by Joyce Prince, CSW
This is an often asked and good question and can be answered as follows. Just as an apprentice becomes temporarily dependent on a mentor, or a student on a teacher, in a well conducted therapy the patient may become temporarily dependent on the therapist. As the therapy progresses, the patient will learn from the therapist and the therapeutic process which will gradually become a part of him or her; a set of ” psychological tools”, a way of looking at oneself which will increasingly reside within the patient rather than with the therapist. The patient becomes progressively more empowered to effectively manage his or her own life. Good therapy is a collaborative process, with an important goal being the transfer of the “psychological tools” from the therapist to the patient, so that ultimately the individual can discontinue therapy with fortified emotional and mental “muscle”.
Direct advice is given relatively infrequently in therapy because constant advice would turn over to the therapist the patient’s responsibility for his/her life. This would not be a collaboration, and the “muscle” would continue to reside in the therapist. The dependence in this case would be permanent, not temporary. Each new life situation would have to be brought to “the master”, which would not be helpful in building up the patient “muscle”.
Instead, the individual in therapy goes through a process of self-inventory and exploration of feelings, of memories, of behavior, of assumptions, of relationships, of fears, of new and different ways of handling life encounters, guided by the therapist/mentor. Gradually the patient becomes able to handle situations on his/her own, without the therapist’s presence. As the individual absorbs and accepts both the information gleaned from this process and becomes more able to explore and self-reflect on his/her own, the capacity to manage the psychological world is increased. This also broadens the behavioral response repertoire to the situations which occur in life, making it less likely that one will respond in an inappropriate or ineffectual manner. As the psychological “muscle” of the individual develops, the collaborative guide (therapist) ultimately is not needed.
In summary, the potential “consumer” of psychotherapy should be assured that in a well conducted therapy, while there indeed may be a phase of emotional dependence on the therapist, the collaborative alliance works toward transferring the “muscle” from the therapist to the patient, thereby solidifying and consolidating autonomy.