Blind Side

Blind Side

by Pamela Garber
Empathy is a critical component to effective therapy, except when it contributes to a clinician’s blind side.
Filed Under: Relationships


Get Endless Inspiration and
Insight from Master Therapists,
Members-Only Content & More


Empathy Creates a Blind Side

“Empathic personality style” has a nice ring to it. In counseling classes and practicums, we are taught the importance of empathy and how to convey it to our patients. Empathy is part of every counseling skills curriculum, yet much of its application, the post-coursework expression of empathy, emanates from one’s persona, not from a professor or a textbook. We know empathetic traits when we see them. A smile and a thumbs up gesture, a phone call to a friend after a major event, a pep talk during a rough patch at work are all perfect examples, worthy of Hallmark commercials. If such gestures are second nature, then this is a good thing — right? Many therapists were first prompted by a strong innate level of empathy to become interested in psychology. A curiosity about others, a sense of what it may feel like to be them, and a motivation to help them with improvement are all essential traits for therapists.

Empathy Without Caution

There isn’t a paint by numbers pathway to success in any one profession, but there seem to be similarities in the backgrounds of those who enter the helping professions. Often, the adage about circumstances not making a person but revealing them applies. Is it that the sensitive person meets emotionally charged circumstances or that such circumstances bring out one’s capacity for sensitivity? We all know correlation does not prove causality, but correlation is not to be dismissed. As I reflect on my own peer supervision groups, early counseling classes and colleagues, so many of our histories seem like chapters in an open book, clear as day in my memory. The caring guy who returned to grad school to build a new career after a bitter divorce from a woman with untreated alcoholism. The A-student who began to address unresolved issues with her critical father. And there was Lisabeth, my former supervisor and mentor, who grew up in an emotionally abusive family where her parents were charming to the outside world and could teeter on being just healthy enough when on display. Their personas had so much flip-flopping that the dichotomy drove her nuts at times. Finally, my own abandonment by my father and the ripple effect of his abusive behaviors that predated his leaving. Therapists tend to have emotionally rich histories and a capacity for a rich emotional awareness. But are these histories and qualities enough to ensure future success as a clinician?

Often, therapists don’t shift easily from the mode of helping a patient in the professional realm to the mode of self-protection in the private or social realm.
Just as it is physically impossible to be in two places at the same time, it is impossible to fully operate from more than one emotional state of being. Often, therapists don’t shift easily from the mode of helping a patient in the professional realm to the mode of self-protection in the private or social realm. Factor in the dynamic of therapists’ innately having sensitivity towards the point of view of others, and it is easy to understand why therapists often have a blind side when it comes to looking out for themselves.

Mary’s Story

Mary was the picture of the YAVIS patient as she sat on the couch across from me, smiled politely and asked if I was ready. She was new to working on her own therapy but had been a therapist working with veterans and their families for about seven years. She had graduated from a prestigious university and had a quality of poise and presence.

After polite pleasantries, Mary’s face suddenly seemed to fall into her hands. She was talking in fragments, hands now molded to her face, and I had to fight the urge to ask her to speak louder.

“He told me I was making him crazy. He said I had no right to hate his family.” She became silent, as if she were digesting what she had just said. Therapeutic silence seems to move five times slower than real time. She then smiled and her voice became stronger.

“Don’t you just love recent history? Such a tricky phrase that takes you into two different directions at the same time. If it were so recent, it wouldn’t really be history, now would it? And is history ever really history? There is no such thing in the Land of Oz and certainly not in therapy. But I guess that is where we start, of course. How in God’s name one Ken doll protégée could morph into…”

She started laughing to the point that any more would have been like a Bette Davis scene from Whatever Happened to Baby Jane
She started laughing to the point that any more would have been like a Bette Davis scene from Whatever Happened to Baby Jane.

We were close to ending the session and Mary sounded close to ending her marriage, citing endless criticisms she had endured. The criticism and “picking,” as she called it, typically happened when they were alone, but had recently expanded to being played out in front of others. Often, their audience was his children. Steve had two grade school age daughters from his first marriage. Mary described Steve as being fragile during their courtship.

“At times I’d come away from an evening or early morning with him to head back home and feel like I had to shower all of his pain off me. He would start out as a strong, strapping guy wanting to take me to dinner, movies, or whatever, but by the time the evening took off, it was texts with his ex-wife and children, a sad, vacant look in his eyes and tuning out whatever was left of our conversation, followed up with, well, odd word, but — pleadings for me to see him again.”

I was just about to ask her what that was like for her, but she continued her recall and continued making it all about Steve.

“It was just awful for him.”

I pursed my lips to keep from saying too much after my one-word response of “Him?” followed by what a client used to call my owl-eye stare.

“Well, him, yes, at that time. I know what you’re getting at, but I was okay with him being the center focus at that point. Relationships are like seesaws, and this was the time for me to lift him up.”

“Mary, can you pinpoint at what point it became not okay for you? At what point was Steve’s behavior towards you not okay?”

Through hands that made their way in nanoseconds back to her face, Mary cried suddenly.

“I became a laughingstock. He made it so. Right in front of his kids, ex-wife, ex-neighbors. It had been a risky proposition for me to even go, but then…” Tears formed and she grabbed a tissue from the end table and dabbed her eyes in what seemed like a deliberate patten of four dabs each eye before continuing, “He posed for family photos with his ex and children, ignored me the entire night.
It was as if he was deliberately trying to break me
It was as if he was deliberately trying to break me. I left with him feeling like the child I used to be when my mother and sister each forgot to pick me up from school and I had to ask my teacher for help.”

She threw out the term “gaslighting” as she described the ride home with Steve after the party at his ex’s. Her slightest bit of revealing her feelings was met with Steve’s psychological evaluation of her and “diagnosis” of immaturity. In the next breath, she said, he practically begged her to stay the night with him, that he needed her and would think about what she had said. She was shaking her head as she described ignoring her own upset in exchange for focusing on his wants. It seemed like her emotional pendulum would swing often in this relationship. In a possible attempt to distract from looking at her pattern of focusing on Steve at her own expense, she asked if now was the time to recap her toilet training and her childhood in England. I thought about redirecting her back to the car ride but decided to let this pattern of putting others first, even when their behavior was abusive, have a wider net that could possibly include her life before Steve. My expression of encouragement by curiosity was enough prompting.

“I was always okay, you know. I was the nurse when we kids would all play hospital. Funny, not the doctor, anyway, nurse it was.”

“You can picture it?”

She nodded, “Oh, clever.” Her face became once again hidden by her long hair and her hands, but I knew she was crying. I was prepared to keep her focus on what Mary described as cold, unaffectionate parents and then later in future sessions delve more into the present ground we had initially covered. However, like a detour on a road trip that leads to more and better, Mary processed a direct link between her teenage years and her marriage. Though my own bias and historic blind side in therapy is to identify a plan of action, I yielded and let Mary’s insight be the focus. Insight about trying to win her parents over and this being replayed in her marriage took the focus of the next few weeks. Forever the Freudian, Mary described seeing repetition compulsion in red ink every time she saw her husband. The cognitive behaviorist in me saw this as a concrete decision on her part to change her thinking. No matter the modality, the door was open, and Mary was about to walk through it to freedom.

Mary recalled baking pretend cookies for her mother when her father was working late and saving a couple “cookies” in a tin for when her dad came home
Mary recalled baking pretend cookies for her mother when her father was working late and saving a couple “cookies” in a tin for when her dad came home. She described singing and dancing whenever he was around. Our mutual smiles were slammed shut when she jumped up and started stomping, hands on hips.

“I cowered in the corner when my father’s arrogant, holier-than-thou, pseudo-intellectual family mocked me for having a lisp. And what did I do whenever this happened — and always did whenever any of them seemed displeased? I’ll tell you. I sucked up. I kissed ass. I was a doormat baking fake cookies and singing songs and learning to be gutted by predator animals in the real world my whole fucking life.”

I hesitated before asking what the baking fake cookies behavior looked like in her teen and adult years. She smiled, “I became a good listener. An observer of everything. A helper. The teacher’s pet, the best daughter, sister, student, friend.”

“Others could rely on you for understanding and caring. How did that benefit you?”

Smiling after another pregnant pause, “Well, people don’t bite the hand that feeds, especially while they’re being fed.”


Therapy eventually became targeted on how Mary had learned to focus on others at the expense of caring for herself — the origin of her blind side in both her professional and personal life. Mary had simply adapted to focusing on the needs of others, at the expense of her own. Effective personal and therapeutic confrontation were already in her toolbox, but what was needed — what we worked on — was creating another kind of therapeutic confrontation. This was one through which she implemented an internal filtering system that she could use in order to silently confront other people’s words and deeds to herself. Not an actual confrontation, since it was to be only internal; however, it would be as real as those formidable fake cookies. Actual external confrontation was the homework for future sessions.

© 2020
Pamela Garber Pamela Garber, LMHC earned her Masters degree from Nova Southeastern University and her undergraduate degree from the University of Texas. In addition, she studied film production at the Film Lab Actor’s Lab in Las Colinas, Texas. Combining psychology and film, she developed and produced a behavior modification program called Playing the Tape, a DVD curriculum series with a workbook and assessment. Her website is