A psychotherapist’s angst

My Story, Feb '15

Pallav Bonerjee on his tryst with psychology, people and destiny – the fourth in a series of personal narratives

I recently made a road trip with my wife to Jaipur. We were very excited about the trip and enjoyed it to the hilt. It was our first journey by road, together. Needless to say, I was also a bit anxious. Before embarking on the journey, I took half a day to get the car checked and serviced. The mechanic cleaned, serviced, tuned and checked the tyres thoroughly. Then he sat in the car for a test drive and as I drove, he primed his ears to a certain whirring noise that seemed to come from the rear right wheel of the car. Something wasn’t right. We got out and he put the car up on the ramp to inspect. After fiddling for a while he concluded that the wheel bearings had lived their life and needed to be replaced with new ones. He took about 15 minutes to fit in the new ones and voila, I was good to go! Neat job, you would say. I agree. But it also got me thinking.

Artwork credit: Rajib Das

Very often in the profession of a psychotherapist or psychologist, we come across people who come to us to seek help with a variety of issues. Some come on their own, while others are brought over by their friends and family members. In most cases, we find that there is an implicit expectation that the therapist would be able to quickly ‘read the mind’ of the prospective client and ‘do something’ (almost equivalent to the repairing or replacing, similar to what the mechanic did to my car) so that they may all go back home happy again. The pressure to perform this ‘act of change’ can sometimes be very unnerving for the therapist, who grapples to find the right words to shatter this stereotype about therapists, explain the process of therapy and finally, to tell the impatiently waiting friends and family what exactly is possible in therapy.

In many social situations, my wife (who also happens to share my profession as a therapist) and I find ourselves hesitant to disclose our professions, as we are met with instant reactions like “Oh! We have to be very careful around you then, since you may end up reading our minds”, or simply “Do tell me what I am thinking now”. We want to tell such people that first, psychologists cannot and do not read others’ minds. Second, we don’t want to do any form of reading in social situations at all! We just want to have a pleasant evening, like everybody else. And yet, people invariably end up telling us stories about some friend’s friend who was once visiting a therapist and about their experiences (mostly unpleasant) and that since then, how weary they have become of this whole process of therapy and therapists.

There can be another category of people who are extremely ‘therapy-friendly’ and strongly feel that everyone they know needs to definitely visit a therapist. They start talking by giving out very personal information and express how happy they are to have finally met us and before we know it, pat comes the question: “Would we take some time out right away to listen to them and help them out of a certain crisis”?

In family get-togethers, we often end up meeting ‘surprise clients’. I have coined this term to denote those long-distance relatives who are made by other long-distance relatives to bump into us ‘accidentally’ and who like a quick two-minute consultation about matters which may have absolutely nothing to do with therapy at all. They will hijack the conversation that we are having with someone else and ask pointed questions to solve their case. And, of course, most of them are not really interested in any suggestions whatsoever!

Sometimes, there are calls from friends who want us to quickly help them ‘therapeutically’ over phone or say something magical that will get them to spring back up again from the doldrums. Occasionally, we even get clients in our office who come to us with a list of problems and feel that therapy is merely listing out the issues and patiently waiting as the therapist works out a perfect solution to their problems, one by one.

Psychotherapy is not merely about problem solving and therapists are not ‘problem solving vending machines’. Psychotherapists spend their time with each client exploring their thought processes, belief systems, emotional patterns and coping mechanisms in relation to different stressors. Armed with the knowledge about how people perceive the world, others and events around them, therapists try to help them modify some of their interaction patterns. This allows the clients to cope better and have a more positive outlook towards life. Processes like building self esteem, independence, developing better social skills and managing time more efficiently may be some of the therapeutic objectives. Therefore, therapy cannot happen anytime and anywhere. Also, it takes much more time than people often imagine. It is a collaborative process and requires discipline and commitment from both the therapist and client in order to have a sense of progress.

Artwork credit: Rajib Das

The process of psychotherapy itself can become extremely emotionally and cognitively exhausting for the therapist herself. It requires a high degree of attention and memory, coupled with objectivity and an even temperament. The ability to engage different kinds of people actively and build a strong rapport with them also plays a fundamental role. It is on the basis of the strength of this relationship that the therapist starts guiding and ‘hand-holding’ the vulnerable client. Restlessness and impatience on the part of the therapist are impediments to therapy. This is why a therapist may need periodic breaks, peer group interactions and reviewing relevant literature regularly to be able to sustain personal growth. In addition, the therapist must also be open to feedback from the client about how they feel being in therapy. Presence of good communication skills and command over language can play a pivotal role in this process. Values like gender and cultural sensitivity help build rapport and convey tolerance to the rich diversity prevalent among us, without falling prey to prejudices and discrimination.

The relationship between the client and therapist also tends to be an interesting one, if allowed to mature and progress. It evolves with time and is not necessarily pleasant throughout, just like any other relationship. The role of a therapist is not to please the client or just keep them happy by making positive statements. It is a process where the client has the liberty and is encouraged to be themselves entirely, without any fear of being judged. This is ensured with the right to confidentiality of information discussed. On the other hand, it is also a relationship where the therapist will always end up with much more information about the client and not vice-versa. It is an unequal relationship, which the client must accept, without feeling deprived. Self-disclosure by the therapist is not the norm and its degree varies widely, depending on specific situations and whether sharing such information does actually help in the therapeutic process of the client or not. The therapist has to tread a thin line, without being either too accepting or overtly critical. The target is to eventually make the client more self-reliant and independent, so that they may be able to handle their stressors better in the future instead of feeling overwhelmed.

Psychotherapy does not necessarily always have to deal with negatives. As mental health professionals, we also try to identify the unique set of strengths that each client brings along with them to engage in the therapeutic process. These strengths help to change the myths of perceived helplessness and hopelessness that they may often believe to be true about their own lives and future. Therapy progresses by collaborative exploration, uncovering, supporting and challenging (wherever necessary) layer by layer, the different psychological variables and constructs that may be interacting with each other, while making the client more aware of this process without getting intimidated.

To conclude, the process of psychotherapy may be considered analogous to a process of self-discovery and insight. It is aimed at making individuals more aware and alert of their thoughts, emotions and behaviours. It is a collaborative and participatory process and works best when a client is interested to engage in it voluntarily. For it to be successful, there must be a sense of connect between the therapist and client. There are different forms of therapy that one may specialise in. However, at the very core, all aim to help the client with their challenges by actively listening to them and being empathetic, while at the same time restraining oneself from doling out advice freely and frequently. The objective may be simple, the process is not!

Pallav Bonerjee is Consultant Clinical Psychologist at VIMHANS Hospital, New Delhi. Whenever stressed, he never fails to spend some time with his own therapist, who has a wet, black nose and goes by the name of Copper!

Rajib Das is a Kolkata-based artist. His work incorporates illustrations, comics and cartoons, each with its own spirit – fun, funky or serious. This is his passion and what he was meant to do in life.