks of the trade
that they never learn the trade.

I recently discussed that trade with Wynne Leon and Dr. Victoria Atkinson for their podcast, Sharing the Heart of the Matter:

Episode 20: The Art of the Interview with Dr. Gerald Stein on Anchor.

During our conversation, we talked about some of the things I learned and how I came to learn them during sessions with my clients, interviewing members of the Chicago Symphony for its Oral History Project, and working as an expert witness. I also described my understanding of the human tendency to render simplistic judgments of others. Finally, Wynne Leon and Dr. Atkinson asked me about matters of the heart involving a psychiatrist I knew, Dr. Jerry Katz, and my father.

Those matters of the heart fit the focus of Sharing the Heart of the Matter.

I hope you will listen: Episode 20: The Art of the Interview with Dr. Gerald Stein on Anchor.

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The photo of A Session with a Psychotherapist is the work of Mike Renlund. It was sourced from Wikimedia Commons.

To Hide or Be Seen: That Is the Question

A therapist claims a special talent in performance of a common, but elusive function: penetration of another’s makeup. For counselor and client both, however, the obstacle to understanding each other is the same: they look at each other through the lens of their own psychology.

Be careful.

Think of the psychologist as a perfected version of yourself at the job life requires of everyone, every day: making sense of the social world. A friend or neighbor, if comparable to you in nature, presents no challenge. The likeness to you makes the task of “getting inside his head” effortless. “He is not so different from me,” so you say.

Should the essence of the acquaintance not match your own, on the other hand, you don’t “get him.” His extraversion collides with your introversion, talkativeness with your thoughtfulness, risk-taking with your risk-aversion. The behavior strikes you as unpredictable, inconsistent with your standard for thought and action. The man might still be attractive to you, perhaps because of his dissimilarity. No matter, misunderstandings and conflicts follow.

In the end, you shake your head, wonder what you are missing, and can’t explain “why he is like that.”

Individual life experience and the basic, inherited stuff in our brain limits us.

“Oh, you’ll have fun. Come on,” one says.

“What is he thinking? Who does he think I am?”

Both parties are at a loss.

A competent mental health professional received the trained-advantage of getting outside himself, to search into and through the eyes of the other; to imagine himself as the other. The doc discards inadequate evaluations as he would blurry glasses. Ego-driven attachment to initial assumptions and impressions cannot be permitted. The counselor must be willing to start over: to trash, revise, or rebuild the faulty conception he created for replacement by a new one.

Here is a crucial truth about true understanding: you will never grasp everything about the other.

Add one more, perhaps more important: your perspective of the other is your invention, neither the other as he is or as he thinks he is. The drawing you made of him is like an  antique map of creation; inexact at best.

My therapeutic peers and I never lived in a patient’s shoes despite his resemblance to predecessors who sat in the same office. We could not claim precise insight even if we traveled through terrain similar to his life’s path.

“You don’t know me,” is always a true statement whether spoken by a friend or client, though we might discern qualities he does not admit to himself.

Each of us wears blinders. We screen off part of life. Emotional survival depends on it. Secrets from our friends and loved ones are dwarfed by our veiled sense of ourselves. Those who live astonishing lives of travel, accomplishment, and courage, still do not fathom the entire world, the world of every other person, nor the world of their truest self; not just revealed under the pressure of every imaginable test, but the self of everyday life.

Do not say, “If I’d been in that situation I would have behaved this way!” Imagined bravery and principle offer comforting self-delusions employed by those who pay nothing for a ticket to a game they never played.

The keeper of a quiet life, alone in a studio apartment next to a floor mate with the identical window view, does not share his neighbor’s every idea and emotion. His sensibilities, intellect, and history create divergence from his counterpart’s meeting with the passing time.

Even when nothing is happening, his internal confrontation with himself is not yours, not knowable to you.

The hurdle to comprehension is high, in part, because most of humanity is not psychologically-minded, a few therapists included. If we are to come close to a workable relationship with our buddy, spouse, parent, or child, — together with our patients — we must work and rework. The job is like that of an eye-glass grinder, refining the shape through which we take on the world of the other. And, if those we meet are rare types, we hope they perceive our dilemma and gamble more self-revelation than ever before; self-exposure coupled with the display of the tender, still hurting places beneath their raised guard and penetrable skin.

The potential reward is to be known as best we can, despite the isolating entrapment by our sausage casing enclosures and inevitable insecurities. Praying, too, the one who said “It will be fun,” recognizes our less than enthusiastic answer is not so peculiar. Out of such mutual effort we might, on occasion, walk through life hand-in-hand; imperfectly fit as we are, knowing with confidence the other is expending — not just money, attention, patience or passion — but the ceaseless labor to improve the lens with which to see us.

And to see himself.

Might this be one definition of a devoted and talented therapist? A friend? An ideal beloved?

Maybe all three.