Therapy is a different way of talking and a different way of hearing. Therapy is as much a listening cure as it is a talking cure. Hearing one’s words in a space in which they aren’t necessarily interrupted or soothed but just hang, means they can reverberate. The individual hears whether the words that have emerged are the right words. They are brought face to face with what lives inside of them but is hard to say.

How the client enters the room, whether he or she looks at the therapist or at the floor or smiles or uses the same opening words such as ‘what a week’, are all artefacts of the therapeutic encounter. Delight, a soothing arm around a back, common in friendship, are absent. In its place the therapist conveys an intense interest in seeing their client. 

Therapy is a collaborative, democratic venture. The client initially drives the session because of what they bring and the way they set the pace. Each client I meet evokes differing aspects of me. The way I feel about each of them is distinctive. Therapy is an emotional journey for the therapist, not just for her patients. I’m on my toes, empathetic and trying to choreograph myself so that I don’t puncture anyone’s dignity.

Clients need to be heard

Each person who comes to therapy needs the same – to be listened to, to be thought about and to be heard in a private space – as well as something distinctive and personal. A young woman wants me to be a more distant version of her capable but, from her perspective, invasive mother. I have to see my own self as someone who can respond to what she needs without undermining her mother. The couple who need to see that the very things that annoy them in each other are the parts of themselves they like to disavow reminds me how a third person (the therapist) can tilt conversation to enable them to reknit their intimacy.

The academic professor has to be persuaded of the intellectual reasons for why emotions might be of value for her and why risking experiencing them with me will be useful. She likes to tussle and wants me to tussle back and I do. It’s the way to reach her but it wouldn’t suit many people. A man in an aggressive struggle with his stepson needs to know how his actions can have a positive outcome rather than a negative one. His reported conversations make me wretched inside, and the struggle to offer him an alternative puts me in a teacher situation.

Each individual craves acceptance even though they may be diffident or even tetchy. Knowing that motivates me to get underneath the cruelties and difficulties that I am hearing about.

How can I be useful? Who am I a proxy for? What will enable my client to consider something from a different perspective? How can I parse their feelings so that they increase their emotional repertoire rather than repeatedly play the same no longer productive song?

Such are the demands of the consulting room and what gets stirred up in the therapist.

Susie Orbach photographed with founder, Louise Chunn