Almost all developing therapists move through a phase of resisting ambiguity. The uncertain, variable nature of psychotherapy can be intimidating and leave you feeling like a novice with every new challenging case. I often wish for a map that would help me guide my clients on their paths from suffering to contentment.

But there’s a reason ambiguity is inherent in this work: Psychotherapy is relational in nature. It is part theory, education, and research, and part human connection. The latter is the source of ambiguity that can be difficult to move into as a beginning therapist, but it’s also central to effective therapy.

Common factors research highlights the importance of the therapeutic relationship above and beyond specific theoretical orientations [1]. It provides empirical evidence that the therapist’s authentic human presence within the therapeutic relationship is a key factor of change.

Being with Your Authentic Human Presence

How does one learn authentic human presence? Certainly some theories of psychotherapy lend themselves to such lessons, but ultimately it’s not about acquiring a new skill. It’s about returning to your innate characteristics that facilitate meaningful connection between you and another person. But that task is difficult for two reasons.

One: We are already learning a new, complex skillset that takes time and practice to master. Only when that foundation has been built can the more advanced relational skills be applied.

And two: We are working against a socialized system of beliefs and norms – one that reinforces the denial of certain intrinsic qualities we possess as living, feeling human beings. But in an opportune twist of irony, our clients are struggling against the same harmful system.

Throughout our development and socialization, many of us learn that emotional pain equals weakness, the appearance of perfection is valued and envied, and suffering must be hidden. It’s unfortunately a common cultural value that influences people differently depending on their various identities and backgrounds [2].

Vulnerability feels like a secret we’re pressured to keep from those around us and sometimes from ourselves. I’d like to think psychotherapists comprise a special subculture that is accepting of emotions, imperfection, and vulnerability.

However, we too are subject to sociocultural pressures pushing us to conform to the world around us. After all, it is infinitely easier than challenging norms. If we appear to our clients as fully competent, without mistakes, emotionally strong, and knowledgeable, we can maintain the “expert” image that affords us a sense of power and control in the therapy room. That can feel good as a beginning therapist full of uncertainty and self-doubt. It can feel safe.

That sense of safety is not bad by any means; it’s an important developmental step. But once you’ve found your footing at that stage, it may be time to venture out into the unknown, ambiguous realm of authentic human presence.

You’ve already begun strengthening your foundation of education, personal and professional experience, and clinical supervision. Now you can work to reconnect with your humanity in the therapy room.

It requires self-trust and the courage to go against the safety of structure and control in a session. It requires you to lean in to the ambiguity. To be fully authentic. To free yourself of social influence and be present with the person sitting across from you – the person who has so vulnerably come to you for guidance in navigating the difficulties of life.

To be authentically human is to experience emotion, imperfection, and vulnerability; things most of us, including our clients, are taught to compensate for or hide at all costs.

Society teaches us they are synonymous with weakness. We also feel threatened by them – fearing their acknowledgement will strip us of our power and leave us exposed. That feels bad.

But that bad feeling is subjective and socialized. Emotion, imperfection, and vulnerability are objective truths of our human reality. And just as we regularly ask our clients to allow themselves to experience their authentic humanness in therapy, I would like to make an argument for the value of authentic humanness in your practice as a psychotherapist (Brené Brown, Pema Chödrön, and Mark Epstein, among others, may agree).

Being authentic in your humanity could be one of the best gifts you give to your clients – those you see now and in years to come. When you acknowledge and own these human parts of yourself, you open yourself up to growth as a clinician and to connection with your clients that can serve as a vehicle for healing.

Being with Your Authentic Emotion

During my first two and a half years of training, I tried to hold back tears with my clients. I thought tears would make me seem unprofessional; expose me as the inexperienced trainee I was trying so hard not to be.

I adhered to the socially-induced belief that equated tears with weakness. That is, until a group therapy client expressed heartfelt gratitude for the healing I had helped him achieve during the several months I worked with him. I felt my eyes well up and then, without thinking, tossed out an emotionally distancing response: “You’re going to make me cry!” Cue empathic laughter from the group.

During supervision immediately after the session, my supervisor looked at me solemnly and said, “I wish you would have let yourself cry. To model genuine emotion and connect with the appreciation he expressed to you.” By protecting myself from the vulnerability of emotional expression that I feared would compromise my role as a facilitator of the group, I deprived the client of experiencing how connected I felt to him in that moment.

I wish I could go back and sit with a few tears, with the discomfort of vulnerability. For two reasons: First, to show him how touched I was to have played a meaningful role in his healing, and second, to model for the entire group that authentic emotions are agents of connection and good to express.

It’s been three years since that group session, and I’ve since freed myself to shed a few tears with clients when the authentic emotion has arisen. I still hear my former supervisor’s words every time I feel my eyes well up.

I choose to let authentic emotions be seen and experienced by my clients. In those moments, they can see unequivocally that I feel and understand their pain. That I am choosing to hold the pain with them rather than distance myself from it.

I am implicitly conveying that their emotions are valid and welcome. I’m telling them that they are not just clients on my caseload, but valued people to whom I feel genuine connection.

Being with Your Authentic Imperfection

I have a lot to learn and always will. While meeting with my first transgender client, he openly and jokingly questioned whether I had any experience working with trans-identified individuals.

I didn’t.

As I started to panic at the thought of risking my credibility and power as the “expert” in the room, I considered the many risks my client has taken to be his authentic self. He gave up great power and privilege to pursue gender confirmation in a society that largely reacts poorly (to say the least) to those who challenge the status quo.

I chose to highlight rather than hide my imperfection in that moment and turned over some of my power to him. I told him the truth: I did not know his experience, nor did I know how it was going to show up in our work and the therapeutic relationship. But I was invested in him and his healing. My honest admission, as uncomfortable as it felt for me in that moment, increased our rapport and his trust that I had his best interests in mind and not my ego.

Being authentically imperfect as a therapist goes hand in hand with genuine openness, allowing us to acknowledge areas in need of growth and perspective. In a field that increasingly seeks to understand the nuances and importance of identity and multicultural competence, we are often called to seek information about our clients’ idiosyncratic experiences and admit that we don’t know everything about what it means to walk in their shoes.

We are not expected to have the answers or the innate knowing; rather, we are taught to approach identity and culture with an openness to learn and adapt. We must fit therapy to the client – not the other way around. If we own our authentic imperfection, we can set aside our preconceived notions and rigidities, connecting instead to the person across from us who inhabits a wholly unique perspective.

Being Authentically Vulnerable

I saw a therapist for a while during graduate school and loved every minute of it, though you wouldn’t have known by the heaviness I carried as I walked to my car after each session. She was warm and wise, and her words often come to mind as I work with my own clients.

One of my favorite interventions of hers was a simple, beautiful question: How do you want it to be? It simultaneously pulls clients in as active, empowered agents of their own change, and allows therapy to progress according to their personal sociocultural perspectives.

One client in particular – perfectionistic, eager for the “right” answers, and very hard on himself – heard me ask that question so frequently that he would finish a statement, look to me, and say, “I know, I know, how do I want it to be…”

I always wanted to give my therapist credit for the gifts she indirectly gave my clients – it just seemed too terrifying to allow my personal and professional therapy to collide. But at some point I thought, “If I can’t securely defy the stigma of psychotherapy, how can I expect anyone else to do it?”

Challenge accepted.

The next time her words came to mind with that client, I gave her the credit she deserved. He was caught off guard. “You have a therapist too?” “Of course. I am a vulnerable human who, like everyone else, experiences pain. I’m working through mine, and I’m here to use everything I’ve got to help you get through yours.”

While self-disclosure is an advanced skill that must be practiced with care and purpose, it can be quite powerful when used appropriately. I was intentional with my self-disclosure, using it to convey to him that even his trusted and respected therapist was vulnerable to pain and imperfection.

I intervened to reverse his belief that he was inadequate or weak for seeking therapy. I conveyed that vulnerability doesn’t need to be suppressed, compensated for, or desperately avoided. It can be embraced. It must be embraced – it’s a truth of our humanity. I wanted him to know that vulnerability and security can coexist.

Bringing Your Self into the Therapy Room

We cannot hide from our clients. We have emotions, histories, and experiences just like them. They can see all our visible identities and they surely make some assumptions about the invisible aspects of us as well. They can see our reactions and lack thereof.

We are transparent despite our best efforts to convey expertise and perfection. We can choose authenticity and use it to give our clients the genuine experience of connecting to another human being in a meaningful way. We can show them it’s okay to be emotional, imperfect, and vulnerable. We can show them it’s good. It’s healthy.

Authentic vulnerability is what connects us to the people around us. It allows us to feel love. It’s how we help our clients take secure ownership of the human parts of themselves that often feel so threatening and painful. It’s how we help them heal.

References

[1] Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: the evidence for what makes psychotherapy work (2nd ed.). New York: Routledge. ISBN 9780805857092. OCLC 227918397.[2] Mesquita, B., De Leersnyder, J., & Boiger, M. (2016). The cultural psychology of emotions. L. Feldman Barrett, M. Lewis, & J.M. Haviland-Jones (Eds.), Handbook of Emotions, 4th Edition, New York: Guilford Press.

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Katie Pesch, PhD

Katie Pesch, PhD

Katie is an early-career psychologist from the Counseling Psychology program at Iowa State University. She completed her doctoral internship at the University of North Carolina – Charlotte Counseling Center. Clinically, she is interested in individual and group counseling, using an integrative approach that encompasses trauma-informed, humanistic, psychodynamic, feminist, and relational-cultural theories. She is passionate about clinical and neuropsychological assessment, but also vocational assessment, as much of her graduate research centered around career development and vocational identity. She is now working as part of a consulting team in Minneapolis, specializing in psychological assessment applied to talent selection and leadership development.
Katie Pesch, PhD

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