2017-07-13 / Guest Column

How The Psychotherapist Listens To His Patient

By Michael Feld, L.C.S.W.
Certified Psychoanalyst
Licensed Psychotherapist

The most important job of the psychotherapist is to listen to his patient. The way the psychotherapist listens is very different from the way we listen to people in the course of regular social conversation. The primary difference is in what Karen Horney described as the quality of the psychotherapist’s attention. One of the components of this attention, and one which Horney emphasized as most significant in doing psychotherapy, is wholeheartedness.

Wholeheartedness of attention is the quality of being entirely absorbed in the process of listening. The therapist devotes his full attention to the patient, using all his faculties, concentrating and immersed in the information the patient is conveying, using everything at his disposal to receive the communication from the patient. This includes listening with his conscious reasoning, his intuition, all of his feelings as they emerge, and all of the time being open to the patient and in the moment with the patient. Sometimes, the therapist is distracted because of personal worries, such as concerns regarding his spouse or children. At other times, the therapist’s own remaining neurotic features can interfere and distract his degree of attention. When this happens, he should go back to and analyze these features. The therapist must always self-scrutinize himself, since he is the instrument with which he does his work.

Karen Horney had a strong interest in Oriental culture. She wrote that the concept of wholeheartedness was developed and learned on a higher level by Oriental people through exercises, postures, breathing, meditation and yoga. This intensity of concentration is a quality of Zen Buddhism, and is characterized by an unlimited receptivity. An openness to let everything in, and not qualify what one feels. It is the job of the psychotherapist to absorb everything communicated by the patient, and to work on those impressions that do sink in with everything at his disposal. This includes his feelings and his knowledge. But always in the service of the patient. Wholeheartedness of attention requires the therapist to be open to the messages of the patient, even in the face of his own fear and anxiety. This means staying with the patient, especially when uncomfortable, unpleasant and difficult matters are being presented.

Prepared as a public service from the office of Psychotherapist Michael Feld, L.C. S.W. (718) 444-8560

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