Bearing Witness and Being Seen

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.

By Joseph Burgo

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


  1. Your words have been very helpful to me – my therapy “ended” (if it ever really ends), a few years ago, but I’ve had to re- visit a few problems with my therapist since then. I didn’t really grieve for my mother, when I lost her, in my teen years – and I wonder if that’s the tearful grieving I continue to do, for my therapist.

    1. That’s another important topic — the grieving that comes up at the end of therapy. Yes, it can overlay an earlier loss, as with your un-grieved mother, but the end of therapy is also a very real loss.

  2. that is nice that you say that therapy can actually treat people and help make them better. I have a lot of trouble believing that because I experienced abuse by a mental psychiatric hospital and NOW I AM very jaded about mental health people. I want to believe that there is genuine treatment for us that have had a lot of trauma in our lives, because that provides hope. THAT is why i like reading your website because you come across as providing hope that people can get better.

    1. I do believe therapy can help. I also know there is a lot of bad therapy out there, and a lot of damage done by the “helping profession”. I’m sometimes dismayed at how often people write to me about truly awful experiences they’ve had with their therapists or psychiatrists.

  3. Cry out in your weakness

    A dragon was pulling a bear into its terrible mouth.
    A courageous man went and rescued the bear.
    There are such helpers in the world, who rush to save anyone who cries out. Like Mercy itself, they run toward the screaming.
    And they can’t be bought off. If you were to ask one of those
    “Why did you come so quickly?” he or she would say, “Because I heard your helplessness.”
    Where lowland is, that’s where water goes. All medicine wants is pain to cure.
    And don’t just ask for one mercy.
    Let them flood in. Let the sky open under your feet.
    Give your weakness to one who helps.
    Crying out loud and weeping are great resources.
    A nursing mother, all she does is wait to hear her child.
    Just a little beginning-whimper, and she’s there.
    God created the child,
    that is your WANTING,
    so that it might cry out, so that milk might come.
    Cry out! Don’t be stolid and silent with your pain. Lament!
    And let the milk of loving flow into you.

    Rumi (annotated version)

    Dr. Burgo, again a heartfelt post very relevant to the therapy experience (my therapy experience anyway). Oh how I long to be seen, to feel someone bearing witness to my lament. Everyone must want this. I cannot imagine the feeling. Working in pediatrics, I see newborns and infants in their mothers arms, in ecstasy, in a perfectly mirrored state (both), in total joy. It is amazing to see. I want to know what people feel like who had that kind of mom or dad. What does it feel like inside? Every time I go into therapy now we talk about my inability to feel the empathy and kindness and compassion that he feels for me (he says he feels for me). I have thought it would come from validation and I constantly ask him for that. He refuses the request. I beg him to ask me hundreds of questions about me so I can tell he is interested or something. He asks questions few and far between. I do believe on some level that he cares about me. But I cannot FEEL it. Do you have any suggestions because this really does feel important. Maybe it has to do with the hard part of being vulnerable, weak, and to “cry out in my weakness”. Maybe then I could feel some of his tenderness and empathy. How can I be strong, and become weak so I can accept some help? Sorry about the long post. Thanks again

    1. Maybe the issue is accepting and attaching to the therapist you do have and what he really has to offer, rather than pining for the one who (you imagine) will make you feel the way you hope to feel. It sounds as if you have some idealized expectations that are getting in the way of you appreciating what’s actually there.

      1. I think you are right on. A part of me is constantly searching for someone to rescue that little kid in me. It feels like a very strong need. I tend to idealize people I perceive to be stronger and smarter. I am actually very aware now of a need to idealize YOU and I don’t even know you. All of the above is also mixed in with shame of feeling so needy on the inside. I’ll keep working on it! My therapist will be able to help me work this out. He is well aware of being idealized by me and doesn’t accept it. Thanks for the help.

    2. I empathize with the wilderness you are currently in – it may be that you are trying too hard for too much and too soon and as a result missing what is on offer from your therapist -between the lines. My advice is go easy on yourself-continue the journey (putting expectation aside) and you may be surprised by what positives to will begin to receive.

      1. Thanks for your empathy Stephanie. Can someone “bear witness” to someone elses pain through a blog? And it does seem like a wilderness. Go easy on myself! Ha! What a rare and true quality. Who is so tender with themselves? It is a quality I aspire to and I definately will continue the journey. Thanks again

  4. GREAT post-again! Thanks.
    Trauma-whether it’s failure to bond with a parent-or other forms as manifested in various Survivor Groups challenges “Meaning” so profoundly… and meaning is absolutely vital to our well-being.
    I’ve spent my Professional life working with Vietnam Combat Vets. I didn’t start out with Vets-I got “dumped” with these..”Difficult Clients.” At the height of the Vietnam war all references to “Shell Shock”/Neurosis were (conveniently?) dropped from the DSM. (And what a battle it was later getting PTSD IN the DSM.) These men and women may have had very healthy relationships within their families/others growing up and then…they went to war. Bearing Witness was challenged repeatedly by my clients and they brokered “NO BS”; being female, a non-vet, one who could not possibly “understand” were additional hurdles in establishing the relationship. If they kept coming back (and some had no choice because it was me or jail and I was perceived as “easier”-little did they know!) eventually “trial balloons” regarding their experiences would be sent up. My response/reaction was studied very, very carefully. If these more benign experiences were accepted and validated more experiences were disclosed and processed as intimacy deepened. Meaning is so highly personal and essential to these men and women as it is for all of us. If they couldn’t find the “words” I gave them maps to show me where they were-I made tons of copies many of which ended with numerous pen-tip holes by the end of the session. One of the vets took a piece of paper during a session and drew a straight “baseline” which stopped abruptly, drew another continuing straight line about two in. above where the first left off, then dropped back down and continued that straight line back at the “baseline”. This was a description of his life as he “saw/felt” it. “I need to get this” (as he pointed to the line above the baseline) “back with this” (back at the baseline.) What an exquisitely simple yet accurate rendering of “trauma.” I had probably every first-person account, every work of fiction, history etc. from that era shoved in bookcases in my office. Yes, I “lost” some of my books etc. but it was a small price for the privilege of working with these men and women.
    I can honestly say it was trial by fire in my “rookie year” as a T. I can also honestly say I love these guys and women. They taught ME so very, very much about what it means to be human and live-and die-in this world. I know I have been humbled by the greatness of these “every mother’s son or daughters” who walked (or were mandated) into my office and trusted me enough to bring me into their “world.” Ultimately “Meaning” was imperative to their healing. I believe I have been fortunate beyond belief to work with these men and women. I often feel they gave me far, far more than I gave them. I mentioned something to that effect one day in group (yes, they had regular individual sessions as well) before I had to retire due to medical reasons. They started laughing and said, “Doc Nona, You’ve survived more LPs, ambush patrols, mortar attacks, human wave attacks, mines, satchel charges, Hot LZs and shit than any ONE of US has!”
    And as much as I grieved leaving work I knew there was nothing in my personal world/ medical challenges I couldn’t bear either: I was “taught” by the very best.

    1. Thanks so much for talking about the depth of your experience. I feel very much the same way — that I am privileged to be doing this work and so very fortunate to have the trust of people who teach me so much.

  5. Great post. I gather from reading your descriptions of various mental states in other posts that you’ve “been there” yourself and know what they’re like in the moment. Your clients no doubt benefit greatly from this in being seen, listened to and empathized with.

    When looking for a therapist, do you think it’s a fair question to ask if they’ve ever successfully worked through a serious psychological problem in therapy?

    1. I try to imagine what I would say if someone asked me that question (and nobody ever has). I think I might pause for a moment and then say, “Yes, I have.” I wouldn’t go into detail and I’m not sure what the client would know based on my answer. On the other, I might say, “I think you’re worried that I won’t be able to understand just how much pain you’re in and what it means to suffer as you do.” That would probably get closer to the import of the question. In any event, there’s nothing wrong with asking.

      1. Your second response never occurred to me, but I think articulating that person’s fears to them when they are afraid to, and in just that way…that to me is excellent therapy.

        1. It seems to me that it gets at what the client is really concerned about. My guess is that or or she would feel more reassured by that response than just having the question answered.

      2. Let me begin by saying I hate inrucanse companies. Now that you know where I am coming from, you should also know that for me the best kind of therapist is a psychiatrist. This gives me the best of both worlds – analysis and meds – with the emphasis on minimizing meds.I have been in therapy for over 10 years now. I have gained confidence and now I conduct interviews. Meeting a new doctor I say straight up that 30 minutes of our hour will be spent with them answering MY questions. It works!How else can a successful professional relationship be established? We would never hire an employee without knowing something about them, would we?Ranting. Sorry! 🙂

  6. You write about this important part of therapy: “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. ”

    My questions are, do you develop these feelings for each and every client? What happens if they don’t develop? Is it better for a patient to see a therapist who after quite a while doesn’t have these feelings for him or her and suspects they won’t develop, or to leave and find a therapist who can potentially develop these feelings? Have you ever referred out a patient to another therapist because you had a sense had not or could not feel genuine affection for the client?

    1. Interesting questions. Earlier in my practice, when I didn’t understand defenses well and the way they can shape one’s entire character, I worked with a few people that I didn’t feel affectionate toward. Their therapy didn’t last very long. Nowadays, I feel I am always able to get beyond the character defenses (at least in terms of my ability to empathize with the pain) and feel some degree of affection for everyone. For that reason, I’ve never referred anyone out. If a client feels that a therapist is simply doing his or her job without any real feeling of emotional connection and fondness, the client should certainly bring it up and discuss whether a referral to a different therapist is in order. I say this advisedly, because the therapist may actually feel affection but the client can’t experience it due to his or her own difficulties.

  7. Hi Joseph. Thankyou for the post which resonnates with me. Not being seen and heard is important.

    I wanted to clarify something. Your post mentions ‘ 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.’ Can I just clarify the his or her is that the therapist or the client?

    As the recipient of ‘hair raisingly’ bad therapy due to mis diagnosis (i.e. being diagnosed on the basis of initial presentation (which turned out to be medical) rather than getting to understand me I am not sure if you mean that the narcisstic wound was mine or theirs.

    Could you elaborate please

    1. The “his or her” refers to the closest noun in the sentence — that is, the client. In other words, the client doesn’t feel that what the therapist has to offer satisfies what the client needs.

  8. For me, this seems to have been one of the most healing parts of therapy, this process of having someone “bear witness” and of “being seen”. I also find it’s a very difficult thing to experience when it’s something that is new, fresh, intensely desired and absolutely terrifying. I’m thankful for my therapist who dances delicately in our work and who continues to stick with me when I complain of his treading roughly on my feet. This experience of therapy is something that touches places inside me that I never realised existed and makes me hunger for more. Validation, shared experiences, the ability to relate to another person … it is painful, it is good … it touches what is so very raw.

    In the last week or so I’ve started seeing how nearly all behaviour can be used as a defense mechanism. Even this question of pay can be one we as clients can get majorly caught up in for multiple reasons including that dealing with that issue can be easier than accepting that yes, someone is there who is available, who is listening and scariest of all, who cares. If we can reduce it in our minds to “well he is being paid to listen and be present” it can feel safer; we can also have a mixed kind of peace (along with the fear and sadness) in knowing that “if I stop paying him, he will be gone”. Then there is the other side of things where I want so much to matter to someone; and for those few minutes … I do.

    What a puzzle it can all be, and yet sticking with the puzzle is so rewarding hopefully for both client and therapist. It really helps in reading things like what you shared here; knowing something more of where the therapist is coming from and also that shared attachment. Knowing also that while the therapist bears witness to the client and provides something healing there; we as clients can also bear witness to the therapists experience of their work and hopefully give them validation through that.

    1. Very nicely put. I especially agree with your point about how it’s possible to use one’s thoughts and attitudes about the fee in a defensive way.

    2. Also, as two therapists have told me, the things they say to their clients are things they (the therapists) need to hear as well.
      Two people are getting therapy, not just one.
      A therapist said to me, “I support myself when I support my clients.”
      And Dr. Burgo has said that being a therapist helps him feel less alone.

      You wrote, “I want so much to matter to someone; and for those few minutes … I do.”
      That’s a bittersweet statement to me… “for those few minutes I do.”
      For a few minutes you matter to someone.
      Wow. Jeez. Makes me really want to move on from therapy.
      I want to matter for more than a few minutes.

      1. Just because your session is over doesn’t mean your therapist stops caring about you. In order to prove they love their children, do parents have to devote their attention and interest exclusively to those children and nothing else? Again, there are some idealistic expectations at work here.

  9. It never ceases to amaze me how soothing it is to know that therapists – especially mine – actually does ‘care.’ As the product of an NPD/BPD mom, I was brought into a situation where secure attachment wasn’t possible; the ramifications on self-esteem, recognition of need, capacity to emote, willingness to trust, etc etc as a result of that lack of attachment seem never-ending. Infinite really. Like I’m a hopeless case, a pointless waste of potential, a non-issue to the world, my community, or my family. And then my therapist sits there and listens. Just sits there. And listens. She validates the feelings behind that suffering, but never accepts those conclusions as reality. I try so hard to make her see otherwise. It’s funny really – how hard I work to prove how pointless I am. Both inside that room and out. Heroic efforts to re-create the only dynamic known. But it never works. She never waivers from her conviction that I am ok, from her willingness to absorb the pain, or from her want to care and connect more and more. I don’t understand yet why that is; I highly doubt the money is worth it. I suppose her answer would be – but you are. A beautiful sentiment of course, but not one of a variety my heart or mind accepts or believes yet. But I do believe in her. In her capacity and her care. She has shown me enough; I know who she is. And with that knowledge I tinker ever so slowly with moving closer to the affection offered and further from the abandonment of the past. Very, very (very) slowly. Amazing.

    1. “A beautiful sentiment of course, but not one of a variety my heart or mind accepts or believes yet.”

      Izzy, this made me smile a bit, because my T would suggest that we are absolutely attached and committed to such negative feelings.

      Don’t know how it works, but the idea – I think – is that we form beliefs about ourselves at a young age (I’m not lovable, I’m hopeless, etc) and then we become “hooked” on feeling that way. It kind of makes sense to me conceptually, but I also always end up asking, “but why would I do that to myself? If I stub my toe, I don’t go back and do it again cuz I somehow love the feeling! That’s crazy!”

      The answer has become predictable, “sure, consciously you may not wanna feel worthless, but unconsciously a part of you begs to differ.”

      It sounds like your T is determined to make it safe enough for you to consider forming a new – and more accurate – set of feelings about yourself.

      1. I one time asked my therapist, “Who in their right mind would want to feel bad. Who would want to prove to themselves that they are bad. What’s crazy!” I said that, in angry, because my therapist suggested that my self injury was, in part, my way of confirming to myself that I was bad. That it was me and not my mother who was “bad”. I’m was asking my therapist if he was crazy to suggest such a thought as if burning myself intentionally was not crazy. It’s complicated, our thoughts and feelings.

  10. Very interesting article….Does this apply also to marriage therapy? I felt our therapist was too critical and I had had enough. Plus my spouse could see the therapy wasn’t working so terminated earlier than was expected. I still at times get a bit angry when I think back and then I wonder why the angry….was she right and is the problem is with me? I really didn’t feel she understood.

    1. Sounds like ineffective therapy. I don’t think this applies in the same way to marriage therapy because the focus isn’t on the relationship between the therapist and client.

    2. Dr. Helen:Upon the discovery (relief it had a name, acltualy) that I was ADHD at the age of 44, I went to a therapist for a while, and a psychiatrist for meds and further questions. It sort of made me angry to be “patted on the head”, handed a prescription and shown the door, for $175.00.Are all psychiatrists intentionally vague, or is it just their way of being non-committal, so as to protect their hind quarters?My disillusion with both the psychologist and psychiatrist has left me to handle things on my own the past ten years. I’ve read 7 books on the subject. The closest they come to thinking the same is parallel lines that don’t meet.I agree with carrie on insurance companies. Seems weird a 26 year old holder of a Harvard MA is able to tell my doctor, and therefore me, when I am well, what kind of meds are appropriate, and what meds they will pay for.Thoughts? Suggestions?

  11. All of that…the validation, empathy, etc., triggered my wish to be loved by my therapist (the love I needed at birth).
    Not just freakin “care”, not “affection”, actual, personal love.
    I deluded myself that he did love me for a while and then faced reality.
    Reality is hard.
    I imagine people have left therapy because of that disappointment, or they get stuck in transference (yearning for The Golden Fantasy from their therapist and feeling rage and shame about it).
    I actually did leave for two hours because of that but then I was like-shit, I need the eggs (the empathic support).
    I give myself a lot of credit for persevering because that wish for love and the acceptance of not being loved is intensely painful.
    Of course I’m really grieving and raging about the original love I never had.
    Therapy for me is like submitting to surgery without anesthesia and not jumping up from the table and running away.
    I feel I deserve an award of some kind. Something very, very impressive.
    Whatever I get, I earned it.

    1. One of the things we often have to work out is the longing for some kind of love from the therapist that will heal all the damage and take the place of the missing love from childhood. No therapist, however caring and able, can do that, but that doesn’t stop clients from idealizing us and wishing that we could. In the face of disappointment, it’s easy to devalue what the therapist actually has to give because it’s so much less than the fantasy.

      1. >In the face of disappointment, it’s easy to devalue what the therapist
        >actually has to give because it’s so much less than the fantasy.

        That, I think, is profoundly insightful and useful … for all relationships, not just the therapeutic one 🙂 Thank you for that.

      2. I agree, and his compassion, empathy and caring were actually helping a lot, until I decided it had to be real, personal love for me in order to ‘count’.
        It doesn’t have to be.
        It’s odd that my therapist’s tone of voice, body language, etc. feels like personal love towards me but isn’t.
        I wonder what it feels like for him, to behave that way towards a person he doesn’t actually love?
        Seems like it would be really hard work.

    2. Congratulations Maureen! You are an extraordinary iuadvidnil with the unique ability of making those around you feel special. It is wonderful that your colleagues and clients appreciate your talents.

  12. I’m definitely devaluing what he has to give…I’m sure eventually I’ll stop doing that.
    We’re talking about my disappointment.
    Thank you for your reply.

  13. “No therapist, however caring and able, can do that, but that doesn’t stop clients from idealizing us and wishing that we could. In the face of disappointment, it’s easy to devalue what the therapist actually has to give because it’s so much less than the fantasy.” … wow, not sure about for others, but for me reading your reply to Sara is making things fall into place in a way they hadn’t before. I’m seeing how this is what I, and I’m sure countless others, do with all relationships. In the therapy one especially I’ve seen where people are caught up with wanting their therapist as mother; lover; friend; rescuer etc etc. and when this doesn’t happen because it can’t; it can override everything else and get in the way of receiving what is really there. Again in therapy I understand that exploring that in itself could be powerful and helpful; but often it also seems to lead to people running away from the therapist (and other relationships) so the pattern begins again elsewhere. Have you written more about this elsewhere? and if not, I really hope you will … it seems to be such a big issue for so many. How to value the therapy relationship for what it is instead of our fantasy …

    1. I haven’t written more about this but I’ll put it on my list for future posts. If the therapist doesn’t recognize this process and help the client deal with it, as you say it can end up with people running from treatment and just repeating the pattern all over again.

  14. Dr. Burgo, you wrote; “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.”

    It seems to me you’re also saying…
    I guess you could say there’s a kind of reciprocal process of bearing witness and being seen, deeply important for both therapist and client in generating the sense of personal meaning.

    Because if you are, I think that’s pretty cool and feels true.

  15. I’ve been seeing my therapist for nearly two years and as much as part of me wants to be seen and accepted and understood I think a bigger part of me is scared of being seen. Terrified in fact. I had a session today and as hard as I tried I couldn’t stay present – I kept ‘spacing out’ as my therapist calls it and I was probably only really ‘there’ for maybe a minute out of the whole hour. It’s the same every session and I don’t know why I’m so scared. My therapist wanted me to push against a cushion she was holding to try and ground me and I couldn’t even do that because it felt too exposing to do that with her there. I think my current therapist understands me better than anyone else I’ve ever seen (and I’ve seen a lot of different people) but I still can’t let myself be seen. I just don’t understand why.

    1. My guess is that what you feel is there inside to be seen is very “ugly” — a source shame so profound that all you can do is hide it.

  16. Hi, I feel sometimes that having real feelings for my therapist is somehow inappropriate. I can see it is natural, having to tell all is not easy especially when I get kind useful personal feedback. It can also make me angry. I want to heal but sometimes don’t want to deal with the reality that I’m developing a relationship that isn’t real . I don’t really get to know him and its all confined to an particular place and time. Also the therapist can’t really choose to not see you even though each time we go we make the choice and pay. In essense, they have to have positive regard. They have to see you. They don’t and perhaps would not choose to have you in their life except in these circumstanses. I feel perhaps its sentimental to think this interaction can equate to any type of real relationship. This is not to say I don’t value therapy, I thank god for it, I just want to be rational about the quality of the interaction. I hope this doesn’t seem like I don’t appreciate your writing, I do, I just have thought a bit about this.

    1. If you pay tuition for a college seminar and develop a strong connection with your professor, do you consider that relationship to be unreal, even though you don’t socialize together? We all have these fantasies about a perfect therapeutic relationship that involves no limits or payment, but that’s just an ideal. The therapeutic relationship is real AND it has unusual conditions and limits that make it unlike most other relationships.

      1. I know there is an element of being irrational In what I say but it just feels very unequal at times. I don’t give or help or listen to him. So it helps to think that, well I pay for this so its fine that one sided. It can be confusing to deal with. But also, the therapist has perhaps 15 patients or more a week, I can,t see how they could develop significant feelings for each person. I actually do try to think if it in terms of a teaching relationship, I’ve been lucky with great teachers generally in my life and I am learning so much in this process. But its a lot more personal than a relationship with a teacher and there is a lot more at stake. Thanks very much for your response. I think its thoughtful that you take the time to respond individually to each commenter.

  17. that was a nice, thoughtful post.

    have you considered writing about the ‘fit’ between the therapist and the client? this is a personal concern for me. my therapist (my second) who i started seeing this january, and i seem to be very different people, and that seems to be partly a problem.

    i don’t know if the readers here are acquainted with jungian typology or the MBTI, but i am an introverted feeler (INFP) while my therapist is an extroverted feeler (ENFJ). she finds me isolated, idiosyncratic, and ‘devoid of emotion’, to quote her. i find her to be somewhat superficial, a bit like a social butterfly even in the therapy room, and she interprets all my interests or hobbies as replacements for real relationships, in a somewhat condescending way.

    i think what she says has some value, but i cannot help think that she might have her own self as a model for normality, and therefore, interpret reductively anything that is otherwise.

    my previous therapist, who i saw for 5 years, felt different. i find it hard to type him, but he was perhaps an extroverted thinker or an introverted thinker (INTJ or ENTJ), and we seemed to share quite a few values. he made interpretations at times which put me off, but i took it in my stride and didn’t feel misunderstood.

    it would be very helpful if you considered putting down your thoughts on therapist-client compatibility.

    1. I’ll add that to my list of topics. But I wonder if your current therapist is taking up your apparent lack of emotional contact in terms of the relationship between the two of you. That’s where I think it would be most important to look.

  18. This post spoke deeply to me and even helped me understand my own processes a little better. I’m one of those with a lot of shame and low self-esteem, and I’ve spent the last 2+ years simply grateful that my therapist is still there and doesn’t seem to hate me yet. It’s nice to read that maybe the affection I feel for her isn’t one sided (even if there’s a difference in intensity, so-to-speak) and that maybe I haven’t “manipulated” her into staying all this time (I’m bypassing the part where I mention that she’s told me several times that I haven’t manipulated her into staying and I just didn’t (don’t?) believe her :)). I wonder why it’s so hard to believe her, even her actions and not just her words.

    Anyway, no response necessary. I just wanted to let you know that I deeply appreciated the post on this.

  19. The experience of “being seen” was one of the most important things I got from my spiritual director. No therapist, but it felt like therapy, and had the effect of one, even lasted for years.
    Yes, there was a time when I felt that I existed through his eyes and was very much afraid of ending up being abandoned and therefore ceasing to exist, and I was also afraid of this imbalance ending up being permanent; am I going to need to be witnessed by him for the rest of my life?
    I am writing to tell everyone who is interested that one “grows up” in such a relationship, that is, eventually one learns to witness themselves. That blank mirror of Alexis’ (and mine, and yours) will reflect a human being of beauty and goodness.

    One then even becomes strong enough to cope when others behave in a downright mean way. I am just recovering from my first (and, hopefully, last) encounter with a narcissistic person. I never knew that there is a relationship pattern of “idealize, devalue, discard” – she was just a teacher of mine (grown-up art student), and I now almost feel grateful that I have acquired this very important life experience for such a cheap price. That is, it all happened in a matter of 8 weeks, and in a relationship (?) I could just leave. This was no marriage, no financial partnership, no friendship (although my goal would have been something like friendship: my opening up and offering some genuine interest and love created the conflict – I did not know that there are people who seem to be such genuine role models and then respond to love and appreciation with cruelty).
    It is puzzling when someone who is considered important just looks through me like I didn’t exist. I chose to ignore this treatment – back then, I didn’t know that this is the very thing to do, I just followed an inner instinct or so – and it saved me from lots of trouble.
    (She eventually banned me from all her classes. A few months before, I was her model pupil and a very devoted member of her fan club. It was a surreal experience, one indeed questions their own sanity before finding out that though this be madness, yet there is method in it.)
    Dr. Burgo / Joe, your site helped a lot during the “research” phase. Thank you.

  20. Following is a poem which your comments about clients feeling alone, worthless, brought to mind. “Non-Existent”, an acrostic poem which I wrote during a season of depression and feeling worthless.

    Needless to say, since
    One is ever voiceless,
    Not a soul will know,
    Even care, if
    Tender mercies
    Intrinsically yearned,
    Truly are merited,
    Yet denied.

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