Do Psychotherapists and Counsellors Listen too Much?

When Psychotherapists and Counsellors start their training, usually the first thing that they're taught to do is to listen to what their clients say, and then to give succinct summaries back to the client, so that the client can hear what they've just said, and that they've been heard. In worst case scenarios, this leads to experiences of sitting down with a therapist, pouring out one's heart to them, and hearing back in a some-what parrot-like way, the gist of a the problem for which one so desperately is seeking a solution. Of course, it's important that your Counsellor or Psychotherapist actually does listen to you, and certainly that is better than simply having one's feelings shut down, or covered over by advice. That said, I do think that in a way, therapists still do listen too much.

The reason why I say this, is that we all use the defences that I've written about in previous posts, practically all the time. Furthermore, it is usually the use of some of these defences, that are actually creating the problem in the first place. Frequently, even at the start of a first session, a client's defenses will stop them clearly describing to me what the problem is that they'd like me to help them with. For instance, when I ask during an initial session what the problem is that my client would like me to help them with, they may reply with the defence of projection (of their will) by telling me (indignantly) that their psychiatrist thinks they have a problem! Or they may reply whilst using the defence of withdrawal, telling me about the problem in such a small tone of voice, and without making eye contact, that it's as if they're miles away from me. If we can't clearly agree on what the problem is that we're trying to address through therapy, it's unlikely that we're going to be able to work together effectively on dealing with that problem.

According to intensive short term dynamic psychotherapy (ISTDP), it is our defences that creating our problems, and therefore are hurting us. It's my job to (with the client's permission) to interrupt their automatic and unconscious use of defences. For instance, withdrawal and isolating is often part of what perpetuates depression. By helping a person to see in a session how they withdraw from me by not looking at me, mumbling, or talking in a small tone of voice, I can help them to begin to experiment right there and then with making some of the changes that will help alleviate the depression that they wanted my help with.

This brings me in a roundabout way to the title of the post. Psychotherapists and counsellors need to do more than just listen. Sometimes actually helping a client is to interrupt them, and help them to begin to express the emotion that they need to deal with, rather than spin around helplessly getting nowhere because they're using a defence without even realising it. I'm not suggesting a tactless of callous form of therapy. To skillfully interrupt a client's defence in the right way at the right time is an act of caring, and healing. The people who come to me for therapy usually don't know the technical information about defences and different styles of therapy, but they can feel the sense of relief when their use of defences has been interrupted and they can actually feel themselves again, and begin to choose a more healthy way of relating.