Thoughts on the Therapist’s Vulnerability
As the title suggests, I have been thinking a bit about the therapist’s vulnerability, specifically in the interpretive process, as it pertains to the act of doing therapy. There are, of course, a lot of ways in which a therapist is vulnerable in the therapeutic process. There is the vulnerability that sometimes exists in feeling like one does not know quite what to do in a particular therapeutic situation. There is the knowledge that every session essentially starts with the unknown of what might come of any given hour. There are also the legal and administrative vulnerabilities, as well as the ethical dilemmas that arise, of being a private practice clinician.
Each of these are real and not to be dismissed, though are not quite the kind of vulnerability I am talking about. Then, to be certain, there is the idea of being vulnerable in the sense of being revealing. That clinically, with good judgement, there are times in which it is helpful to share something about oneself or ones lived experience with a client. This kind of technical intervention can help build therapeutic rapport and normalize what might otherwise feel alienating and deeply shaming to the client. There might even be the vulnerability of expressing a feeling or a thought about what is happening in the moment for the client, again a restorative or reparative enterprise to be sure, but not quite what I am trying to feel my way towards here.
So, what else might I be trying to get at when we talk about the vulnerability of the therapist in terms of the interpretive possibilities of the therapeutic encounter. Though descriptively elusive, I suspect most who have done this work in a way that involves a deliberate relational focus has felt it in one way or another. Closing my eyes, even now, I can have a sense of a kind of resistance or a longing that comes up, or a sense of incompleteness almost, as I try to feel my way into the various relationships I am maintaining through my work.
Perhaps part of the way we can begin to decipher this is vis-à-vis the phenomenon of the transference. An awareness that there is someone the client is wanting me to be, or making me out to be, or trying to turn me into in the service of reexperiencing some past trauma. Of course, pure transference interpretations seemingly lack this vulnerability as well. We all know the stereotype of the cold psychoanalytic posture, sitting back and analyzing, telling the client something about what they presume is happening and then leaving the client somehow to figure it all out. Not how all analysts or schools of analysis work, by the way, but even the modern day relational or intersubjective schools do something to operationalize and dissect the relationship, with most of the interesting psychoanalytic literature being derived out of some misstep by the analyst and need to enter into an authentic relationship, rather than dramatizing the therapeutic value of precision and the delivering over of insight.
I think to get further into what it is I am talking about; it is better to talk about transference as an existential phenomenon. The transference is not something that was that is happening again now. It is something that is happening now that contain elements of what was. The transference as a phenomenon is some subcategory of what is really important, which is the awareness that you and the client are being with and doing something to one another. That maybe one or the other of you is using the other in some manner that needs to be experienced and lived into before it even can be explored.
A supervisor recently pointed me back to an important concept of Freud’s, I believe in his paper “Recollection, Repetition, and Working Through”, where Freud talks about the need to “analyze the defenses” before we can ever “analyze what is being defended against”. Or as this supervisor reframed it, forget about the content, show the client what is happening. I think this begins to get more to the type of vulnerability I am talking about. The awareness that, before any sort of psychotherapeutic technique can enter the frame, we are always already and principally in a relationship with another human being. Which means that all the vulnerabilities that we place on a client in that encounter are ours as well. We therapists have a lot of ways of protecting ourselves from this vulnerability. We can use theory, technique, rote interpretation, meticulous attention to defending against it using body language or word choice, even our power and authority in the therapeutic session can be a way of deterring this experience, insisting that all the attention must be solely and squarely on the client.
Bear in mind, when I am talking about vulnerability here, I am not talking about what the therapist is doing wrong, or that the client is even maliciously inflicting something upon you (though they might be), it is simply an expression of vulnerability as an acknowledgement that something is happening to you. To both of you (or all of you in the context of couples or group work). And that thing often needs to be confronted and demonstrated to the client in a way that recognizes basic structural and developmental needs. It is a complicated business doing experiential relational work. A considerable amount of time is needed outside of the session. I don’t think anyone does this intuitively. Perhaps in moments, but there is a consistency and an intelligence—in the form of discernment—that can be crafted from spending time refining this as an actual technique. We bring in too much of our own baggage otherwise. Useful baggage, but baggage none-the-less.
How do we use what client and therapist are doing to each other to show the client how they are doing what they are doing, not just to us, but likely to many others in their lives. It certainly isn’t the same thing as offering an intervention as that word is usual meant. It isn’t even offering what we might call a mere interpretation. There is an interpretation involved, but one that shows and evokes. You’re not just letting the client know what just happened, you are bringing them into it and lighting it up. The interpretation itself becomes an appeal or call to reckon with what it is they are actually doing to themselves and the people in their lives through the potential space of the therapeutic encounter.
The reason I talk about this as the therapist’s vulnerability is that if the idea of working this way doesn’t make you nervous or uncomfortable, I don’t think you are understanding and should perhaps go back and read this a few more times. To work this way requires an incredible amount of risk. It demands a profound sense of the responsibility of what it means to do this work and to know the things we do and say could have an immeasurable impact on people’s life. It is also, almost inevitably, going to be painful, certainly for them and quite likely at times for you as well. Not just in our need to bear the client’s pain, but in the awareness that being before the suffering other reinvites the many ways in which we ourselves have suffered, as both client and therapist, as well as in the many other roles we have had to embody throughout the course of our lives. Therapy is a process of repetition and recapitulation, not just for the client. It is in giving ourselves over to this process with them, that we show them how to bear it, and it is in their allowing us that opportunity that they show us how to bear it as well.
