I drew some interesting criticism with my blog post Therapy: A Customer Service Profession?.  Several of my fellow therapists wondered about me as a therapist, whether I was too reactive to the client I wrote about, and what it said about my professional skills and/or perspective.

Since self-evaluation is part of the therapy process for our clients, it seems important that we engage in it ourselves.  So, what makes a good therapist?

In graduate school, I was told that in therapy, the relationship is a primary source of healing.  There were studies that said interns got as good (or better) results than more experienced therapists, because their clients felt so cared for.

I like that idea.  It rings true with a lot of my professional experiences.

But I’m wondering if it’s less and less true.  Is the healing relationship an antiquated notion, out of touch with where our culture is going? Take the experience I had last week, for example.

I was just meeting with a client and discussing a situation where she was demeaned by her boss at work in front of her colleagues.  Should she speak up or not?  That is the question.

Since I’ve been on a self-esteem/self-worth jag on my blog of late, it seemed only natural to ponder that question here.

We learn to parent, to a large extent, by having been the children of particular people.  What I mean is, we saw what parenting looked like up close throughout our childhoods.  Once we’re parents ourselves, we get a chance to imitate, or to do it differently.

This can often be more fraught than it sounds.

I had a professor who once said that there’s nothing useful about  comparing our pain to other people’s.  What she meant is, our pain is our own, and there’s no sense in judging it.  The sense is in accepting it.

She wasn’t talking about dialectical behavior therapy, though she could have been.  Because DBT attributes a lot of our subjective suffering to the judgments we place upon ourselves.

It’s a crucial relationship commandment: Know thy partner’s buttons.  What I mean is, learn what provokes a strong reaction in your partner (even if it makes no sense to you, especially if it makes no sense to you.)

In Ben Affleck’s Best Picture acceptance speech, he didn’t sprinkle his wife Jennifer Garner with accolades.  Instead, he thanked her for working with him all these years.  ”Marriage is work,” he said, “and there’s no one I’d rather work with.”

Since then, there’s been speculation that his marriage is on the rocks.  I thought his speech signified the opposite: that their marriage is a living breathing organism, and they tend to it.

My client–we’ll call her Marta–alternately cries and acts tough: “I don’t need anyone…will anyone ever really love me?…screw it.”   Her latest boyfriend is just like all the rest, with lots of promises and very little payoff.

Marta has been traumatized.  First, as a child, and now, as an adult, she continues to put herself in harm’s way and choose bad bets as partners, which leads to retraumatization.  It reinforces the belief that she is, in fact, unlovable, and that people don’t really love and treat each other well anyway.  It’s a grim view of the world.

Clients leave therapy for a number of reasons.  Some of them relate to the skill of the therapist; some relate to the readiness of the client; some just to circumstance.

I believe that a good therapist is supposed to make herself obsolete (i.e. help the clients reach goals so they can move on from therapy, help them create other emotionally supportive relationships in their lives.)  But with that said, some clients are facing intractable or chronic problems, or consistently encountering new ones.  So sometimes, I get to know them for a while, sometimes years.

Ultimately, though, it’s a finite relationship, and that means eventually, I’ll have to say goodbye.

We’re not really supposed to speak about money in polite company.  Therapists who are incredibly comfortable talking to their clients about sex and intimacy and even abuse can balk when it comes to discussing their clients’ finances.  In some ways, it feels like the last taboo.

But money does affect mental health, and it can certainly affect our relationships.