Good therapists question themselves all the time. It’s called “professional self-doubt”, and the good thing is that it means they are always questioning their methods and actively seeking growth with each client. I try to practice this. Sometimes it’s hard, and I take this question to my supervisor. Am I doing enough? Am I therapy-ing enough? Do I need to take six more trainings this year? (The training glutton in me says: unequivocally yes). Could I learn more? Should I do more? And these are good questions to ask, because it means you never get to rest on your laurels. It can also get exhausting.
My clinical supervisor said something reassuring a while ago. “They’re getting a corrective experience no matter what”. She knows I could fall down a bottomless vortex of wondering whether I am doing enough in therapy. Except when it works, because then it is seamless and magical, like playing music: completely in flow. The most effective thing in any therapy, of any variety, is simply the relationship itself. A good therapeutic relationship is effective enough, no matter how many trainings that therapist attended that year. So, for a therapist, there is always a tension between always wanting to learn more, and knowing that the relationship is enough.
People come to therapy thinking they’re going to get one thing, but the thing that works for them is usually another. People come to trauma therapy especially thinking that they are going to “get to the bottom of it”, find a way to tell the excruciating story, and that in telling that story they will be healed. That’s not how it works, not even close. Actually, I have clients who have successfully completed therapy never having once told the story of the traumatic event.
The most crucial thing I can offer is mostly invisible: it’s attunement. I love that it has music in its name, because it is also a transformative force that you can’t see, and it’s difficult to even begin to articulate what makes it so powerfully transformative. But will I try? You bet I will.
Attunement is a quality of a relationship: it’s a steadiness, a reliability, a kind of deep attentiveness, a kind of regard for the other person that has a thread of adoration weaving through it. It’s more than kindness. It’s a devotional kind of effort to really see the other person in their wholeness, paired with an honest effort to meet their needs.
Attunement is where all intimacy is really built.
The best example I can give of attunement is a good-enough parent with a new baby. There is a lot of time spent gazing at the baby, taking in every aspect of them with every sense. When the baby signals a need, the attuned parent calmly meets that need, reliably, soothingly, every time. The more we drink them in, the more we sense them, smelling their hair and the milk on their breath, touching our cheeks to their soft velvety cheeks, feeling their weight as they sleep on us, gazing into their eyes like they are portals to another world, the more we soak them up with our senses, the more our brains change to be capable of nurture. They change us. They imprint themselves on us. And I imagine that the message the baby gets is that they have solidly landed in this world, that they are welcome, that there is nothing to fear, and that they are irresistibly loveable no matter what.
To me, that sounds like a pretty good way to feel. To feel likeable, loveable, no matter what. A lot of us lose that feeling along the way. And some of us never had it to begin with.
When people come to therapy, they come for all sorts of reasons they can name and far more that they can’t. They might say they are experiencing anxiety or depression, or a deep hopelessness or lack of purpose. They might have thoughts that keep them up at night, or feel distant or desperate in their relationships.
I pay attention. I listen to their words, and the arc of their stories, but I also listen for what they don’t say. I get curious about it. I notice the tension on the brow, the catch of breath, the shoulders up around the ears, the head dipping down with shame. I match my energy to the person I’m with, and I even modulate my tone of voice to meet them: offering strength to match their anger, softness to make some space for vulnerability. Sometimes, when a person has been badly hurt or neglected, it’s painful or uncomfortable to receive my attention like this: we talk through it, but I don’t stop. Attunement an essential ingredient.
After a long time as a therapist, I’ve realized a few things. One is that it’s impossible to say the right thing at the right time. Words fail. One is that the learning will never end, and that’s a good thing. But the biggest one is just the magic of being together.