Collaboration: “Get Over Yourself”
If you knew that within the first several sessions of therapy, the bulk of what you will explore and the grooves of how you will explore it will have largely been set, how would approach those first few hours?
Collaboration in psychotherapy in its simplest definition is “working together” in relationship. Fostering collaboration has been researched and attributed as one of several “therapist factors” which we recall contribute to roughly 30% of therapy efficacy. Few would disagree that the “therapeutic alliance” matters greatly and without it, therapy is likely to fail or even be harmful. At a bare minimum, therapists are already modeling collaboration regularly through reflecting, attuning and offering feedback.
Therapists also have the option of teaching collaborative skills explicitly. These include speaking clearly and succinctly, listening non-reactively, considering alternative perspectives, appreciating the relationship, and noting the balance of the relational exchange. A future conversation is needed for each of these skill areas but for now, suffice to say, that just the process of collaborating to develop specific practices that are relevant to each client is, in itself, a way to foster deliberate development.
Moving forward, in a deliberately developmental context, we can now open a discussion on how not just therapists but practitioners can understand the role of collaboration to foster optimal agency and growth. This requires “getting over yourself”, not in a demeaning, self-critical sense, but by challenging the paradigm that a therapist is solely responsible for fostering the therapeutic alliance. Here’s the developmental question: How can I help my therapist to help me better? This is a practice of “getting over yourself” as it encourages clients to see themselves through the eyes of their therapist.
To make this point more salient, I’ll introduce a very brief definition of “transference” in the therapy relationship. This will be by no means comprehensive but will support the premise that even a basic understanding of this dynamic in the therapy room can boost a client’s self-agency to collaborate.
Transference, described initially by Freud, occurs when a client redirects or “transfers” their past relational imprints (e.g. with mom, dad, or siblings) onto the therapist presently. More simply, transferences are “relational frames” being re-enacted. Transferences may be “negative” such as expressing intense anger with the therapist for minor misattunements which remind a client of their deficient caretaker. Transferences can also include heroically “positive” idealizations, sometimes as an attempt to shape the therapist into providing a corrective experience. There can be varying degrees of awareness of transference behaviors, but the historical imprints that drive them are by definition unconscious. In fact, when the old relational frame is understood, the transference is usually reduced and the client can see the therapist in a more realistic and balanced way.
Again, this is greatly oversimplified. And in an attempt to prevent reductionism, I want to point out four things I am NOT saying.
1) I am not saying transference is “good or bad”. It is a highly likely and normal occurrence in the course of therapy or working with mentors of any kind.
2) The terms “positive and negative” do not mean that one or the other has a better therapeutic outcome. The point is transference dynamics can free clients from historical frames as they become more conscious.
3) It’s a mistake to reduce the therapy relationship to a pathologically driven endeavor based solely on transference. There are many impressions formulated “here and now” without the influence of history. I’m spotlighting just one aspect of the relationship, and contend that each of us has parts that unconsciously want to be met by a “good dad” or “good mom”. The therapist is hopefully a corrective representation to past hurts.
4) I don’t take a position on whether transference should be worked through directly in the therapy room or indirectly in the privacy of the client’s mind as this will vary in every counseling relationship. Some successful therapeutic alliances never need to directly address transference and others need to address it in order to have a successful outcome.
Here's another way of looking it. Your therapist is simply just a person. They made a professional commitment to set aside time to work with you for an hour a week and who knows what they’re doing the rest of the time? Therapists, like everyone else have joys and problems. They have good days and bad days. They regret making mistakes and are self-critical, wondering if they ate the wrong thing for breakfast. As a client, you have little or no idea about much of this. And this is the way it should be as it’s not your job to take care of your therapist.
And yet, you’ll notice, based on just one hour a week, you likely create all kinds of ideas about who the therapist is. Continue to bear in mind that the information you are processing is almost surely a blend of “here and now” sense impressions and your historical relational frames. Recall, frames distort the sense perceptions; that is, you include certain information and reject other information about the therapist before it has even become conscious. You then “create your therapist” with some degree of accuracy and, of course, some degree of inaccuracy.
So “getting over yourself” is the practice of taking the perspective of the inverse of this. How can I help my therapist help me better? You can assume that your therapist is also constructing you based on what you present verbally and otherwise, and all of this data is being filtered both accurately and inaccurately.
Why is this such an important developmental move? How you present yourself, what you share or don’t share matters greatly in how you are seen by the therapist. This means you can massively impact the counseling process by sharing what is most salient, truthful and meaningful to you in a given exchange. It then follows, the degree to which you hold back the truth of your experience is directly correlated to the therapist constructing you, and thereby “seeing” you, completely inaccurately!
This is not at all to say that you should share everything, discretion is necessary. This is also not to suggest shoring up and “presenting yourself” inauthentically so the therapist only sees you in a “positive” light. But as a practice you can help your therapist help you by attempting to be clear what you want to share and what you don’t. The practice of helping your therapist to help you can clarify your own process and generate a more meaningful and coherent narrative which influences the therapy session before it even begins.
How could this practice in therapy serve you outside the therapy room? Perhaps the top reason people come to therapy is due to relationship issues. I believe it’s safe to generalize that our closest relationships involve some degree of transference. We are seeing and being seen, to some degree, inaccurately by everyone. Becoming aware of this can be quite liberating, to live with the understanding that you may never be fully understood by your relations and to stop expecting it to be different. Additionally, it’s clear that since no one knows what your inner world is like, it’s quite helpful to explicitly show people what you want them to see. “Get over yourself” and see yourself through their eyes.
Back to the original question, at the beginning of the article. One study suggests that the vast majority of topics you will cover and how they are covered in therapy is largely solidified within just nine sessions. Of course, you can always “break frames” but the point is, setting the trajectory of therapy- being that 70% of its effectiveness is due to “client factors”- is collaborative and largely dependent on the client’s ability to shape their own therapy with as much self-agency as possible.
There’s a guided visualization on collaborating with your therapist available here: https://www.integralsomaticawakening.com/resources. Try setting aside 15 minutes before your next session and see how it impacts your practice.