Tuesday, May 5, 2020

The Case of the Whiny Therapist

We are assured that Freud is dead. Deader than dead, if you must. And we are assured, on the highest psycho authority, that psycho professionals have gone well beyond Freud’s dopey ideas.

We are assured of such, but it turns out to be so much swill. Concepts like transference are trotted out in utter seriousness by utterly serious therapists like Lori Gottlieb. I do not see that she has received any psychoanalytic training, so I will assume that the concept of transference is taught in doctoral psych programs.

The second issue with the letter she offers in The Atlantic this week is quite simple. Therapists have, despite my urgings, chosen to lead with their emotions, to use their capacity for empathy as a therapeutic balm. Then they throw in a few bromides and nostrums, and trust that insurance will foot the bill.

We would be far happier if therapists used their minds, and not their hearts. One understands that empathy-- the psycho medication of choice these days-- is very useful for a mother in the nursery, when dealing with a human being who cannot express himself with words.

And yet, a therapist who feels empathy with his patients will be infantilizing them. Moreover, if he has a minimal notion of what the term means, he will be feeling their feelings, feeling just as depressed, anxious and vulnerable as they are. In truth, in a work situation, a therapist ought definitely not to expose vulnerability. If he does, he will be subtly, or unsubtly, asking his patient to take care of him. 

The woman who writes to Gottlieb has certainly gotten the message. It involves the difficulties of living through social isolation and lockdown.

Here is the letter:

Since the COVID-19 lockdown began, I have done only one tele-health appointment with my therapist of six years. The world has changed for us, and I feel deeply that I should not create more of a burden for my therapist while he is going through the exact same thing.

I’ve seen several TV interviews with therapists talking about how bogged down they are with their patients in crisis now. I just don’t want to do that to him. I think that giving him the gift of time may be what he needs right now.

He always talks to me about “the right of self-protection” and how I don’t have to “take care of him.” Still, most people may want to gravitate toward their therapists even more at this time of crisis, and I want to take the pressure off of him and give him some space to deal with his own feelings. He’s only human.

I’m wondering if my feelings are common.


New Baltimore, Mich.

How, pray tell, does Laura know what her therapist is going through? Allow me to make a therapeutically incorrect observation. I suspect that Laura knows because her therapist has shared his feelings. He has told her that he is having a hard time. She concludes that perhaps she should not burden him with her troubles. This tells me that he is making her feel like a burden.

In short, why would we not take what she says at face value? It’s the least that a respectful professional can do. Aren't we supposed to take what women say seriously? If you want to know one of the reasons why we don't, look no further than Freud.

Unfortunately, Gottlieb does not. She thinks the woman is making it all up, or better, that she is reenacting something from her childhood. This theorizing, which falls under the heading of the Freudian transference, assumes that if the patient says something that we do not like, then the patient is projecting something from his past. The therapist bears no responsibility for the patient’s projections.

I emphasize this point because therapists imagine that they are perfectly innocent, and thus, if a patient gets angry at them, the only cause must be unprocessed infantile anger. In truth, and I would emphasize this point, in Freudian treatment, when a psycho analyst refuses all human interactions and all human exchanges, when he refuses to look his patient in the eye, when he treats the patient like a social pariah, even a contagion… he is creating conditions where anger directed against him is appropriate. Most self-righteous analysts will reject this. It’s one reason why psycho analysis is quickly fading away. Not quickly enough, however.

For the record, here is Gottlieb’s explanation of transference-- again, she casts no aspersions on the therapist, and makes it all a function of Laura’s mind:

In transference, a person unconsciously directs feelings about another person (generally from childhood) onto an entirely different person in the present. This happens outside the therapy room too. For instance, a husband may feel controlled by his wife when she asks if he’ll run a simple errand, because she reminds him of his demanding mother. Or a person whose boss laughs just like his abusive father may cower around that boss even if that boss is kind and gentle. The problem with transference is that instead of reacting to the person right in front of you, you’re reacting to a template from the past. In relationships, transference prevents us from connecting with people in a meaningful way.

As for the husband and wife in the example, it might be the case that what appears to Gottlieb to be a simple errand is the fortieth simple errand she has asked him to run in the past half hour. It may be that he needs to prepare for litigation and does not want to take time away from a valued client to do something trivial. Again, the theory of transference is not innocent. It is a cudgel that therapists use to beat down their patients and to make themselves feel innocent.

Gottlieb does not consider that Laura’s therapist might have communicated to her that he believes her to be a burden:

That’s because many people who worry about burdening their therapist grew up feeling like a burden in their family. A child with a sick parent or sibling might try to be “easy” and not bother anyone with his seemingly less important needs. Or a child with a parent who is constantly overwhelmed might get the message, tacitly or explicitly, that her needs are unwelcome. (“I’m exhausted,” the perennially beleaguered parent might say. “Please don’t bother with me with this right now.”) Or a child with a parent who finds the child’s feelings of sadness or anger distressing might feel guilty for upsetting that parent and become hypervigilant about not burdening anyone with her feelings. Or a child who is forced into an adult role (say, his father dies and the 12-year-old boy moves into the father’s role) feels responsible for taking care of everyone else and always puts his own needs last.

And yes, clients do ask their therapists and even their coaches how they are doing. It’s called being polite. It does not need to be reduced to an emotion-laden drama. In fact, in many cases therapists and patients are not experiencing the same challenges. For one, if someone is consulting a therapist, the therapist is working. Many people today are out of work.

Gottlieb continues:

Of course, we’re in a unique situation right now—therapists and their patients are experiencing many of the same challenges due to the global pandemic. And while some patients wonder how their therapists are doing—all my patients have asked me that question—they need not view continuing their sessions as a zero-sum game: If I bring you my problems, I’ll exacerbate yours. If I minimize my needs, there will be more room for yours.

As I was saying, the transference based approach ends up blaming the patient for the therapist’s incompetence, his whiny neediness:

In other words, you say you’re trying to protect your therapist, but I have a feeling that the person you’re trying to protect is yourself. If you stop having sessions, you don’t have to examine your feelings and patterns and behaviors at a time when you may, like many people right now, feel most vulnerable. But this doesn’t really protect you—it just makes it harder to feel the full range of your emotions, which is ultimately what helps us connect authentically with both ourselves and others.

The problem is that the therapist has felt the full range of his pathetic emotions and can barely do his job.The answer to Laura is simple: find a new therapist.


Anonymous said...

The answer to this woman's letter could be: "Your therapist WANTS you to call so he can make money. He is far more burdened to get less income than to hear your woes. Don't worry, if you burden him, he can describe (therapeutically, of course) how hard his life has been. He has no inhibition preventing him from talking to clients about himself. So go ahead and call!"

UbuMaccabee said...

“Your therapist WANTS you to call so he can make money. He is far more burdened to get less income than to hear your woes.” LOL. He deserves to get a fat paycheck for the suffering of listening to this wahman for an hour.