When I started summarizing my short research after interviewing city based 25 clients and 18 therapists, I was only slightly surprised from the insights I gleaned from client – therapist relationships. As it is well established that this relationship is critical for a successful therapy, I tried to understand how the dynamics is working among the highly educated and financially stable demographic in India.
Among those who were receiving therapy to resolve difficulties in career, relationships, parenting or treat depression, mild anxiety and personality disorders, non-psychotic mental-illnesses, one recurrent scenario was that they had to change their psychologists at least 2 or 3 times before settling on the right expert who they are comfortable with and can trust. Surprisingly this is true even in cases where they did their homework of checking profiles and reviews, getting references, understanding their cost structure, etc.
The general reasons for having to change the therapist are that they were not empathetic enough, gross mismatch in style, inescapable judgmental tone, lack of genuineness, unstructured sessions, and delays/cancellations of sessions. What surprised me is that psychologists are constantly told to imbibe these very qualities during their education and trainings. It is a sad irony that individuals who realised the benefits of psychological therapeutic processes and approached the experts at the right time are punished by these half-trained counsellors. Empathy, non-judgemental conversation, rapport-building, maximising good and minimizing harm are the basic tenets of ethical counselling. Why then are so many counsellors in India finding it hard to adhere to the basic doctrines? Is the profession still in early stages in our country and talented people are not yet attracted? Is it because the country has still not woken up and not enough institutions of training and research are established? Are the clients not clear on the process or expectations? Where is the glitch?
Some reasons for this bad state of affairs in India could be that most trainings and courses of psychologists are trapped in theoretical curriculum without robust hands-on trainings, lack of encouragement and clear framework from government on counselling, lack of awareness and respect from general public on the profession. Counsellors highlight that many individuals still do not understand the process or outcomes and many look for short-term fixes, few also prefer to handle the difficulties themselves presuming they understand the psychoeducation and therapy process. It is especially difficult to maintain the rhythm and focus where the therapy is initiated due to pressure from family and friends before the individual trusts the process. But all these should not stop a psychologist from following basic values and ethics which are established to maximise help and minimize harm.
It is also a fact that some client-psychologist relationships work and some simply don’t. As some of the experts pointed out, it is better not to get too fixated on the formation of right relationship and that it should happen naturally and slowly as long as the basic tenets of ethical counselling are in place. As one very experienced counsellor pointed out, sometimes we need to accept the hard reality of a mismatch, even if it means that individuals end up taking more time to find the right expert. It is worth the pain as the stakes are high – ‘getting some peace in your life’. It is endurable to find a new therapist than giving up gains from the successful first step of initiating the therapy, altogether.
Despite these examples, there are successful cases where clients vouch for the patience and expertise of their therapists and worship their therapists for saving their lives. These individuals successfully stopped the therapy after their therapist found that the individual is ready to function well in a tough world and capable to handle complex issues. These people invariably trusted their counsellor and persevered for many months.
Clients need to accept the reality that therapy pulls you out of your comfort zone. One of the important factor which leads to a successful therapy is the ability of the client to stay the course despite discomfort or shock or anger, as our own thoughts feel alien and startling to ourselves for the very first time. If you run away from the process or from the therapist at the first hint of this uneasiness, you are wasting your money. This is when your courage to accept some tough realities work miracles. In fact I will go out on a limb and say – it is near impossible to start the journey of self-realisation and solve your life problems in a comfortable and assured setting. If you and your therapist see eye to eye in every aspect and think most of your life problems are externally induced, that is when you need to run.
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