What does your patient (client) expect from you? Their life is in turmoil, problems ascend from the sky and land squarely at their feet and they need answers. The danger here for therapists is to become everything for that person, father figure, sexual object, confessor, adviser and most of all the only person who has ever really listened to them and understood! In this paper we will explore the dangers to both therapists and to clients when both parties start to see the therapist as a God – the know all – see all – understand all, a being who will magically whisk away all those terrible feelings and leave a well-adjusted happy person behind.
From the time therapists began in the early 19th century patients have idolised their doctors as someone special amongst all the people they know, whether that be male or female it does not matter but the relationship structure of the powerless under the spell of the powerful. Freud and others recognised that patients often transfer their needy emotions to the therapist (counsellor) in the form of a love object. Most after some period of therapy actually find their feelings for the therapist actually diminish to one of respect or care but not as intensive as the early sessions. This bell-shaped graph of emotion shows the early mistrust to dependency to eventual co-dependence and finally disengagement from the carer to an independent self supportive state of mind. Of course these same therapists realised that dependency works the other way in counter-transference where the therapist becomes dependent on the patient (client) and finds disengagement fearful and experienced as a loss. CBT specialists
In order for therapists to deal with the problem elaborate rules were devised over the years by societies and expressed as boundaries of behaviour (ethics). In these rules the therapist should be aware of transference in both directions and deal with the situation by gentle rejection and assurance to the client that these feelings are normal and will pass. However for many therapists and clients these intense emotional feelings do not always go away and ethical lines become crossed by the therapist who allows their need for worship and to be treated in a God like manner to blur their judgement for the patient’s well-being and on-going treatment.
God Like Worship
What entices the therapist to slip so easily into the God complex? One definition is that the therapist themselves have a needy personality from childhood. Where maybe from a large family of siblings where parents have to share out the love available – where competing for attention often results in frustration and feelings of being alone even in a house surrounded by others. As adults they often search for people who are giving in nature to satisfy their need for attention that was sadly lacking in childhood. So when confronted with an attentive client the therapist can find themselves feeding off their loving worship, enjoying the attention, the worshipfulness of the client that allows the therapist to feel powerful, loved and above all needed.
A second area is that of the therapists self -esteem. The therapist may have feelings that they are not fulfilling there own professional standards, that they are failing their clients through lack of knowledge, professionalism and so constantly look for clients to assure them through their God-like worship that they are doing a good job, that they are succeeding in helping them feel better. The therapist is constantly asking the client questions such as, “are you feeling better?”, “have things improved?”, and “are these sessions helping you?” All are genuine questions for any therapist to ask from time to time to check or measure progress but when asked to often can indicate that the therapist is looking for approval or commendation for the work so far. In other words they want to hear they are doing a good job for the client. Here the therapists self-esteem can be boosted and help them to continue to treat clients with a new-found confidence. However this confidence is only temporary as the self-doubts creep back in over time and further reassurance is needed from the client to boost the ego once more to its God-like heights. When one particular client is constantly praising the therapist then in turn the therapist creates a need for that client that makes it imperative they continue in treatment. To achieve this the therapist is constantly searching for new reasons to continue the sessions not for the sake of the client but in fact for their own needs.
A third area is professional snobbery, here the therapist has a reputation to keep, a need for recognition both by the client as an expert but also the adoring public for their outstanding work or achievements. Here the therapist becomes the centre of the counselling process in which they are magnanimous in their Godly status amongst fellow colleagues and the public arena. This dangerous self-importance can lead to recklessness on behalf of patients who believe this person to be that all-knowing God who will answer their need to be treated by the best – the one with the outstanding reputation amongst his peers – that therapist who is hard to see (get an appointment with) as they are so busy and in demand. Of course this same therapist has the largest fees to pay and so the client perceives they are getting the best as they are paying the most.
The Crisis Trap
Every therapist is aware of the trap of transference and counter-transference and despite this knowledge can find themselves sucked into an unhealthy situation even without realising what is happening until a crisis emerges where the patient and therapist meet at the junction of an emotional precipice where decisions have to be considered about the continuance of therapy itself and the disengagement from those emotions that have crept up so silently. Once in this situation the therapist has the difficult task of repairing the relationship either by toning down their own responses to the client or recommending the client see a new therapist. However for the therapist who is addicted to the attention of the client this is a hard decision – to send away the very person who is giving them the need they have become drawn too. For some therapists there are other concerns such as being found out, a professional complaint, an incidental family interference or crisis of confidence about their own skills in counselling. This can lead to a fear response effecting other client’s sessions and outcomes. A therapist in emotional crisis cannot be effective in helping clients when they are more concerned with their own welfare than that of the patient.
Is it so surprising that as therapists we are any less than anyone else in need of love, attention, to have needs met, to feel wanted and appreciated by others. So it is not surprising that given the opportunity to feel worshiped in a God like manner that so many therapists fall from grace and into the trap of hero-worship by the very clients whom they should be looking after for their emotional needs and helping them to grow so as to deal with their own (the clients) real life problems and to move forward being able to cope with life.
There is no easy solution to this phenomenon of transference and to offer a simple guide to avoiding the situation would be futile as every situation brings differing dynamics that each therapist has to confront and deal with as professionally as possible. However it would be unfair not to point out some obvious rules of thumb for therapists who succumb to God Worship, at least to think about.
First once you realise as a therapist that boundaries have been crossed a general discussion with a peer professional may help to reassert their personal perspective about themselves and the client involved. Secondly the therapist should consider breaking with the client and so end the unhealthy situation by recommending another therapist (usually of the same sex as the client). Third if the transference is one-way (from the client only) then to explain to the client the reasons for their feelings towards the therapist and how in counselling a inverted bell like pattern of emotions can be seen as a healthy progression through stages of the sessions towards a healing process in the end. That mutual respect is a far healthy outcome than God-like worship that in fact may colour the outcome of the treatment. To take the I’m OK – Your OK position in that both parties to the transference have needs to be met and acknowledge those needs but within the boundaries of good ethical practice. Fourth is to realise that to be appreciated by the client for doing your job is a worthwhile reward but that there are limits to that praise that have to be tinged with realism about the therapist’s role in counselling as a guide and not a God-head for the client to worship at.
I started out in this paper warning therapists about the trap of transference and how it can become addictive to have clients worship you and hold you in unnatural high esteem. That it is natural for all humans and not just therapists to seek love have needs met and feel wanted. However therapists are unique to our society in that they must be trusted to keep boundaries and professional standards when offering treatment to vulnerable clients who often desperately need to have answers to their problematic lives with an atmosphere of trust, respect and humanitarianism Magic may be expected from the client but realism and genuine support and understanding is the real magic offered by therapy to the client.