Many features of the psychotherapy relationship contribute to growth and psychological “healing” to the extent it is possible. In an earlier post about attachment theory, I discussed the importance of the emotional bond between client and therapist for development, especially the therapist’s ability to empathize with and ultimately feel genuine affection for his or her client. Implicit in that emotional attitude is the therapist’s conviction that the client’s experience, however painful and chaotic, is worth paying attention to. It has value and meaning. The simple fact that the therapist devotes his or her full attention to the client’s experience — bears witness to it — contributes to the healing process in ways we don’t often mention.
Human beings are social animals: part of our sense of self comes from our relation to other humans — being seen, acknowledged and validated by other members of our pack or tribe. To an important degree, this is what it means for life to have meaning. I have a number of clients who live extremely isolated lives; they’re deeply pained because they feel they don’t matter to anyone, that they’re invisible and that it wouldn’t matter if they were to disappear. It isn’t just that they feel lonely and long for emotional contact with others; without anyone to bear witness to their lives, they have trouble maintaining a sense of their own personal worth and the meaning of their existence.
The roots of this experience of personal meaninglessness lie in the failed mother-infant relationship. One of my clients had a mother almost entirely unable to empathize and whose own emotional troubles prevented her from mothering my client in any meaningful way. Two other people I work with had extremely narcissistic mothers; as a result, my clients have a hard time feeling that their own needs and experience are worth paying attention to; they tend to devote themselves to other people’s needs and sometimes feel as if they don’t exist. One of them will occasionally fall into an existential depression where he feels as if his life has no meaning and he might as well kill himself.
When the empathic link between therapist and client is strong, it can help make up for (but not entirely erase) this deficit. Clients — especially ones who struggle with profound shame and low self-esteem — often feel deeply grateful for their therapist’s attention. They also find it difficult to believe that it means anything, especially in light of the fact that they must pay for it. It takes a long time for them to have faith in the therapist’s regard and to make peace with the fee. Eventually, the clients who stick with treatment come to understand that you might buy an hour of a professional’s time, but you can’t buy his or her affection.
I have lately come to realize that part of what deepens my affection is the experience of being seen and valued by my clients. I’ve made the mental link to memories of that moment when my children were infants and began to recognize me, in however limited a way, as a real person. Before then, I felt love and concern for them but it deepened when our relationship became more “interpersonal”, for lack of a better term. I guess you could say there’s a kind of reciprocal process of bearing witness and being seen, deeply important for both parent and child in generating the sense of personal meaning. I care for and am concerned about all all my clients; over time, when we go through challenging periods together — say, when hatred and violent anger enter the field between us — and they continue to value the work and stick with it, trusting me to do my job, my affection grows deeper. I assume this is true for all therapists.
When clients choose to leave therapy early on, it may be for many reasons but one of them might be the feeling that they are not “seen” or understood. The ability of the particular therapist to “bear witness” to and make sense of the client’s life doesn’t meet his or her needs. In that sense, these clients withdraw their validation of the therapist; it can be a sort of narcissistic injury because it chips away at that sense of personal meaning he or she derives from being valued both as a professional and as a person. After this long in the field, I know I am always a bit hurt when a client quits in the midst of our work, especially if I’ve attached. When I was young in the field, it would shake me quite a bit, making me question my worth as a therapist. Now it’s a passing sadness. I’ve learned to let go graciously, wish my departing client well and try to understand what I might have done differently.
* As a footnote, I want to say how deeply validating I have found it, that so many people (more than 30) tentatively want to participate in the project I outlined in my last post. To do work that I enjoy and to be appreciated by others for my writing and professional skills gives me a great sense of personal meaning; it contributes to my sense of self-worth. Thank you all for bearing witness to my efforts here and for expressing some preliminary interest in this new venture I have in mind. I’m very excited about it and hope it will have meaning for you, too.
** As a second footnote — I’ve finished a rough first draft of my book. It still needs quite a bit of revision and polishing, but the preliminary drafting is done. I should now be able to return to regular posting here on the webste.