Radical Listening is the Secret Ingredient to Successful Psychotherapy By Steve Alexander, LMHC on 12/13/22 - 12:32 PM

I recently woke up feeling sick. I had a sore throat and could hardly utter any words beyond a whisper.

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“I need to immediately call and reschedule all of my private practice clients,” I instinctively thought. However, I began considering how frustrating it is when my clients cancel on me at the last minute. They were expecting to see me, so I decided to work. I work virtually so there was no risk of getting anyone sick. I also felt as though I had enough energy to actively engage with clients as I regularly do. The only problem was my raspy voice.

Despite my attempt at fortitude, my mind wouldn’t quite let me off the hook. I became flooded with a barrage of critical thoughts about whether my clients would view me as being “less than” if I communicated with them through a hoarse voice. At one point, I conjured up a fantasy of being fired by one of my more critical clients. Further, I even imagined that if my voice was only at 30% of its capacity, I should only charge 30% of my rate. This flurry of thoughts helped me to empathize with many of my clients who struggle with overthinking.

As I proceeded throughout my day, I quickly became aware that most clients interacted with me as usual. Either they didn’t notice or didn’t care. I did have one teen ask if I had been practicing ASMR (Autonomous Sensory Meridian Response) — a pleasurable sensory experience — and another client asked if I was sick. Two out of ten clients wasn’t too bad. In the days that followed, I noticed a similar trend of clients being more concerned about their own problems than they were about me sounding a little different.

However, the experience offered a great lesson in self-awareness. Though I pride myself on “active listening,” I tend to talk way too much in therapy. I guess that I enjoy hearing myself speak. After all, I worked so hard to get a Dual Master’s in Counseling Psychology and I deserve to be heard, right? Talking makes me feel brilliant, but it is not always effective when getting clients to tell their stories.

Having a sore throat forced me to shut up more often than I wanted to. At times, I felt enraged with myself for not being able to point out patterns in my client’s distress or offer carefully planned interventions. Fortunately, over time, I accepted my fate as a somewhat voiceless therapist and stopped trying. To my surprise, clients did well with more space. They even made connections on their own without the imposition of their self-aggrandizing psychotherapist. Perhaps Carl Rogers would be proud of me.

But, how about the client that I fantasized about firing me? Towards the end of our session, I shared this fantasy with her. She had been talking about struggling with intrusive thoughts and I thought that this disclosure might be appropriate. She found my concern humorous, and I used it to help her understand how she could accept negative thoughts without necessarily having to change or challenge them.

Now that my voice has mostly recovered, I still find myself utilizing the lesson I learned from when it was hoarse. I remind myself to have clients lead and be the main experts in the room. As a therapist, we can sometimes be speechless and still have a voice.

Questions for Thought and Discussion

Did the author’s plight resonate with you? If so, how?

Do you tend to talk more than you think you should with clients?

Are there particular clients with whom you tend to talk more? Less?

What could you do to improve your presence with clients?   

File under: A Day in the Life of a Therapist, Musings and Reflections