Dr. Phil is great at his job. He cuts straight to the heart of the issue, elicits an emotional response from clients, and gets people to commit to making changes (whether they are ready to do so or not). Though he may be a bit like a bull in a china shop, what he lacks in finesse he makes up for in fortitude and enthusiasm. This is part of his appeal; viewers enjoy his direct, take-no-prisoners approach.
But this is not exactly what happens in your average therapist’s office.
In most cases, therapy is more like an archaeological dig; the client and therapist root around and sift through layers of history to make sense of things. Problems are identified by a particular shard or clue, which leads to a greater understanding of patterns and the interaction between self and environment.
Frequently (and increasingly, given managed care), goals are identified, and therapist and client embark upon a journey of exploration to create solutions and generally make things better.
What’s essential is that the client be involved in devising such solutions, so that they reflect her circumstances and goals. In other words, therapy is about the client’s needs, rather than the therapist’s agenda or Neilsen ratings.
I know, it sounds boring. It’s much less exciting than the high drama of Dr. Phil. In reality, therapists rarely say things like, “Stop doing that!” or, “Wouldya cut that out?”
And that’s exactly the point.
There are some issues which are appropriately suited to the stage tactics of Dr. Phil, or, for that matter, an advice columnist in your local paper. For example: “My son refuses to turn off the TV in his room, and spends hours watching his favorite shows instead of doing his homework. What should I do?” The solution is straightforward: “Take the TV out of his room.” (Duh.)
Whereas it’s obvious that such an exchange is not actual therapy, people assume that this advice-at-the-ready approach can be generalized to other, more nuanced and multi-dimensional problems, such as how to co-parent with a difficult ex or whether to invite your mother-in-law to move in with you.
Recently, many of my clients have come to therapy for quick answers to overwhelmingly profound questions. The underlying assumption is that, as a degreed and licensed therapist, I have omniscient powers which dwarf their own.
The best example of this was the couple who sought my help, and, after one 50-minute session asked, “Should we get a divorce?”
They were clearly desperate, and had agonized for years about whether to stay together. Despite (or perhaps because of) such desperation, they were not interested in addressing issues or diving into their murky relational waters; they did not want to invest in therapy as a way to engage with each other and, by so doing, decide whether theirs was a union worth saving. They wanted me to tell them what to do and be done with it.
Clients often hope that their therapist will reveal The Truth and provide them with The Answer, in the same way that a soothsayer (or Dr. Phil) might. Those who are desperate, scared, or just plain tired of thinking and feeling and wondering, might hope to be rescued, delivered from problems which seem intractable and unassailable.
It’s likely that this is a universal fantasy, something we all experience at times. On a symbolic level, it probably represents a desire to return to childhood, to be cuddled and told what to do by a loving, parental figure. And to be relieved of the burden associated with making a difficult decision.
Though shows like Dr. Phil didn’t create this fantasy, they certainly perpetuate it. And they give people false hope that therapy will provide an easy answer, one that doesn’t involve struggle or introspection.
Which brings us to another part of the problem: advice, though often sought, is rarely taken. Before people attempt therapy, they usually ask friends and family what to do. It’s likely that they’ve told others about their slacker boyfriend who refuses to get a job and spends his days surfing the internet. And it’s equally likely that the predictable suggestion (“Ditch that dude!”) has been ignored.
Why are we so likely to reject advice? At times, it may be because we believe that the advice is poor; we just don’t like it. In other instances, we don’t want to hear feedback from others because they have not walked in our shoes, and don’t truly understand our experience.
Alternately, we might feel weak-willed or submissive if we heed someone’s advice, so we prioritize our need for autonomy and self-determination over our need for resolution. Finally, we might discard suggestions because we’re not ready to hear them, even if we know they’re spot-on.
In short, advice-giving is often ineffective. People make changes when they are ready to do so, and when motivation comes from within. This is why, though guests agree to stop their self-destructive behavior in front of the cameras and under extreme pressure, they may not actually do so once they leave Dr. Phil’s stage. Techniques that make for great TV do not necessarily make for great therapy.
So next time your therapist declines your request for advice, or offers a mere suggestion rather than an absolute mandate, you might (after your frustration subsides) consider that she is doing you a favor. Sometimes, a therapist’s best answer is, “I don’t know.”
Because ultimately, you’ll find out for yourself. And you’ll know much more than any therapist—including Dr. Phil—could ever tell you.