The Moments Therapists Don’t Usually Talk About

Following Up with State of the Art Presenters

Rich Simon

Every clinician knows that therapy isn’t always the effortlessly smooth exercise in empathy and healing that countless workshops, journals, and books portray it to be. Whether we want to admit it or not, we all regularly have our moments of being caught off guard, feeling ineffective, and being filled with more questions than answers. To make matters worse, most of us practice in settings in which there are few outlets for us to discuss our most challenging moments and go beyond wondering “Is it just me?” when there’s a broader issue to think about and an important lesson to learn.

Providing a forum for moving away from an Ivory Tower view of what happens in therapy to get down to a more nitty-gritty discussion of what it is that therapists really was our primary reason for putting together our State of the Art 2013 virtual conference. Central to State of the Art were a series of candid conversations with leading therapists about the stuff that rarely gets discussed—how they recover from mistakes, improvise, and open themselves up to hearing hard truths from clients.

We also included a number of dialogues with leading therapists about tough issues in the areas of couples and family work, integrative mental health, and trauma therapy, and conducted follow-up interviews in which they responded to questions triggered by their original conversations. Hearing from them was both empowering and reassuring, a reminder that even the most cringe-worthy moments in therapy happen to the best of us and can be dealt with. To show you what I mean, here are my favorite moments from each session:

Esther Perel & Bill Doherty on “Commitment and its Challenges”

Secrets and the way we handle them in the consulting room is one of the most under-discussed issues in our field. As Esther and Bill show in this clip, many types of complicated secrets arise in couples therapy and there are different ways to work with them. Watch to see the contrast in how they handle the tension of secrets in work with couples while maintaining boundaries, talking one-on-one with partners, and staying honest and helpful.

Diana Fosha & Chris Germer on “The Now Moment in Psychotherapy”

With more therapists adopting a quality of “nowness” and immediate presence with clients, there are more opportunities to come up against issues of transference and vulnerability. As an example, Diana shares how her soft, empathic voice—normally considered an asset in our profession—proved unexpectedly provocative for a traumatized client. Watch the clip below to see how Diana handled a tough moment of client pushback.

Mary Jo Barrett and Dick Schwartz on “Treating Trauma: A 30 Year Perspective”

By definition, trauma specialists are regularly confronted with situations that are hard to hear, hard to talk about, and hard to handle. In the fraught therapeutic relationship, words of care and empathy uttered by well-intentioned therapists can sometimes recall the manipulative language of abusive relationships. In this clip, Mary Jo cautions about the difficulty of maintaining an atmosphere of accountability and safety in therapy in the face of clients’ previous experiences with abusive caretakers.

For these and 40 more candid interviews, in-depth discussions, and practical guides from expert therapists who are familiar with many of the same cringe-worthy moments and daily hurdles as you and I, log in or sign up for State of the Art 2013.

Topic: Professional Development | Couples | Trauma

Tags: boundaries | empathy | Esther Perel | family | integrative mental health | Mary Jo Barrett | mental health | relationships | state of the art 2013 | talking | therapists | therapy | Transference | trauma therapy | traumatized | treating trauma | virtual conference

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