Being a Therapist, Reaction Paper Example

Abstract

In the present paper, the profession of therapist is discussed. The central idea of the essay is to find out what it is like to be a therapist according to Jeffrey A. Kottler. In this context, his book “On being a Therapist” is reviewed and critically evaluated. Having crossed the first line, I shall cross the second one in order to see how the knowledge of Dr. Kottler is applicable to me. In this case, crossing the second line is a bit different than mentioned above, since it refers to the process of self-cognition and learning. Still, if everything was seen through a personal perspective, no objectivity would be possible and it would be the first rule the therapist should not cross, or at least try not to do that as long as possible. Thus, the structure of the paper consists of two parts – critique of the book and personal application of the issues covered in it.

Key words:therapist, psychoanalysis, countertransference, patient, self-cognition.

Being a Therapist

In every scientific discipline, where theory and practice entwine, there are two lines with which each scholar or scientist should deal with – the first one is a line between theory and practice, and the second one is a line of personal attitude and scientific objectivity. While in the first case, in order to succeed and become entirely in charge of one’s knowledge, scientist should cross the line; in the second case, he or she is most encouraged not to cross that line, because after passing the Rubicon it becomes difficult to judge where science and where personal self-estimation or problem resolution starts. The central idea of the essay is to find out what it is like to be a therapist according to Jeffrey A. Kottler. In this context, his book “On being a Therapist” is reviewed and critically evaluated. Having crossed the first line, I shall cross the second one in order to see how the knowledge of Dr. Kottler is applicable to me. In this case, crossing the second line is a bit different than mentioned above, since it refers to the process of self-cognition and learning. Still, if everything was seen through a personal perspective, no objectivity would be possible and it would be the first rule the therapist should not cross, or at least try not to do that as long as possible. Thus, the structure of the paper consists of two parts – critique of the book and personal application of the issues covered in it.

Critique

In psychology, just as in any science, a book can be good if it describes accessibly theoretical framework of the issue, or puts an emphasis on the practical implementation of the theory, or describes scholar’s personal experience. The book is brilliant and become a “guidelines” for future students, when it combines all three aspects. This is exactly the case of Kottler’s book. The first striking thing is book’s narrative perspective and its structure. The narration is conducted in frank and friendly manner; there are no taboos, or restrictions for the issue to be covered. It describes almost every possible aspect of therapist’ life, like narcissist and family reasons for the job choice, development of skills and reasons for burnout and even failure as a specialist. It touches such problematic issues as therapists’ fantasies about their patients and issue of the countertransference. The main benefit of his narrative perspective is that those issues are treated as normal and natural implications of the chosen profession. Kottler tells the story as a person who had experienced all those problems or seen them in reality of other practitioners. The main motive of the whole book is that therapists are also human beings; they are not some supernatural creatures that could withstand everything and everyone. Thus, the book helps professionals, their clients and family to understand the essence of the profession and life path of a therapist.

Strength of the book is its comprehensiveness and simplicity of the structure. The narration goes through the explanation of the core interconnectivity between patient and therapist, described in the first chapter. Then the reasons for therapy system to work successfully are explained in the framework of “powerful presence of a therapist, active placebos, being with the client, and structures for risk taking” (Kottler, 2010, xiv). Further Kottler explains the two-dimensional perspective of a therapist’s success, meaning work and personal life and how they invade one another. He honestly explains the main benefits of the profession, and, in the next two chapters, describes numerous hazards of the field and implications for both patient and therapist. In the final chapters, he emphasizes problems resolution techniques, meaning creativity and risk taking in cases of burnout and boredom. Thus, Kottler was one of the first to address the inner side of the therapist practice in the most open, critical and progressive manner.

From the first glance, it may seem that due to the frankness, personal experiencing of the issues discussed, interactive manner of narration, the book would lack a strong theoretical basis for its development. In this case, the situation is quite the opposite. Kottler managed to build a three-dimensional model as close to reality as possible. He used classical psychological concepts and models in order to describe the problematic issues, appealed to personal experiences and provided vivid case studied in order to prove credibility of his suggestions. For instance, when Kottler (2010) referred to the countertransference he stated that it was first described by Freud in “his relationships with patients (Dora) and colleagues (such as Fleiss and Jung)” (117). Then he outlined theoretical discussions on the topic, representing various perspectives. Finally, he had provided case study of one therapist, who was feeling aversion his patient because of her bad treatment of husband and child. On the ground of those statements and examples, Kottler (2010) could develop further discussions of connected problems like therapists’ fantasies about patients (120), borderline clients (125) and difficult client behavior (126). As a conclusion, he emphasized the ways for success in difficult cases (138). The mentioned structure of the explanation contributes to the vividness and simplicity of comprehension. Thus, it makes the book accessible for a wide range of readers and helpful for a critical self-perception by students and young practitioners in the field.

From all mentioned above, it may seem that the book is flawless and that it might suite everyone. It would have been so if we all were the same or if every reader was ready for the read. In this context, the strength of the book in its frankness and holistic aiming to discover what is behind therapist’s calmness, professionalism and preciseness might as well become its weakness. In this sense, I mean that, for an unprepared reader or a student-beginner, the book might be quite depressive and discouraging at some points. For instance, when Kottler refers to benefits and hazards of profession, eventually, there are more cons than pros, and the problems he discusses are frustrating, at times. In this context, his frankness might be seen as discouragement from entering into the field. In this statement, I was trying to be as objective as it is possible, since my personal perception is that not everyone can be a therapist, it is rather a vocation than a job and this book aims to help those people who already realize that they cannot do anything else.

Personal Perspective

In my case, Kottler made me reevaluate the reasons why I am in this field and also why people choose the profession of a therapist. In this context, the most valuable was his discussion of the main hazards and benefits of the profession. Particular feature was that he stated a couple of benefits and then went to a long row of the disadvantages and possible hazards. According to Kottler, the main benefits of the profession are ability of gaining needed attention and self-estimation. He suggests that individuals that enter this field are inclined to self-perfection; desire to be treated as authority, whose advices are the most credible and respected. In other words, being a therapist is one of opportunities to satisfy narcissist inclinations which are quite strong among therapists. On the other hand, it is also about doing good things, meaning, in the end of the day, what keeps therapist from exhaustion and frustration is his feeling of doing something right, helping people to resolve their most intimate problems and facing their fears.

Another benefit is a tandem of healing-cure relationship between therapist and patient. While a therapist is trying to help and heal a patient, he is also going through the transformation, both physical and mental. He learns how to heal him-self and strengthen his health through self-discipline, concentration of attention, preciseness, self-awareness and critical thinking, not to speak of the fact that therapists learn a lot about the surrounding world and themselves through the reactions to this world (Kottler, 2010, 49-50). As in case of Kottler, the decision of becoming therapist was dictated by desire of making sense of the surrounding environment and events in his life.

Keeping in mind a several benefits of the profession, the list of hazards exceeds them thrice. According to Kottler, some of them include constant mobility, high rates of turnover and burnout, identity problems due to the training type. The beginners have specific difficulties. They have a fear of inadequacy, avoidance of failure, academic pressure from peers and superiors, struggle to develop academic identity, which inevitably results in confusion and frustration (Kottler, 2010, 69-71). In other words, beginners suffer from difficulties in accommodating themselves into academic and practicing environments while preserving their personality and developing professionalism. Occupational hazards for the further practice include high expectations of social environment to this profession and difficulty to correspond to an imposed status. Among other hazards are sleepless nights, due to clients’ nightmares and desire to resolve them; various sources of stress (client-, self-induced, work- and event-related); one-way intimacy; progress of narcissism; small salary and, finally, fatigue, futility, isolation, boredom and burnout. From my personal perspective, the most hazardous was the problem of conflict. For instance, when patient’s family conflict had triggered personal experiences in therapist’s family, it was most difficult to deal with an objectively in that situation.

Concerning my personal evaluation of pro and cons of the profession, I think that all mentioned above by Kottler is true, although I have not experienced most of the implications yet. On the other hand, I consider that the person choosing the profession of a therapist does not have any other choice but to follow his/hers vocation. Thus, the main pro of this path is that an individual has essential requirements for the job – desire to help people, ability and balance between inner narcissism and personal charisma. In this context, the benefit of being a therapist is again in self-actualization. This refers to those who choose profession due to their inner need; on the other hand, those, who come here for money, have seen the main benefit in private practice and high social status. In any case, just as Kottler outlined, the main pro for this profession is self-estimation and self-actualization irrespective of motives.  Concerning cons, I believe that Kottler’s approach to this issue and my personal attitude can be summarized in one statement that therapists are eventually consumed by their work and their patients. All hazards mentioned by Kottler come from one root – therapist’s openness to the pathologies of his/hers patients. In this context, I mean not only openness in relationship or countertransference with some patients, but openness of therapist’s mind and inner self to patients’ problems and their resolution. The main con is that a therapist might get too far by keeping somebody’s secrets and problems inside his head. In any case, this is a hazard we all take, when follow our vocation.

Except for reevaluation of the reasons why I had chosen this profession, this book had given me immense practical advices how to act in specific situations, like difficult patients and sexual attraction. The first thing to do, in case of a difficult client, is to find out the hidden motives for this behavior – denial of problem, self-estimation, desire to conquer therapist mentally or physically. The problem is that it is hard to generalize, since each case is unique and needs a special treatment and therapist’s activity scheme. What can be stated in general is that, first of all, a therapist should be patient and attentive both to himself and the patient. Sometimes the reason for deviant behaviors is triggered by therapist’s attitude or misperception of the situation. This might refer to the inconsistency between tempo of patient’s progress and therapists desire to succeed. In this case, therapist might forget that his mission is not in curing a patient but in helping him to heal himself. The case of sexual attraction is the most difficult one to deal with, it needs specific attention to what is triggering such pattern of behavior, and, based on that answer, certain treatment should be chosen. On the other hand, there are things I should never do under any circumstances. First of all, I should not confront the patient directly about seductive behavior, since it would result in frustration, automatic denial and patient’s shrinking from the previous openness in discussions. The reason for this is that direct discussion of feelings and therapists strict rejection, irrespective of the form used, would make the patient feel rejected, humiliated and vulnerable, which, in its turn, might trigger even worse psychological state than the previous one. On the other hand, “if transference feelings are interpreted, the client may fall back on denial” (Kottler, 2010, 131). The case when therapist backs of and leaves things the way they are might result in the future escalation of seductive efforts. Subsequently, decision differs from case to case, but eventual solution might be to pass the patient to a colleague, particularly, when it refers to countertransference.

My personal perception of countertransference and its influence on the effectiveness of my job as a counselor is more neutral than positive or negative. I consider that this phenomenon is an inevitable in the career, and it cannot be predicted or prevented. As we all are human beings, and we have our preferences in everything, therapists also have theirs. I think I would try not to avoid or reject this phenomenon in my practice, but struggle towards its minimization. How would it influence my effectiveness? It would be both a challenge and experience, since I would have to struggle with my own human perception of the person in front of me and judgments of an unprejudiced therapist. I think that my effectiveness would be harmed in case the escalation of the countertransference takes place, meaning when my judgments would be dictated by my personal attitude rather than professional one. In order not to reach to that and pass patient to a colleague, I would have to tackle the problem on the initial stage of its development, meaning I would have to put a lot of efforts into my self-analysis and self-control. I am sure that this struggle would be difficult, exhaustive and even frustrating, but, in order to achieve successful resolution for myself and the client, I would have to measure myself. This does not mean that I consider the phenomenon entirely negative, on the initial stage, it helps to develop mutual comprehension and stability of progress, on the other hand, the escalation of  countertransference is hazardous for both patient and therapist.

Finally, what I really would like to avoid is burnout and boredom. In this sense, the book had helped me a lot. I can make my own plan of how to avoid this inevitable implication of the profession. First of all, I will have to move towards differentiation of approaches and practices used in treatment. Although this is not yet the case for me, since I had not built my own academic and practical identity, I should start from now to keep myself opened to alternatives and creative thinking. In this context, very helpful would be participation in national and international thematic conferences, meeting new people, seeing new perspectives of treatment and ways of self-improvement. Secondly, in the future, it would be both interesting and refreshing to do some teaching. I think it gives even better opportunity to learn something than conferences, because students have a different perspective on the same topics, and they are not restricted by terms of correct/incorrect. Thirdly, I would have to learn making work breaks, avoiding workaholic lifestyle. Fourthly, I would have to learn how to control the source of stress and deal with unavoidable stress. The best way, in this case, might be physical activity. Finally, I would have to take personal responsibility for my life, both professional and private, in order to keep the balance.

Overall, I would conclude that this book is a must for everyone who had chosen counseling for their vocation. This book gives an integral picture of what it is like to be a therapist, what to expect and how to deal with the pitfalls of this profession. Personally, I had learned a lot about myself and the reasons why I had chosen this field. Kottler had also taught me how to be self-critical and gain benefits from it. I am sure that this book will stay for many years as a guideline in my career building.

Reference

Kottler, J.A. (2010). On  being a therapist. 4^th Ed. London, LD: Jossey-Bass.