There is a strange historic illusion, derived from the old-school therapy days, where stern-looking Freudians sat in front of austere-looking bookcases, wearing ties and holding ALL the answers. The oracle on YOUR mental health. The sentiment being, the therapist is both superhuman (devoid of mess and emotional chaos of their own), has all the answers, and knows you better than you know yourself. I remember even my mum suggesting the therapist at our local GP was an actual mind reader… “Be careful what you think, Jodie.” Ultimately, this created the illusion that therapists preach from a higher place, are unreachable, or are, without a doubt, a symbol of a vast landscape of difference between the therapist and their clients.
For me, even when I trained two decades ago, this uneven playing field between therapist and client felt significantly problematic. I remember my first therapy session, where I strangely felt like I was being told about myself by someone who’d only just met me. This could, of course, have been my resistance, but it could also have been because I was being told about myself by someone who’d only just met me. I remember nodding and agreeing and thinking this was mostly how therapy was. My access to any other more disruptive views that levelled the playing field was limited.
At this time, there was less access to therapists’ real lives; they remained an enigma in the age before public profiles and social media. What you experienced in that 50-minute session was mostly all you got from your therapist; they were, for the most part, a blank canvas. The therapist being a blank canvas means that you can transfer and project deep feelings about yourself, parents, and other significant people in your life onto them. This focuses the therapeutic work on the relationship between you, without a perceived idea of them as a person to muddle your view. This landscape has changed significantly with the rise of social media and the way we have access to other people’s lives. This will surely have an impact on the therapeutic relationship.
When I launched Self Space, I wanted to modernise some of the outdated ideas and principles I found unhelpful about therapy:
– I wanted to make therapy more flexible and on demand, creating a dynamic structure that meant the client had autonomy over when to book, as opposed to being prescribed the same time every week with a penalty if they wanted to move or cancel.
– I wanted wellness to be in the hands of the clients, with the emphasis that this was their therapy journey, and they could choose a therapist that felt like a good match, and see them when it fitted their lives.
– I wanted spaces to feel aspirational and lovely, eradicating the strobe lighting and sticky chairs that developed a subtle sense that there must be something wrong with me if I’m here.
– I wanted the experience of coming to therapy to say, “It’s a good thing that I am here.”
– I wanted to hire therapists who felt like real people, with real pasts, real stories. People with lived experiences, people from different backgrounds who felt the same and not different from their clients.
– I wanted clients to experience themselves as having the answers within, with a good therapist who could shine a light and give it a little “hey, look over here.” A therapist who could stand on the sidelines and cheer and give a kick up the arse when it was needed.
– I wanted clients to feel that the therapist was unequivocally on their side, because they too were messy, complicated humans who understood deep compassion, not because it was their job.
Therapists are messy humans too….
The old phrase that used to help with nerves when public speaking, “imagine everyone with no clothes on,” works on some level because the invitation is to see everyone as fallible, imperfect, vulnerable, messy. It helps us to recognise ourselves in others, and when we understand this, we feel a togetherness, not an otherness.
When we recognise others as human, we feel less alone, and feeling alone is the single most compounding thing with anything connected to our feelings or mental health. Working with a therapist that ‘just gets it’ is deeply helpful in many ways, but primarily because it helps us to feel seen, heard, and less alone.
As a clinician, I try to meet my clients in the most part as two humans trying to work things out, walking alongside them, a gentle nudge here and there, and most certainly holding them to account when I feel it helps. Sometimes I lead from the front. I’ll share the theory when I think it might give context. I might drop a poem or a piece of writing in here or there, and I might (without going into specifics) say that some of my other clients are experiencing XXXX, all when I feel it has relevance and usefulness to the client’s experience.
I am a clinician who will occasionally give an opinion and very occasionally advice, particularly if a client asks for it, but for the most part, I know they have it all within them, and it is my job to hear what they are saying. It’s my job to interpret, understand and/or make sense of it, and pass it back to them in a way I think they might understand. “I wonder if we were to think about XXX” or “Can you notice anything familiar?” or “This reminds me of something you said about XXXX.” I am also not shy about revealing myself or sharing relevant vignettes from my own life, if and when I feel it’s deeply appropriate and might be useful. When a client feels particularly alone, I use this technique more. I notice I do this often around fertility issues, parenting challenges, and occasions around career stuckness. I don’t go into a huge amount of detail, but I do share. If a client asks me personal questions, I might say, “Can I take some time and come back on that so I can check in with myself and sometimes my supervisor about the appropriateness of this?” But if a client asks me if I have kids, or if I am married, or if I have always been a therapist, I will, for the most part, answer, and if relevant, will ask how hearing that makes them feel.
I share in our book a vignette about a client who I’d worked with for some time. One day, they arrived at the session, and I’d just that moment realised I’d lost my necklace. I had my hand on my chest and felt it wasn’t there. It was a chain my dad had given me on my 18th birthday and meant a lot to me. When they were brought down to the therapy room, they asked, “Are you ok? You look flustered,” and I answered truthfully that I thought I’d lost a chain my dad had given me, and it meant a lot. This led to a few minutes of us both looking for it, followed by a really lovely session where we talked about her dad, lost and found things, and sentiment. It felt very connecting and also creative for the client. At the end of the session, I stood up to walk her out, and my chain fell out the leg of my trousers! We both laughed, but it also felt symbolic of where we’d been and what we’d been discussing. There was something liberating for her in seeing my vulnerability, and it connected us into her story in a way that felt uniting.
Equally, I’ve had several experiences where clients having seen too much of me is unhelpful. I had a client see me out on a date. They had been walking behind me and seen me holding hands, talking, and were, thank goodness, able to bring this back to the session and say they’d felt really uncomfortable to see me outside of therapy and wanted to make sense of what they were feeling about it. To them, I was their person; they had no reason to imagine me in an outside life, and it wasn’t helpful for them to think of me as being someone else’s person too. Nor should they, unless it’s useful to the therapeutic process and their journey. But life happens, and these things will arise. They are most useful when a client can share and you can use it as part of the work.
How then to manage the client experience when you are a therapist with a public profile?
This question has been on my mind for some time, both as a clinician and the founder of a business that is calling for us more and more to have a public profile, and as the overall person responsible for a very large clinical team. Many of whom have their own platforms outside of Self Space. As the founder of Self Space, I try to honour authenticity and share some aspects about myself. I try to lead from the front but not too publicly. We want to be a human-led business, but I don’t want my clients to know what I had for breakfast or that I moved house. I have blocked social media, and I’m very conscious about what I do and don’t share, and I want to put my clients’ wellness at the forefront. I caveat my work with new clients by saying that I am fairly public, and that might impact who and what they think of me already and might impact the work.
If they come to work because they’ve heard me on a podcast or seen me on social media, I ask what they thought, why me, and that I might not be at all like they imagined. I try to integrate it into the work from the beginning. The truth is we do not have enough data or enough research to understand what the impact is of therapists who have social media followings that blur the boundaries between professional and personal, and what impact this will have on their clients. In my mind, that alone is enough to make it unsafe. I still fully believe that clients’ experience of their therapist should remain as blank as possible, not an enigma, but at least opaque. Helpful to know they are human, less helpful to know that they are struggling with their boyfriend or went to Miami at the weekend on a hen.
We have a responsibility.
As practitioners who are trained and qualified, we have a responsibility to make decisions that are in the best interest of our clients. I do not mean the profession should be self-sacrificing, but I think we should be asking frequently and often, “What impact might this have on my clients? Is it helpful?” and “Do I know enough about what I’m pushing into the world about myself to know it will not be imagined in a way that might be unhelpful for my clients?” As clients, we also have a responsibility to ask ourselves who we are choosing as a therapist and why. I recently found myself looking for a new therapist and starting first with a couple I had been following, one I thought was cute and funny, and another I was fascinated by.
After consideration, they were not suitable for me to work with because of these thoughts. Had I decided to work with either, I would certainly have brought that reality to the table early for discussion. I also found myself in a rabbit hole searching for Jordan Stevens’ therapist because I’d heard him rave about them. While I didn’t find his therapist (I think a good thing!), I was drawn to the type of therapy he talks about, something I know little or nothing about and am exploring at the moment.
What might be more helpful for me is to consider researching the type of therapy they are in — in this case, IEAP — and then finding a clinician that I like who specialises in that area. It’s all learning — and we live at a fast-paced, frequently changing time for mental health and wellness. We need to be constantly in contact with the knife edges of what feels safe, and useful and what doesn’t. We need to question ourselves as clinicians and ask often, ‘Why am I doing XXXX?’ ‘Does it serve me? Does it serve my clients?’ What are the risks and what are the gains?
Anything that poses any type of potential threat to my clients is not something I’m prepared to risk, but I’m going to stay curious on the subject while it’s present and maybe until it finds a resolve. But until then, I’ll refrain from sharing my snotty morning musings with the wider world, just in case!