Question: “How can I overcome feeling stuck when working with clients whose problems are similar to my own?”
Whenever I have clients who present with anxiety and rumination, it’s as if they’re reflecting my own struggles back to me and sometimes feel at a loss to help them.
When we talk through the client’s issues, part of me is thinking, “Yep, that’s exactly what I’m struggling with too,” and if we do reframing or restructuring or any other intervention to help the client with their anxiety, they might say it’s helpful right after we’ve done the intervention. However, in the next session, they say the anxiety and rumination is still there or that it’s stronger.
When this happens, I feel myself become anxious and I start to ruminate. “Oh my God, I can’t help this person, I feel like a fraud, why am I even in this job…how can I help the client deal with their anxiety when I can’t seem to deal with my own?” It’s like I’m expecting myself to have the answers, being a “professional”, and I’m sure the client hopes that I have answers for them but instead it’s as if we go around in circles.
Other therapists I’ve spoken to have encountered a similar issue, finding it difficult to help those who seem a lot like themselves, and I’m wondering what I can do – and what therapists in general can do – when they come up against this frustrating problem. To me, it feels like I’m being met by my own projections and defences, except I can’t escape them because they’re coming right at me from someone in need of my help.
Response from Dr. Chua:
I quite like meeting a client who share my experiences. It seems pretty nice to find that we aren’t so different after all, and it opens up a point of connection. If we understand some of what they are going through, that makes empathising easier. Your client is not you though. Your client’s struggles aren’t exactly what you are struggling with. There are similarities because you are both human, and our struggles are part of that universal human experience.
But to be exactly the same suggests that we fail to recognise what is different in our clients. On the other hand, to feel like we’re completely different suggests that we fail to recognise what is the same.
As Rogers said, ‘empathy is [the perception of] the internal frame of reference of another with accuracy and with the emotional components and meanings, which pertain thereto as if one were the person, but without ever losing the “as if” condition.’
We need to empathise with our clients, not identify as our clients. If we identify as our clients, we begin to assume that they are exactly like us and thus we stop listening to them, and we start seeing them as if they are us.
None of our clients is us, but we do face the same task with all clients. How do we see, understand and accept them as an Other? They have their own lives, experiences, desires, feelings that are distinct from ours. They are not there to be the answer to our insecurities and have problems for us to solve so we can feel like we have accomplished something with our lives.
Likewise, we are not the answer to their problems. James Hollis wrote, ‘It takes great courage to ask this fundamental question: “What am I asking of this Other that I ought to be doing for myself?”’
As therapists, it’s important to remember that, just as our clients bring themselves into session, so do we. In other words, we also bring our doubts and confusions, self-judgements and hang-ups, biases and assumptions into the room. This is why I constantly advocate therapists receiving their own personal therapy: in receiving effective therapy, you’ll be able to work through your issues and blindspots in a way that will enrich your ability as a therapist.
Similarly, regular effective supervision can help you process issues and challenges that arise in the room with your clients. It’s easy to forget how complex psychotherapy is. Without good supervision, it’s like learning to drive a car in the dark without an instructor.
Having your own regular therapy and supervision are the key ingredients to dealing with the challenges you’ll face as a therapist, and this is regardless of whether you’re a trainee or an experienced therapist. We’re all just as humans and we owe it to our clients to provide them with the best help we can offer.
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