Therapeutic Zeal

What is Therapeutic Zeal?

Therapeutic Zeal is a mis-alignment between the therapist’s desire for progress the client’s need for process. An urge for movement when things feel stuck or when other uncomfortable feelings occur. When a client comes to therapy there is an implicit, if not explicit, expectation that the therapist will do something. Tension arises when the client does not seem to be making progress, is regressing or is simply having a hard time in life that cannot be immediately solved. 

The impulse is to do something now, the what to do is unclear.

The urge for progress can be seen as a defense against feeling something, like being ineffective. It can manifest as a need to make a plan or as an impulse to refer the client out to another therapist.

From a psychoanalytic lens this urge is explored as counter-transference resistance. A resistance to having the feelings that the client stirs up. From a mindfulness perspective it is an avoidance to being present with what is.

Counter-transference resistance provides data. Information about the client and the emotional constellation of their situation. Cultivating curiosity about what you, as the therapist, are sensing can open the door to explore the effects the client is having on you and most likely other people in the client’s life.

Counter-transference is the feelings that a client stirs up in in the therapist.

Counter-transference provides a perspective that helps orient to the client’s circumstances. There are many different kinds of counter-transference. Subjective counter transference refers to the the feelings that are a result of the therapist’s experiences. For example if a client talks about losing their mother at a young age and you lost your mother at young age, that similarity elicits your own feelings and experience mixed in with what the client is experiencing. Objective counter-transference refers to the feelings elicited by the client. For example if the client is depressed and gives off a particular heavy vibe and you feel heavy around them and others around the client also feel that heaviness, that feeling is specific to the client’s experience. 

However everyone has their own reaction to heavy feelings and your reaction to that feeling would be considered a subjective counter-transference. It’s not like an either/or, its more like layers within an experience. Both subjective and objective counter-transference exist simultaneously. Being able to distinguish between subjective and objective aspects of counter-transference builds an awareness of the client/ therapist dynamic.

Track your impulses, thoughts and feelings with clients. Describe your reactions to yourself through writing or consulting with other professionals. These practices expand your perspective. How you use that information with your client is is a therapeutic process in and of itself. 

The meaning we give the discomfort effects how we react to it. 

The insights gleaned from exploring counter-transference resistances can be used to hold space for difficult feelings. Knowing the client might need a relationship in which to feel hopeless shifts the perspective. Having the feeling is more important than solving it. It models acceptance, both for the feeling and for the client. The focus shifts to the role that the client may need the therapist to play in whatever they are going through. This is called an anaclitic counter-transference. The therapist becomes the therapeutic presence that the client needs. It is important to note here that role may not give you the feelings that you are a good nourishing caregiver, it may be to be someone who can tolerate the criticism or anger that the original caregiver could not tolerate, someone who can be with it without trying to control or change anything. 

There is still something to do, a role to play, just not what you might have expected.

Communicating with the client about counter-transference reactions is also an option. The client has been in their situation longer than you have been with them, you can directly consult with them about what they stir up in you. A question like, “I am having the impulse to give you advise, is that what you are interested in? Or would you like me to just listen right now?” does many things. It lets the client know that you are thinking about what they want, it demonstrates a desire to help, it is gives them choices, it is evidence you are interested in how you effect them. Client’s answers will vary. They might want advise, they may tell you you are the expert and should know what they want, they may not know…… What ever they answer gives you more information. If they are annoyed, explore that, if they want advise try giving that to them and see what they do with it, if they don’t know, then ask them what it is like to not know. 

The goal in these situations is to get the client to put more words to their experience, not to solve it and make it go away. 

Therapeutic zeal is when the therapist’s desire for change overrides what is therapeutic for the client. Question your reactions and intentions before acting. Stick to noticing and describing the situation you are sharing with the client. Sticking with the feeling allows both the therapist and the client to explore and understand the circumstances causing the discomfort more throughly. 

It’s a good time to focus on rapport rather than achieving goals.