I’m struggling to deal with my client’s criticisms

Question: “I’m sorry if my problems are causing you stress. Isn’t this supposed to be my therapy session?”

I’ve been working with a client for a few months now, and his main issue is relationship conflict with his partner who, according to him, places unfair demands on the relationship and doesn’t listen to him.

As we explored his relationship conflict, I asked him what his needs are in the relationship and if he feels these are being met (I didn’t want to put words in his mouth or demonise his partner).

He responded, “I told you she expects too much of me and you’re asking if my needs are being met? You’re just like her – why is it so hard to listen? You’re supposed to be a therapist!”

I noticed this triggered an angry, defensive response in me even though I tried to remain calm. Ironically, I felt that it was he who wasn’t listening to me and wondered to myself if the same pattern exists between him and his partner where he prejudges what’s been asked or said and then goes on the offence.

Further in the session, he would say things like, “See, this is why no-one listens to me – not even you”, and I try so hard to be compassionate, but I really find it difficult that he’s lumped me in with the partner who, in his view, dismisses and ignores his needs.

I even tried to be open with him and said, “I noticed that you feel I don’t listen to you. I can assure you I’m here to listen to you and help you as best I can. What I want to avoid is to assume how you’re feeling or how things are for you, and I felt surprised to hear that you think I’m not listening.”

To this he replied, “I’m sorry if my problems are causing you stress. Isn’t this supposed to be my therapy session?”

I know he’s going through a difficult time at the moment and I can connect to and empathise with that part. What I can’t empathise with is his apparent decision to substitute me for his girlfriend.

How can I deal with this empathy block that I’m experiencing? How do I get past or address the conflict that has come up between us? I feel myself being on the defensive in session and it’s affecting our work together. It’s like a tug-of-war where I’m struggling emotionally to drop the rope and help the client to deal with what’s going on for him.

Response from Dr. Chua:

It does sound like this can be a challenging interaction and that you feel you are being accused for not listening. This then leads you to feel defensive and you try to convey to him that you are listening, but it doesn’t seem to work.

Let’s break down this brief conversation snippet:

Therapist: “What are your needs in the relationship, and do you feel like these are being met?”

Client: “I told you she expects too much of me and you’re asking if my needs are being met? You’re just like her – why is it so hard to listen? You’re supposed to be a therapist! See, this is why no-one listens to me – not even you.”

Therapist: “I noticed that you feel I don’t listen to you. I can assure you I’m here to listen to you and help you as best I can. What I want to avoid is to assume how you’re feeling or how things are for you, and I felt surprised to hear that you think I’m not listening.”

Make authenticity your focus

It might help to frame your intention of openness to the client as being congruent with the client, and self-disclosing to your client.

The master therapist, Carl Rogers wrote:

“Genuineness in therapy means that the therapist is his actual self during his encounter with his client. Without façade, he openly has the feelings and attitudes that are flowing in him at the moment.

“This involves self-awareness; that is, the therapist’s feelings are available to him to his awareness – and he is able to live them, to experience them in the relationship, and to communicate them if they persist.

“The therapist encounters his client directly, meeting him person to person. He is being himself, not denying himself. Since this concept is liable to misunderstanding, let me state that it does not mean that the therapist burdens his client with overt expression of all his feelings. Nor does it mean that the therapist discloses his total self to his client.

“It does mean, however, that the therapist denies to himself none of the feelings he is experiencing and that he is willing to experience transparently any persistent feelings that exist in the relationship and to let these be known to his client.

“It means avoiding the temptation to present a façade or hide behind a mask of professionalism, or to assume a confessional-professional attitude.

“It is not simple to achieve such reality. Being real involves the difficult task of being acquainted with the flow of experiencing going on within oneself, a flow marked especially by complexity and continuous change…” (1966, p.185.)

You told your client: “I felt surprised.”

You told me that you felt “an angry, defensive response.”

Now, as Rogers says, it doesn’t mean the therapist yells at the client and expresses the anger, but that you are willing to be transparent with this persistent feeling of anger and defensiveness in the relationship and let it be known to the client. The caveat of course is that you don’t feel this way with all clients (i.e. this is less about the client than it is about you feeling angry and defensive with everyone).

Let’s explore some options on how focus can change the direction of therapy:

Therapist: “What are your needs in the relationship and do you feel like these are being met?”

Possible responses you could offer as the therapist:

What is it that you think I am not hearing?
It gets you so mad because it feels like no-one ever listens to you, not even me.
I get the feeling that you think if I listen, I will completely understand without needing to ask you any questions to clarify.
Questions really frustrate you, huh? Is this what happens with your partner?

From these responses, we can see that the therapist is:

Following the client’s focus on listening and perhaps wanting to make sure the client is heard.
Empathising with the expressed feelings.
Bringing up the client’s expectations of the therapist, with some self-disclosure.
Commenting on the strong angry response but in a more detached fashion as an observation and leads the conversation to the partner.

There’s no right or wrong response here but each one has a different focus and intention. Roleplays would be useful here for you to try different responses with a colleague and see where each one leads.

Reflection

Now, let’s look back at the original response again:

How does this response feel to you now? Does it feel congruent and authentic? If not, what needs change? When the therapist expresses their self-awareness of the internal world, the expression is with intention to focus the client on something. What did you want your client to focus on?

If I were to paraphrase what you said to me, it sounds like what you are saying is:

“I am doing my best to listen to you and to understand you, but I feel like you aren’t really hearing my compassion or seeing that I am listening to you. It feels like you already assume I’m not going to listen and you come in ready to tell me off. But somehow no matter what I do, you feel like I’m not listening.

“It makes me feel like I have to keep defending myself and to keep telling you, ‘But I am listening. I am listening.’ And we get in this tug of war where I’m trying to convince you I’m listening, and you are trying to convince me I’m not listening.”

If this sounds about right, then it is worth reflecting what you want your client to focus on if you choose to disclose this. There is no empathy without congruence, but empathy can be present even without self-disclosure.