How do I become a good therapist?

The single most important charge for any of us to truly be a good therapist is a commitment to knowing deeply our own emotional self, personally and professionally.

In my role as a supervisor to recently credentialed professionals with an interest in psychoanalytic therapy , I find myself answering one question repeatedly: “How do I become a good therapist?”
The answer is multifaceted. Theory is necessary. It provides a framework and model from which we understand the workings of a human mind. Reading is helpful. It keeps us involved in the community of colleagues and ideas. And ongoing supervision is vital. It tempers our blind spots and the demand to know. Yet the single most important charge for any of us to truly be a good therapist is a commitment to knowing deeply our own emotional self , personally and professionally through an ongoing commitment to individual and group therapy.
I don’t mean the basics of family origin and birth order. I mean the ugly, painful, shameful parts, and those parts that have yet emerged in analysis. As we begin work as new clinicians trauma, loss, hate, misrecognition and the injuries that spawned our defences still obstruct and ghost the affective dynamics present in relationships with our self and others. Those parts of our mind and body are revealed as we engage deeply with a patient who mirrors what is not yet conscious in us. It’s hard to see ourselves clearly when we look from within our own filters, but often times, a patient provides us with this opportunity as feelings in the here and now arise, shadowed by a lived past.
As an analytic therapist who works with early developmental phases where the self and object world are in the process of emerging from a more undifferentiated state, I am responsible for knowing myself as a person and as a clinician as best as I can. I am charged with exploring and integrating my own defended and unacknowledged developmental states in order to work with them in my patients. What is a defended developmental state? That definition varies by literature. I understand it as an experiential sense within us, with its unique personal sensations, feelings, associations, thoughts, and fantasies born in developmentally important eras of our life. When these states are aroused, they seep into the present experience and haunt it.
In therapeutic relationships, we are transported to these states and in time begin to see the developmental origins and learn their contours and terrains. Typically these states are emotionally stimulating so we need others to walk there with us. Once there, the supervisor or analyst working with us helps us study and describe the scene so we come to know them with words. They help us see the past separate from the present, to see the overlay.
In any good healing practice, be it psychoanalytic or meditative or shamanistic, we travel to these states over and over, leaving breadcrumbs in our wake. That way the next time we find ourselves entering one, we recognize where we are headed, what lives there and how we walk back out to our centered, observing self. The point is not to cure but to integrate these states so we may fluidly move between them while maintaining our observing self to provide language and historical narratives for the strong feelings. Or we return with an intuitive gut impression that is a different kind of knowing. All means are employed to map the terrain. The more parts of ourselves we have access to and have access to in another, the more the right and left brain are integrated, the more we have then to offer for those who work with us.
These unconscious landscapes are not to be mastered and left behind. The un and nonconscious, and the conscious are always present together in time. They coexist. Freud’s archaeological metaphor is apt here. At any one moment, the many-layered pasts are present though not perhaps accessible to consciousness. These are states we come to know and sense in ourselves and the people we work with in order to better be with them and ourselves. In an ideal world, we move seamlessly between them when our internal and interpersonal lives awaken them. In gaining a more full awareness of our experience at each stage we are provided with an opportunity to utter words where there were none, thus developing new abilities to organize and integrate experience and then communicate it to ourselves and others.
Simultaneously we allow for the feelings however intense they may be. It’s a lot to bear and process, but it makes us more spacious and deep, and this growth and humility, in turn, makes us more empathic, dynamic, and astute clinicians. If we have not explored these ephemeral and concrete worlds in ourselves, how can we sense them, experience them, and work through them in others? The greater our ability to intimate our early life experiences, the less they automatically control our actions and relationships in and out of the office. Also, greater is our ability as clinicians to sense the defended and unthought experiences of those we work with and to meet them with attuned intervention. We all have stories we believe about others and ourselves that inform our reactions. Let’s be curious about them and how they were written.
We use the language we generate in therapy and deep supervision to name and describe the entirety of our formative experiences. We learn to tell our stories as we felt them then and live them now. This is difficult work. This is anxious work. Our vulnerabilities resist the exploration and tender exposures at every turn. Still, there are no shortcuts to becoming a good therapist?
Jordan Price is a psychotherapist with a private practice in Austin, Texas. He specializes in group, individual, and couples therapy. He is a graduate of the Center for Group Studies in New York City and actively engages in training and growth. Jordan enjoys writing, presenting, and working with colleagues. He has psychiatric hospital experience working with psychological severity which helps him be with people in any condition. Jordan continues to study with an emphasis on the coupling of affect regulation and psychoanalytic approaches. He blends what he learns in this field with his love for the outdoors and music.
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