My husband and I were discussing this just this morning and I thought I would "think aloud" here. While training to be a Couple and Family Therapist at The Ohio State University, I received one message loud and clear from my mentor/advisor. She cautioned us trainees to be aware of the "hats" we wear in our varied roles. In the initial training period, when my ego was especially fragile and my goal was to be seen as a "good" therapist, I was pained when she observed that she had seen me wear my "therapist" hat in a particular session,as revealed through my posture, language and in all, the pretense of being the expert in the room.
As I grew, both personally and in my training, I began to value this message immensely. I recognized that the more human and "me" I was in the room, the more I was allowing my clients to be themselves too. This meant I could shed a tear when I was moved, be gently frustrated when I wanted to challenge someone or importantly, sit with the discomforting thought that I had no clue what to do next!
The medical model has, unfortunately, made experts and gods out of doctors and to some extent, mental health providers. While this system poses a disadvantage to the client due to its undermining his or her power in the equation, it also thrusts a lot of pressure on the provider NOT to make mistakes or not to accept them when they are made. I believe this system was created because some physicians are responsible for people's lives, however, let us not forget that the responsibility lies always on both sides.
Particularly in therapy, clients who are motivated to change how they feel, act etc., are likely to experience that change sooner than those who place the responsibility entirely on the hands of the "expert". In my experience, clients who placed this burden on me often struggled with a general sense of powerlessness in most life situations (personal, medical, academic etc.). I would see the light switch turning on when I addressed this directly and asked the client what role I played in their lives. Years of being told what to do had contributed to their lack of agency and again, the entire system (including the client) was responsible for this. One client told me that I was the first person who had treated her like a human being (I nearly cried when I heard this).
Let me be honest- it is hard to resist that feeling of being powerful when someone sees you as the person who will "fix" his or her situation. Often, I have to directly convey, to my clients' disappointment, that I do not have the answers but am willing to walk with them on that path. What I know I can offer as a therapist is: caring, empathy, questions and importantly, frequent reminders that I do not have expectations that a "good" client should behave in a certain way or do a certain set of things. We all have plenty of these expectations in our other worlds; let therapy be one place where we can just be.
Sujata V, Ph.D, MFT
Always Learning..through the good AND not-so-good times!