How Do You Prevent A Client From Giving Over Too Much Power To You As A Therapist?

This is one of the questions that I was asked the other day and I thought it was an interesting and fascinating one. What does power really mean in the context of the therapy office, and what steps can (and should) the therapist take to make it knowable?

A client often arrives in my office feeling some combination of confused, embarrassed, depressed, bewildered, hopeless, isolated, anxious, shy and scared. They may or may not have some idea of the origins of their discomfort, but they are frequently in a state of extreme vulnerability.

Unfortunately, many therapists often have little awareness of just how much authority we have when we meet with the client who walks through our door in such a state of susceptibility. From the (oftentimes) big desks, to the psychology books on the shelves and the diplomas on the wall, all these things conspire to convey authority and power. That power has in turn often been sanctioned not just by educational institutions, but by State licensing bodies, institutions that the therapist is employed by or affiliated with and referring bodies and collateral agencies that a therapist is allied with.

But our real power lies not just with the physical accoutrements of our profession, but with our ability to define reality for a client. Given that clients arrive in a state of vulnerability, I am imbued with a huge amount of power to recognize the struggle facing an individual client, and to assist them in defining how they could navigate the complex world differently in order to re-emerge in better psychological shape. How powerful a skill-set is that in the face of a client’s fear that there is no way out of their predicament?

Whether it is our intention to convey this perspective or not, clients will often hears our words as, “I, the therapist, know better than you. Lean on me only. Trust me only.” Our job is to help a client understand that it is they who have the power to change, by changing their perceived relationship to the world/people/things they fear. Until that goal has been achieved, the therapist is seen as the conduit, as having the power to accompany the client through what they believe to be an impasse; it is part of our work to help our client to challenge their prevailing belief system. (“I am weak. I will always be at the mercy of my mother/husband/lover/friend/foe. I will always feel this way. I will never be free of self-defeating thoughts. I will never have a partner. I will never have what I want in life. I will never figure out how to identify and achieve what I want in life, etc.”)

So, in answer to the question, “How do we prevent a client from giving over too much power to us, as therapists?” I think the obvious answer is to talk about the nature of the perceived power in the room.

In practical ways, how this can translate is to:

* Have a conversation about the ways in which the client sees the therapist as powerful. How does this power translate for each client? In what ways does the client feel dis-empowered in the therapy room? In what ways do they feel that their power is being marginalized or minimized by you, the therapist? Does the client feel that this is the only place in their world that they are, and will ever be, successful? What changes can be made so that the power imbalance is made known and is constantly factored into the therapy?

* Foster an environment of relational equals. The therapist needs to be clear that there are limits to his or her power and knowledge, and that this needs to be communicated to a client. Beyond the level of that power and knowledge, lies a whole world of learning for each therapist – some of this learning happens in the context of therapy with that client. The client should understand that their job is to begin to rely increasingly on their ability to think independently and to trust their internal experience and rely on their internal judgments. The therapist’s opinions, view and ideas are no substitute for those of the client, who is the real expert on their life.

* Help a client understand how therapy is important, but it is only just one of several important supportive tools that can be used to grow the life that you truly desire. There are other supportive mechanisms that can be used: community groups, support groups, improving friendship networks, 12 step groups, interest groups, faith-based groups.

* Restrict the number of sessions a client tries to attend. For most purposes, attending therapy once a week is more than enough time for an individual client to make substantial changes in their life. Unless there are extenuating circumstances in a client’s life, entailing substantial emotional upheaval (i.e. severe depression, imminent loss of parent, divorce, miscarriage, etc.) I usually restrict the number of therapy sessions a client attends to one per week. Permitting more sessions than is needed sends a message that it is only through the therapist that the client can re-emerge into their life fully. This idea can and should be challenged by the therapist.