Blog

What is most valuable for therapists during therapy?

This was the central question of a study led by Marit Råbu of the University of Oslo. More specifically, she and her colleagues were interested in how psychotherapists experience their role as patients and the confrontation with their own painful experiences, and how this might influence their work as clinicians.

To investigate this question, she and her team recruited eight psychologists between the ages of 30 and 40 and conducted a three-stage study of the participants’ therapy experiences.

First, the researchers asked participants to take reflective notes in response to the following interview questions:

1. Why did I go to therapy and what did I expect?

2. What impact did the therapy have on me personally?

3. What did I learn from this?

4. What influence did my therapy experiences have on my work as a psychotherapist?

In the second step, participants took part in a full-day focus group to read each other’s notes and discuss their experiences in therapy.

The third step was to submit a reflective note after the discussion, using the same interview prompts as in step one.

What did Råbu and her colleagues find? The participants’ narratives revealed six themes and showed that in therapy they were working on “real problems with real suffering.” In other words, the treatment was not just a learning or intellectual exercise. The results of their study are summarized below.

Topic 1: Suffering – Real Needs. Through therapy, the participants’ experiences of suffering were validated – and they realized that their need for therapy was real. Most participants had difficult and stressful relationships in their early years that later led to complications and difficulties. One interviewee said: “My father was an alcoholic and a gambler, and my experiences with him affected the way I dealt with others.”

Theme 2: Ambivalence in sharing vulnerability. As patients, participants asked themselves, “Am I in therapy as a (future) psychologist or as the person I am?” and “Will my therapist think I am too vulnerable or emotionally unstable to help others?” The psychologists in this study recognized that viewing their therapists as colleagues rather than patients who are there for them to address their personal problems would not be conducive to their own healing process.

Topic 3: Living the language of psychotherapy. Participants profoundly recognized that the words they used to describe their personal vulnerability “reached” another person (i.e., the therapist). They had feared whether their therapist would accept and understand them. They expressed relief that they were understood and that it was possible to make sense of their experiences with their therapist.

Theme 4: Therapists become so important that they can easily hurt. Interviewees emphasized the importance of humility and relational strength in the therapist-patient relationship, especially when processing frustrating, confusing, and/or painful experiences. One participant reported that her therapist “took my mother’s side” when they explored a personal dynamic: “That really struck me. That’s something I’ve kept in mind: how hard it can hit you when you, as a therapist, treat a patient in a rough or angry way.”

Topic 5: Dealing with shame together. Interviewees were concerned about being vulnerable with their therapist and expressed fears of being “too much or too much of a burden” to be a psychologist. Their doubts ranged from “Am I a burden?” to “What does she really think of me?” to “Will I be able to help others if I am so vulnerable?” Also particularly important was dealing with and processing the shame associated with their vulnerability.

Topic 6: Using your own therapist as an inner role model when working with patients. Interviewees internalized their therapists as role models and, in turn, drew on their therapists’ approach when working with their own patients. They characterized their therapy as a learning forum that also extended to their own development as clinicians. One participant reflected:

“The therapists have influenced me in a kind of model learning. I notice that what they have said to me has influenced me, for example the metaphors they have used, which I keep and take with me. Sometimes they are not so useful when I reuse them, but sometimes I find them helpful. Then I feel like I have my therapist on my shoulder during the session, and that feels good.”

References