Psychotherapy depends on conversation and rapport. However, the conversation ends up being artificial and the rapport is not based on true friendship. Psychological counseling is a fabricated relationship which lacks reciprocity and relies on financial remuneration.
Jacqueline Olds and Richard Schwartz discuss one of the serious realities of counseling in their book The Lonely American. This serious reality exists because of the problem-centered nature of counseling. They first mention “a curious set of rules” that exist in counseling and say, “the rules are quite different from the rules for ordinary relationships. The most striking difference is that the usual expectation of reciprocity disappears“1 (bold added). All the drama and narrative dialogue are about the counselee and her issues and problems. The counselee gets to talk about herself and her litany of personal problems whereas the counselor does not get to talk about herself and her own problems, except for something brief that might be said to establish rapport. The expectation is that the focus of the counseling will be on the counselee’s “problems and life and words.”2 The counselor does not get equal time for her own issues.
Dr. Thomas Szasz describes counseling simply as “rhetoric” and refers to counseling as “conversation.” Szasz asks, “In plain language, what do [the counselee] and [counselor] actually do?” He answers, “They speak and listen to each other.” Szasz asks and answers, “What do they speak about? Narrowly put, the [counselee] speaks about himself, and the [counselor] speaks about the [counselee].”3 The spotlight during the counseling hour is on the counselee.
The counselor/counselee relationship is diametrically different from normal relationships where there is reciprocity. Turn-taking occurs in normal relationships. One person speaks and another listens, but the listener gets to speak as well. The focus of attention is shared between one another’s “problems and life and words.” In normal conversation there is close to equal time given to and taken by both parties. The down side of the counseling relationship is that it is not the normal way conversations are carried on in the real world.
While “there are no reliable statistics” on what is called “self-disclosure,” it is considered to be unprofessional for a counselor to disclose her own personal issues to a counselee whether the time is paid for or not.4 Imagine a counselor talking about her own marriage problems or her own relational or professional issues, saying for example, “My husband and I do not see eye to eye lately on a lot of matters,” or, “This has been a tough month. Some of my counselees have not returned and I have expenses to cover and my own personal income needs.” When such self-disclosure occurs, it is typically the end of the counseling. Why? Because the counselee is there to talk about her own problems and not to listen to the counselor’s problems.
Regardless of how dull and boring the counselee may be, the counselor has the responsibility to listen thoughtfully and often to hang on every word the counselee utters in an effort to obtain an accurate understanding of the problem and to respond appropriately. Normal friends will seem mundane after a therapy session focused entirely on me.
Olds and Schwartz aptly describe such skewed relationships:
The special partnership that allows a therapist to earn a good living and a patient to focus on neglected aspects of his life and experience would be a disaster outside of the office. Used as a template for other intimate relationships, it is selfish and self-absorbed. Other than therapists, only an occasional very self-sacrificing parent or a spouse who aspires to martyrdom is likely to sign on for that long term. A problem with psychotherapy is that it can make all other relationships look like they fall short when it comes to sustained, attentive caring and leave the patient circling back to therapy as the only relationship that is good enough.5
Psychotherapy relationships are abnormal from the very beginning in that they are not true relationships but rather purchased relationship time. At the end of each session the relationship is on hold until the next appointment. Psychotherapists have been called “paid friends.” However, we consider “paid friend” to be an oxymoron, that is, a contradiction in terms.
Prior to 60 years ago such “paid friends,” who had a license to counsel anyone about problems of living, did not exist. Everyone knew then, as we should all know now, that true friends do not charge money for conversations about personal and often painful matters.
Only in the narrowest possible sense is the paid psychological counselor a friend, and that is in the confines of the 50-minute hour and only in the office. Paid counselors do not have lunch or fellowship with their counselees or visit one another as real friends do. As one typical counselor, when invited to lunch, instructed her counselee, “I am your counselor, not your friend.”
We have often wondered if any of these “paid friends” would still be friends if they were not paid. When the money stops the counseling ends and the relationship is over. That’s because psychological counseling relationships are not normal. Instead of being relationships of mutual care, they are business enterprises.
1 Jacqueline Olds and Richard S. Schwartz. The Lonely American. Boston: Beacon Press, 2009, pp. 164-165.
2 Ibid., p. 165.
3 Thomas Szasz. The Myth of Psychotherapy. Garden City: Anchor Press/Doubleday, 1978, p. 11.
4 “Should Therapists Self-Disclose?” Psychotherapy Networker, Vol. 34, No. 2, p. 14.
5 Olds and Schwartz, op. cit., p. 166.
(PsychoHeresy Awareness Letter, January – February 2014, Vol. 22, No. 1)