Malin Gustavsson is a contributing guest writer for CelebrityTypes. In this article, Gustavsson draws on her personal experience as a therapist to share some tips on how to be an effective counselor. As with other guest writers on the site (such as Michael Pierce and Jesse Gerroir) we do not necessarily agree with Gustavsson on every point. In fact, we positively disagree with Gustavsson on the importance of diagnosis. Still, we consider her admonition to be a valuable counterpart to our usual perspective.
By Malin Gustavsson
In this article I am going to provide a handful of tips for the psychologist who wants to better his or her therapeutic skills. Though people have come to think of “psychologists” as being merely the members of one specific profession, my view is rather that we are really all psychologists.
Likewise, because the history of psychotherapy has focused heavily on abnormal people and clinical settings, the cartoonish image of the therapist as an all-knowing expert has been allowed to form in people’s minds. This image tends to obscure the fact that we are all therapists in different areas of our lives and that our loved ones may benefit from our therapeutic assistance when dealing with a whole range of everyday situations. Commonplace problems, such as deciding whether or not to accept a given promotion, may just as easily benefit from being met with therapeutic assistance as clinical ones. So here are some tips for the fledgling psychologist.
Tip #1: Help the Other Person Become Himself
A fundamental mistake that people make when approaching the practice of psychotherapy is that they think of it as advice-giving: The better the advice that is given to the patient, the more of a psychologist you are (or so the thinking goes). Viewed through these spectacles, psychotherapy almost becomes a sort of guide to the stock-exchange: “Buy!”, “Sell!”, “Up!”, “Down!” Follow the therapist’s advice and all of your problems will be naught.
When practicing psychotherapy, a useful rule of thumb is that even if the person is genuinely in doubt about what to do, the psychologist should think of the therapeutic situation as if the other person already knows what to do. She carries the answer inside herself; she just hasn’t been able to clarify that answer to her conscious mind yet. The task of the psychologist in therapy is really to help the other person figure out what she is going to do of her own accord – not to give advice or to be the infallible expert that the patient will look up to.
Again, because the misleading image of the dejected patient and the all-knowing therapist has been allowed to form in people’s minds, people all too often assume that the patient is a weak and indecisive individual with no resourcefulness of her own. But the truth is that most of us are able to come to our own conclusions if we’re encouraged to, allowed to, and listened attentively to.
Think of it like this: When the patient presents a problem, the lazy psychologist will search his pre-existing and personal knowledge to come up with an answer and deliver the best possible piece of advice to the patient. “Your boyfriend doesn’t clean up after himself and expects you to do all the housework? – Of course you should move out!”
This is a mistake – a form of laziness that even many professional psychologists fall prey to. The diligent psychologist will instead remind herself that there is a wealth of emotional nuance and factual information that she is not privy to and which she has not experienced first-hand.
As wonderful a gift as the practice of psychotherapy is, there is still a whole range of things that therapy cannot do. For example, if a person is not emotionally ready to leave her relationship, there is nothing you can say from your own perspective that will impart that readiness to her. It has to come of her own volition, and it will come of her own volition, once the therapist helps her clarify her own thoughts and emotions by reflecting the elements of her own considerations back to her.
The exception to this rule is when the other person is trapped in a relationship with overtly violent elements. In such situations, it is permissible, even advisable, to use whatever authority or closeness you have with the other person to get her to leave the relationship. The reason it can be okay to advise someone to get out of a violent relationship is because a person’s base biological instincts take over when one is habitually subjected to violence. The person who lives in fear cannot rationally decide whether she wants to remain in a relationship or not – her limbic system has kicked in and is deciding for her.
Tip #2: Be Cautious About Diagnosis
While CelebrityTypes obviously places great value on diagnosis here on the site, the psychologist should nevertheless be wary of making diagnosis too central a component of the therapeutic situation. Way too often, diagnosis becomes an attempt to transplant a hard-science mindset onto the practice of psychotherapy – a setting in which such certitude is neither desirable nor possible.
Of course, the practice of proper diagnosis is critical when dealing with patients beset by conditions that have a firm biological foundation (e.g. schizophrenia, epilepsy, brain disease, etc.). But in everyday psychotherapy, diagnosis becomes less crucial. It can even be counterproductive.
The dangers of applying diagnosis should be obvious to most students of psychology: A diagnosis is an idealized prototype, but the actual patient is a concrete and specific phenotype that is shaped by her unique blend of experiences and dispositions. Once we apply a diagnosis (such as a Jungian type or DSM style) everything about the patient that conforms to the type or style immediately springs to mind. This sudden blaze of illumination can be helpful, of course, but it often comes at the cost of our neglect of those aspects of the other person’s psyche that do not fit the diagnosis.
A diagnosis may also become a self-fulfilling prophecy, especially in a clinical setting where the therapist is imbued with medical authority. From the very earliest days of psychology, the field has been rife with patients who unwittingly became more “borderline” or “narcissistic” because the therapist kept referring to them as such. It was hardly a coincidence that the sexually deprived Freud and the erotically licentious Jung kept discovering “hysterical” women who needed help sorting out their sex lives.
Even when applying a diagnosis, the psychologist should always keep the relatively poor reliability of the Jungian types and the DSM styles in mind. Even the mighty Big Five system of personality, so often hailed as the gold standard in psychometric testing, cannot relieve the therapist of his obligation to engage with the whole human being.
Tip #3: Help the Patient Develop Empathy
When people are struggling with problems that are within the normal range of psychological functioning, the gist of their problems can often be traced back to an inability to develop and deploy proper empathy in their relationships.
For the majority of relations in life, empathy is the key to developing meaningful relationships with others. Think about the most empathetic person you know: Even if you don’t like that person when thinking of him critically and from afar, chances are that you nevertheless tend to be charmed by him in the hours that follow an extended interaction between the two of you. This ambiguity illustrates the raw power of empathy to act as the plaster that binds people together and which leads them to perceive relations with one another as meaningful.
Obviously, not every patient is able to develop empathy to the level that could ideally be desired. Like a person’s capacity for mathematics, much of a person’s empathic ability is inborn and cannot be altered by the therapeutic process. Yet no matter what capacity for empathy the other person brings to counseling, the therapist must approach the conversation with an optimistic mindset. The fact that an ideal outcome is not always achievable does not discount whatever actual gains the patient is able to make.
Like I mentioned in tip #1, the psychologist should not set out to equip the patient with a textbook understanding of empathy. The patient is fully capable of acquiring such knowledge of her own accord or to pursue such knowledge in other settings. Instead, the therapist should use the here-and-now of the therapeutic situation to be empathetic towards the patient, so that she will experience empathy first-hand. If the psychologist is successful in getting the patient to feel that the two of them are sharing an empathic connection, the patient will quite naturally wish to extend that feeling to other important people in her life. And she will do so all by herself.
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Image of Hermes in the article commissioned from artist Francesca Elettra.
This article provides educational information on psychotherapy. The information is provided “as-is” and should not be construed to constitute professional services or warranties of any kind.
It’s definitely true that we are all therapists, and somewhat recent research has born that out: talking to a friend is just about as good as talking to a therapist. This has been true of my own experience as well, except I’ve found that actual therapists are almost completely useless, whereas my friends are not. Therapists often sit there and let you do the talking, and are hesitant to say much of anything at all. At best they point you to the latest hype such as CBT. Yes, that’s what I need, yet another therapist. Thanks, therapist! The person may indeed need some major psychological reprogramming, but throwing them at a catchall course that tries to fix everyone’s problems is inefficient and probably doesn’t usually work very well, which is congruent with your point about paying attention to individual differences.
Still, therapists do have a useful role to fill in society, and it is not being a friend to someone who could just as effectively go get wasted at a bar and talk to a random person. The useful role that a therapist ought to play is that of a mechanic or troubleshooter. I’ve learned it’s possible to point someone in the right direction with a relatively small number of questions , rather than sitting their lazily watching them spin in circles, driving themselves crazy with no clue of what to fix or how to do it. When I’ve looked back at the problems I’ve solved in, I’ve been shocked at how utterly ineffective therapists have been.
And that’s one nice thing about the MBTI. Hand someone an inventory, help them find their best fit type, and point them to personality page. The sections on strengths and weaknesses are especially useful. With regards to empathy, I question whether what you can quickly teach someone is really much more than “listen to what they said, add that to what you said, and divide by two.”
I have a couple more quick comments in direct reply to points you made:
> Of course, the practice of proper diagnosis is critical when dealing with patients beset by conditions that have a firm biological foundation (e.g. schizophrenia, epilepsy, brain disease, etc.).
_All_ conditions have a firm biological foundation. Please do not spread dualism. That said, if you know what the biological foundations of schizophrenia and epilepsy are, I know some people who would like to speak with you :)
> the relatively poor reliability of the Jungian types
I think you mean the relatively excellent reliability of the Jungian types. CAPT’s latest statistics are something like .7 test-retest reliability.
“_All_ conditions have a firm biological foundation. Please do not spread dualism. ”
Please do not spread monism, in the absence of any evidence whose interpretation does not rest on the belief of the interpreter in one metaphysical system or another. That the brain has something to do with the psyche is not empirically refutable, but the question of whether brain events are the causes of psychic events, are coincidental with psychic events, are consequential of psychic events, or are merely contingently associated with psychic events, remains unanswerable in the absence of some pre-existing belief in the “factuality” of one point of view or another that ultimately rests on one’s commitment to one or another unprovable metaphysical hypothesis. That one can alter or disrupt psychic function chemically or surgically does not “prove” that chemistry or anatomy “causes” that function anymore than the fact that cutting or electronically altering communications on a telephone line “proves” that the telephone system determines the contents of those communications.