Yes, it is common for therapists to be emotionally distant during therapy sessions, though I do believe this is changing because patients have been turned off by this attitude for ages.

The original idea was for the therapist to be taken out of the content of the sessions by placing all the attention on the patient and the patient’s needs. This was thought to be best for the patient because the therapy was all about the patient. However, the problem with this approach is that the therapist comes across as sterile in personality, taking away their human experience which is what my clients love about how I conduct my sessions. I bring up real-life examples of how I or one of my clients was able to overcome the exact issue they are confronting proving that they can do the same and that they are not alone in having this problem. I learned that this was a great way to interact with most of my clients as a result of working at a social club for mentally ill adults with nearly 200 clients showing up in a single day. My boss told me that the reason she gave me the clients to interact with that she did was because I was an excellent role model for them as a person who had come through difficult mental health problems yet had a healthy marriage, was taking courses for nursing school, and working at the time. As she put it, I was an inspiration and role model to them.

I never really thought of myself in that role till she brought it to my attention, but I certainly was very clear with the clients that they could either allow their mental illnesses to control them, or they could control their mental illnesses. I was also clear with them that they had to ability to create a great life if they would stop using their mental illness as a crutch for everything that was not working in their lives.

Of course, there were clients there with more serious mental health issues causing mayhem in their lives. But even for them, there were things that they could do to help themselves if they were willing to do the work to make that happen. I had one client in the program that I worked at after the clubhouse who had been diagnosed with paranoid schizoaffective disorder and was barely functioning when I arrived. I learned much from his psychologist about how to best work with him and knew that his best bet was to be placed in a program that had lots of structure and lots of support for him. Within 1.5 years he had gotten his GED. Seventeen years after I had worked with him he was no longer in any program successfully living in an apartment with a roommate and doing fine.

I do believe that much of the healing occurs with human-to-human contact by demonstrating how people interact in a reasonable and caring manner sharing human situations. I also believe that too many people in the field of mental health are fearful of their patients. One cannot expect to be able to help another if one is fearful of what a patient or client will do to you. Sure, sometimes clients can get angry and many times they have good reasons for being so. Sometimes clients do foolish things such as a client of mine who was thrown out of 3 therapists’ practices for demonstrating her dislike of how they were treating her by putting stickers on the headlights of one, moving the magnets representing the therapists’ whereabouts on the schedule board of another, and staring up into the office window of another. I never had that issue with her because I let her know that she would never be thrown out of my practice – abandonment being the largest fear of someone like her with borderline personality disorder. She did not come to me for that, she came to me to stop drinking alcohol.

If a therapist is there to help a patient grow, by all means, demonstrate the behavior you are looking to emulate by treating the patient as a ‘normal’ person, and in so doing they will rise to the occasion in many more circumstances than many therapists believe is possible.