[sunrise]

I was reading an article online about therapists' difficulties connecting with some clients. It was the flip side of what I read from time to time in this forum--how difficult it is to connect with the therapist, how people can just go to therapy and say almost nothing, or say inconsequential things, or not say the things that matter. It was interesting to read a therapist's viewpoint on the sometime-difficulties of connection and how to deal with that.

The article is here:
It's not about you: matching your clinical style to your client's needs

Here's a brief excerpt that got me to thinking:

...when things don't go so well—when we sit with passive, sullen, unengaged, unforthcoming clients for session after session—we often think it's because we lack the necessary skills, or the clients are unmotivated or resistant...

What stands in the way of connecting effectively? I've found that the major difficulty stems, paradoxically enough, from trying too hard! Many clients, even if they're highly motivated to get into therapy, have only limited tolerance for emotional connection, interpersonal closeness, and sympathetic concern—actions that most therapists assume are central to the alliance and to therapy itself. The harder you try to reassure such clients and show how much you care, the more fearful, defensive, and withdrawn they become.

What's happening here is a failure to match our self-presentation and efforts to connect with our clients' emotional capacity to respond. To put it bluntly, our song hurts their ears, and the more they express their discomfort, the louder we sing. What we need to do instead is work on matching our personal style and way of connecting to theirs, making it easier for them to accept our attention and clinical focus.

He goes on to give two examples of clients, one who was extremely uncomfortable with any emotion or feeling and one who needed more, and how he was able to deepen their connection by matching his approach to the style of each of these clients. And he did all this without trying too hard, which seems to have an impeding effect. (I identified more with the second client, and I see elements of my H in the first client.)

I am thinking back to my own therapy, early on. I remember I was trying to talk to T about something really difficult and was unable to. I sat there the entire session and tried multiple times, sometimes non-verbally, sometimes with a few words at the beginning of a sentence. It was impossible despite a real desire on my part to move forward, so I really liked what this author wrote realizing that instances of non-communication are not simply the client being resistant. I remember at the end of that hour of non-communication with my T, he said to me, "I respect your ambivalence about sharing this with me," and it helped make me feel that it was perfectly normal not to be able to talk to your therapist, that it was OK to be torn between wanting to share and not being able to. He was so accepting of where I was at and what I was capable of. He didn't apply any pressure, and I think if he had, I would have closed up. I think it was like what this author writes about--that he matched me.

Of the accounts here in our forum about difficulty connecting or talking or sharing, I wonder how much is due to the therapist not being able to match, of pressuring, of trying too hard? We always seem to blame ourselves, "if I could only trust, if I could only tell him this, if I could only share my feelings...." Maybe we don't need to think it is all us. Maybe we are trying too hard. Who is pressuring us? Is it ourselves? Is it the T?

Anyway, just wanted to share that article... That online mag has good articles sometimes.

[ECHOES]

our song hurts their ears, and the more they express their discomfort, the louder we sing

I am smiling because this absolutely happened a month or so ago in a session and T referred to it as bringing out her marching band. I was so hurting and inside myself and she kept hurling other perspectives at me and each one felt like a blow. It caused a huge disconnection at that time.

Sunny, I wasn't able to use the link you posted, but thanks for what you quoted here.

[sunrise]

ECHOES, I fixed the link; thanks for letting me know.

[Brightheart]

I honestly think you need a good match between client and therapist as well or the connection simply will not happen. I was very lucky to have found a T who could easily adjust to me. I needed to be nurtured and he enjoyed nurturing. We complemented each other very well and it worked beautifully. I'm sure being a good therapist must be hard work too. I really dislike the notion that therapists are "acting" with clients, though. I like to think that we have the ability to bring out the best in them.

[sunrise]

Originally Posted by Bether91068

I really dislike the notion that therapists are "acting" with clients, though.

I guess I'm an idealist (or maybe naive?) because I don't think they are acting! The therapists I have encountered have all seemed very authentic to me. I think a lot of clients would be able to see right through them if they were faking it. What I do think would be hard is if a therapist was in some sort of situation where his or her job dictated the type of therapy he had to deliver. Like in the UK, I heard that there is this big push to have clients get CBT. Well what if the therapist started therapy with a client and quickly realized CBT was not a good fit? Would they have to do it anyway because their boss said so? I think that could lead to some very inauthentic situations.

I think I'm straying from my topic....

In regard to the article, where client 1 needed less emotion and more of a business-like therapy session, and client 2 needed more personal involvement and compassion from the therapist, it reminded me of couples sessions with me and my H. I knew the therapist well as he was my also individual therapist, so I knew how he was with me in session. Then along comes my husband to join our sessions, and sometimes T could be kind of different than he was with me. There were times he used the "businesslike model". I felt like saying, "why are you doing this? this isn't how you are with me." It was strange. I learned that T could adapt his skills and techniques depending on the people there with him in the room and what those people needed and would respond to. Of course, he wasn't completely different, but I got to see a different side of him. I can't imagine him ever saying to my H, "what are you needing from me today?", a question he frequently throws at me. I think if he said that, my H's eyes would bug out and he would be thinking "WTF?"

[chaotic13]

I didn't like the acting comment in the article either. It just didn't seem to fit with the tone of the whole article. I wonder the author used this for some subtle message that I didn't quiet get...I will have to read it again. There have been several times in my therapy struggles where I've looked back at an interaction and asked myself... how heck did she know how to approach that issue with me. I think my T relies a lot on her intuition. I also think, like the author, she's demonstrates the patience to let the connection happen without forcing it. I am definately someone offen finds the attention given me in therapy...painful at times. My T has been pretty good at adapting to that.

Nice share Sunrise.

[mixedup_emotions]

I was taken back by the "master actor" versus "character actor" comment as well. Since I'm very early on in therapy, I hate feeling as though he's "playing a role" and is not genuinely interested or cares. I guess as time goes on, and our relationship builds, I will see things differently.

Good article, otherwise! Thanks for posting!!

[ECHOES]

Interesting, because I totally feel the acting.
It's what they do to "be" what you need, what you want.
I try not to dwell on it which is odd because it is reality. It's obvious when I tell her that her expressions of empathy feel forced and insincere, for example, and so she stops doing that and tries another way. It's confusing because it's also my unwillingness to believe that any empathy is sincere.
I think the 'acting' is what makes the relationship therapeutic versus other social relationships.

[Brightheart]

I really think it's about finding something in themselves that their clients need...but the capacity for it has to be there to start with. That's why I like to think that the relationship is reciprocal in its own way. If the therapist is feeling good about what he/she is giving to help their client, it has a way of benefiting them as well. My therapist told me he became a therapist because it made him feel good to help others. I believe everything that happened in the room between us was genuine and sincere. And I think we both ended up feeling good about it.

[lifelesstraveled]

Thanks for sharing this Sunrise! I loved the article! I never thought about what it was like for the therapist not being able to connect and that they worry about it too.

"Many clients, even if they're highly motivated to get into therapy, have only limited tolerance for emotional connection, interpersonal closeness, and sympathetic concern—actions that most therapists assume are central to the alliance and to therapy itself. The harder you try to reassure such clients and show how much you care, the more fearful, defensive, and withdrawn they become."

This statement fits me to a T. There is only so much "niceness"---concern and closeness and emotional connection---I can can handle from T or anyone. One session T kept saying how concerned she was about me. The more she said it the more I wanted to yell "WHY!!! I dont' believe you! I dont want you to be concerned!!" I wanted to tell her to stop saying it. Even when she says how happy or proud she is that I did x,y and z....i hate it. LIke today she kept going on about how great it was that I did x,y and z and I just wanted to say OK OK...LOL.

Thanks for posting this! i wonder if T read this---she was a little less forward about things today...

[sunrise]

from Steven Shapiro, author of article:
"The more you develop a broad range of skills, comfort zones, and flexibility, the more you'll be able to tailor your approach to the needs and styles of a variety of clients. You'll be a master actor, able to adapt to a broad range of roles, rather than a character actor, who plays essentially the same part in every script."

When I read this I didn't interpret it to mean the therapist was an actor when he was with the client. I took it as an analogy about the application of a broad range of skills to a broad range of clients rather than applying the same narrow skills over and over again to all clients, whether it was what they needed or not. I think we all do this to some extent in our everyday personal and professional interactions. You have to know when to act/be a certain way in particular situations. For example, in some of my professional work, I have to be accommodating, cooperative, motivating, etc. In other situations, I need to be direct, even blunt and no-nonsense, and almost authoritative. You have to know when to bring out what skills for optimal results.

When my T asks me in session, as he so often does, "what are you needing from me?", in a way it is an invitation to tell him who he should be. What skills do I need from him that day? How do I need him to "act"?

Originally Posted by lifelesstraveled

Thanks for sharing this Sunrise! I loved the article! I never thought about what it was like for the therapist not being able to connect and that they worry about it too.

Thanks, lifelesstraveled. I really liked reading that they worried about this too. It made the relationships seem more reciprocal. I have always felt my relationship with my T was reciprocal but it was really nice to read this in writing.

Originally Posted by lifelesstraveled

i wonder if T read this---she was a little less forward about things today...

Maybe you could share it with her, especially the paragraph that really fit you to a T. (I loved your pun )

[Brightheart]

Originally Posted by ECHOES

Interesting, because I totally feel the acting.
It's what they do to "be" what you need, what you want.
I try not to dwell on it which is odd because it is reality. It's obvious when I tell her that her expressions of empathy feel forced and insincere, for example, and so she stops doing that and tries another way. It's confusing because it's also my unwillingness to believe that any empathy is sincere.
I think the 'acting' is what makes the relationship therapeutic versus other social relationships.

If you feel the "acting" and the empathy seems forced, it probably is. Something isn't working between the two of you. Maybe you should discuss this further with her.

I find it interesting that some of you don't like the emotional closeness. I loved it and still miss that a lot. My T had a tender tone that I only heard once or twice, but it turned me to total mush inside whenever he talked to me with that voice. I told him that it was like he was caressing the pain out with his voice. Maybe someday I'll stop thinking about him so much.

This was a very interesting article. Thanks for posting it.

Thanks for posting that, Sunny

I know that T works very hard to give me what I need on a given day...some days I need a little more distance, some days I need a TON of reassurance, some days I want to feel close and intimate, other days I just want to rest or play. He is very good at matching where I am at...I don't feel like it is an "act"....I feel like he is just in tune with where I'm at. I'm sure his hard work is the reason we are so connected.

Sometimes he gets it wrong (like this past week) and it's rupture-city. But then we both look at our parts in what happened and we can move forward with a new understanding. I know T is always willing to look at how he acts and how that affects me and our relationship.

Reading that article made me realize how good he is at his job

[Xtree]

I think we have to remember that Ts are human too, they are people just like us. They go home and argue with there H, raise their adolescent and pay bills. I am sure at times it can be very difficult for them and they do the best they can.

Xtree

[majella]

I thought that this article about therapists worrying about connecting with their clients, looked really interesting .... so I started reading it.

But something funny that happened - when I clicked on the 2nd page link to keep reading the article, something must have happened to my internet, but I got this message ....




"Failed to connect"

lol!

Quite funny I thought ... especially when in the middle of reading an article about therapists who are having trouble connecting with their clients!



Will see if my internet is back up and see what page 2 of this article now holds!

LOL majella!!

When my T leaves me a voice mail, the button I push on my phone to retrieve the message says "connect" which always makes me giggle.

The word "connect" has such a different meaning now that I'm in therapy

[Behindthecouch]

Hi Sunrise,

amazingly I think you've just given me the answer to the exact problem I'm currently having with T. Especially that part you quoted I suspect its something that's not even been considered.

Unbelievable - thank you so much.