So, the billion-dollar question: What does a therapist actually do?
Ask 10 therapists and you’ll get 11 different answers.
Different modalities have different opinions on this. Some think of the therapist as something like a doctor, taking a case-history and recommending treatments. Others see them as something like a teacher, instructing and correcting behaviour, giving and checking homework. Others see them as a coach, or as a scientist, or as an artist, or, or, or. There are lots of similar, but different interpretations of the therapist’s role…
The Psychodynamic Therapist’s Role
The psychodynamic therapist’s job is a to be a person with whom it is possible to be totally honest without being afraid of judgement or criticism. Naturally, pretty much every psychodynamic therapist has their own ideas about what this should look like. But, basically, the therapist’s role is to listen both rationally and emotionally, ask questions and challenge assumptions, and suggest interpretations which will help you become aware of yourself and what is going on between you and the people in your life.
They will encourage you to be honest and to say whatever you need to say, no matter how “awful,” “rude,” or “unfair” it might seem. They will help you defend yourself from your inner critic and then to understand what that critic is trying to protect you from. They will ask questions and actually listen to the answers you give. Most importantly, they will have been through therapy themselves and will understand what it means to have someone to talk to who gets it, who actually listens, and who actually cares.
The non-reciprocal relationship
It might sound a bit of a strange thing to say, but the challenge here is being human. All therapists, regardless of modality, are human beings who feel all the things and have all of the desires, needs, phobias, and foibles that non-therapists do. Some modalities, particularly those which see themselves as “medical” and “scientific,” try to avoid this difficulty by simply rejecting and denying it.
In the psychodynamic view, however, this essential humanity is exactly what makes therapy work. It makes things tricky and complicated, but without it we have no hope of making the emotional and intellectual connections our clients need in order to heal and grow.
Keeping out of the way
Most people don’t need another parent, sibling, boss, or teacher. They need someone who is none of those things: neither a stranger, nor a friend—someone who is impartial, and on your side, and able to challenge you when you need it. And so the therapist needs to be able to consciously and intentionally not do and say the things a friend, sibling, or parent would typically do or say. They need to do the things that will actually be helpful and healing in the deepest way possible.
As you can imagine, hovering in this middle-ground is very challenging, and in order to keep the lantern alight for the client to return to when they’re being swallowed up by darkness, the therapist needs to set aside a lot of their own thoughts, impulses, needs, memories, fears, and coping strategies and focus only on what will keep the lamp burning. This doesn’t mean that they are playing the martyr, or being fake, artificial, cold, or restrictive—these days most therapists are openly warm, sharing, and caring in their practise.
But if I, as a therapist. am constantly inserting myself into the conversation, interrupting the flow of the client’s thoughts and emotions, then I am interfering with their process and signalling that their story is less important than what I think about it. I’d be doing the opposite of what I should be doing.
This means that if I want to serve my client in the best way I can, then I simply can’t do and say all of the things that would make the relationship “equal.” And so for the therapy to work, it’s not possible for the client to know as much detail about their therapist as the therapist knows about them.
To Conclude
This takes some getting used to, for sure. But that is also part of the therapeutic process: learning that old patterns aren’t universal—different kinds of relationship are possible. It is perfectly possible to have a deep, trusting camaraderie with someone whom you seem to know nothing at all about. But over time you will come to know them and the things that make them sad, or angry, the things that make them laugh. And they will, in time, share some of the experiences which have led them to react the way they do. It just won’t go the way you’re used to in “normal” life, and that’s exactly the point.