I Would Like To Know The Extent To Which Therapists Are Trained To Remain Neutral.
Question: I would like to know the extent to which therapists are trained to remain neutral when faced with a client who wants advice on whether he or she should stay in a relationship. I expect that where the client is clearly being badly treated by his or her partner, a therapist may urge the client to seriously consider leaving, but in many, perhaps most instances, it is difficult to know where to draw the line between what constitutes unacceptable abuse and what is admissable human nature. Please comment.
Answer (1) I will try and speak for myself here. I am trained to look at all angles of a relationship when a client is thinking about leaving their partner. I know that I cannot accept anything at face value and it may be an issue with the client/clients partner and or a combination of both (which is usually the case). So I challenge the clients thoughts and feelings and support the client while he/she works out whether the relationship is good for them or not. It is not up to me to say whether somebody should leave a relationship although in some cases where it is really obvious and dangerous I will suggest that this might be in the best interests of the client and any dependants. Sometimes the line between human nature and abuse is pretty hazy but it doesn't take long to work it out once the client has talked through what is going on in the relationship and I will name it as abuse if I think it is the case. I hope this helps.
Answer provided by Jacqueline McDiarmid, Psychotherapist
Answer (2) An audit of safety issues for the client and any children would be conducted and if needed a safety plan would be developed and contacts given to cover emergencies. I would not presume to give advice to a client because I will not have to live with the consequences if my advice is wrong. To do so would both ignore the person's right to make and learn from their own mistakes. It would also ignore their abilities for eventually making a useful decision of their own. I would not use this principal, however, to excuse me from giving you my honest response to your abuse, be it physical violence, or the more subtle but similarly devastating forms: repeated 'put downs', humiliation in front of friends and children, threats to harm others or pets, being controlled financially, invasions of personal privacy, denial of physical warmth or sexual humiliation. People subjected to regular abuse of any kind can begin to lose sight of what is acceptable and unacceptable in relationships. By feeding back my normal reactions to your abuse in an objective informed manner, I would hope to help you regain perspective and appreciate the level of abuse you may have come to (to some extent) excuse and minimise. In this way, I expect you would gradually be able to consider future options: separation, family violence or anger management for your abusive partner, reconciliation.
Answer provided by John Hunter, Counsellor
Answer (3) Therapists carry into their sessions, sometimes unexamined, culturally prescribed 'normal' prescriptions about what is good and poor health, good or dangerous therapy, male and female traits etc.. A therapist urging or not urging a partner to 'seriously consider leaving a particular relationship' depends a lot on their client's ability to fairly represent what goes on the three sides of their relationship (his view, her view and the whole view - remembering that what people say they do and what they actually do in a relationship are often very different); on what they have been told by and what is omitted in the telling of their client; on how savvy the therapist is about the triangle of influence they inevitably join by urging or not urging, and particularly on their views of what is healthy and unhealthy functioning in a relationship.
To one therapist the problems elicited may be an opportunity for growth in the spiritual workshop of intimacy but for another the same problems may be described as a bitter power struggle. May I move this discussion on a bit further by quoting from an article by Frank Pittman.
'Whatever psychotherapy is, it is not about therapeutic neutrality. Therapeutic neutrality is a stance inherited from classical psychoanalysis, in which the silent, passive analyst refuses to react or comment on what the patient is saying or doing, thus encouraging the patient to regress into a "transference neurosis" on the analyst. Needless to say, such unresponsiveness brings forth all manner of crazy emotional responses. Except in classical psychoanalysis, neutrality is not only rude and inappropriate, it also makes you crazy.
Even if a therapist could be neutral about the issues at hand - impossible! - that neutrality would at best bring the therapy to a limping halt and at worst seem to be an endorsement of the client's persistence to barrel the wrong way down a one-way street. One of the horrors of psychotherapy is the affirmation clients may feel from their seemingly neutral therapists that they are "okay" even when they are doing terrible things to themselves and their loved ones. Therapists may actually encourage clients to feel better about themselves by blaming their lives on other people, on the nature of human existence, or on the peculiar mores of the society around them. Therapists should of course help people step out of their crippling state of victimhood.
Good therapy is not a chaste love affair between buyer and seller of psychotherapeutic services. The therapist and the customer don't even have to like one another. The therapy may be working best when you don't like your therapist, when you get the firm impression that your therapist doesn't like you very much either, and when you are being told that you have to do something you don't want to do if you are ever to feel good about yourself. In fact, the therapist is hired to scrutinize you sharply and find something about you that is unlikable and unworkable, and then to help you isolate and discard the offending behavior. If the therapist sees everything the way you do, the therapist would be in the same fix you're in. And if the therapist thinks you're wonderful the way you are and just wants you to realize it, the love affair that results is different from therapy. Therapy is an inherently adversarial process, not an alliance to buffer innocent victims against a world that isn't gentle enough.
Some therapists believe in marriage so strongly they see singlehood as a state of emotional deprivation that is the cause of all the pain in the life of single people. Such therapists may rush people into ill-advised marriages, some of which will work and some of which won't. Other therapists distrust marriage so totally they see it as a dangerously oppressive state of exploitation and impending doom. They assume that any pain a married person suffers is brought on by the marriage. These therapists likely experienced disappointment in their marriages or their parents' marriages. In between are therapists who idealize marriage, and give full support to perfect marriages and short shrift to those with problems. Some therapists, especially those who didn't come in from the Sixties in time, still believe that mental health comes from running away from home, and if people are too old to run away from their parents, they can run away from their marriage.' Frank Pittman
Answer provided by Peter Fox, Clinical Psychologist
Answer (4) I believe that the most effective therapy enables a person to reach his/her own decisions. However, as a therapist I would encourage a person who remains in an abusive relationship to explore why he/she does so. I personally do not think that there is anything called "acceptable abuse", and would not pretend otherwise. In answer to your question, if a client is clearly at risk, whilst the therapist may "remain neutral" by not judging you for your choices, there may be duty of care in the specific situation that includes discussing steps to ensure your safety.
Answer provided by Dr Wendy Sinclair
Answer (5) I tend to agree that the notion of remaining neutral is a myth - isn't it interesting to notice how many replies you're getting to this question? (including this one!!) May I rephrase this to ask to what extent therapists are trained to help you make your own decisions regardless of whether they agree with you or not?
You refer specifically to questions of abuse in relationships - in this as in other matters, opinions, theoretical orientations and trainings vary, so, again as in all matters, I can only speak for myself.
When it appears that the client's wellbeing is in danger and that action is required to get this person safely out of that situation, it is of course vital that the matter be referred without delay to the appropriate authorities, especially where children are involved, but I have no easy answer as to how to make that decision, except to say that in such cases I myself, as therapist, would seek other professionals' opinions and advice.
I think that one of the most important factors in ascertaining that a therapist helps you make your own informed decisions is the therapist's own personal qualities, particularly his or her ability to recognise and seperate his/her feelings, opinions etc from those of the client.
In other words, the therapist's ability to take off their shoes and walk in their clients' shoes.
In quoting the Native American saying, which goes something like "Great Spirit, let me not judge my neighbours before I have walked two miles in their mocassins" we sometimes forget that, in order to walk in somebody else's shoes, we first have to take off our own. This can be one of the most difficult things for anybody to do - we may think that we truly understand somebody else's predicament - and we may believe this in all sincerity and integrity - and we can still sometimes be wrong.
As so many of the beliefs, attitudes, feelings etc that influence our perceptions are unconscious and constitute much of the material that we deal with in therapy, it is my opinion that the single most important factor in a therapist's training is the therapist's own development, and certainly in many therapy training courses the trainees are required to undergo a substantial number of therapy sessions themselves - my first basic training course in London, for example, required me to have a minimum of 150 individual therapy sessions over a three-year period before being allowed to practice, and let me assure you that in my opinion and experience this is a very minimal requirement - I have personally undergone several hundred hours of personal therapy and supervision since.
Unfortunately not all therapy training courses recognise the importance of personal therapy for the therapist - some courses make little or no requirement of the trainees to undergo therapy themselves. In my opinion- and I know that not everybody agrees with me - this makes it harder for them to make the required distinctions and to form a productive and healthy therapeutic alliance. I think it is easier to guide someone on a journey that you have undertaken and perhaps continue to undertake yourself.
Answer provided by Donald Marmara, Somatic Psychotherapist
Answer (6) The task of the therapist is to help the couple understand their relationship with a view to helping them to make an informed decsion as to whether their relationship is a healthy one It goes without saying that if a therpist considers that a situation is dangerous to either of them eg if there are weapons in the house, or escalating violence violence It might be suggested that the couple have a temporary separation until the situation is safer
Re: neutrality. Most effective therapists have had therapy themselves. This is part of the training process so that their biases, conflicts etc are highlighted and managed. It is important that therapists do not work through their own problems by seeing clients. Therapists are also encouraged to have regular supervision to make sure that their work with clients is appropriate.
Answer provided by Susan Alldred-Lugton, Psychologist
