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June 14th, 2011
10:08 AM ET
Can I ask my therapist personal questions?Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health. Asked by J. Johnston, U.S. You are asking one of those all important questions that is seldom discussed, and you are thinking about the issue with remarkable clarity. I wish I could give you an answer of equal clarity, but alas, one of the reasons this issue is not often discussed is because it is so complex and potentially problematic. To some degree all psychotherapies are built upon a knowledge differential between patient and therapist. The therapist is in the relationship to focus on the patient and to provide knowledge and/or guidance of one sort or other, depending on the type of therapy. The patient is in the relationship to focus on him or herself and to attempt to use the interaction with the therapist to "get well" or at least better. Freud - the inventor of psychoanalysis - recognized early on that this imbalance made the therapeutic relationship much different than any other type of adult relationship. When was the last time you willingly spent extended periods of time with someone who only talked about themselves? In the case of psychotherapy the balancing element is the fact that the patient pays the therapist, so that quid pro quo is established. A powerful result of this arrangement is that the therapist typically retains a fair amount of anonymity. In some types of psychotherapy - for example traditional psychoanalysis - this anonymity is considered to be essential to the treatment because it allows the patient to project his or her fantasies on the therapist without the realities of the therapist's personality intruding. When successful, the therapist becomes a stand-in for early parental figures. Because this process is viewed as essential, most psychoanalysts won't answer direct questions about themselves but will rather use the questions as a chance to explore further the patient's fantasies about the therapist. In other types of therapy, such as cognitive behavioral therapy, the anonymity of the therapist is far less essential to the way the process is believed to work. As a result, cognitive behavioral therapists are typically far more willing to answer questions about themselves, especially if providing an answer is perceived as being of potential benefit to the patient. In your particular case, I do have some advice, which is that you ask your therapist exactly what you asked me and be prepared for any type of response, recognizing that what you get back from the therapist will be dictated as much by the type of therapy you are in as by your relationship with the therapist. But one word of warning. The psychotherapeutic relationship can be profoundly powerful, but it is always to some degree built on an illusion, because the therapist is also a human being and therefore has problems of his or her own. Sometimes seeing these vulnerabilities can empower a patient, other times it can weaken what was previously a powerful tool for therapeutic change. By the way, this is not a new problem. Tibetan Buddhists counsel against getting too familiar with a guru for fear of seeing their human failings. More than 200 years ago, the great English author Samuel Johnson wrote that anyone who is deeply moved by a work of literature and then goes to meet the author in person has only himself to blame when he is sorely disappointed by what he finds. Johnson reminds his readers that if the author wasn't struggling with the same issues as the reader he never would have set them down in print. |
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love. Recent Comments
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Great answer to a tough question. I love the historical context you provided. Nice work!
Very truly said and using Tibetan buddhist and Samuel Johnson as an example shows the deeper sense of knowledge of an expert.
I have struggled with this as I have a very close relationship with my therapist. When I first started seeing him, I did not know anything about his credentials so I began to search online. Amongst the professional information was personal information I have always wanted to ask him about but it isn't relevant to anything we are doing or his treatment of me, so I don't feel I can. He would probably not mind if I asked, but I have long felt that I should not invade the things he keeps private when he shares so much of himself otherwise. While this is not specifically the topic being discussed, I want to recommend this book to women who have a very deep relationship or complicated feelings about their therapist. It is called "In Session: The Bond Between Women and Their Therapists," by Deborah A. Lott. It is out of print but available used on Amazon. It is somewhat expensive but it literally rescued me from crushing depression and the unexplained physical illnesses I suffered when I thought I had fallen in love with my therapist. I was able to talk my therapist about my transference (which is a common phenomenon – and I despise it), learn that it was okay in some instances, and understand how to control it. A year later, and three years into our relationship, things are better than ever and I just was able to complete a major step forward in life and treatment with his assistance.
First: AS a therapist I can tell you: you can ask ANY QUESTION YOU WANT. It's the therapists responsibility to say whether or not s/he can answer it.
Second: If you're in traditional psychoanalytic therapy (read this again – traditional – not contemporary psychodynamic therapy) – run far away. I won't go into details, but it's expensive, time-consuming, not well-supported in the empirical literature, and, most importantly, there are other, less time consuming, less expensive, and more effective therapies out there!
What is the difference? How do I know which therapy a certain therapist may provide?????
As a therapist of 35 years the answer is that you can ask any question but it is not really the therapists role to answer questions but rather to help you find answers as well as a better understanding of you and your problems. Most therapists today utilize some form of cognitive behavior therapy and it is as simple as asking before the appointment is even made what types of therapy are utilized by the particular therapist. Be sure to check credentials and certifications.
I think it's perfectly okay to ask your therapist any question you want to ask. If the therapist doesn't want to answer, she'll probably say something like "My personal experience isn't really relevant here, let's get back to talking about yours," or "I only share some personal information with patients, but that was a good question to ask. Let's get back to you."
Alright Trebek...I'll take therapists for 200!
Another therapist perspective: it's ok to ask semi-personal questions of a therapist, realizing that as a matter of judgment, the therapist may not be able to answer. Regardless of clinical orientation, therapists' codes of professional conduct require us to maintain good boundaries, for the sake of the client. Therapy cannot be friendship; healthy friendship is mutual, responding to the needs of both. But of course we can be friendly, sharing recipes and stories about our vehicles or our cats. And the ambience of the counseling office can be personal too, revealing something distinctive about the therapist.
Sure why not.
The best question to ask the therapist is "How will I know when I'm cured?" Live With Intention, DrBillToth.com/blog
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