Theraphobia: A therapist walks into a Christmas party

A few years ago at a holiday party in Manhattan, at the home of an actor friend, a giddy young woman asked, "Are you an actor like everyone else here?" I replied: "No, I'm a psychotherapist, actually." "Ah! That's great! Hilarious! So... actor."

She walked away, laughing.

Being mistaken for an actor was a first, but the walking away part wasn't exactly new. Even in such a seemingly psychotherapy-friendly place as New York City, people don't like therapists. Or rather, they like their therapist. Or really, they like therapists to stay where therapists belong: on the other side of their Upper West Side treatment rooms safely behind their steno pads. Unlike actors (the life of the party) we're not welcome.

As far as I can tell, the aversion to therapists encroaching on everyday turf is a product of broad distaste with two fundamental principles of psychotherapy, both of which are taken as givens by therapists and lay persons alike. And both are principles I take exception to, both in and out of my office. I'll address them separately:

Interpretation

Interpretation has profound currency among psychotherapists so much so that it's almost ubiquitous with the very concept of therapy. You go into your therapist's office and talk about your life, and the therapist interprets not only the content but also how it's delivered, your body language--even what isn't said. It is assumed that the therapist has some special capacity not only to interpret what's being said, but to interpret it psychologically. This sets the therapist's interpretations apart from everyday interpretations. We're led to believe that therapists can see and understand in particular ways that allow them to know who we really are.

I don't do that. I mean, sure, I interpret. When someone walks in with a scowl I figure they're upset. If they're sniffling, I imagine they've been sick.

What I don't do is make interpreting so special, because I don't think that's the mechanism through which I can be most helpful. It assumes that I have some special wisdom that (guess what?) I don't actually have. What I take as helpful in the therapeutic process is the activity of two people (you and me--or more, in the case of group therapy) working together to create the therapy. One of us doesn't have to have special interpretive powers in order for that process to be successful.

Boundaries

Freud believed that the analyst (essentially a psychotherapist who practices psychoanalysis, the therapeutic method Freud invented) must make himself (herself came later) a "blank slate" on which the patient could project feelings and experiences that aren't really about the analyst (e.g. feelings towards a parent). In order to keep this slate "clean," the analyst should disclose as little personal information as possible.

Even for Freud this was, of course, a fiction. Freud saw patients in his home, developed a significant international notoriety that his patients were no doubt aware of and, famously, slept with several of his patients. But regardless, the tradition of the tight-lipped psychotherapist has endured, even among therapists who consider their practice as having little to do otherwise with Freud's tradition of therapy.

Sadly, this traditional notion of boundaries doesn't just make us unwelcome at holiday parties--it's a serious issue in the therapy room as well. In much the same way that interpretation creates a certain specialness (i.e. distant, removed from) on the part of the therapist, the strict application of boundaries keeps the therapist separate from the patient. The therapist, perhaps, feels safer from this distance, and his or her authority is less likely to be challenged. This distance is at the heart of what I perceive to be the complaints so many people have about therapy and therapists. The very people (therapists) who ought to be seen as warm, welcoming and friendly often end up coming off as cold and distant to the very people (clients, patients) who most need to get closer.

Is it a bad rap?

No. The reluctance many people have to hanging out with therapists is an honest commentary on the real experiences so many have with therapy. I'm not surprised that people don't want to sit next to me at weddings. I think much of how therapy and therapists work in the world has justly earned the profession a bad rap, even as there are those, like me, who don't indulge in these practices.

And if someone's willing to stick around and ask more questions about what I do, I'll gladly seize the chance to challenge the stereotype.