THE BLOG

Tales From Both Sides of the Couch: First Sessions

09/08/2013 04:43 pm ET | Updated Nov 08, 2013

All my life I have been drawn to stories -- listening to them, telling them and writing them. Stories entertain. They fire the imagination and they capture deep truths about human nature that stay with us for a lifetime.

In my psychotherapy practice I listen to the stories patients tell about their lives and I use my skill to help them change their stories.

As a teacher of psychotherapists I use stories from everyday life to help students master complicated concepts.

In this blog, as well, I use stories from both sides of the couch to illustrate the how and the what of the work I do as a psychoanalytically-trained psychotherapist.

In this following story, it was I who knocked on the therapists' door, setting in motion a process that was crucial to my graduate training.

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I sat in the waiting room, nervously comparing the time on my watch with the time on the small clock on the side table. The walls, indistinguishable from most waiting rooms, were shades of beige. The furniture sleek, metal, minimalist and modern. I crossed and re-crossed my legs, trying to appear engrossed in whatever magazine I picked up from the table.

On the dot of 3:30 the door opened and a man emerged. Shaking my hand, he told me his name was Dr. K.

Dr. K was tall and lean, in a well-fitted black turtleneck and crisply ironed gray slacks. Tidy looking, I thought. At 22 years of age, anyone over 40 fell into a vast universe, but I pegged him to be about 45. With his faded blonde hair, goatee, mustache slightly turned up at the ends, I imagined he was of German or Viennese ancestry. This seemed promising since in my graduate studies, all the best therapists seemed to come from Vienna or some other Austro-Hungarian country.

Earlier that fall when I arrived at my psychotherapy internship, one of my first tasks was to find myself a therapist. This was something our faculty had encouraged all us first year students to do. While I couldn't imagine why I might actually need therapy, I had a vague but undeniable feeling that this would be good for me.

Upon entering the office, Dr. K, with a wave of his hand, invited me to sit on the leather couch across from him. He smiled. I smiled.

Silence.

"So what can I help you with?"

"Well, I'm a graduate student, so I thought I should be in therapy," quickly adding, "I guess I want to understand myself better."

I could see by his expression that this was not the way most patients introduced themselves. He continued asking variations of the same question, apparently in search of a concrete problem. Wanting to please, I tried to hard to think of the right kind of problem, but nothing came to mind.

Session one meandered to an unsatisfying close, as did sessions two and three. Each meeting seemed to leave Dr. K more puzzled about how to help.

I arrived 10 minutes early for my fourth session and saw Dr. K drive in to the parking lot in a shiny, red Corvette. He zipped smoothly into a space, gunning the engine a final time as he turned off the motor. Before getting out he took a few moments to close up his sunroof. My jaw dropped.

How could Dr. K be driving this car? I had already wondered about his life outside the office. I had noticed his wedding ring. I had imagined two children, a slightly artsy wife. And I just knew he drove a Volvo. But now I saw a man, a man looking exactly like Dr. K, driving a red Corvette.

Wasn't that a car of a man having a mid-life crisis? A man who needed to be admired? This was not the kind of man I wanted as a therapist.

Now, I actually had something I wanted to talk about with Dr. K.

After some small talk, I hesitantly told Dr. K how surprised I was to see him behind the wheel of a red Corvette. He dove right in, quickly explaining how he was a serious car aficionado and how the Corvette was an extraordinary car. Even though I did not yet understand the idea of transference, I was waiting for him to be curious about my thoughts. Instead, he rambled on in car speak, describing the engine horsepower, the fiberglass body and all of the mechanical specifications. He seemed to be trying to convince me -- and maybe himself -- that his reasons for owning this car had nothing to do with its hot color and styling. I sensed that I had made Dr. K defensive. I felt uncomfortable having that power over him. It occurred to me that Dr. K cared more about his car than for getting to know me as his patient. That thought make me even feel alone and deflated.

Soon thereafter I quit therapy with Dr. K.

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So why didn't this therapy work?

At that time I couldn't have put into words what was wrong, I just knew something was missing. Today I understand that noticing his red Corvette and daring to talk to him about it had been my first real communication with Dr. K. It was his job to recognize the importance of this moment and capitalize on it, using my curiosity about him and his car as a signpost pointing the way into my inner world. Instead I was left feeling disappointed and shut down. In my mind, Dr. K was just another show-offy, self-involved guy, with little apparent interest in me. Maybe I even felt some envy.

Yet another therapist, driven by theory, might have assumed they understood what my reaction to the Corvette actually meant, too hastily interpreting a meaning. He too, would not have been listening.

In technical terms my thoughts about Dr. K and his car were bits of transference -- feelings related to other important figures in my life that I transferred onto him. This transferential moment could have been an important opening, enabling this therapy to get off the ground. Dr. K's response, however, did not allow for further exploration and I was wise to call a halt to that therapy. Happily, the next practitioner I saw was more attuned to listening and hearing my story.

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