Common Therapist Mistakes Part 4: Colluding in “either/or” Thinking

In my last blog, I talked about ways to avoid answering direct questions when they are a function of projection. I hope the take away was that since the client is projecting, the issue may not be about you at all. Therefore, it is best to help your client process the projection rather than just answer the question. Often times, you never have to go back and answer the original question. Another common mistake when processing projections is assuming that you know what your client needs and try to fulfill that need. In the case of a client wondering if you are frustrated, this might occur in the form of “either/or” thinking. Either you were frustrated or you weren’t. Even after asking the questions described in the previous blog, it may be a natural inclination for you to think your client still needs to hear you reassure them. The following is usually even more powerful.

Teach Clients to Identify What’s Needed from Self and Other

The conversation with Lindsay (described in the previous blog) went on to encourage her to identify what she would need from herself if I had been mad, and what she would need from me if I had been mad.

Me: So, Lindsay, when someone is mad at you, what do you need to do for yourself?

Lindsay: I don’t know, I just want to make them stop being mad at me.

Me: Of course, that would be nice, but I believe that you can’t always make that happen or even if you can, there might be a part of you that wouldn’t believe them no matter what they did.

Lindsay: I probably need to remind myself that I can’t be perfect, or that I’m doing the best I can. I could also validate that I had done nothing wrong, if that’s the case.

Me: I like that. Supporting yourself is helpful because only you can really know what your needs and intentions are.

Lindsay: I always criticize myself when someone is mad at me, even if it’s a misunderstanding.

Me: When you wondered if I was mad at you, what could you have done for yourself?

Lindsay: (after a long pause) I could have told myself that it’s okay to inconvenience someone if I am really in need.

Me: That’s a great resolution of your ambivalence of whether you should have called. Both can be true: that you are in need and someone might be inconvenienced. I believe it is okay to inconvenience someone a little if it helps you a lot. So, what do you need from a person if they are mad or inconvenienced?

Lindsay: It would be nice to know that being mad at me doesn’t mean that I’ll be rejected.

Me: How could you find out?

Lindsay: I guess I could just ask if you still cared about me even though I had inconvenienced you.

Me: When you ask a question like that, I think it is both strong and vulnerable, which is a nice combination to have in relationships. When you came in today, you seemed mad. I think it was because you were assuming that I would be mad and possibly reject you, so you were beating me to the punch. It’s great that you can just state that you need to know if I still care even if I was inconvenienced. That’s really what you wanted to know and is much more important than whether I was mad.

Thus, it wasn’t about if I was mad or I wasn’t - something much more important was at stake. Lindsay needed to know that people could get mad at her and still care about her since that is something that would happen throughout her life. If I was too quick to reassure her that I was not mad, we would’ve missed an opportunity for expanding her grasp of the complexities of relationships.

My book A Clinician’s Guide to Pathological Ambivalence: How to Be on Your Client’s Side Without Taking a Side can teach you how to avoid this and other common therapeutic mistakes by developing skills to work directly on resolving ambivalence. I would love to hear from you. Please scroll down to the bottom of this page (past the banner of recent posts) to leave a comment.