Fears and the therapeutic process
The following songs, version one and version two, were inspired by the client and therapist fears and concerns introduced by Randolph B. Pipes and Donna S. Davenport, in their classic text, Introduction to Psychotherapy, Common Clinical Wisdom, Second Edition. The audio is not quite ready yet, nor are the second and third songs, both adaptations of Blue Oyster Cult's Don't Fear the Reaper.
But for those of you that can't wait to jump into clinical discussions, feel free to respond first two the lyrical forms of these two versions of my original song, What If?
What I'd like to ask you, the blog visitor and participant, to do is to identify which fears (spelled out in these two versions of the song), have surfaced most frequently, first in patients you've seen, and second, within yourself as you face your patients.
What if? (Client fears version)
Dr BLT
words and music by Dr BLT
What if
I’m treated like a number there
A case, not a person
Cause they just don’t care
What if my therapist
Lies to me
And tells me
I’m kind and good
As good can be
What if my problem
Is just shrugged away
What if my values
Aren’t shared today
Will I be treated by someone who’s skilled
Or someone incompetent to treat my ills
What if I’m pressured into saying words
Words that are best unsaid, and never heard
Will I become dependent
On this therapy
And then simply dropped
Left in misery
Will I be engulfed by my therapist
With this be confidential, of this I insist
Will I be exploited, punished then dismissed
Rumination has its price
But if I just roll the dice
What will come of therapy
will I heal
or simply bleed?
Think I’m bad
Will my shrink
Consol me when I’m feeling sad
When friends find out, just what will they think
Will they think I’m crazy cause I see a shrink
Will my therapist think I’m more insane
Than I think I am, will it be a game
Will my shrink discover things about myself
I don’t want to know,
Things up there on a shelf
Rumination has its price
But if I just roll the dice
What will come of therapy
will I heal
or simply bleed?
Will I learn things
I don’t’ wanna know
Of my emotions
Will I lose control
In the end will
I find there is no hope
Help this is serious!
This ain’t no joke
What if? (Therapist fears version)
Dr BLT
words and music by Dr BLT
what if you are smarter
than I tend to be
what if you just get too close
dependency
what if I am made a fool
as I apply
interventions meant to rescue
you, not I
what if I'm not competent enough
for you
what if I just make you worse
what will you do
what if I don't like you and
you try to sue
these are fears I have
about this me and you
what if you don't like
my personality
what if all these sessions
bring catastrophy
if I lose control of them
where will that lead
what if I have feelings
that are hard for me
chorus:
Rumination has its price
But if I just roll the dice
What will come of therapy
will I heal
or simply bleed?
what if differences I make
do not exist
what if things go nowhere
and you do insist
that we find success inside
my efforts here
what if I am run by
supervisor fear
what if I disrupt your life
and all your ways
will I pull the rug from under you
today
will that leave you feeling
that I messed you up
maybe it's the process
I don't trust
(return to chorus)
What if we all had fears would my therapist be able to get fixed. What if my client fears what comes next the confrontation of things they have put on the self.
We all have fears, whether it be the client or the clinician. As clients we have to look at many different aspects of the therapist that you go to. Is the therapist empathic toward me, my fears, and goals? Does he know how I feel? Could I open up to him after building a rapore with him? Is he truthful? Can he be trusted? What kind of personality does he have? These are just some of the many items that need to be answered by the client. Without answers than the client would be wasting his time going to that particular therapist because the client could not be at ease with the therapist.
As a inspiring therapist or an experienced one we have the fears, such as can I help this client, can I gain his trust so that he can face his challenges? How do I go about helping this client achieve his goals? Do I reveal personal information to help him and how much? What type of theories could I use to help him in his search of himself. What theories am I comfortable with when helping the client? Do I know myself, my limitations, my fears? Do I feel competent enough to help other people? Do I dominate the sessions or do I let the client work out his own ideas with our suggestions? Are they the right suggestions? These are a few things that we all must look at when it comes to our clients mental health and what they want to accomplish in the time allowed
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Dave had great comments! I totally agree with his remarks. We all have fears and insecurities in some areas in our lives whether it be personally, professionally, or in relationships. It is how we deal with our fears and insecurities will determine our outcome.
What an insightful song. As a client, I have felt very vulnerable. Would I get help? What will the counselor think of me? Will they really care how I feel? Can they help me or am I just wasting my time? A lot of thoughts and feelings run through your mind when you expose all your fears, anger, and confusion. Will the counselor make me feel better or feel condemned? There is a risk when you become truly honest with yourself, your motivations, and intent. How will I feel after eveything is exposed? That is the risk you have to take.
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I can relate to the fears from both the client and the therapist!
As a client, the fear of what people will think of you when they hear you are going to a therapist is huge. When we all live life as though we have our stuff together, going to a therapist means there is something wrong! The question " Should I really tell the therapist everything?? or should I mask my truth the way I do in public??"
As a therapist... beware of the: "I can fix anything... I am a new therapist syndrome" The hardest thing to do is just listen. Listen with a third ear! I must remind myself that I may not have an immediate solution to the client's problem! Being PRESENT to the client may be the most important thing I can do to win his or her trust! This whole process reminds me of learning to ride a bike,we start our with training wheels ( our practicum, with a supervisor to help along the way)
After confidence is built up we can go on our own, that doesn't mean we will never have tumble but we can get up and continue to journey!
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As a future therapist my most pressing fears are:
Will I be forced into a “therapeutic style mold” by supervisors during my training?
Will I do more harm than good?
Did I actually learn enough to help anyone?
Can I really be an effective therapist if I am not completely together myself? Or, does that make me a better therapist because I can empathize with my clients?
Every day that I am closer to my goal of advancing and starting my practicum, I find new and interesting fears and doubts to plague me. On good days, I KNOW I can do this, I was born to do this. On bad days, I KNOW I can’t do this, who am I trying to fool? When I look at this thought process from a more objective place, I see that it may be that because I question myself constantly, I can be a good therapist. Complacency, overconfidence and arrogance are not ideal qualities for a therapist! I will never suffer from any of these and that is probably a blessing.
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I've never been to therapy, but the concerns in the song are definitely valid and ones that I would have. Everyone fears not being able to be 'fixed' or that the person helping them isn't able to help them properly. I would also definitely wonder what others would think of me for seeing a 'shrink'.
As a future therapist I also have many of the same fears mentioned in the song. I worry about saying and doing the wrong thing, that I haven't received enough or proper training for what I will be dealing with, that I've forgotten how or what I should do in a given situation, etc... However, if you stop and think there are a lot of people who have similar fears when beginning a new field of practice, so the fears we have are not uncommon.
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I think having fears, as a therapist, is good if we do not let them consume us. Having fear means that we are humble, that we recognize we are human (& not superhuman therapist experts), & that we recognize our limitations & inadequacies. A good therapist will allow these fears & realizations to motivate them to learn, grow, and evolve. The complacent therapist who has no fears will grow stagnant and ultimately have more to fear than the fearful, hesitant therapist. Of course, these fears should be tempered with a quiet confidence and willingness to listen and grow with the client. As long as we are willing to listen to our fears, be challenged by them and grow from them then these fears can be beneficial.
I think it is important to remember and always be conscientious of the fears of the client. EVERY client will come to the table with fears and we hold the power to assuage those fears. The most powerful weapon against fear is to acknowledge it and bring it to light. Validation, normalization & exploration are the keys to confronting, minimizing and learning from fear.
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I totally agree with you Leah. Fear to me is a jump start to think out side of the box within a clinical perspective, allowing you to not only challenge yourself as a therapist, but also challenging your client. The fear within allows you to continue moving forward with the treatment without doubt and/or fear of failure. As a therapist, the fear challenges you to look within the context and use the creativity to allow you to retain and obtain needed information on your patient. As a patient, the fear challenges you to face the fears that you once put away. The fear to me symbolizes the obstacle needed to be reached to continue the trail of success and perseverance. Fear leads the person for success with holding back, it brings confidence and willingness to try new things.With fear, you are able to look within and validate the feelings, thoughts and behaviors that are associated with the known feeling in order to further explore the unexpected.
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O no! What if I need to see a Dr. a head Dr. Do I really need psychotherapy? and if I do and my family or friends find out; what will they say? I guess I will go and see a psychotherapist regardless. What if this Dr. doesn't believe me? What if this Dr. thinks that I'm being over dramatic. I wonder if this Dr.has experienced any of what I've been going through? I will only share those problems which everyone else have.
These are all validated concerns and fears that a person whom never had experienced psychotherapy might have. I know that I did. After my first session I felt that my psychotherapist could only relate to the stressors of being a mother, working, raising children, having a husband in addition, attempting to get an education all at the same time.
These are common daily life stresses and she would not look down upon me for it. But, I seriously second guessed myself, as far as how much to share with her. Mentally I kept thinking "what will she say if I throw in second marriage,drugs, alcohol, step kids,anger outbursts, uncontrollable crying spells". Would this then change the way she sees me. Would she then think "what the heck is she doing trying to become a therapist?" On the flip coin to that, I felt that she was uneasy at first and didn't know how to approach me. The only thing she could reiterate time and again was "wow that is a lot to deal with" which only made me wonder even more if she was truly listening to me. She mentioned how booked her scheduling was and how in the meantime I could call the 1-800 number should I have an emergency. Perhaps she felt that I knew exactly what was wrong with me and chose not to elaborate for fear of being wrong. So she resorted to only acknowledge that all was indeed a lot of anxiety causing issues. Maybe she felt that she needed to see more of me before she could even began to engage my attention.
I feel that both as a client and a therapist the fears are mutual. For the client the fears that the therapist will pass judgment, label, think less than, be seen as a weak, pathetic, sorry excuse of human being, a piece of empty hollow mass loitering this earth.For the therapist, the fear of the client thinking that they don't know what they are doing, detect newness, think that they are really no good, that the client will worsen, commit suicide under their care, not being able to help the client, not know how or simply be brain blocked. So, in all, fears come in different shapes and sizes. As thoughts can be constructive or destructive. I think above all, both client and therapist share similar fears;these being personal criticism, reputation, and failing to meet expectations for self or for others.
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I agree with the prior blogs of my fellows future therapist. When we are in the position to help, I hope that I can draw from what I have learned in class as well as from my fellow students and be their for my clients. That I am human and can also be flawed, is important to recognize, but it will make me a better therapist, because I will then make sure that my client gets from our sessions the 110% of what they need to help them come to terms with their perspectives issues and at the same time I am relearning to become a better therapist.
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I agree with the prior blogs of my peers. I think as a new Therapist i am wondering if i am going to be able to detect when im am having counter transference/ transference issues. so i feel that every therapist should have a therapist to discuss any feeling of discomfort or concerns.....
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