Tell Me More

03.04.13

‘LA Shrinks’ Therapist on What Shrinks Really Think

‘LA Shrinks,’ premiering tonight on Bravo, promises to show what therapists are really like. Rachel Krantz speaks with three therapists to find out what they’re really thinking.

Television’s newest experiment in reality programming, LA Shrinks, premieres tonight on Bravo. The show promises to go behind the scenes to show what therapy—and the personal lives of therapists themselves—is really like. While trying to decode one’s own complexes is nothing new, exactly what’s goes on in your therapist’s mind during sessions is another story. Rachel Krantz spoke with three therapists—including LA Shrinks cast member Eris Huemer—to find out if they’re really listening, what they wish they could tell us, and, yes, if they’ve ever wanted to set us up on a date.

1. Why is it that when you ask your therapist what they think, they always ask: “Well what do you think?

Michael Y. Simon, licensed marriage and family therapist and the author of The Approximate Parent: Discovering the Strategies That Work With Your Teenager:

What makes you feel your therapist is always asking a question when you ask a question? Sorry, couldn’t resist. It’s a technique I don’t use often, but it’s part of the traditional therapeutic response to try to get you focused and attentive to what you think and feel, instead of the therapist’s response. It’s often based on a respect for the client’s ability to find answers based on the material they produce in therapy and eventually for the therapist to become kind of obsolete over time.

Eris Huemer, M.S., M.A., LA Shrinks cast member:

I think that patients should ask their therapists what they think, and that therapists should tell them. I also think they should be allowed to ask them personal questions. There’s this fear that therapy is some ivory tower, that your therapist is some god-like image. You should even ask your therapist if they’ve been in therapy, and if they haven’t, I would really question that.

2. Why am I so worried about whether my therapist likes me?

Drew E. Permut, the author of Inside Your Therapist’s Mind:

It’s almost a universal concern. If you want to know if someone wants to work with you and respects you, that’s fine. If you need the person to like you, then probably that’s one of your issues. Yes, the therapist shouldn’t dislike you, but why is it important that he or she like you so much? That’s probably one of your problems.

M.S.: I think you’re worried because you’re being vulnerable and open, and it’s scary, and just like in any relationship, when you show what’s inside, you want the person who sees it to like what they see. But, of course, it can be more complicated. You may have come to believe through early-childhood experience that you have to be a particular way to truly get someone’s attention.

3. A recent New York Times piece suggested many therapists fantasize about setting up their patients. Is that true?

E.H.: Of course! Not to mention you get asked by patients all the time, “Don’t you have any single friends?” I would love to, if I could. I always want to help my clients get a life that they want and deserve. A lot of times, as therapists, we’re attracted to broken birds. We want to just help them find that job or find that relationship. Of course that’s not ethical. That would get in the way of therapy. They have to find that strength in themselves.

D.P.: Sure. But everything we think and feel as therapists, we analyze ourselves. If we think we want to set someone up, it may be because we feel her sense of hopelessness. If she evokes that feeling in me, she probably evokes that feeling in lots of people. So then the question is, why can’t she do it for herself? The same thing if you find yourself thinking, I’d like to get a drink with this patient, and be his friend. Maybe that means this guy is talking to me in a way that feels like he would with a buddy in order to deflect from getting to the real issues.

4. What else do you often wish you could say to your patients?

E.H.: Sometimes I just want to say “Get over it! You’re so hanging onto these problems, and you’re not living in the solutions.” You want to tell them to stop focusing on the little things and get over it. But you can’t do that. Because people have to do things in their own process.

M.S.: I’d like my clients to know that when they are vulnerable or mess up or feel weak or struggling, I don’t feel negatively about them. When I’m with someone who is really struggling, I generally get saturated with a kind of enormous respect and admiration for that person’s willingness to show that they are human.

5. Sometimes I wonder if my therapist is really interested in what I’m saying. How can I know?

M.S.: I’d say ask your therapist, rather than trying to guess whether they are. That’s one cool thing about the therapy relationship: you can ask things that you might not normally ask “in real life,” as my clients put it. You might sometimes want to ask your friends “Hey, are you bored with me?” or “Are you uninterested right now?” but many people are scared to ask.  But, the cool thing is, if you feel safe enough in therapy, you can just ask—you don’t have to guess!

E.H.: If you don’t intuitively feel that your therapist is connected, or that they don’t genuinely care, then you need question your relationship. If a lot of times the therapist just says “uh uh, uh uh,” and is very quiet and not as collaborative, that’s a warning sign. In my practice, I’m constantly challenging my client, I’m constantly having direct interaction with them, so they know I’m connected.

6. Why can’t my therapist ever just tell me what to do?

D.P.: Therapy is supposed to be about helping the person develop themselves and their own capacities. If you become the person that answers questions and gives advice, in a way what you’re doing is preventing the person from developing themselves.

M.S.: I’ll tell you what to do. I have no problem with that. Here goes: Dude, get a good night’s sleep. You work too hard.

7. Can I ask my therapist to give me his/her notes on me?

M.S.: In most cases you have the legal right to request a copy of your therapist’s notes. It isn’t always a good idea for everyone though. It has to be addressed on a case-by-case basis. Talking about why you want them, how you’d use them, and about the implications of the request can be very meaningful. So, yes, you can ask, but no, it won’t always happen, or be a good idea.

8. What’s the big trend in psychoanalysis these days?

E.H.: I’m finding more that more short-term, solution-focused therapy is something that patients are wanting to do, rather than long-term care. Also, evidence-based practices are popular in mental health right now. Meaning, there are proven interventions that work, for specific problems, and there’s evidence-based treatment for those problems.

9. How do you avoid getting too emotionally attached to me as a client? I mean, I’m very loveable.

M.S.: I’m supposed to feel somewhat attached to you. That’s normal and healthy. In my particular therapeutic approach, if we don’t have an actual relationship, it’s very hard to help you. But I have to learn how to separate from my clinical work life and be very good at understanding, articulating, and managing my emotions and physical (stress) reactions in relation to the work.

10. Be honest: Do you even have a long-term plan for us?

D.P.: It’s actually both long-term and week-to-week problem solving. The therapist has to have an overall idea of where you’re going. For example, somebody comes in, and they’re having problems at work. They’re a chronic procrastinator. In the course of getting to know this person, you realize they grew up with very critical parents, making them afraid to submit work. But you may decide we’re not going to talk about their family history right away—we’re going to have to get to that obviously—but there are things this person needs to navigate immediately at work. So you’re saying, I know where we’re going, but let’s deal with this practical issue now.

M.S.: There had better be a long-term plan, with every client. It’s sort of like what Yogi Berra said, “You’ve got to be very careful if you don’t know where you’re going, because you might not get there.” Or more to the point, there is a long-term plan, but it doesn’t mean I always know what will happen in advance. Sometimes I have to improvise, based upon a certain grammar I develop with my client. The closest activity to psychotherapy, in my view, is jazz. I know it’s a bit elliptical, but the long-term plan is usually to collaborate in making excellent, authentic music.