The Wounded Healer

Some clients believe that therapists need to have experienced certain issues themselves in order to help them with those issues. I have mixed feelings on this subject. Although I can certainly see the value of the 'wounded healer' (and I count myself in this category) the therapist needs to have done a lot of work on themselves and be in a good place to help others. Clients who are seeking a therapist who has been through similar experiences to them won't have the awareness of how 'recovered' a therapist is though. 

Having worked on drug treatment programmes in prisons and in very exclusive addiction treatment centres, it is clear that the majority of therapists working in addiction are in recovery themselves. It is also apparent that the clients value their experience highly and believe that therapists in recovery make the best therapists for other addicts. In fact, I've been told, emphatically, that it is pointless for a counsellor with no experience of addiction to work in the field because 'they can't understand what's it like'.

Having worked in a wide variety of areas and organisations, I wonder why the field of addictions counselling is predominantly inhabited by those in recovery and why so many clients are adamant on having such therapists. This doesn't seem to be a phenomenon in other fields. I've also worked in specialised domestic abuse services and, although it is true that the majority of staff in these organisations are survivors of domestic abuse, the same cannot be said about the therapists. And I don't think that clients value survivors more highly than people who have not experienced domestic abuse because clients rarely ask about this.

We could also consider how LGBTQ counsellors might dominate this field when clients believe that a straight, cis-gender person may not be able to understand them. Also, I know plenty of religious groups that would only consider being counselled by someone in the same religion. 

But there are lots of other issues where clients do not expect or want their counsellors to have experienced the same problems. For example, I worked for years with survivors of childhood sexual abuse and rape. There was not one single occasion when anyone suggested that clients would benefit from having counselling by a therapist who was also a survivor. And when we consider mental health and personality disorder (not that I subscribe to the medical model), I've never heard anyone say that clients need therapists who have had experience of depression, anxiety or schizophrenia themselves. 

During my training, I came across Mearns and Cooper's concept of 'existential touchstones', which allow us to use the experiences that we have in common with a client as a bridge to getting closer to their experiencing. And, Mearns and Thorne warn that if therapists assume that they will understand a client's experience because, they too, have been through the 'same thing', then that can lead to false empathy where the counsellor relates back to their own experiences from their own perspective instead of the client's, rather than have an accurate empathic understanding of their client from their frame of reference. Just because the counsellor has had a similar experience to their client and may be able to relate to them on a personal level, they will never be the same experiences because they are two completely different people with their different experiences. So, it is important for the counsellor to be aware of what belongs to them and what belongs to their client, and to mindfully choose what to do with one's own experiences (e.g., bracket them or use them in a transparent, congruent way) whilst endeavouring to communicate to the client an empathic understanding of their world. 

In fact, the counsellor's personal experiences can sometimes get in the way of fully meeting their client when they: relate to their client's from their own perspective, when strong emotions or intrusive thoughts arise without the counsellor being able to bracket them, or when a counsellor's anxiety takes over when talking about certain subjects that they have not fully recovered from. Sometimes it is the case, then, that a counsellor's experiences prevent them from being fully present with their client. So, sometimes it might be that the best counsellor for a client is not the one who has had similar experiences at all.

There is also the question of when and how it arises that the client learns of their counsellor's experiences, which is a self-disclosure. This is a complex issue and research findings indicate therapist disclosure might or might not generate boundary issues, can either enhance or diminish perceived credibility and competence, and can enhance or compromise the client's view of both therapist and client roles (Audet 2008). The issue really does seem to depend on the individual counsellors and clients and the particular issues in question. 

This post was prompted by someone who contacted me with an enquiry about counselling for a relative of theirs. The only requirements were that the counsellor must be divorced and have life experience. As a twice-divorced fifty-something who has been around the block a few times, I feel fully qualified... but I do wonder if I will meet the client's expectations.