Power in the therapist-client relationship

DD's post seems to suggest a difference between being invested in the therapy vs. being invested in the therapist.

I think what the thread shows is that there are widely varying experiences of the inherent power imbalance, varying intensities, and also many different ways of managing it. I would still maintain that the imbalance is there from the get go.

Here's a quote from an expert on the topic:
"Patient-therapist relationships are tilted toward the power of the therapist because of the structure of the relationship: patients bring the most vulnerable facets of self to their therapists' strongest aspects." -- Sue Ellkind PhD

Because loss is an inevitable part of all relationships. None of them will ever last forever. Many of us accept that, not cynically, not guardedly, just naturally as the way of life. So we may feel loss and sadness, even grieve, but we don't necessarily equate the grief we experience as suffering, or even if we do feel we suffer, it is temporary and we pick up and move on if we allow ourselves that natural process of grief. You may just need more time, Budfox. That's okay and it can hurt like heck when we encounter loss in life, but hopefully you will be able to experience your feelings and eventually heal and move forward.

Yes, if you already have an answer to the question asked, are bound and determined it's the right answer, and will slot every answer another participant gives into your answer, it would seem that way. If you don't think that way, the diversity of answers would suggest that each therapist-client relationship is unique and that no theory can really fit them all.

Uh...first of all she says TILTED, not "is." She allows for more possible experiences and answers than you do. Our poll is certainly tilted towards one answer to the question, if you count just the "client" and "therapist" responses. That doesn't mean that those who chose "client" are wrong about, again, their own experiences.

The rest of the book you took the quote from is actually about impasses and ruptures in therapeutic relationships, not merely the question of power in the relationship. There's talk about how each therapist-patient relationship is unique, and talk about how clients have power but surrender it to the therapist (and this can cause problems). And there's talk about client power over the therapist too.

this is an unusual poll and i'm very interested in everybody's responses, i can kinda see both sides, i mean if therapy is that important to you to get you through daily life, of course the thought of it ending would upset you, but like was mentioned, you can be 100% invested in the process without transferring that need onto a therapist (this is just from my brief therapy sessions) i found that although the T may have solutions to your problems they also have to remember that it's up to the patient to decide how much to reveal, what they take on board and how much dependence they foster, a good T should know this and be very aware of it and apply the correct actions and responses, but therapeutic styles vary, i personally was going through Gastalt therapy which put a lot of the responsibility on my own actions and decisions, i think that was good for me given my somewhat analytical nature, i think the T was wise in her decision to apply that type of therapy for me, never once did i feel a "power" struggle, i kind of think the word power here is incorrect, i think it depends on the individual patient, therapist and type of therapy, and im sure the reasons for the therapy are intertwined with the end result,

so i guess, yes a T can have "power" but only if you give it up to them, a client can have the power to completely ignore all directives and end therapy any time they choose.
That's just my take on what i experienced, we are all different so take my experience with a grain of salt and like most things in life its not a "one size fits all" question. Great thread tho, very enlightening.

What the… I thought this was a discussion about power in therapy. Unclear why you are offering me this unsolicited life lesson? Total non sequitir.

I agree with those who say that the therapist holds more power, as long as we keep the focus to the area that the client needs help with. After all, one is expert (or we hope is) and the other is not. Knowledge is power. And so is having the skills. So in that sense, the therapist has the power.

Not exactly the same, but in some ways almost my plumber has more power than I do. I'm not a handy person. My plumber is. And when the pipes burst, we so desperately needed the plumber. We paid anything she charged us.

Comparably, the therapist holds way more power than a plumber. I can't deny that. If my therapist were to decide to abuse me, nobody could come even close. My plumber knows so little about my weaknesses and my past and my suffering and how I feel about myself. My therapist has documents and pages on them.

Which is why my plumber does not go through such extensive training and supervision nor has such a long ethical code. There is less danger of my plumber doing traumatic damage by sleeping with a client, than my T. Which is quite funny in real life because the last plumber to our house was actually a young lady (a rarity!) and I did feel attracted to her. Whereas I don't feel attracted to my T at all. But I digress.

So I'm not of the mindset that it's all relative. Sometimes people who don't want to admit to the therapist having power, don't want to admit to their own powerlessness or need in that area.

But in my view it's wrong to say that if you have power in X area, then therefore you have all the power. My therapist can't help me or change me without me participating in it. I'm not in a prison cell being dragged to a torture chamber with my hands and feet all tied. I have a choice. I have a will.

Similarly my plumber can't come over unless I call her. In addition, there are other areas where I or any client might be more powerful than their therapist. They might have more physical strength, know more about history, have more connections, expertise in economics, knowledge of dance, whatever. You might one day see your T come to your workplace to buy a drill not having any idea what things to look for in a good drill. There you have more power in that area. You could in fact lie to your T and she would not know it. So that's what I mean.

The therapist is here to help ME solve MY problems. The one-sidedness which can make some people feel powerless (sort of as if being questioned by the police), is actually meant to keep the focus on the client for their benefit!

In addition the client can ask for a T's qualifications. One can also complain about the therapist to her face. You are allowed. You can refuse treatment, leave. You can file a complaint, sue the T. Change therapists. Take a break. Choose one of many other alternatives to improve your well-being than going for therapy.

I was traumatized by two therapists, and in one case, I chose to file official complaint because I thought it was bad enough. That person eventually lost their license after they were sued by couple more people. Apparently I was not their only victim. I felt extremely powerless at the time but I'm so glad there are things one can do when/if (I hope it does not happen to anybody) a T misuses his or her power. And if you ever go in for therapy and think you're totally powerless, talk to some other people. Might give you perspective.

But she ain't saying it's tilted toward the client.

Yes I know, I read the book. Her point is that therapist-client is analagous to parent-infant, in terms of attachment dynamics and vulnerability and inherent power imbalance. I don't think she means that clients surrender power willingly or necessarily even consciously. A competent T understand this and acknowledges it out loud as one did with me. Conversely, the one who traumatized me said "why do give me so much power"? That's like asking, why does a baby give its mommy so much power.

How is this unsolicited? Thats how a discussion works - one person talks, another person listens to what the first person says, processes it, thinks about it, sees if they have ever experienced anything similar that might relate to it or that the first person might possibly find relatable, formulates a careful, caring response - then the first person just shoots it down? i think there is a definition for this. Along the lines of abusive. Demeaning and disregarding the other persons response.

And your point is...?

I didn't introduce her into the conversation and set no store by what she says, but what I've found to be true in my own life. So why does it matter to me that she says it's tilted toward the therapist? In my response I said the poll results were tilted that way, and throughout the thread I have said that my thinking I have power as a client is clearly unusual. My point is that you seemed to think quoting her should end all discussions because it "proved" your point of view.

If I were the only one on this thread who thought I had more power than my therapist, I might say, "oops, my bad, yes, I've been deceiving myself, how silly of me." But I'm not the only one who thinks that.

Lots of clients go to therapy and end up re-enacting parent-child dynamics, sure. Lots of them don't.

And because something is analogous does not mean it is the same.

You might as well be speaking Greek. I have no idea what any of this has to do with the discussion at hand. Oh the tangled web we weave when we practice to deceive…

It was very clear to me. But I've been learning unaluna-speak.

More seriously I don't see where deception came into it at all.

Sorry, I was just trying to be kind because I know you are really in pain about what transpired with your therapist which was reflected in your comment that I quoted (I thought it was, at least.)

I took it as a freudian slip.

Same as yours, just offering of my own perspective. I offered Elkind's quote because it is clearly relevant, and she makes her living examining this stuff, consulting with Cs and Ts, studying what goes wrong and right. I never said it proves anything.

I am just trying to see the forest for the trees. That seems to bother some people enormously.

Seems we are down a rathole, and probably saying much the same thing anyway...

I appreciate the sentiment, but your post could also be perceived as presumptuous and patronizing, and a manipulation. I did not say that before because I try to practice restraint to avoid derailing the discussion. My post was in reference to DD's post. I was not looking to open up my issues for general comment.

Pax then.

It really was just meant as kindness. No ulterior motive. I apologize. I won't make the mistake again.

Exactly. To me this is self-evident. It's not even controversial to say there is an inherent power imbalance.

All these denials of therapist power, in their tone and content, seem to confirm said power.

Regarding how one can be invested in something and not suffer a tremendous sense of loss when it ends: I think of therapy as being kind of like a class, a situation in which I am there to learn. I am invested in it, I want to learn. But I think at a certain point I'll be ready to end it, and maybe it will be kind of bittersweet and all, but it'll be okay to move on.

When I read threads on here I always feel like some people focus so much on the therapist, trying to read them and figure out what they're up to and what they think or feel or whatever... and it just seems like the wrong focus. Therapy is not about the therapist.

This is also in response to the post you quote.

If the profession is so dangerous, so untrustworthy...why trust what its practitioners say in any form?

If those of us who claim clients have power are deceiving ourselves...might not therapists also have a vested interest in claiming the power in the therapist-client relationship for themselves in their literature?

I would not trust any therapist, in person or in the professional literature, any more than I would Benedict Arnold. (Apologies to the Brits on here.)

Then the therapist should help the patient to form a healthier relationship.

Painful...yes. but suffering which is a strong word to me and I see it as a prolonged pain and that would definitely not be the case. Then again I've lost a lot of people in my life in a variety of ways and while painful I've learned to move on somewhat quickly. Of course this assumes that I wasn't severely mistreated in anyway...that's a whole different story...resolution is far more complicated. Plus the way I use my T seems to be different...I do not focus too much on my relationship with my T because the relationship is not all that important in my therapy as long as she continues to serve the purposes I need her for as a therapist. I focus strictly on my goals and for my goals my relationship with her is pretty minute in terms of importance. I see her for her training and knowledge only...so far that has proved effective for me. She's a sounding board and a guide. The guide is where her knowledge and training come into play.

I guess it's to be expected when you're on a site for people with mental disorders (myself included) who are more knowledegable than the rest of the population about such things, that SOMEONE has to chime in and diagnose or make some observation about someone else that they don't know.

I've got less than 200 posts on here so even if you read everything I've ever said you don't know me enough to tell me that I don't know anything about power dynamics or that I'm in denial. You don't know my issues or my therapist. That's the irony of YOUR statement. Diagnosing ME. My statement was in regards to the overall results of the poll. I'm speaking FOR MYSELF when I state my belief that people seek out therapy when they are at their worst.

I didn't NEED to be told that I have the power. I said that only as an indicator that my therapist acknowledges MY power.

We also meet when I say we meet. Maybe you run around your therapist's schedule, but I'm not using my sick time to show up mid day because he has an opening. We have evenings - on MY time.

He decides when the session ends? Well the expectation is an hour. We've gone over that and he's allowed that. At that point, he's into overtime that I'm not paying for so overtime is at his discretion. But it's not like he's stopping me from walking out the door. So I don't know what universe YOU live in that you can't see the power that you have but you can just stay there. ANY relationship, power goes back and forth (except in the instance of children). If you're married, each person has power regarding different things. If he brings home the money, that's all good. If he wants to be an a-hole, he can cook his own meals, do his own laundry etc.

I also want to thank Atisketatasket and walkthatroad for backing me up in my absence.

The difference between what you did and what I did, was that I made an observation about the poll, and you decided to chime in your opinion on ME.

I can tell you that you haven't taken my power away, but I know that that particular comment was not directed at me. Just thought I'd make that clear.

I like my therapist. I've only been seeing him for 3 months and I'd like to consider myself invested. If it were to end, I'd be sad because he's the first therapist I feel I've really connected with. Replacing him would be difficult, but not impossible. But there's loss on his end too.

There's money. What power does he have if all of his clients quit and don't show up? He replaces me? Sure, but there's the chance that he'll fill that one hour spot with someone he doesn't find nearly as interesting as me. Someone who doesn't want to do the work, comes in week after week griping about the same old thing leaving him to wonder how far might we have gone together. Thinking back on the progress we were able to make TOGETHER. Granted, I'm the one truly benefiting from it but even that is not likely entirely true. My therapist is fairly new. My unique set of issues and how they manifest themselves when put together - I might be a very interesting case study. I'm not saying I'm all that and a bag of chips, but to say that I would be the ONLY one to "suffer" is not a statement that can be absolutely stated as true.

But what if you were not ready to move on but it ended anyway? The disparity in terms of need means the client (assuming again emotional investment) walks away in greater distress (maybe much greater). You can see all over this forum people talking about fear of termination coming suddenly like a thief in the night, or being destabilized by some abrupt change imposed by the T, or going into a spiral because the T is on vacation, or just because the T looked at them funny. That is power.

Thats what my exT used to say and I accepted it, squashing my own instincts that were saying this is not healthy. To sit in a room with someone for months or years having an intimate and personal relationship, and being expected to suppress the natural need for mutuality is insane. It is a bizarre fabrication of the therapy biz and a form of gaslighting to suggest that the client need not wonder who the hell is sitting across from them, whether they can be trusted, what needs and wounds are driving them… while simultaneously expecting the client to reveal all. Especially if the client is experiencing intense transference or other feelings toward the T. For me the secrecy and obfuscation and withholding was psychological torture. I mean that literally.