Is it possible for a client to become dependent on therapy?

Question: Is it possible for a client to become dependent on therapy, perhaps as the only satisfying relationship they have?

Answer (1) Being initially dependent on therapy is usually treatment phase related and a common enough phenomenon. However, one of the main ideas of therapy as I understand it, is to eventually free the client up enough from whatever is blocking them, to seek out, pursue and manage healthy relationships outside of therapy. The very nature of the therapeutic relationship is to stimulate but not necessarily to gratify ones' needs. It is supposed to be, "an as if experience" and therefore if conducted responsibly, is fundamentally, somewhat frustrating. If the therapy is too gratifying and the experience becomes overly comforting, a sort of addiction to it and the therapist is certainly possible and we then have what Freud called, an interminable therapy. That is, one that cannot be properly brought to a mutually satisfactory conclusion.

Answer provided by David White, Psychotherapist

Answer (2) Anything is possible, but good therapy should assist you with creating the life that you want and moving ahead - including acquiring quality relationships. If serious dependence develops (which it theoretically shouldn't, but could), then it may be time to review and update the issues that you are working on, one of which may be the dependence! A degree of dependence is OK - that's the point of therapy, to provide you with a reliable supporter and problem-solving resource - but a good therapist will assist you to become stronger and increasingly independent.

Answer provided by Stephanie Thompson, Psychologist

Answer (3)
The simple answer to your question is a definite yes. However this is not a trivial question and deserves a full answer. This is what I think. Often when clients arrive for therapy, they come because they have found it intolerable to live with their current life-situation. It's not surprising to learn that they have tried all sorts of ways to overcome the aspects of their life-situation that give them distress. They may have found that they are unable to depend on their well worn ways of coping - often negative coping mechanisms such as addictions including workaholism, substances, promiscuous sex and so on. The client may find no solace in family interactions and most friends are simply unable to help without trespassing and taking up emotional space that does not belong to them. At this stage the client might be isolated and having to carry on as though they were independent.

If all goes well in therapy, the client will embark on and complete a journey, starting at unhealthy independence, travel via dependence (for a time) and eventually arrive at healthy interdependence. Interdependence is the healthy state of equilibrium for human beings because there is both give and take. However to get to interdependence the client may for a time become quite dependent on the therapist. This could feel like the only satisfying relationship the client has as you have written in your question. It could also feel like the only hour a week when everything seems manageable and in perspective. Like it or not clients then have to live for another 167 hours a week in which they progressively learn to put in place some of the insights and changed behaviours they and their therapist have talked about.

Once again if all goes well, clients will develop their own internal therapist who grows stronger over time and eventually replaces the therapist they have been paying to see. Certainly both client and therapist will change as a result of any therapeutic engagement and in particular the therapist will grow in experience and understanding. It is not possible to have a therapeutic arrangement where both parties do not affect the other. I hope my answer is of some use to you.

Answer provided by Scott Jordan, Psychotherapist

Answer (4) We crave connection of some sort. The experience of meeting and discussing highly personal and private thoughts, feelings and conduct with a receptive, non-judgemental, person can take on a meaning for the client beyond its true importance as a professional, objective, humane therapeutic episode. You might want to discuss this with your therapist, I am sure s/he would want to help you work through this. For me no matter how long or brief the therapy is, it is part of my therapy with clients to plan for a proper ending of the relationship without feelings of loss or abandonment. Without dialogue about the process, the therapeutic relationship may become another barrier to moving on to a more independently functioning life.

Answer provided by John Hunter, Counsellor

Answer (5) The question you raise is an excellent one. I would suggest that a level of dependency occurs in all relationships, including therapeutic ones such as with counsellors, doctors, and other therapists. This is because dependency is an immutable aspect of Relationship. Whilst currently popular in psychological and self help literature, it is however too simplistic a notion that dependency is 'bad' and independence is 'good'. Like yin and yang, both are aspects of all our relationships. As infants we are entirely dependent on our parents for all our needs; as adults, we are dependent on a much broader range of people to meet our needs. We also develop a level of independence - which means the ability to meet and satisfy our own wants and needs without input from others. It has been discussed since the time of Freud, that dependence is in fact critically important for therapy to be effective. Through allowing ourselves to trust another and receive help from them, we are choosing a level of dependence - we are seeking to have some need met - whether it is to be heard, to be validated, to be challenged, to be educated etc.

Therapy can be deeply satisfying, as it may be one of the only places in a person's life where they can reveal any aspect of self in an atmosphere of safety and acceptance. In this way, therapy is a surreal environment. But the therapeutic relationship does allow for the individual to work on his or her self, strengthen identity, and develop new skills or approaches before trialing them in real-world relationships. Sometimes our growth will require us to become more dependent; to ask for help, to recognize we need others etc. At other times, we will strive for more independence by testing our own limits or meeting our own needs. As Scott Jordon has responded, one of the integral aspects of good therapy is to internalize the useful qualities, knowledge or skills from your therapist. I would recommend that rather than adopt a dualistic view of dependence as healthy/unhealthy, that we instead look at how and where we are dependent and independent. Even so-called unhealthy dependence must somehow be working for us - perhaps it is keeping us from being alone, perhaps it provides financial support. If we simply bring our awareness to these aspects of our relationships, we are in a better position to make choices - perhaps we sort out our financial situation so we have more freedom than dependence in a particular relationship.

Answer provided by Michelle McClintock, Psychologist

Answer (6) The above answers to your question are so excellent that I am released to take up the reciprocal of your enquiry. Is it possible for a therapist to become dependent on providing therapy as the only satisfying relationship he or she has? The stories of children of therapists say the answer is for some, a resounding yes. For example: "A surprising number of children believed that their parents themselves had found in their practice a surrogate life that was both richer and less personally demanding than their own lives." Interview with Thomas Maeder, author of Children of Psychiatrists and Other Psychotherapists "To hear some therapists' kids tell it, their parents saw so many problems that they had formed the notion - or at least communicated it to their children - that most marriages were loveless and rotten, and houses were closet dens of iniquity." His advice "Anything that is obviously identifiable as being psychotherapeutic probably does not belong in the parent-child relationship."

Anne Wilson Schaef gave testimony to her relationship addiction in her exodus from a contemporary psychotherapy practice in the book, Beyond Therapy, Beyond Science. She offers as a dedication her release from the codependency of therapist on client: 'I dedicate this book to all of my clients for whom I had goals and knew what was right for them and what would heal them. I began to see that setting goals was a form of control. I was arrogant and out of line. ... I was operating out of a series of assumptions that I was taught in my training that I now know frequently exacerbated the problem and facilitated my clients' adjustment into an addictive, sexist, racist, self-destructing society, and I am sorry for that.' The book was an important part of her recovery as a psychotherapist. There are layers and layers of privilege and dependent co-evolution in both client and therapist sharing the business of therapy. 'The universe is like a puzzle and each one of us is part of that puzzle. No-one else can take our place in the puzzle.'

It is no small challenge to stay honest and clear about our dependence when we work within an industry that succors addictive behaviour. 20,000 self help book titles listed on is a fraction of the supply line. In Buddhism, the hungry ghost is insatiable. How often did you check the forum this week?

Answer provided by Peter Fox, Clinical Psychologist

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