Author: David Helfgott, Psy.D.

The Client who didn’t get Anything out of Therapy

The client had been away for two weeks on vacation and had initially scheduled session for the day following her return. But a few days beforehand, she called to cancel and said she would call back to reschedule. I followed up with her a few days later. She said she’s going to hold off on treatment for now and is not sure if she’ll resume. I said I respected her decision and would wait to hear from her further, that my door is always open for her to resume our work. She contacted me two weeks later to say she wanted to come in to explain. When we ultimately met in session she says she didn’t want me to think she had taken therapy lightly; that she had really been trying. But she alluded to way sessions would always start: that she had nothing to say and was upset she had to be the one starting- that she cannot just talk about nonsense, why must I force her to make such silly small talk about her week, and that she needed to go deeper into her psyche, complaining that I never asked her deep questions, that I never made deep interpretations. Now, I know for certain that we had had some incredibly deep sessions, filled with flowing tears, marked with revelatory “aha” moments, moments of contemplative silence following an...

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The Jerk: A Dynamic in Couples Counseling

One of the couples I see weekly struggles with issues that are, unfortunately, so common to us all. He complains about her nagging him all the time over “silly” things, while she says the things she complains about are not “silly,” and his saying so invalidates her legitimate concerns. This is one of the many cyclical patterns in their marriage which perpetuates an unsatisfying and even miserable life together. But in one particular session, I tried to look more closely at his experience of her “nagging.” The first thing that struck me was that many of the things she “nagged” about were regarding actual mistakes, mental errors and general imprecision in his statements. This resonated with my present experience of him as well: in the days leading up to our most recent session, where some adjustments to the scheduling were needed to accommodate commitments on their end, I found him to be quite confused over the phone. He seemed to having trouble locking in one time, putting it into his calendar and then repeating it back to me. Perhaps he was preoccupied… I don’t know. But when I moved to explore it during this session, he glossed over it, downplayed his confusion, and then said, “well, I don’t want you to think I’m a jerk or anything…” and then changed the topic to his recent frustration regarding his elderly...

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Bearing Fruit

A few weeks ago, I wrote about a session I had had with a middle age man who was struggling with several things that had begun to break down in his life, such as his health, his job, and most pressingly, his marriage. His wife had “checked out” of the marriage long ago and had been living with another man, much to my client’s chagrin. However, as I had noted, it was long before he decided to do anything about it, the first step being finding a therapist. The main point of my article was the Countertransferential moment whereby this man interpersonally conveyed to me the silent suffering he was almost accustomed to going through, and not being “allowed” to say anything about it. Here is a small excerpt of the thoughts I had about him from that article: “Every week he would present another almost absurd way his wife had disgraced their marriage and disregarded both him and their daughter that lived at home with him. Why had he put up with that situation for so long?… For him, it [likely] mirrored his teenage years during which he lived without his biological father together with his mother and her new husband. She had several other children with him and would often tell my client how unwanted and “in the way” he was… But… he “put up with” the...

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Where did all the Anger Go?

She “bitches” at him, and normally he just takes it; he looks the other way and lets it roll off his back. In my therapy with this couple, we have been working on identifying the pattern that recurs over and over again. She’s always nit-picking and he “chooses his battles.” In public, however, when she gets mad at him in ways he feels others can overhear, he gets very mad at her; he becomes embarrassed and finally blows up, and finally brings up all those times in private that he didn’t say anything in return, as if he was waiting for an excuse to finally let her have it. In exploring deeper, we learned that the manner in which she criticizes him is as a parent would do with a disorganized and careless child who constantly needs reminding, prompting, structuring, etc… And when it occurs in front of other people, he becomes afraid people will actually see him that way: as lazy, a do-nothing, an incompetent loser. But we were still left with questions in our sessions: Is she mostly right? Or is he oversensitive? Does she do this with everyone: treating most people around her as needing her help because she feels best about herself when she is in charge and is taking care of everyone around her? Or is she truly pointing out an unfortunate character flaw...

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What is Countertransference?

Today a client was putting me fast asleep. No sedative or hard drink could have done a more masterful job than this client. He had me bobbing and weaving for at least a few minutes while simultaneously I was feeling absolutely horrible that I had become that tired and was struggling so mightily to keep awake and attentive to him! What was I to do? One term that floats around in psychotherapeutic jargon that many patients find rather mysterious and some therapists might even call obsolete is “Countertransference.” This term has been defined then redefined repeatedly over the many decades since Freud. Originally, it meant the private thoughts and feelings a therapist has while with a client that artificially restrict the ways the therapist can understand the client’s problems. These feelings need to be recognized and “removed from the treatment,” so as not to distract the therapist from properly understanding the client’s life. Over the many decades through which psychotherapy has evolved, Countertransference has come to take on a whole new meaning. While it still does refer to the particular way a therapist thinks and feels about a client, it now is seen as a source of invaluable information and therapeutic power, rather than of distraction. While a therapist still needs to recognize the particular way they understand a client, the treatment actually benefits from the therapist learning from...

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