How to Listen Like a Therapist

Just as we use a camera lens to focus in and out as we look at the details and the background, therapists try to listen for distinct themes as well as the general landscape of what people say.
09/14/2013 09:03 am ET Updated Nov 14, 2013

How to listen like a therapist:

You walk into a cocktail party. As you stop in the hallway to hang up your coat, you hear the buzz of voices. Excited, some laughter, no voice distinct. Sounds like a good party, you think. You walk in. Gradually, you begin to pick out individual voices. "Is that Sam?" you wonder. "Maybe I hear Ann." You think you recognize a voice you know and you wander over. The buzz morphs into increasingly distinct cadences. "Yes, the trip was great!" "We were in San Diego last year, too -- did you go to the zoo?" "We love the weather there!" It is Ann -- you're glad to see each other -- a quick hug and then you're deep in conversation. "I thought it was you! Tell me all about your vacation!" And magically, the background din melts away and all you hear is each other.

That amazing process -- of gradually focusing what we hear -- is how therapists listen, too. In the cocktail party, we shift from hearing the background noise to focusing in on one or two voices. In therapy, we shift from hearing many themes to focusing on one or two. That's one of the things that beginning therapists learn to do. We're all used to doing that with our eyes -- scanning a scene and then focusing in on something -- but we're not all used to doing that with our ears. Consider this process as you listen to this exchange between a young woman and her therapist at the beginning of a psychotherapy session:

Ms. A: Boy, that was a packed week! I hope that you had a good weekend. I'm not sure that you remember, but I went to my parents' house last weekend. My sisters and their kids were there -- and Aunt Sally. I don't know if you remember, but she's my mother's sister. What a houseful. I helped a lot. It was my niece's birthday and we had a big party. Our birthdays are about two days apart. Funny, my sister remembered that the morning of the party -- they were apologetic about not including my name on the cake -- that was okay. I babysat so that my sisters and their husbands could go out to the movies -- they don't get to do that much. I'm going back to my mom's place in a week and will have to miss a session. I just wanted to remind you.

Therapist: Sounds like you were really helpful to your family. How did you feel when they didn't remember your birthday?

Ms. A: It was fine. That's usually the way it is. It's in the middle of the summer so it tends to get lost in the vacation hubbub.

Therapist: You're also worried that I won't remember things you tell me, like that you went home last weekend and that you're not coming next week, maybe you just expect that people won't remember things about you.

Ms. A: Well, that's always been the way it's been in my family. I'm not someone who people remember things about.

How does the therapist listen here? First, she just hears the din of the Ms. A's opening words -- the details of the week's report, comings and goings, names of family members, things she's done. But gradually the therapist begins to hear some distinct patterns. Ms. A keeps using the word remember, and she mentions many things that people either have forgotten about her or that she worries that they will forget. The therapist asks about this, and Ms. A acknowledges that this is a long-standing issue in her life. Then the therapist further sharpens the focus by noting that Ms. A includes the therapist in the list of people who are likely to forget things about her. Now the focus is squarely on Ms. A's feeling that she is likely to be forgotten. From the din of the busy weekend, Ms. A and her therapist have honed in on what is likely an important and central theme in Ms. A's life -- one that they can productively explore.

This kind of listening can help us in many types of situations -- not only in psychotherapy sessions. Teachers, consultants, friends -- anyone who is trying to help another person to better understand his or her thoughts and feelings -- listens in this way. But just as we use a camera lens to focus in and out as we look at the details and the background, therapists try to listen for distinct themes as well as the general landscape of what people say. They want to hear how people describe things, how they jump from thought to thought, and what kinds of feelings they have when they talk. This helps them to get a sense of how people feel about their thoughts, their relationships and their lives. Both ways of listening are important as therapists listen to people to try to help them to understand themselves more fully and to live more fulfilling lives.

For more by Deborah L. Cabaniss, M.D., click here.

For more on conscious relationships, click here.