Totally Useless, Part 1

Early in my practice, I once said to a supervisor: “I really had a good week! I was a good therapist!” She laughed and laughed, and said, “Enjoy it while it lasts!”

In the moment, I may have felt taken aback but, as the years passed, I began to hold onto those words like a smooth stone in my palm, soothing and cool through hot, prickly times of anxiety and discomfort.

I do try now to bask in it, to treasure the fleeting moments of efficacy and fruition. Revel a bit in the subtle, satisfying clinical “I told you so’s” when things work out for the better – because those supplies, a belly-full, will be needed as the process passes through dark times: times when both of us will be  lost, disoriented, overwhelmed, anxious, drained, powerless, paralyzed, hopeless, and totally useless.

That’s the gig.

The good news is, just as that “good session” feeling is fleeting and temporal – so is the “bad session” feeling – and, for that matter, so is any feeling of any kind.

So, we may never know the ultimate effect, if any, of that terrific feel-good session until long afterwards – the flowing, connected vibe long since passed. Likewise, the 45 minutes struggling with an awful, dreadful, at-a-loss impotence may generate far more than we could ever imagine.

Simply put: empathy only feels good when we offer it to someone who is feeling terrific.

To empathize with someone in pain, to hold their feeling with them, is necessarily painful. Feeling lost, useless, and powerless is the absolutely expectable outcome of working to truly understand someone who is feeling lost, useless, and powerless.

Recently I attended a brilliant staging of King Lear at EPBB theater gym ( As the Shakespearean agony escalates, the innocent are outcast and slain while the evil and oblivious are utterly annihilated. As the dead bodies piled up at my feet, I sat – unable to affect the outcome, disrupt the action, or protect the innocent. Watching, witnessing the power of destructive acts spread in ever widening circles, I thought: I know this feeling. I do this a lot. Maybe everyday.

I wondered, maybe this is why such stories exist and need to be retold. Maybe we all need to build up this muscle, to increase our ability to tolerate the tragic so that we can look squarely at our loved ones and our neighbors, and not flinch or retreat when the everyday tidal waves of tragedy move through their or our own lives.

What good does all that do? It depends.

It depends on what you hope for, what you expect.

Maybe it doesn’t do much.

We might not know for a good long while.

But sometimes, it may do more than we will ever know.


copyright © 2011 Martha Crawford

6 responses

  1. Seems to me that you folks are simply a neutral listenining party. After 6 years of multiple sessions weekly in psychodynamic therapy that all of the talk about “holding the feelings with us” as if we are “in it together” is BS. Like watching a sad movie, or a funny play, it may have a brief impact, but as your Winnicott blog post highlights–you are in fact detatched. Observers. There is much doubt about any deep feeling on the part of someone who just watches and listens in a unilateral relationship versus providing help.

    Perhaps every session could be considered a success for you. “Yay–I listened and I got paid!!!” That isn’t useless by the way. It would just be nice to have some honesty for a change about the fact that we aren’t really “in it together.” Maybe in therapy together paying you to listen, but that seems about it. Maybe that is the real truth about the limited field of your responsibility.


  2. Hmm. I can only speak for myself, but, to me statements about “neutrality” and “detachment” aren’t about maintaining an emotional disconnection, its a behavioral prescription to the therapist. The reminders about the limited field of responsibility – I hear as reminders to control my impulses to take direct, or directive action in my clients life – that no matter the emotional impact I need to restrain my actions and not behaviorally over-involve myself.

    I imagine there are some clinicians who can forge relationships, build intimacy, work to establish trust, watch people, human beings who they see for concentrated contact over years and years struggle, weep, rage and rejoice – and “feel” neutral. Maybe they are are in fact better suited to different aspects of the work than I am. I, for good and ill, have to spend a good part of my own energies managing, containing, repairing and recovering from my own internal emotional involvement. That may or may not be a good thing, for me and/or my clients. That may suit some kinds of cases better than others.

    I also think that you make an important point, which brings up a central duality – that therapy is simultaneously a “real” and a “not real” relationship for many. We are all, always ultimately alone. I walked out of my therapists office each week still carrying my wounds. He set mine down, and moved on on to someone else’s. At the end of his work day – he had to return to tend his own wounds again.
    Perhaps our own needs are never as central to anyone else as they are to us, and can never be.
    But, I do believe others, (as well as ourselves) can be deeply effected, changed even, by the revelations of these needs – even if action cannot be taken to fulfill them.
    Thanks for your comments.

  3. Personally, I would love to know about my therapist’s “own internal emotional involvement”.

    There are some of us who don’t assume we are affecting our therapists, I’d like to hear it.

    Do you ever speak it? Someone may appreciate hearing it.

  4. I do frequently discuss with my clients the effect they have on me, the feelings they evoke.
    No two people can sit in intimate spaces together with out both people being changed in my opinion, but that is certainly not acknowledged in many practice models of psychotherapy… My work is based on many of the more contemporary two-person, psychoanalytic models (that is also the therapy I recieved) and some Jungian influence- many more traditional models see the therapists response as inherently problematic, intrusive to the patient, something to be kept out of session…

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