What therapy is NOT

therapy couch

Therapy is not just talk.

Make no mistake: Therapists are not mere conversationalists. They do not, as a rule, enter the therapy room unprepared and unaware of the responsibility that comes with the title. During session they assess, conceptualize, hypothesize, diagnose, set goals, intervene, evaluate progress. Between sessions they write letters to judges, probation officers, immigration lawyers, youth protection agencies. Throughout the day they confer with colleagues, supervisors, psychiatrists, teachers, school counselors, social workers. And, last but not least, they keep up-to-date records of all matters pertaining to the treatment of their clients. Having laid the groundwork, they go into session with a plan, knowing full well that it may have to be modified to meet the client’s needs.

The seamless quality of the therapeutic encounter is only possible because the therapist is prepared. Simply put, therapists work hard at making therapy look like it’s “just talk.”

There are, of course, exceptions. Every profession has its share of miscreants, misfits and misguided souls. I myself have met a few. As you, no doubt, must have.

Therapy, to me, is less about talk than it is about silence. Not the silence of defiance or avoidance. But rather the silence that lets clients hear their inner voices, the silence that fosters creative thinking and opens up new possibilities. Silence, as an intervention, is a powerful form of communication. It invites reflection which, in turn, enables clients to work through the issues that brought them to therapy. Like all interventions, silence is most effective in the context of a trusting relationship between client and clinician.

My training is in marriage and family therapy, and it is from that perspective that I broach the subject of silence. In my early days as a content-driven intern, I talked to fill the silence and asked questions that had little therapeutic relevance. To my surprise, the more information I gathered, the less I knew what to do with it. It took me months to shift from Grand Inquisitor to participant observer.

As my level of comfort with silence grew, my need to be central to the therapeutic process lessened. This led me to experiment with spatial configurations by moving my chair back a few feet while I instructed clients to carry on as if I wasn’t there. I discovered that the repositioning of my clients’ chairs prior to their arrival produced rich enactments with minimal intervening on my part.

Non-verbal means of communication such as silence, space, and touch are potent signifiers in the therapeutic setting. Making use of them requires a certain amount of creativity, which is one of the mainstays of therapy, the willingness to take calculated risks, and sufficient sang-froid to handle the fallout, should there be any.

2 responses to “What therapy is NOT

  1. very nice work!

  2. Never would have thought of that approach, that said, Im not trained….