During our second therapy session, a 78-year-old patient recently expressed some doubt about whether or not therapy would really help her. She had been feeling increasingly depressed over the last several years as she faced the challenges of aging, and she wasn’t sure that our meetings would improve her mood. I answered her question by explaining that my role as her therapist is mostly to listen to her and that my role as a therapist is fluid and can change as our work progresses. As I spoke I watched her facial expression change from uncertainty to pleasant surprise. This isn’t the first time a patient has asked me this question, but her strong reaction made a lasting impression on me.
On reflection, I think that two elements of my response elicited my patient’s reaction. The first is the fact that I identified myself as a listener. One important reason why some people feel lonely and isolated is that they often don’t have people in their lives who stop and listen, not only to their words, but to the messages they are trying to communicate. An intervention often used in practice is referred to as active listening. Dr. John Groho, founder and CEO of Psych Central, writes, “While therapists are often made fun of for engaging in active listening, it is a proven technique that helps people talk and feel free to continue talking even if the person they are talking to doesn’t have a lot to offer the other person (other than their ear).” Active listening allows clinicians to engage with clients in a way that helps them feel really heard, and that thereby validates and encourages them. Once my elderly patient understood that my role in her life is to be there to listen to her express her thoughts and feelings, she became eager to return for further meetings with me and became open to the possibility that therapy could help her through this difficult time in her life.
The second element of my response that I think resonated with this patient was my message that the time we spend together is hers to use in any way that she wishes. While I certainly make recommendations to my clients on how to best use therapy sessions, the choice on how to focus our time and what goals to set is ultimately always left to them. I am ever cognizant that they are the experts in their own lives and should therefore be in control of our work together. At a time when these people are feeling most vulnerable and life seems out of control, this general approach can be tremendously empowering.
While these tools are effective in therapy, they represent behavior that I believe is important in everyone’s day-to-day lives as we interact with friends, family members and colleagues. While the skills described here are not easy to learn, or to practice, they can make a significant impact on our relationships and help build trust and understanding among the people in our lives.
By Kira Batist-Wigod, LCSW, MPS-H
