Making Mistakes in the Therapy Room

mistaken therapistIt makes sense to start with an assumption that, as practitioners, we are seeking to offer our clients a safe and solid relationship, an effective therapeutic alliance, and interventions which are skilled and helpful.

We try to avoid making mistakes, being clumsy, causing harm or distress, damaging the therapeutic alliance.

…and of course it makes sense to try to avoid ‘getting things wrong’.

However, there are a couple of unintended consequences of this, which do not serve our clients, the therapeutic relationship or us:

We can think of making mistakes as something we should avoid at all costs, which leads us to avoid risking getting it wrong, and therefore avoiding the kind of brave honest interventions which can be very helpful to our clients.

This strategy can backfire, because our avoiding taking a risk raises the risk that our clients will not get the benefit of us really turning up for them.

Avoiding risky interventions leaves our clients at risk of staying stuck, vulnerable and troubled.

There really is no risk free strategy in our work.

Secondly, if it is unacceptable to make mistakes, then we, and our clients, are really in trouble when dealing with the mistakes that we inevitably will make. We’re left in an impossible situation, discombobulated, possibly in shame, withdrawal and panic – not the most helpful qualities to offer our client, especially when we’ve just been somehow clumsy, inattentive or inappropriate.

 So, what can help?

Firstly, there are lots of things we can do to avoid mistakes – pay attention to our trainers, mentors, supervisors; make getting enough of our own therapy a priority; be sensible in which and how many clients we work with, give ourselves enough time to arrive with our clients; notice our areas of difficulty and work on them in therapy, further training or study, and so on.

Secondly, accept the fact that we make mistakes in our work. Try as much as possible to relax with this.

When we make mistakes

Usually the first impact is to the contact between us and our client – they, we or both of us withdraw, attack or dissociate in some way.

We need to pay attention and do what is necessary to rebuild safe contact. This can be in a variety of ways:

If we have gone into panic or withdrawal, then take the time it takes to come back – whether it is deep breaths, or feeling our feet, or thinking about granite or whatever it is – do it.

If our clients have withdrawn from contact – what do they need in order to come back?

The two interventions which are often most helpful when we get things wrong are: to acknowledge what we’ve done, and apologise. In my view, not doing these two things clearly honestly and quickly, are where counselling and therapy can start going wrong.

What next?

As counsellors and psychotherapists, we are called on to hold a safe space for our clients’ experience, often particularly their experience of things not being ok in some way.

So here we are with our client who has just had something go wrong, in this particular case – with us. We can bring our therapeutic support to that experience -How is it for our client to have had us make a mistake? What responses do they want to make? What kind of support would be helpful?

When we have repaired the relational rupture, apologised and addressed the here-and-now difficulties, we might then be interested in deeper meaning, significance and resonance of the event. Why did we make this particular mistake with this particular client? Is it familiar to them? To us? Unpicking and unpacking this can be enormously fruitful, making sense of the countertransference that we may have acted out, rehearsing a strong self protective response to a prior deeper wound, or simply offering our client an experience of a relationship which has been repaired gracefully.

So what is a mistake?

Of course we cannot assume that we and our client have the same experience of what a mistake is. We might do something we feel mortified by, but which has no impact on our client. Our client might be outraged by something we’ve done which we feel is entirely acceptable. My view is that establishing the truth of this is not usually a priority – we still need to do what we need to do to bring ourselves back, to support our client in their experience, rebuild the contact, find what we can to acknowledge and apologise for, and makes sense of the experience.

ERT Stephenv2


Copyright Stephen Tame 2014. Permission granted to reproduce for personal and educational use only.
I’d like to particularly thank Nick Totton, Allison Priestman and Michael Soth for their influence on my thinking about this, though of course my conclusions are entirely my own responsibility.
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