Healthy Therapy Demands Clarifying Roles and Challenging Myths

To this day I am reminded of an analogy that came to me during my first year of graduate school. At the time, I had been thinking about the role of mental health therapists and the client’s responsibility in therapy. I had also been considering the relationship and dynamic of a healthy therapeutic process.


The image was of two people walking slowly together in the dark. The therapist holds the flashlight for the client to better see what lies before them. As the therapist shines the light, perhaps illuminating a fork in the trail, discerning exploration takes place investigating the consequences of choosing one path versus the other. Therapist helps the client in reviewing similar paths that were previously selected, evaluating benefits, dangers and repercussions. Old narratives are explored so that the client can make an informed and knowledgeable decision as to which direction reflects healthy change. Past decisions may have promulgated by unbalanced or deficit-based influences at the time, including negative views the client held of themselves or choices that were derivative of an unhealthy relationship or in response to trauma.

This process provides invaluable insight into how life experiences influenced us in the past, evaluating which choice would reflect a healthy departure from old ones that caused harmful symptoms. Unhealthy habits and self-talk are identified, inciting the client to now make healthful choices because they can now more clearly see which path will decrease symptoms and improve wellbeing.

And again, further down the path, another fork. As the therapist shines the light, the client learns to more clearly see the direction that is healthiest for them. Because of this therapeutic process of self-reflection and self-discovery, clients liberate themselves from impulsive and consequential choices. In this way, the therapeutic process continues and the client learns for themselves how to identify outdated and unhealthy influences. Then, they can choose a healthier direction moving forward. This metaphor illustrates the role of therapist as explorer and reflector, using relevant therapeutic modalities. The client, ultimately, is the driver and decision-maker.


This analogy defies common lore which dictates that therapists have all the answers and can ‘fix’ people. The therapist shines the light and provides support and skills, but the client makes their own choices and activates themselves.

Let’s look at some myths.

The therapist has better access to important information.
The therapist is more powerful than the person seeking change.
The therapist has all the answers.

When mental health therapists behave as if they know the inner world of a person better than the person knows, it puts those in therapy at a disadvantage. It also eliminates numerous opportunities that would otherwise exist for the person to begin to trust inner wisdom. It doesn’t allow them to tap into resources for calm, confidence, reassurance, self-compassion, creativity, insight, and other positive qualities. The goal of healthy therapy is for the person seeking help to advance from reliance on the therapist to being in the driver’s seat of therapy, to being co-therapist, to becoming his or her own therapist. An individual will continue to seek redemption, love, affection, acceptance, re-parenting, and everything else he or she needs from a therapist if the therapist enables this dependency through significant over-giving, knowing, and authorizing.

Similarly, when a therapist maintains the misconception that they have it all together and are nearly flawless in their behavior, communication, relationships, emotional intelligence, and the like, it sets an unrealistic expectation for the person in therapy. It also encourages an unjustified idealization of the therapist. This unrealistic expectation can reinforce shame and self-doubt for people in therapy rather than reinforcing the idea that we’re all OK, even with our flaws and limitations. The shame and doubt leads to self-criticism and contempt. This in turn leads people to want to get rid of the parts of themselves they don’t like.


Sadly, there are some mental health therapists who still advocate for the removal or mental/emotional amputation of certain human aspects because they are destructive or self-destructive. This method does not lead to wholeness, health, or happiness. Instead, the underlying burdens which fuel the destructive behavior are not addressed. There is an akido to psychotherapy that Carl Rogers referred to when he wrote, “The curious paradox is that when I accept myself just as I am, then I can change.” By not emotionally amputating an aspect of a person and, instead, by bringing it closer, a person has a chance to change.

It’s in the best interest of people in therapy for mental health therapists not to focus on removing flaws, but rather to set the example that we’re all born loving, lovable human beings who are doing the best we can based on our experience and the physiological limitations with which we were born.

Certainly, there are a small percentage of individuals who are born without the capacity for empathy or remorse. However, this doesn’t mean that they are necessarily evil or unlovable. There are countless resources about sociopathy. The point is that very few of those in therapy are born with the issues they have. They might have predispositions or propensities for certain coping mechanisms or symptoms. However the issues people struggle with are largely a result of life experience, not always chemical imbalance. Any chemical imbalance is often a symptom, not a cause. The fact is we all suffer, we all struggle, we all face challenges, even therapists.

At its best, effective therapy encourages us to accept and love ourselves, despite our limitations and difficulties. Mental health therapists have many beautiful opportunities to help make this shift happen through recognizing and treating people with the dignity they deserve. But first, therapists need to find their own humility, self-compassion, and self-acceptance. Only then will a therapist see those coming to them for help as people.

When a therapist sees a patient, therapy is not being done. When a therapist sees a person walk through the door, half of the therapy is already done.

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