What Should The Relationship Between Psychologist And Patient Be Like?
The psychotherapy process is, above all, a dynamic that is established between the psychotherapist and the patient(s).
However, that doesn’t mean it’s just a conversation; Beyond the words of the dialogue, there is something more: a therapeutic relationship that allows something like training to be established. The psychologist “trains” the patient in new ways of behaving, feeling and thinking.
However… What should the relationship between psychologist and patient be like? In this article we are going to make a brief comment about it.
The relationship between the psychologist and the patient: main requirements
Although even today going to a psychologist is a relatively unusual and still slightly stigmatized action for part of the population, fortunately it is becoming more and more common that when a person suffers from some type of psychological problem they seek professional help. Through interaction, professional and user establish a link through which to work.
This bond that is aspired to in therapy, sometimes called “rapport”, must be worked on over time in order to be able to offer an optimal service.
We understand the therapeutic relationship to be professional bond that is forged between therapist and patient and that is aimed at treating one or more specific aspects or problems that hinder the quality of life of the patient or their environment and that the former wants to change. This relationship must always be based on mutual respect, and especially focused on the figure of the patient or user.
If the therapeutic relationship is positive, the achievement of results is facilitated regardless of the technique to be used, the subject does not feel confused and easily shares their thoughts and emotions with the professional and promotes willingness to change. The aim is to create a climate and environment in which the patient can feel protected
At the therapist level, it is necessary to manifest a certain level of proximity in which the subject can feel accepted and heard. The presence of empathy and cordiality in the professional also helps. Likewise, authenticity is also relevant: the ability to be yourself and respond honestly to the questions generated during consultation. Finally, it is worth highlighting the absence of judgment towards the patient, active listening, interest in others and the search for their well-being as basic elements of this relationship.
Professional help
One thing must be kept in mind: a psychologist is a professional who is offering a service and who is charging for it. This implies that we are in the middle of a professional relationship, in which, although it is inevitable and desirable that a certain connection or even affection appear, we should not confuse said bond with other types of relationships. Thus, the relationship between psychologist and patient is not neither friendship nor any other type that is not professional
If this is so, it is for a good reason: the relationship between both people seeks for the patient to achieve solve a problem that you do not see yourself capable of solving on your own, and requires professional help in which the psychologist must be objective in order to find a way to achieve the patient’s well-being. Likewise, one of the parties has all the information about the other while the second party knows practically nothing about the other.
Transfer and countertransference
Two of the most famous and at the same time most important concepts regarding the relationship between psychologist and patient come from psychoanalysis, these being the terms transference and countertransference.
Transference refers to the projection by the patient of the patterns of behavior, upbringing, affection or desire that they felt towards another person in the figure of the therapist. Although the transfer itself is to a certain extent positive since it allows this information to be externalized The truth is that taken to the extreme it can make you think about the existence of strong feelings that cannot be reciprocated due to the type of relationship that both people have. In other words, transference can be considered as the set of reactions that the therapist generates in the patient.
Transfer is understood as a positive element that allows us to work on various topics that otherwise might not arise. However, it must be appreciated that the transference can also lead to the appearance of excessively intense feelings towards the therapist, to the point of falling in love or hatred. These will have to be worked on in therapy.
On the other hand we can find countertransference, or the set of emotions and feelings that the patient can awaken in the therapist. Although a certain countertransference will obviously appear in most therapeutic processes, the professional must first be able to identify these emotions and subsequently act as objectively as possible, and if necessary should refer the patient. This countertransference is usually valued as negative, since it limits the objectivity of the psychologist and can have an effect on the therapeutic relationship itself.
Directivity level
One of the elements to be assessed in the relationship between psychologist and patient is the level of directivity of the former in the session. The psychologist is a professional who has trained for years in the field of the human psyche and its alterations, possessing extensive knowledge regarding behavioral patterns, but this does not imply that it is simply going to tell us what we should do. There will be times when a psychologist is more directive and indicates more clearly the guidelines to follow in the intervention, while in others the role will be more passive, acting as a guide that leads the patient to find their own answers.
There is no one way of acting that is more valid than another at a universal level, but this will depend on the patient, their problems and their personality, as well as the level of collaboration between psychologist and patient or the objectives of the intervention. There will be patient profiles that require one way or another of action. In general, today it is intended promote autonomy of the patient and that he is able to find his own answers.
Valuing language
Another aspect to take into account is the language we use. It must be appreciated that psychologists are going to deal with a large number of people from very different backgrounds and educational levels. Thus It is necessary to adapt the language so that it is understandable by the patient, doing it naturally.
Likewise, the use of technicalities may be something that reflects knowledge on the part of the professional, but we must remember that the patient is in consultation seeking to solve a problem and not admire our cultural level.
A human soul touching another human soul
Although it is important to be clear that the relationship between psychologist and patient is a professional bond, given in a therapeutic context and in which the psychologist must be objective, this does not imply falling into a relatively common mistake: coldness
It is not strange that many professionals, especially if they have just started although this is not necessary, maintain a slightly distant attitude and think and express themselves only in terms of treatment or focused on the problem. But although the intention that many of them have is to make a separation that does not confuse the patient between what is a professional and personal relationship, Excessive distancing makes it much more difficult for them to feel understood by the professional and even trust him.
And we must not lose sight of the fact that the main basis of all good treatment, one of the main elements of any type of therapy, is the establishment of a good therapeutic relationship.
Feeling understood and valued by the professional is something that in itself is therapeutic, and should be favored by both parties. An open and close attitude, which reflects unconditional acceptance towards the patient and active listening to what they say and worry about, are in fact some of the aspects that are most close and at the same time most productive in order to promote a change in the patient. Let us also not forget that whoever becomes a psychologist He does it because he wants to help others so they can live their lives without limitations and without excessive suffering that allows a normal life.
Doubts about the therapeutic relationship
As is already known, a large number of people with different problems come to a psychologist’s office. The psychology professional will try to respond to the demands that come to him in which he sees himself competent, trying as much as possible to be a useful help for the resolution of the problems, both expressed and not, for which he is consulted ( referring to other professionals if they do not feel competent). However, It is common for patients to have doubts due to misunderstanding of some elements typical of psychological therapy.
Below we will see a series of problems and doubts that some people have had regarding consulting with a psychology professional.
1. Client vs Patient: what am I?
Although psychologists generally tend to talk about the people who come to them as patients, It is also not unusual for them to be referred to as clients or users Some people may interpret this name as strange, but this issue is easily explained. At an etymological level, a patient is considered a subject who suffers from an illness and who requires external action to solve his or her problem. In this procedure the subject is a passive entity that receives the solution to his problem.
However, in psychology, individuals who come to consultation will have to make a series of behavioral and cognitive efforts if they want to solve their problems, with the psychologist being a guide or help to achieve this goal but always maintaining the individual an active role in their recovery This is why some professionals prefer to call the people who come to their office clients or users rather than patients.
It is only a way of referring to those who come for consultation, and whether they are called patients, clients or users, in practice the processes and operation of the therapy and sessions will be the same (the main methodological variations being those due to the different currents that exist in psychology).
2. Lack of comforting response to emotional expressions
This aspect, although it can be taken for insensitivity on the part of the therapist, does not have to be. It must be taken into account that the psychologist You should try to be objective and observe the situation from a distance in order to be able to help the patient in the most efficient way, although it is true that the professional must establish a relationship of trust with the person who comes to the consultation so that they can speak sincerely.
Furthermore, cutting off the patient’s emotional expression can be counterproductive, since Altered emotional states can allow us to focus attention on the underlying reason for them and awaken the patient’s own understanding of phenomena that were previously unknown.
Likewise, it must also be taken into account that throughout the day a psychology professional sees multiple cases of people with very diverse problems, so they must know how to put an emotional distance with their patients in order for their personal life and his own psyche, as well as those of subsequent patients, are not affected.
However, it is true that some professionals try to take this into account so much that they appear somewhat cold, which in turn can be counterproductive as the patient does not feel that their emotions are legitimate We must remember that the psychologist deals with people.
3. The one who talks the most is me
It is common for many psychologists to wait a relatively long time before speaking, with some awkward silences in the sessions. These periods of silence are intended to give the patient time to prepare their speech and dares to express ideas that would not be related in a shorter period. Thus, it is intended that he/she explore and declare the thoughts that come to mind regarding the questions previously raised, no matter how absurd he/she believes they may sound. This may reflect contents of great importance for the treatment.
They also allow the professional to reflect on the most useful methodologies to apply according to the information that the patient relates, restructuring what he knows about the individual in question and achieving a deeper understanding of the case.
It must also be taken into account that The professional’s level of directiveness varies depending on the theoretical current he or she follows Despite this, it is a fundamental requirement that the professional actively listen to what the patient tells him.
4. My psychologist tells me things that are not what I ask him about
This issue appears in many cases as one of the issues that patients/clients/users understand the least. It is common for the patient to explain a problem to a therapist and the therapist links it to something that is apparently secondary to the first one.
In these cases, it is possible that the therapist has considered that the problem for which the patient is consulted is due to another phenomenon that is considered of minor importance by the patient. Thus, The aim is to work on the underlying cause of the problem referred to trying to attack its possible cause more directly.
5. Therapy is unpleasant for me
This aspect can be highly conflictive. Many people come to consultation with a specific problem about which they have a specific point of view. However, the actions that the professional may advise may clash with the user’s expectations, and some of the propositions may be adverse and contrary to the user’s wishes.
It is necessary to keep in mind that even though some of the professionals’ recommendations may not be pleasant for the person who receives them, the therapist will always try to find the best possible method or the one that has proven most useful in most cases. cases to help solve your problem. Examples of this are therapies such as live exposure in cases such as phobias, which, although they may arouse rejection in patients, have proven to be the treatments of choice with a high success rate.
6. Same problem, different treatment
There is a large number of theoretical currents in psychology, varying the approach and techniques used (although there is usually great eclecticism). Besides Each person has a different life, circumstances and even brain configurations
In this way, what for one patient may be an effective treatment from the first moment, in other cases it may be ineffective and even harmful depending on the case. The professional will try to adapt the treatment as much as possible to the particular circumstances of his user/client/patient so that it is as effective as possible, always taking into account which treatments are usually most effective and varying the strategy if not. be functional.
7. Psychological therapy is not useful for me
Many patients come to this conclusion after a few therapy sessions. The truth is that generally It takes a certain amount of time for therapies to have a consistent effect Furthermore, we must keep in mind that the psychologist is not going to make the problems disappear. It is professional help that guides us and makes it easier to overcome problems, but not without requiring our own effort to achieve change.
However, if taking all this into account and after a relevant period of time the therapy does not seem effective, it is essential to communicate this to the psychologist. In this way the professional can clear up any doubts that the patient may have in this regard, vary the therapeutic approach (it is necessary to remember that the configuration of each psyche is different and that what is useful for some to overcome a problem is not useful for others. others) or refer to another professional with a different perspective on the problem that may be more appropriate to the case.
In the same way, it must also be taken into consideration that the professional must be able to know the thoughts and events that the patient experiences Hiding data that may be useful for the recovery of the patient or client can make it very difficult for the professional to develop a useful strategy to treat the problems referred to in consultation.
Furthermore, compliance or non-compliance with the tasks and challenges that the professional indicates and the generalization to daily life of the professional instructions (which may be difficult to carry out), will allow the patient to advance or not in their recovery, there could be large differences in achieving the desired results
Conclusion
Throughout this article we have attempted to clear up some of the doubts and misunderstandings that some patients have regarding psychology professionals. A psychologist’s consultation is a space for guidance, help and treatment of very diverse problems. A good professional will try to do the best for his patient and ensure that he improves and recovers.
However, this does not mean that in all cases patients’ doubts are due to ignorance or misunderstanding. As in all professions, there are individuals with greater or lesser skill in the exercise of their duties, as well as cases of professional malpractice.
