Joy in the Psychotherapy Relationship

Joy2Naomi, one of my long-term clients and a therapist herself, has been talking in session lately about joy. The importance of joy in the mother-infant relationship, in adult romantic relationships, and in the relationship between therapist and client. Her ideas have grown out of her own practice, partially stimulated by our work together and informed by Allan Schore’s writings on enjoyment-joy (part of the inborn affect system). Naomi’s views have had a strong influence on my own: we therapists learn so much from our clients, especially when they are thoughtful, gifted clinicians themselves.

This is an over-simplification of her views, but Naomi believes that joy is what makes the agony of infancy bearable. Helplessness and vulnerability, the reality of separation from mother, intense emotional pain of all kinds — these experiences are an inevitable part of early infancy. The joy we optimally experience in relation to our mothers helps to make the pain bearable. Feeling joy in her presence and finding this joy reciprocated helps us to bear the trauma of separation from her. Finding that our own joy elicits equal (and even greater) joy in mother allows us to endure feeling small, helpless and vulnerable.

The alternative experience, what I’ve described elsewhere as “unrequited love,” leaves behind a feeling of inner defect or core shame.

In an earlier post, I wrote about the role of love in the healing psychotherapy relationship; joy plays an important part in such healing, but it’s not the same thing. Over time, we come to feel and eventually we convey to our clients the love we feel for them, but even from the beginning when it would be premature to speak of love, we need to make clear to our clients that we enjoy working with them. Personal warmth, genuine smiles, even laughter — according to Naomi, all these will convey the pleasure we take in working with our clients. It’s not in the words so much as in the emotional atmosphere.

Too often, newly minted therapists in the psychoanalytic mold feel constrained in this respect. Because we’ve been encouraged to adopt the “blank screen” professional mien, where overt expressions of warmth would interfere with the development of the transference, we inhibit our smiles and laughter. We come across as reserved rather than warm; we might even seem intimidating or scary. Over time, as we gain experience and come to feel more confident in our abilities, we relax. We allow more of our ordinary human warmth to show through. But even then, I don’t think we feel comfortable with the overt expression of joy.

I was thinking about all this in a recent session with a client, a young woman in her mid-20s whom I’ve been seeing for about a year. At the beginning of every session, after I’ve greeted her by name, Selena says, “Oh hi,” in a tone that conveys indifference. Her facial expression is a blank. Sometimes she’ll say, “What were we talking about last week?” It sounds as if she hasn’t given our work together a thought since we last met. Selena seems to be saying, “I don’t care about you and you don’t care about me. We take no pleasure in our work together.”

Last week, I finally addressed this issue in session. I hadn’t planned to do so in advance but the right moment seemed to present itself. I described the way our sessions always seemed to begin, using pretty much the same language as in the last paragraph. I said, “We’ve been working together for about a year now. We’ve come to know one another, we’ve developed a relationship, and yet it often seems as if we’re strangers. Sometimes it seems as if you believe I don’t like you and you don’t seem to like me.”

Selena seemed quite surprised by this. She said, “Sometimes I imagine that you must be bored, listening to me talk about the same things all the time. It must get pretty tedious.” I said, “Just imagine how awful it would feel to come in, all eager and interested, only to find that your therapist was bored with you.” I suggested that the appearance of indifference with which she began our sessions was an effort to protect herself. I reminded her of what she’d told me earlier in the session, that her own mother “had never seemed all that interested in” her.

Then she looked at me and said, “Well do you like me?”

Twenty years ago, I would have done the usual psychoanalytic gymnastics, reflecting the question back to my client in order to address her own feelings about herself. Instead, I told her the truth: “Of course I like you! I’ve been working with you for quite a while now and I’m interested in you. I look forward to seeing you and I enjoy our sessions.” I was speaking in an animated and personal way. I meant her to feel my joy in our work and my affection for her; I believe she did.

Psychotherapy is hard work, often full of pain. A client’s experience of our joy in the work we do together, our pleasure in their company, makes the process bearable — just as a mother’s joy makes the pain of infancy bearable for her child.

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

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43 Responses to Joy in the Psychotherapy Relationship

  1. Dagan says:

    Great story! It’s amazing how much you have the ability to make a difference in people’s lives when you work in the psychology industry. I think you definitely made the right call when you told her the truth.

  2. Becoming Attachable says:

    As a mother of an 18 month old and devoted reader coming to terms with my parents and their narcissism, it was a JOY to read this post from you. My therapist and I talk often about how my parents simply didn’t delight in me, which is also evidenced in the limits of how they are able to be with my daughter. I love the way that your client describes it being a balm for the many things that are hard about being a baby. With this in mind I think I have felt that switch happen for my daughter many times. It feels kind of like an easing that happens within her.

    As a child, I was so fortunate to have a babysitter who really drew me out and enjoyed me. While that wasn’t enough to protect me from the ill effects of my parents approach to me, it was a memory that I could call upon and do still call upon as I wrestle with who I am in adulthood.

  3. Kim says:

    Hi Dr. Burgo,
    This is one of many posts that you have written that helps me contemplate some of the dynamics at work in my own therapy. True joy seems like such a genuine feeling, made more beautiful by the depth which can be achieved in some therapeutic relationships. Much like a family bond. Just feeling “seen” in therapy in a loving manner brings a tingly feeling in my heart which I think is joy. It does feel important to have that dynamic because of the pain and courage it takes to really work in therapy. I’m glad you (and my therapist) think it is an important aspect of the work. I have to admit though, I have had a very hard and long time (and am still working on) feeling the relationship is genuine and caring enough to trust that joy can come of it. Geez it takes a lot of work!

    • Joseph Burgo says:

      It does. But you bring up an important point — sometimes the work involves learning to trust in the joy. Most people who come from difficult backgrounds have a hard time trusting that the joy is real.

  4. Sent for meds says:

    Yay, happy post! I’m not sure how my therapist feels about me. But it is abundantly clear to me that she loves her work. And since I am her work, then…

  5. Catherine says:

    Joseph,

    Absolutely it’s an arduous process to change your ingrained emotional and thought patterns and reactions and related external behaviors. Even when we believe that our therapist is committed to us, and we’re committed to the process and we’ve gotten used to unpacking ALL the raw, ugly, unvarnished stuff, and we start to *know* it’s working for us, there are just times when you need to hear and *feel* that your therapist (still) LIKES you and likes working with you!

    My therapist, who has 30+ years of experience, is wonderful at making me feel that I am in good hands and safe and liked. Our process together is working, and that that makes us both pleased. We both feel that joy that we’re getting there, and as I *feel* that growing bubble of love for myself inside, especially these last few months after 2.5 years of work, I know she feels it, too, and it makes her happy for both of us. We increasingly refer to our work as *our* journey together.

    My questions for you Joseph: In your own many years of undertaking therapy, did you have a therapist who expressed this joy to you about you and the work she/he was doing with you? What about a therapist who never did? Do you remember a palpable moment when it made a difference either way that you would share? Thank you for validating us, as always.

    Good healing for all,
    Catherine

    • Joseph Burgo says:

      I did not experience this joy from my own therapist, and it took me a long time after the end of therapy to understand just how much that impacted me. He was not exactly a blank screen, and he was quite warm in his approach, but I never felt what I’m describing in this post. That has been a lasting sadness for me. I did feel that he was deeply concerned about me and I think he did an excellent job of understanding and tolerating me (especially my rage) but the joy bit was missing.

      • Catherine says:

        I’m sorry your therapist didn’t feel/or convey any joy for you and about you, Joseph. You needed this celebration of you and the healthier you that you were working so hard *with* your therapist to become. You deserved it. We all do. Your clients benefit from your insights and your willingness to trust yourself, as do we here.

        Joy in healing to all,
        Catherine

      • Y says:

        Do you think you will ever try therapy again in order to feel the reciprocal love/joy you speak of in your post? It’s never too late!

  6. Evan Hadkins says:

    Sounds like Selena would make a good conventional psychoanalyst.

    Do you have ideas on how training could be done better. If it produces people who can’t relax when they are with others it can’t be all that great (over-emphasis on deliberateness?).

    • Joseph Burgo says:

      I agree that it isn’t all that great. I think what happens is that clinicians become much more warm and spontaneous in their practices without changing their theoretical views as they continue “towing the party line.” I think training could be improved by a greater emphasis on warmth, joy and love in the relationship, rather than the over-emphasis on remaining a blank screen.

  7. Cameron says:

    Great post, I sometimes get paranoid my therapist is bored with me yabbering on about all my problems and issues etc I guess however, it’s been selfish of me not to consider her feelings more and support her as a person too. Part of it is clearly that we spend the whole time talking about my biggest fears, doubts, anxieties and really my biggest problem (my core shame issues) it can be hard to seem enthusiastic when you’re shitting yourself about the tough feelings and memories you’re just about to discuss. However that’s something for me to think about, that my discussions with her aren’t all about me.

  8. Dolma Beck says:

    Your post brought back very warm memories of the therapy I had in
    my middle twenties. He always made me feel that my stories/ life, were
    interesting to him. His warmth and love is still something I can recall,
    quite clearly, nearly forty years later.
    Reading about you with Selena reminded me of those times.
    Feeling joy in my children, still surprises me.
    Now, with my four year old granddaughter, I get to return to the soft joy that only little people can bring. Thanks for this post, Joe. It reminds me of what treasures are right
    here with me..

  9. What a wonderful post! Over my lifetime I’ve seen my therapist three times, once for my initial therapy of several years, a decade later for an analysis, and a few years ago for some situational stuff I was dealing with. Over the years I watched him change from showing primarily the blank slate to offering a much more genuine interaction, including real joy and humor in our sessions. He himself admitted that he was trying too hard to keep that blank slate in those early years. So, yes, more training about relaxing and allowing organic emotions as they come up in sessions seems to be in order. There is little enough joy in the world–artificially withholding it doesn’t seem to benefit anyone.

  10. Lauren Vork says:

    “Twenty years ago, I would have done the usual psychoanalytic gymnastics, reflecting the question back to my client in order to address her own feelings about herself. Instead, I told her the truth: ‘Of course I like you! I’ve been working with you for quite a while now and I’m interested in you. I look forward to seeing you and I enjoy our sessions.’”

    Thanks for this. Made me tear up a bit, for some reason.

  11. M says:

    I feel as if I have been through (and am enduring) a therapeutic relationship that, when it comes to feelings of joy, has certainly waxed and waned. I began therapy more than 5 years ago (abandonment is my issue) and felt such love and support. We often spoke openly about our loving feelings for the other, would exchange emails (about my therapy issues) cards and little gifts. Smiles were abundant. I truly felt as if my therapist were interested in me, enjoyed our time together, and truly cared for me.

    Now that I am functioning better regarding my presenting crisis, the love, support, emails, cards, gifts and even welcoming smiles are dissipating. The sessions feel comparatively flat. We used to chat for a few minutes before jumping in, but more recently, sessions are beginning by sitting in silence until one of us can wait no longer. (I have explained my discomfort with this technique and asked that we go back to the friendlier beginning. The response was, “I will consider it.”) When I have attempted to make a joke or otherwise bring the relaxation and joy back, the therapist isn’t picking up on it as in the past, or simply says, “I don’t get it,” and moves on. I have even spoken about my feelings of ‘selfishness’ (as Cameron, above, wants to do), but when I try to show more concern, I am shut down as in, “We are not here to talk about me.”

    From someone who openly took on the role of good enough mother and even stated that we have a ‘friendship,’ it’s as if I am now, surprisingly, being ‘pushed out of the house.’
    Comparatively, attunement is less, and I often feel as if I am not ‘growing up’ quickly enough.

    My question is this: How much responsibility should a client accept when it comes to creating a positive therapeutic relationship? Is it my job to just be me in all my “truth” (both light and shadow sides) or should I attune more to the relationship and work harder to create (or in my case, re-create) that positive therapeutic environment? All of this has led me to consider leaving therapy, but given the intense emptiness I continue to experience at times and the suicidal ideation (imagery) that creeps in, I don’t know if it’s a good idea to quit, but at the same time, it takes so much work to stay in it. I have recently felt as if I am being triggered in therapy instead of regulating.

    • Joseph Burgo says:

      Well, I don’t think it’s your responsibility. But the development sounds backwards in the course of your therapy. I don’t think that the kind of loving feelings you describe happen early on in therapy, at least not authentic, deeply felt ones. They’re “earned,” so to speak, over time. I don’t mean that if you’re a good client, you earn your therapist’s love. I mean that loving feelings develop over time after having gone through a great deal of shared experience, much of it painful and vulnerable.

  12. TPG says:

    Interesting. I always felt like time was too precious in the therapy room for much joy’ing around. I found and find sustained joy with my friends, my family, and my shared community, maybe because I know those relationships have a future that depends on those people’s continued voluntary engagement with me as on my engagement with them. I couldn’t imagine sustained joy with a time-limited psychologist any more than I could imagine it with my current doctor or my attorney. That is to say, it would be highly limited. There’s joy with a doctor, yes, when a baby’s heartbeat is detected, or it’s five years cancer-free. But those are moments amid the business of being a patient. I guess there were a few moments of joy in the therapy room — aha moments, and the like. But those were all sort of guarded, within the artificial frame of the relationship. That was fine. There was still plenty of good work to do.

  13. LK says:

    Oh this is poignant and quite painful actually. Thank you for this insight Joe, I want to give my response but not sure what it is… I think I am jealous of your client or maybe of anyone who has felt this from their parents/mother/therapist/anyone… what a difficult journey this is. I don’t think I have the guts to ask anyone ever again if they like me or like spending time with me. It’s too crushing to have the platitudes and reflected questions.

    • Joseph Burgo says:

      I understand. I think that a client asking this question and my answering isn’t the usual way it occurs, and I agree with another site visitor who commented that my answer won’t reassure her. One gets the sense of concern/joy as it develops over time, and true reassurance that one is cared for in this way takes a very long time.

      • LK says:

        There is something about your description there – about it not being the ‘usual way it occurs’ that ignites my wish to be the one and only client that my therapist responds to in that way – to be the one he is different with. I think partly this is due to the fact that he was different in the beginning and he himself has learned about how to be a more effective therapist while working with me. In the beginning he wasn’t very strict about time and would let my sessions run on (some times by an extra unpaid 40 minutes) and he would respond to my emails and share parts of his life with me. When I reluctantly revealed how painfully attached I was, how jealous of his wife and kids I felt and how it agonised me to be away from him he discussed with me how he would gently change his interactions to help with this. He took full responsibility and I can see the changes are working even though I so didn’t want him to change in the beginning.

        Since writing my first response to this post I am feeling different about it all. I feel more secure in my attachment with him. I trust him and know that the way he interacts with me is genuine and sincere. I also can see he is human and makes mistakes and isn’t this perfect, idealised hero I made him out to be. Slowly (very slowly) the work we are doing together is sinking in. It’s transforming from a state of knowing logically and intellectually but not feeling it to really knowing and feeling and believing in what we are doing.

        I feel like if he was to say he liked me and enjoyed spending time with me fall further into this parent/child transference love. I’d want to have examples and I’d be looking for details. The child ego in me would be going on overdrive trying to eagerly fish for evidence to support his claim while the parent ego in me would be chastising the child – telling myself ‘he’s just doing his job, it’s just another trick to get you to believe x, y and z’ – however the adult in me is observing this exchange and becoming less judgemental of the way I am. It’s upsetting to see how desperate I am to be reassured and how much I long to be parented but also I can see a huge change in myself in under a year of therapy and feel hopeful for the future. I am also managing to go a fortnight between sessions now without freaking out – these things do take time, you’re of course totally spot on Joe. I can see myself transforming and I’m grateful of that.

        Thanks once again for your dedication to your blog and your commenters. It’s a wonderful insight into the internal lives of others and the therapeutic experience.

        • Joseph Burgo says:

          Your therapist sounds like a very competent, compassionate guy. And I do understand the painful struggle you’re going through. I hope your work together continues to be so helpful to you.

  14. Alyboy says:

    The problem with telling Selena “of course I like you!” is that she most likely doesn’t REALLY believe you. It might make her feel good for 5 minutes or 5 hours but it doesn’t address the fundamental problem that she believes she is not all that likeable. In fact, I will even go as far as to suggest that this approach is actually stealing something precious from Selena – its stealing from her the opportunity to acknowledge her shame which is the necessary step to begin developing her true sense of self.

    Also, I just wonder if on some level you sense that Selena is perhaps not developing in her therapy; is struggling to acknowledge her own sense of inner defect and shame and you feel that well a little dose of “of course I like you!” is all that Selena is capable of – but for me it’s a bit like prescribing an antidepressant.

    My analyst has never told me that he likes me; when I do bring this up with him (which used to be very very often) he always reflects this back to me to address my own feelings about myself; and as you mention, overtime my development has not come from the words but the emotional atmosphere – he always shows up for our sessions, he always listens to me, shows genuine interest in me, and does not get put off by my bouts of rage. And yes it has taken a long time but I feel if he gave into my needs early on by giving my that warm smile and telling me “of course I like you!” I wouldn’t have had the REAL growth I have experienced.

    • Joseph Burgo says:

      We do talk about her shame, and I agree that it’s essential; but I’ve come to believe that the true healing of shame comes from the experience of joy in relation to others.

  15. Corey says:

    Afternoon Dr. Joseph,

    First off, the phrase “emotional atmosphere,” I enjoy that one and will have to adopt the term in the future. It’s context captures and describes the emotional energy (hence E-motions) that we give off and create in a quck and efficient manner. This post also caused me to think of our interactions with each other as “Social Mirrors.”

    The interaction with you and your client exemplifies this with the give and take of your interest/joy and her indifference/anxiety over whether or not you were genuinely interested in her or just the client/counselor relatonship that you each sustain. Your demonstrative reflection/answer to her question will probalby “win her over” and allow her to look more often and express her own “mirror of joy.” (Off topic: I would surmise that the narcissist spends most of their time gazing in their own mirror.)

    As I learned and continue to learn more about the client/counselor relationship, I would always wonder why the counselor was “supposed” to seem emotionless when it seems the crux of these interactions are emotional. I understand guarding against transference but it struck me as also potentially inhibiting the client through the perception of intellectualizing their experience. I guess a balance has to be attained and I imagine that comes with expperience.

    CW

    • Joseph Burgo says:

      I agree about how strange it is that therapists are supposed to seem emotionless. I think it’s a residue of the effort of psychoanalysis to appear “scientific” and to be accepted as a profession.

  16. Karen says:

    I don’ t know how my last therapist/psychiatrist felt about me. There were times when I felt that she may not have been listening. I’ve had 4 different therapists and I don’t feel that I ever experienced joy from any of them. The first therapist–I had to quit as I relocated. The second (a man) demonstrated annoyance and anger. He yelled at me using his wife’s name and caught it himself and made a comment about it. It made me feel very emotionally unsafe and I quit seeing him. I think he was fine with that. My 3rd experience–the therapist was another woman and she claimed that she had been a therapist for 25 years. She wound up calling me for my help as she had (according to her) been involuntarily committed. I visited her at the facility and it was quite obvious that there was something really wrong with her mental health. She seemed so different. She wanted me to call her doctor, so that he would get her out of the facility. I called him as she requested and he refused and told me that she was a very sick woman (long story). Her family even called me and I spoke to her attorney as well. I think her license was suspended. Imagine that–you seek a therapist because of needing help with your own issues and something like that happens. After that incident I became very distressed and distrustful of people in your profession and this impacted me in ways that I can’t even begin to describe here. When your trust has been so broken and abused it is the last thing that you need to have happen. I actually never discuss it. I recall I tried a few times with people, but they were the wrong types of people to talk too (no compassion or empathy). I did briefly touch upon the episode with the last therapist, but when I sought her out it was mainly because I was in crisis. It was only extreme stress due to a health situation which occurred at the same time that my mother was committed that the stress was so overwhelming that I attempted to try counseling again.

    I appreciated reading this article, but like you I don’t feel that I ever experienced joy from any of the therapists that I’ve seen. It may have made a huge difference. I really don’t even know if they were all that concerned about me either. That’s been missing in my life–the feeling that other people have any desire to understand me, let alone care or feel concern about me. My life feels populated by people that want that from me, try to demand it, yet it has never felt like a two-way street.

    Even when it came to the one therapist–that was yet another familiar life experience of other people always trying to get me to take care of them in some way–everything always being about their needs. It feels so repetitive. I have a hard time relaxing around people given my past experiences. Their neediness and self-absorbed behaviors just feels so overwhelming and spiritually crushing to me.

    Thank you for your article and for your wonderful blog.

    • Joseph Burgo says:

      You’ve had a string of bad therapists and I wish I could say that was unusual. You’d think that therapists would be a healthier, better qualified group of professionals than they actually are.

  17. Sarah says:

    I wrote in the past here about my relationship with my former therapist. He was like a baby who felt what I was feeling. He was into being my emotional twin, he wasn’t interested into asking many questions. He seemed to get a general impression of me and then wanted me to show him my sadness so he could heal me with his “empathy and compassion” (I heard a lot about his empathy and compassion). This initially drew me in and it felt fantastic to have this nice man feeling my pain. Then I hit the brakes-my basic lack of trust and fear of closeness made me examine him for signs of insincerity. I called him out on every failing I could find. He handled it with Christ-like patience for about 5 months, then he said, “If you keep criticizing me, maybe we’re going to have to decide this just isn’t working out”, which is what he eventually decided (without my input). I got kicked out. I understand that he didn’t know how to work with someone as untrusting as I am. I’m disappointed that I didn’t have a better therapist, because I was very hopeful that my therapy would have a happy ending. I don’t have it in me to try again (he wasn’t my first-I’m not good at picking therapists). Anyway, my point is, not all clients can be open to the “joy” for quite a while. People like me who did not have parents at all in a real sense put childhood hopes for love on our therapists, and it’s crushingly disappointing to face reality (“I’m a client, not a loved child or partner”). While my therapist was warmly smiling at me and trying to get our 50 minute, paid relationship going, I was re-living the pain of no-love. I tried to explain that, and he’d say, “I can’t love you like you’re my child or spouse, but I DO feel empathy and compassion!” He’d look so proud. I wanted to punch his face in. I wish he could’ve just been with me in the pain of not being loved but he was too busy dangling consolation prizes in front of my raging eyes. He valued those consolation prizes highly and I knew that, so I decimated them in retaliation for not loving me.
    It was quite a battle. So much for joy in that therapeutic relationship.

    • Joseph Burgo says:

      Sounds like you had a narcissistic therapist, bent more on displaying how empathic and compassionate a person he was, than on truly listening.

      • Sarah says:

        It does-a covert narcissist. It was quite a mind-trip. I elevated a person to the position of my psychological helper and HIS psychology was unhealthy-and this is not the first time. I become like Alice, tumbling down the rabbit hole and trying to see clearly when the person I put in charge can’t see clearly-and tells me I’m the one who can’t see. Someone gets an MFT degree, rents an office, creates a website and acts like they know what they’re doing. I show up with a check, voluntarily put myself in a position of lower status (the one needing guidance) and buy their perspective on me. This can be dangerous. My former ‘therapist’ crashed the therapy car-on my side-got out and ran. I got out too, rehab-ed myself, and from now on, I’m driving.

      • Melissa says:

        After reading your articles on narcissism, I’m wondering how you are using the word ‘narcissist’ when you write, “Sounds like you had a narcissistic therapist…”, as in ‘everyday narcissist’, or as in someone suffering from Narcissistic Personality Disorder?
        And thank you for saying “You’ve had a string of bad therapists and I wish I could say that was unusual. You’d think that therapists would be a healthier, better qualified group of professionals than they actually are” to another reader.
        In my experience, therapists in general are much too self-protective to be that honest. It is amazingly refreshing to hear a therapist strong enough to speak the truth.

    • Cameron says:

      Honestly I can’t believe he lasted 5 months with you constantly criticising him, most people wouldn’t last 5 minutes. I think he could have done much better and probably wasn’t really empathising with you. If I was you I’d ask myself if attacking my therapist was the most constructive response.

  18. FRM says:

    I see a therapist because I assume she has more knowledge about how to do therapy than I do. I don’t enjoy the appointments and don’t really expect her to care one way or the other. I don’t see her as my mother either. If she started in on her liking me or something, I would leave and fine one who was more detached.

  19. Dolma Beck says:

    Hi Joe, hope everything ok with you?
    Weird, that you haven’t written for so long.
    Take care. Dolma

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