Sunday, July 14, 2013

Dear Young Therapist: Don't Be Afraid to Love

"Graduation" by Caroll Lewis
Dear Young Therapist:

Love is a word you've probably not heard in your training. It's probably not appeared in your textbooks, been a topic in seminars, or come up in conversations with your clinical supervisors.

If you've talked about love at all, you've probably talked about avoiding it. You might have even been taught that love is a hinderance to therapy.

The messages about love that I've learned in the past twenty-one years of clinical practice are clear. Love is something that must not be discussed between patient and psychotherapist. It certainly is not something to be experienced--and if it is--it should be concealed and unspoken. Love is too dangerous. It is too confusing. The risks are too great. Patients get confused in therapeutic relationships and mistake care for love. Some patients, traumatized by violence, are too fragile to understand that love does not have to be sexual.

Perhaps you've been taught to be neutral, objective, relatively non-emotional, and essentially impersonal. Perhaps you've even been taught that it's useful to deprive your patients of the emotional connection they want in order to foster growth and achievement of therapeutic goals.

I was admonished by a supervisor once for gratifying a terminally ill patient's needs by expressing care for him. She was concerned that I wasn't giving him the opportunity to work through his infantile infintile (thanks CS for finding my parapraxis) dependency needs.

Later, as a postdoctoral fellow, I was taught to never tell a patient that I was proud of them. It was explained that it was too complex of a feeling and patients would get easily confused. I must not ever express love or pride. Patients need to learn to accept the limitations of the therapeutic relationship so they can learn to tolerate not getting their needs met in their other relationships.

I've also learned some other things along the way.


  • I wasn't even 20 years old when I had an internship at a rape crisis center. I was left alone in a room to be supportive and helpful for people who endured unimaginable traumas. I had no skills, no words of advice, and certainly no therapeutic interventions. I did the only thing I knew how to do: I cared deeply for my patients and loved them. I never said a word of this, of course. I had already absorbed the notion that love is an unmentionable word in clinical contexts. Still, this was the first time I became aware that expressing care and concern (and genuinely caring and being concerned) for people--in and of itself--can be healing. 
  • Two years later I was living in Ithaca, New York. It was my last day working at a supervised apartment program for adults who had developmental disabilities and mental illness. The residents threw a surprise party for me. I walked into one of the apartments to do my last check and I was surprised with a song. After a rousing chorus of "For He's a Jolly Good Fellow" each one of the residents and staff gave me a hug. Most of the residents whispered in my ear that they loved me. I whispered quietly into each of their ears "I love you too." I worried what people would think but said it anyway. It was true.
  • Two years after that I sat on the back stoop of a shelter for runaway and throwaway teens. A male resident had ran away from the runaway shelter. As he was thinking of returning, I sat with him while he raged against the world and how poorly he had been treated. I looked at him with all the love in my heart. I remained silent fearing what would happen if he heard those words. 
  • Three years later I sat with an gentleman in his late 50s. He'd been diagnosed with HIV before the virus even had a name. He was having a bad day--filled with pain from the side effects of his medications. He was afraid of dying alone. I sat next to him on the couch and held his hand. I loved him and wished I had the courage to tell him that.
  • Three years later, I met two women that forever changed the course of my career. My supervisors and teachers, Robin Cook-Nobles and Judy Jordan, regularly--and fearlessly--talked, taught, and told me that it was okay (and powerful) to love my patients in appropriate ways. I vividly remember the rainy afternoon Robin said that it was okay to love patients, and okay to talk about it. I've never heard a psychologist say that aloud before. I've never heard a psychologist say it again since leaving the Stone Center.
  • Later that year I drove to do the oral section of the second part of my comprehensive examinations. My intervention, though concealed with flashy prose and the relational cultural model of the Stone Center, rested in my love of my patient and this song. I almost failed. My intervention was not seen as a strong one. I was not doing things like I was supposed to--I failed to conform to accepted protocols. My stubbornness and belief in the inherent worth of my patient carried the day. I passed.
  • A few years after that, as a post-doctoral fellow, I worked with a rather ornery teenager. Rather than talk with me and tell me how much he disliked me and the rest of the world, he sprawled himself out on the couch and pretended to sleep. Every so often one eye would peep open to see if I was still paying attention. I sat for the entire hour focused on him, loving him, and imaging how his parents might have (or might not have) just sat gazing at him with love when he was a tiny baby. My supervisor, Louise Ryder, seemed moved to tears when I told her this story. I was too. 


I've developed a good deal of technical brilliance in the last twenty-one years of working with people. I can create masterful interventions in a variety of modalities and nimbly conceptualize people and problems from a variety of theoretical orientations. You'll need to learn how to do this too, young therapist. It's a necessary part of learning to be a good at what we do.

Technique and skill, however, are not enough. Don't let yourself dwell too much thinking you are something special. Most trained monkeys can develop technical brilliance with the number of hours we spend in supervision and class.

There are more important things that cannot be taught. They must be discovered.

You'll need to learn to loveLoving patients is a dangerous method. Yet in the end, I think you'll learn that it is the only method that you'll keep by your side--day in and day out--for your entire career.

Love is the only method and theory that I have. It is the place from which every action I take as a psychologist originates from--at least on days in which I am not cranky. I suspect many other therapists, of all training and orientations, would discover the same after wading through years of injunctions against and fear about love.

When I graduated from high school my mother gave me the book her mother gave to her when she graduated from high school. In some ways, this passage started my development as a psychologist. Vicktor Frankl writes in his book Man's Search for Meaning:

Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him. By his love he is enabled to see the essential traits and features in the beloved person; and even more, he sees that which is potential in him, which is not yet actualized but yet ought to be actualized. Furthermore, by his love, the loving person enables the beloved person to actualize these potentialities. By making him aware of what he can be and of what he should become, he makes these potentialities come true.

More recently, reading Gail Hornstein's book To Redeem on Person is to Redeem the World: The Life of Frieda Fromm-Reichmann,  I came across this passage from Erich Fromm's book The Anatomy of Human Destructiveness:

To have faith means to dare, to think the unthinkable, yet to act within the limits of the realistically possible; it is the paradoxical hope to expect the Messiah every day, yet not to lose heart when he has not come at the appointed hour. This hope is not passive and it is not patient; on the contrary, it is impatient and active, looking for every possibility of action within the realm of the real possibilities. 

So there you have it. Love and Faith. The two bookends of my professional practice as a psychologist. Deceptively simple. Incredibly powerful. Often scorned by the professional community.

I'm old enough to no longer care how my fellow psychologists evaluate me. I'm skilled enough to know how to wield these twin tools of relational growth and change within the safe boundaries of a therapeutic relationship.

I'm thankful that I've never met a patient that I couldn't love or couldn't learn to love. It's from that space that I begin to see the seeds of where a person might be able to go, grow, and let go. It's from that space that I can find the confidence to let go of wanting a patient to be something I need them to be (or society needs them to be) and let them go about finding what they need themselves to be.

Still, young therapist, I don't frequently tell my patients that I love them. It is often dangerous and disruptive to use the word. Patients can become incredibly confused and conflicted. Too many therapists also become confused and conflicted.

Just because love is dangerous, doesn't mean it shouldn't be thought about.

I am not afraid to love and to say that I do when a moment of genuine honesty is the best intervention. Don't forget this, young therapist. Don't forget that our work is built on a foundation of faith in humanity and love of the person who sits across from you.

The flashy (or boring) masterful interventions and protocols you learn are necessary. Caring and loving and believing in humanity is necessary. Neither, on their own, is enough to accomplish much of anything. Joined together you have the possibility for movement and growth.

You need to both become a master at your craft and a master at loving a fellow human being--being with a patient, loving them, caring for them, and having faith in them--in combination with masterful interventions--that allows another person to find themselves.

We wither and die alone.

We grow in connection with others. We grow in being loved by another. We grow in finding that after all we've experienced, you've got the love inside--it's been there all along.





I had a dream that our hearts are like flowers
opening up every time that we love
and I'm wondering if we just try and risk everything for love
how can we ever go wrong
Nobody said it would be easy
nobody said it would be fair
all we can do is try to keep our fears from running us
just let our innocence be our cure


For more letters to a young therapist see Dear Young Therapist: Don't Be Afraid of the DarkDear Young Therapist: That Time My House Burnt DownDear Young Therapist: Cultivate Patience and Listen to the MusicDear Young Therapist: Consider Your De Rigueur Requirements | The Post-Doctoral Tie IncidentDear Young Therapist: Are You Ready to JumpDear Young Therapist: Perspective is EverythingDear Young Therapist: Sometimes We Can't Put Humpty Back Together AgainDear Young Therapist: Sometimes Race and Sex MatterDear Young Therapist: Don't Be Afraid to Love; and Dear Young Therapist: Allow for the Unexpected.

44 comments:

  1. Awesome. Great work Jason! :)

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  2. Beautiful post, Jason.

    "I was admonished by a supervisor once for gratifying a terminally ill patient's needs by expressing care for him. She was concerned that I wasn't giving him the opportunity to work through his infintile dependency needs."

    Your parapraxis here is perfect, but what a small, narrow, frightened person your supervisor sounds on that occassion. At the end of life we understand that the meaning of life is to love and be loved. Not to work through our infantile dependency needs.

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    1. Well now that's a total hoot. I'm a bit sad to correct that typo.

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  3. What an incredibly wise and touching letter you have written, not only to young therapists, but to everyone, therapist or not. A reminder to love. How pleased I am to know that Victor Frankl's Man's Search for Meaning has provided you with a touchstone. If I had to choose just one book that had the most powerful effect on informing my philosophy of life I would have to choose Frankel's book. I had the good fortune to read these life altering words at the tender age of 18. More than 40 years later, Frankl's words still echo their power...first to your mother (this writer), and now to you.

    In giving yourself permission to love your clients, you are also giving them permission to love themselves. In writing what you have written, you have extended that permission to young therapists...and you have also extended an invitation--and a reminder to all who read your words--to love.

    Love,
    MIP (Mother of the Irreverent Psychologist)

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  4. On the assumption that love is not going to break ethical boundaries and creates issues, love can be acknowledged. Nonetheless, may better to be understood as "care with respect and esteem" to a client.

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  5. Perhaps the best way to think of loving a client is to place love within the concept of Roger's unconditional positive regard, emphatic understanding, and congruence. When placed within this context, love is less emotional and more therapeutically oriented.

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    1. ... "perhaps the best way to think of love.... " - the best way for whom, I wonder?

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    2. Thank you, I saw this on a night when I was feeling total despair as a client.

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    3. I'm glad you found it at precisely the moment you needed it.

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  6. "...Loving patients is a dangerous method..." I am confused - does this not seem like a counter-transferential situation? Does loving a client breach the ethical boundary of avoiding dual relationships? Unconditional positive regard differs from "love", does it not?

    Perhaps all of this concern/confusion stems from my being one of the proverbial "young therapists" - I officially started practicing in March. Undoubtedly, the technical/theoretical principles and jargon are still fresh in my mind and continue to (will always) influence my actions.

    Cheers!

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  7. Jason, Thanks so much for opening up this subject! I've been 'practicing' for over 30 years and can still remember the very first time I fully opened up my heart and soul to love as a therapist.
    I was called in to a local prison to deal with an in-mate on a hunger strike. He was a convicted serial killer and I didn't think I could deal with him due to the heinousness of his crimes.
    When I entered the room I saw a weak, mentally ill (diagnosed paranoid schizophrenic) confused human being shackled to a hospital bed. I went to sit near him (much to the concern of the guards) and engaged a strange allegorical conversation. I noticed the self-made tat of H.A.T.E. on his fist. During that conversation I felt such a welling up of Love for this person. Here was a man who came into this world as someone's innocent and pure of heart child! I finally experienced what my father, a very wise and talented psychiatrist, had been trying to impart to me for all those years: Make the distinction; Love the person, but not the behaviour!
    I am forever grateful to that man for helping me to connect with my own humanity through Love.
    I whole heartedly echo your wise words "Young therapists, don't be afraid to love"

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  8. The topic of love..... that word is so loaded and certainly means different things to different people.

    "Again we are deeply helpful, when we risk ourselves as persons in the relationship, when we experience the other person as a person in his/her own right, only then is there a meeting at a depth that dissolves the pain of aloneness in both client and therapist"
    - Carl Rogers -

    Rogers didn't put a name to that experience, but if one can call that "therapeutic love", then that's what I strive for every day.

    Awesome thread, thanks Jason!

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  9. Seldom have I ever read a post that has moved me so much or has resonated with my own beliefs about what really works in therapy. Thank you for daring to say it as it is and to fly in the face of all the conventional theoretical wisdom about frustrating dependency needs to aid psychological development. Love within appropriate boundaries, as you said, can be felt and conveyed without words and it is this precious yet scarce commodity that is truly transformative and healing for clients to perceive in their therapists. I have never found a client yet in the 12 years that I have been practicing whom I could not find anything lovable about. To find this and work with it with genuine curiosity is a good place to start in the therapeutic process. Thank you, Jason for highlighting this important issue for trainees, supervisors and experienced therapists alike. Perhaps we all need to examine ourselves and our own genuine experience of being with clients with more honesty and transparency like you have done.

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  10. Jason,

    I am sad - although not altogether surprised - that when you write so heartily about love, that some respond by wanting to reframe it and use more safe, sanitized language. Fair enough, if that's the way you work. But I wonder - if you sequester the loving feelings you (we all) have away from your client, aren't you withholding something vital? Something essentially human? And aren't the clients going to pick up on that sometime? It suggests a willingness to *not* be fully available in relationship, which puzzles me a bit. But that's my way of working....

    Person-centred readers would do well to consider "love" as distinct from "UPR"...

    "What does it mean for a person to possess the quality of tenderness in all its fullness? .... it is without shame, because it is experienced as the joyful embracing of the desire to love ...."

    -Brian Thorne, "The Quality of Tenderness" - The Norwich Centre, 2004

    The wonderfully tender Thorne goes on to say - "I am reminded of WH Auden's reflection 'we must love one another or die'. These reflections of mine are (about) what it might mean, to risk loving..."

    I like what you've written, Jason, because it has so much heart.

    With love

    Ian

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  11. What a provocative article. I don't know if a lot of clinicians would have the courage to say what you did. We are so afraid of lawsuits, but isn't love why we got into this profession? I have often felt that same regret you explain here that I cannot (don't allow myself?) to respond to a client's "I love you." Like you, I worked for a time at a rape crisis center and that creates a bond unlike any other. But with any client, I wonder, how you can possibly nurture someone's development without love? There's been a few clients, yes, that I definitely didn't feel the love for, but for the most part there was love there. Sad that those who would pervert the definition of love by preying upon the vulnerable have made us all so cautious of the word. You have inspired me stop being so afraid of the word, and open up even more. Thank you!
    Glad to "meet" you Jason and looking forward to following you in the future.

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  12. Jason,
    Seldom have I ever read a post that has moved me so much or has resonated with my own beliefs about what really works in therapy. Thank you for daring to say it as it is and to fly in the face of all the conventional theoretical wisdom about frustrating dependency needs to aid psychological development. Love within appropriate boundaries, as you said, can be felt and conveyed without words and it is this precious yet scarce commodity that is truly transformative and healing for clients to perceive in their therapists. I have never found a client yet in the 12 years that I have been practicing whom I could not find anything lovable about. To find this and work with it with genuine curiosity is a good place to start in the therapeutic process. Thank you, Jason for highlighting this important issue for trainees, supervisors and experienced therapists alike. Perhaps we all need to examine ourselves and our own genuine experience of being with clients with more honesty and transparency like you have done.

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  13. Thank you for this thread. It was a beautiful post that resonates strongly with how I see my place as therapist. I am a "young therapist", having just graduated and entering my internship. I feel lucky to have gone through a grad program that taught me that love is what we do (at least as I see it). When I sit with clients I am loving them unconditionally, taking in their stories and seeing their potential. From that place of altruistic love I can journey with them to their best lives, to the achievement of their goals.

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  14. As I approach my first experience in internship I will remember this.
    Thank you

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  15. Love this topic Jason. I think it highlights whether one comes from a diagnostic point of view versus that of really caring and wanting to help people heal. It is being able to look at someone as a soul in this journey of life dealing with their own inner struggles, finding the little child within that also just wanted to be loved and seen as special by their parents. Love is what therapy and coaching is all about for me - being able to honour another soul and witnessing their journey and being there for them as a loving container providing a safe space to explore themselves and find out who the real person is beneath all the the layers of masks. Great topic!

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  16. I just finished my internship and came away from it with the understanding that being of service to my clients involved loving them. For some of them they had never known that kind of unconditional love. This is what we all long for...to be loved by someone for who we are. Thanks Jason.

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  17. Thank you for writing this post. I recall my internship days and expressing clearly to my training supervisor that I was surprised no one had told me that I would love some of my clients....he looked at me as if I had 2 heads! I work with throwaway teens. As a grown woman with maternal instinct it would be impossible for me to shut down the love that develops for some of my clients...it would also be detrimental to some of them not to experience such unconditional loving regard. I often talk to my young clients about love in many of it's forms. Healthy love, unhealthy "love", addicted "love", transient love etc. We all love...and the least of those among us experience many awful consequences to a lack of love and nurturance. It is high time our field gives up it's hyper cerebral approach. Bravo to your supervisors who allowed you to cultivate an understanding of love in the therapy process!

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  18. So many of our clients share the same primal wounding, wrought from poor and lack luster parenting. Our addicted society sees to the rest. What better underscore than love emanating from a skilled counselor, who can help walk the client through redressing that wounding? Without Love, counseling becomes just another barren wasteland of unfulfilled promises and hopes.

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  19. Great stuff man. I think too often we are driven by fear. Afraid that if I as the therapist open my heart, I will be unable to stop, or that it will become about my needs. Your post speaks so well to this dilemma. Nice work!

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  20. Thanks for saying out loud what so many of us have been thinking: that we can and do love our clients.

    I was fortunate to have had parents who expressed and showed love for me when I was a child. I have been able to pass that on to my own children. I am saddened when I think of so many clients who have never had this kind of love, let alone unconditional positive regard. When they start coming to see me and they realize they can say what's truly on their heart, without being chastised or otherwise punished, it can truly be transformative. They are experiencing the healing power of love.

    And, as you mention, I also tell my clients that I am proud of them. When a client who was having deep anxiety about driving following an accident 18 months ago recently drove herself to my office, I was truly proud of her and enthusiastically told her so. The beaming look on her face was all I needed to confirm that my response was on target.

    I don't tell my clients that I love them. I don't want them to become confused or become focused on that. I don't want to undermine the therapeutic relationship. Yet the love is there.

    I am not a new or young therapist. But this message was still important for me to hear. It affirms that my way of doing therapy is good, even though it was not taught in grad school. As time goes on, I become less diagnostic (take that, DSM-5!), and less confined to particular theories or techniques. Rather, I have all those things in my toolbox, and I use whatever tool works for the job, along with my love and passion for my work and for people. It is more instinctual, more intuitive, and more respectful and loving toward the whole person.

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  21. Dear Jason, thanks a lot for bringing up this topic. Reading it was like speaking out what was in my mind. I think it is very important to have the background knowledge, the skills to translate this into hands on interventions, the curiosity towards life, the creativity and open- mindedness in your approach; but at the end you won't go very far with all of this if love was not what drives your engine: love for the individual, empathy for his/ her circumstances, absolut and unconditional acceptance and deeply felt respect. I think clients that went through an Odyssey of different therapist just feel the difference. It opens their heart. Their often hurt souls. It allows trust which is often so hard to get when they had went through a lot of hardships. It's that what makes the true difference: true and serious love openly and unconditionally given to them!

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  22. Great paradox recommendation: Love is something that should be concealed and unspoken. Love is too dangerous. It is too confusing!
    Thanks a lot!

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  23. This is all great stuff and a reminder that even love can be dangerous, it should definitely be thought about but when it comes to patient and therapist relationship, patients learn to love and trust their therapist in order to open up themselves and therapist in return should appreciate the faith that these patients have in them in order to truly help them.

    - KathieRayAnnis.com

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  24. As someone who is still in the early years of my practice, I have found that "love" was sometimes the main thing that was missing in the vocabulary of the teens I was working with. They needed to know that they could act up as much as they needed to but I could still find something to love about them. I could not help but fall in "love" anyway again and again with these beautiful young people and what I could see within them. I feel I know my boundaries and am confident that I have been trained and are competent with the needed skills and these guard that I don't offer them something more than a truthful affirmation of them as a human being. Sometimes their emotional life had been so impaired that they have never seen their selves truly reflected in the eyes of a someone who accepts them and yes - someone who loves them.

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  25. Thank you. Loved this text.. I'll never forget the words of my therapy mentor: "Hannah, if you love you can never do nothing wrong with a patient." And i have loved..which have made the work much more than work or therapy.

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  26. As a patient who is losing her therapist after 7 years, as he is moving out of NYS, I would have and still would appreciate hearing that he is proud of me, that he will miss me and that he loved me with all my flaws. His boundaries are so strong, that my special hope is he will at least hug me when we have our last appointment in October. I truly believe if a therapist humanized his or herself, the transference issues would lessen. One flaw would have taken him off the pedestal he's been on all these years in my mind - it would have made us more equal. It would be really nice to just know my therapist cared about me as a person and whether I got better rather than sticking to the therapeutic boundary-driven approach to therapy. I agree totally with your Post - and also with the Letters to a Young Therapist by Mary Piper - again she expressed she loved her patients also. Thank you.

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  27. If I speak in the tongues[a] of men or of angels, but do not have love, I am only a resounding gong or a clanging cymbal. 2 If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but do not have love, I am nothing. 3 If I give all I possess to the poor and give over my body to hardship that I may boast,[b] but do not have love, I gain nothing.

    4 Love is patient, love is kind. It does not envy, it does not boast, it is not proud. 5 It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. 6 Love does not delight in evil but rejoices with the truth. 7 It always protects, always trusts, always hopes, always perseveres.

    8 Love never fails. But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away. 9 For we know in part and we prophesy in part, 10 but when completeness comes, what is in part disappears. 11 When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put the ways of childhood behind me. 12 For now we see only a reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.

    13 And now these three remain: faith, hope and love. But the greatest of these is love

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  28. A view from the other side of the room: on my first visit with my therapist, deeply suicidal and devoid of hope, at the end of the session she said to me, "My heart has opened to you, and I would really like to work with you." I interpreted it at the time as just a touchy-feely granola phrase, a flowery way to say, "You don't bug me too much, so you can come back." :) With time, as she helped me find my way out of the dark, I learned she wasn't kidding: she filled our room with deep, abiding, unwavering, unconditional love. She didn't talk about it, didn't say it--her boundaries were rock solid--but I felt it in a way I never have in my life. And that is what was able to reach the deepest, most enduring wounds I carried, and enabled me to begin healing that part of me that other therapists could not.

    Young therapists: whenever you can, whenever you feel it, let those feelings of love suffuse your body. You don't have to say it--and it's probably best, in most circumstances, that you don't, because words can be misinterpreted--but if it is authentic and embraced by you, your client will feel it. And, bathed in that medium, the human organism can heal and grow and become gorgeously whole.

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  29. I love this article because I have often wondered why this one word never really appears in the overabundance of psychotherapy books on the market. I also speak from the other side of the room, now entering my transition/termination period after 4 1/2 years of therapy. I am a survivor of childhood trauma. I will admit reading a ton of therapy books about psychotherapy, the therapeutic relationship, warm feelings, and transference as well as books about trauma and abuse. I read them for the most part because I was so afraid of the feelings I started to feel after being numb for so long. I guess you could say I was in a panic, fearing all the feelings that were coming to the surface, including one that at first I didn't "get" at all. The books were helpful in that they provided some background information and insight. But I can tell you that when I have been in the room with my therapist I have so palpably felt powerful feelings of love that seemed to just fill the room, seep underneath my walls, reach out to me in my isolation, and eventually begin to melt the walls I had built. The love I have felt from and towards my therapist has been that real to me. It is not sexual, nor romantic, but more like a platonic kind of love and caring. What I have personally experienced is that this kind of love is very healing and can reach places which have been unreachable. As the previous poster so eloquently stated, "I felt it in a way I never have in my life. And that is what was able to reach the deepest, most enduring wounds I carried, and enabled me to begin healing that part of me that other therapists could not."


    My therapist also has firm boundaries, but at the same time he is flexible because he wants to make sure his interventions are healing and life affirming. He doesn't talk about love much at all. But he makes himself available for check-in calls when I need them. He also gives safe hugs. I have seen tears in his eyes when I have shared some things about my past. He listens so well.
    He normalizes my feelings and things I did to survive. He holds my feelings. He is patient and very kind. When I sit in therapy with him love fills the room, seeps into my life and my heart, and seems to merge with my therapy and add depth to my healing in such a way that seems transformational. I will admit that there are times when I still don't understand everything that happens in therapy. The intense feelings that come up continue to baffle me because of their intensity, and because they are from a long time ago. They feel very real. The pain, grief, and sadness feel very real. These are feelings that are coming up for me as we transition/terminate the therapy, along with feelings of love towards my therapist because of his help, our connection, and how he has been with me in therapy, albeit his kindness, patience, honesty, and treating me with respect and like I am someone who is worthy of his care.

    Thanks again for this article, and even more for having the courage to speak about love in psychotherapy for all the right reasons. If you have any insights on how to integrate this love into termination and beyond, I would love to read what you have to share. With respect to trauma, forming an attachment, feeling safe to tell, and then growing so close to a therapist, it just seems when termination comes around it can feel incredibly painful and scary. At least that's how it feels for me. But I also feel a great deal of love and gratitude for my therapist. It is just hard to think about not having contact with him after all of the work we have done.

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    1. Thanks so much for your thoughtful response, Kimberly. I'm glad you found a therapist that helped you find some of these wonderful gifts. I think a bit about your questions and respond later this weekend.

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  30. This is my second time reading this (any bringing it up in one of my MSW classes) and I just continue to be so inspired by the message presented here...seriously, when I graduate, can I come do my supervision for my LCSW with you...??

    Keep up the great work and thank you for your love and honesty,
    Gianna

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    1. Hi Gianna,

      I'm glad my post has inspired you! I hope you make part of it your own and bring it into the world your own way.

      I'm fairly sure all our different counseling professions like to be exclusive with supervision for licensure and social workers have to be supervised by social workers, counselors by counselors, and psychologists by psychologists. I do occasionally have a supervisee or two. That's one of my favorite things to do.

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  31. I would say that I feel love for my client, as a therapist for 20 years. It is far too dangerous to tell them this, obviously, because, as has been said by others here, the word is far too open to interpretation of so many kinds. It's very common for clients to be 'in love' with their therapist, and for the therapist to say he or she loves them could result in confusion, pain, therapeutic disaster. I remember early in my career telling a client that I liked her (I'm male), when she'd asked, and she became very confused and left therapy with no resolution. I've never done anything similar since. You have to be careful with your client's feelings, you have to take care of their feelings. A lot of what has been said on here is sentimental, and about the therapist feeling good, not about caring for their clients.
    Also it is patronising to say you are 'proud' of your clients. It sounds as if you think you are responsible for their doing something good, as if you've brought it about through your actions, not that they've done it themselves. You are not the client's parent!

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    1. One of the most difficult things, I find, is when therapists become so embedded within one theoretical orientation that they are unable to conceive that there are other possibilities of how our work can be conceptualized and executed. There are nearly as many kinds of therapies as their are therapists. Some place the emphasis on withholding gratification of the needs of patients, others focus on technological interventions, and still others focus on the nature and contour of the relationship that develops within the room.

      From a relational model, it is neither useful or helpful to avoid any of my emotional experiences. They all represent information to be used in the moment, set aside for later, or bracketed off to inform my own personal work. Just because talking about caring feelings is difficult, or fraught with potential for misunderstandings, does not mean it should be avoided.

      You mention that a therapist has to "be careful" with a patient's feelings and "take care" of them. I find it rather imperious and infantalizing to give myself the power (and think I had it to begin with) to decide what is right for my patients outside of issues of safety and abuse. It also is incongruent with my theoretical orientation. I regularly talk with patients about burn out, boredom, warm feelings, annoyance, and whatever else becomes a relevant topic of therapeutic work.

      My DBT training encouraged me--and demanded of me--to become emotionally aware enough to be able to discuss my own emotional experiences in appropriate therapeutic ways when the work calls for it. My training at the Stone Center also encouraged and demanded that I learn about what brings me (and patients) into and out of a relational connection. My Gestalt training encouraged me to be aware of the relational space I enter into with patients, and my analytic training taught me the importance of the intersubjective space and how the emotional experience happens within that place.

      It's not easy work, but it's important. I dare not think patients can do the work of knowing their own feelings if am cannot be present enough to know what mine are and share them when therapeutically appropriate

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  32. I am struggling to understand how "a lot of what's been said on here is not about caring for clients". Was I wrong in thinking that this was in fact the whole point of the piece?

    FWIW, In my experience, the word "sentimental" is used to describe feelings (usually in other people) that we find less than acceptable, or embarassing.

    "After all research on psychotherapy is accounted for, psychotherapy still resolves itself into a relationship best subsumed by the word 'love'. " Burton (1967)

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  33. Cambridge PsychiatristMarch 21, 2014 at 10:10 PM

    Beautifully written, and incredibly true. Thank you for writing and posting your encouragement to Love as an essential part of therapy. I struggle, with letting myself love the ones I treat, out of years of being trained that it was verboten and taboo. Luckily, my own therapist and supervisors share your view - I find your piece a very reassuring read. I've linked to it through my Facebook, LinkedIn, & reddit. Thank you! :)

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  34. I am a young therapist about to graduate with an MSW. This article was incredibly validating. In the end, our "toolkit" may get bigger and bigger, but our instincts and our capacity to love are what ultimately guide our work. Thank you for writing this.

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  35. Thank you for writing this article.

    I know my therapist loves me and that knowledge alone has been the most therapeutic part of my treatment. And I'm not talking about sexual or romantic love. As a teenager who has been rejected, mistreated or 'loved' conditionally by just about everyone in my life, including my family, I can assure you that there is nothing more helpful anyone can do than to just love me for who I am.

    Personally, I find it more confusing when a therapist is kind and sympathetic while simultaneously being somewhat cold and emotionally detached, than when they just like me, plain and simple. Sometimes I can practically see them trying to distance themselves from the situation I am trying to describe to them and I sometimes take it as invalidation, even though logically I know they're just trying to protect themselves. My therapist, on the other hand, just listens and I've even seen the occasional tear.

    Keep writing posts like this :)

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  36. Can't stop crying.. article touched something deeply.. thank you for this..

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