Years ago, when John Duffy, Ph.D, was training to become a clinical psychologist, he asked his supervisor to stop seeing a client. The man was brash and rude and shamelessly cheating on his wife. There was absolutely nothing redeeming about him.
His supervisor, however, had other plans. He encouraged Duffy to empathize with the client instead. “He suggested that I consider what it must be like to be this man. How difficult must it be that I myself, trained to be thoughtful and empathic, could not find empathy for him.”
When Duffy changed his approach, he saw something he hadn’t seen before: His client’s “unlikability” was really a defense mechanism, a kind of “pre-emptive strike” that he developed as a child to protect himself. His father abused alcohol and abused his son. He was highly unpredictable. The only way Duffy’s client could survive was to construct his emotional armor.
Couples therapist Susan Orenstein, Ph.D, also assumes that her clients are doing the best they can and take “unattractive” actions, such as belittling or attacking their spouses, to protect themselves.
Clients adapt in all kinds of ways to navigate their worlds. For instance, psychologist and writer Ryan Howes, Ph.D, shared these examples: “A fake, superficial exterior may actually be a mask they adopted to hide deep insecurities. An obnoxious sense of humor may be the way they learned to get attention from negligent caregivers. An annoying quirk may actually be the way an under stimulated brain tries to stay alert.”
Early in his training, Howes worked with a client who had a hard time making friends and always said “yes, but…” any time Howes shared his suggestions. No matter how hard Howes worked to help this client, he felt like his efforts were useless and unappreciated. “While I appreciated the fact that he was seeking therapy to help find solutions to his problems, I began to resent how dismissive he was of the time and energy I was providing.” Howes felt like he was being shut out and spinning his wheels.
After consulting a colleague, Howes realized that the client’s dismissiveness was precisely the reason he was having a hard time making friends. “If he was having this much difficulty connecting with me, a professional connection-maker, how well would this work with a relative stranger?” Howes said. “This insight was huge for our work. It wasn’t just about meeting compatible people, he’d also need to learn to let them in to his world.”
Seeking Their Own Therapy
Duffy is a big proponent of therapists seeking their own therapy, which informs their clinical work. As he said, “We need to understand our own triggers, and how to respond appropriately when they are being pressed by clients.” Duffy’s difficult client actually reflected back to him something he disliked in himself: “At the time, I was a bit uncomfortable revealing much of my own true self to others, and held a lot of my emotions close to the vest. I presented differently than this man, as I worked hard to be likable and agreeable. But like him, I had work to do to be more open and available myself.”
Howes finds his own therapy to be essential. “I need to constantly explore my own emotions so that I can discern my baggage from [my clients’], and if it’s my own issues I’m reacting to, I can process them in my own therapy. It’s fairly common for something to come up in my work with clients that triggers rich material for me to explore in my own therapy.”
In fact, when Howes is having a hard time connecting with a client, he turns the spotlight on himself first. Maybe he’s irritated because a client reminds him of an annoying person from his past. Maybe Howes and the client share a trait he doesn’t like.
Everything is Material
When Duffy “dislikes” a client, his approach is to be transparent and honest with the person about how tough it is to connect with them. He also asks them how this manifests in their life. “This is not an easy discussion to initiate, but can quickly deepen the therapeutic relationship and create a deep and trusting connection, often for the first time in a long time for the client.”
Orenstein also has used her disconnection with clients as material in session. She helps couples see where certain “unattractive” behaviors lead, and how this impacts each partner. She focuses on what both partners want in the relationship and how that is or isn’t working.
Orenstein tries her best to help partners feel comfortable to share their feelings and experiences. “A big aspect of my job is to find a way to like all of my clients—to find a connection, a way in, a glimmer into their humanity and their vulnerability. I’ve found that when my clients open up and are real in our work together, I’m drawn in and feel connected.”
When Howes brought up the disconnected feelings with his dismissive client, it sparked a discussion about his childhood. His client regularly felt ostracized from his intellectual, aloof parents. Even when he tried to connect with them, he felt like they never let him in. “He developed the same pattern with his peers, he discovered, and while it resulted in many people working hard to be his friend, at the end of the day he was always lonely,” Howes said.
Howes’s initial dislike and disconnection turned into deep empathy. “I was pushed away for an hour per week, but he was alienated for most of his childhood, and perpetuated the cycle with is peer group because he thought that was how people connected.”
Howes doesn’t resent clients who have more difficult personalities or communication styles. In fact, these very challenges help him learn and grow as a clinician. “I’ve found that some of the best work I’ve done in therapy has been with clients who initially presented me with difficult interpersonal material. It’s a great feeling to overcome that together and realize that by working through it the rest of their relationships benefit as well.”
After talking about his childhood, Howes and his client began working together (versus against each other). Eventually, they would even laugh about his “yes, but” statements. He also began making friends. And soon after, he completed therapy.
Over time, Duffy’s seemingly rude, brash client became more open and vulnerable. “I think the relationship we developed over time proved to him that he could, as an adult, let his guard down,” Duffy said. He attended group therapy to help him manage his anger and improve his social skills. And, like Howes’s client, he even started building real connections.