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How should the relationship between psychologist and patient be?

How should the relationship between psychologist and patient be?

May 22, 2022

Although even today to go to the psychologist is a relatively unusual and even slightly stigmatized action for part of the population, fortunately it is becoming more frequent that when a person suffers some kind of psychological problem seek professional help. Through interaction, professional and user establish a link through which to work.

This link must be worked over time in order to offer an optimal service. How should the relationship between psychologist and patient be? In this article we are going to make a brief comment about it.

  • Related article: "4 fundamental therapeutic skills in Psychology"

The relationship between the psychologist and the patient: main requirements

We understand by therapeutic relationship to professional type link that is forged between therapist and patient and that it is aimed at treating one or more specific aspects or problems that hinder the quality of life of the patient or their environment and that the patient wants to change. This relationship must always be based on mutual respect, and especially centered on the figure of the patient or user.

If the therapeutic relationship is positive, it facilitates the achievement of the results regardless of the technique to be used, the subject does not feel confused and easily shares their thoughts and emotions with the professional and promotes willingness to change. It seeks to generate a climate and an environment in which the patient can feel protected .

At the level of the therapist, it is necessary to manifest a certain level of proximity in which the subject can come to feel accepted and listened to. The presence of empathy and cordiality in the professional also help. Authenticity is also relevant: the ability to be oneself and to respond sincerely to the questions that are generated in consultation. Finally, it is worth mentioning the absence of judgment towards the patient, active listening, the interest in the other and the search for their welfare as basic elements of this relationship.

A professional help

One thing to keep in mind: a psychologist is a professional who is offering a service and who is charging for it. This implies that we are in the midst of a professional relationship, in which although it is inevitable and desirable that a certain bond or even affection should appear, we should not confuse this link with other types of relationships. Thus, the relationship between psychologist and patient is not neither of friendship nor of another type that is not professional .

If this is the case, it is for a good reason: the relationship between both people seeks for the patient to achieve solve a problem that is not able to solve by itself , and requires professional help in which the psychologist must be objective in order to find a way to achieve the patient's well-being. Likewise, one of the parties has all the information about the other while the second party knows practically nothing about the other.

Transfer and countertransference

Two of the most famous and at the same time most important concepts in regard to the relationship between psychologist and patient come from psychoanalysis, these being the terms transference and countertransference.

The transfer refers to the projection by the patient of the patterns of behavior, upbringing, affection or desire felt towards another person in the figure of the therapist. While the transfer itself is to a certain extent positive since it allows externalizing said information , the truth is that taken to the extreme can lead to think of the existence of strong feelings that can not be matched due to the type of relationship that both people have. In other words, the transference can be considered as the set of reactions that the therapist generates in the patient.

The transfer is understood as a positive element that allows us to work on different topics that could not otherwise arise. However, it must be appreciated that the transfer can also lead to the appearance of excessively intense feelings towards the therapist, to the point of love or hatred. These should be worked in therapy.

On the other hand we can find the countertransference, or the ** set of emotions and feelings that the patient can get to wake up in the therapist **. Although a certain countertransference will evidently appear in most therapeutic processes, the professional must first be able to identify these emotions and subsequently act in the most objective way possible , and if necessary should refer the patient. This countertransference is usually valued as negative, since it limits the psychologist's objectivity and can generate an effect on the therapeutic relationship itself.

  • Related article: "The transference and countertransference in Psychoanalysis"

Directivity level

One of the elements to assess the relationship between psychologist and patient is the level of directivity of the first in the session. The psychologist is a professional who has been trained for years in the field of the human psyche and its alterations, possessing extensive knowledge regarding behavior patterns , but this does not mean that he is going to simply tell us what we should do. There will be occasions when a psychologist is more directive and indicates more clearly the guidelines to follow in the intervention, while in others the role will be more passive, acting as a guide that leads the patient to find their own answers.

There is no way to act more valid than another at a universal level, but this will depend on the patient, his problem and his personality, as well as the level of collaboration between psychologist and patient or the objectives of the intervention. There will be patient profiles that require one way or another to act. In general, it is currently intended favoring autonomy of the patient and that he is able to find his own answers.

Valuing the language

Another aspect to take into account is the language we use. We must value that psychologists will deal with a large number of people from very different backgrounds and educational levels. Thus it is necessary to adapt the language so that it is understandable by the patient, doing it naturally.

Also the use of technicalities may be something that reflects knowledge on the part of the professional, but we must remember that the patient is in consultation seeking to solve a problem and not admire our cultural level.

A human soul touching another human soul

While it is important to be clear that the relationship between psychologist and patient is a professional type of link, given in a therapeutic context and in which the psychologist must be objective, this does not imply falling into a relatively frequent error: coldness .

It is not strange that many professionals, especially if they have just started although this is not necessary, maintain a slightly distant attitude and think and manifest themselves only in terms of treatment or focused on the problem. But although the intention that many of them have is to make a separation that does not confuse the patient between what is professional and personal relationship, Excessive distancing makes it much harder to feel understood by the professional and even trust him.

And is that we must not lose sight of the fact that the main basis of all good treatment, one of the main elements of any type of therapy, is the establishment of a good therapeutic relationship.

Feeling understood and valued by the professional is something that by itself is therapeutic, and should be favored by both parties. An open and close attitude, which reflects unconditional acceptance towards the patient and an active listening of what he comments and worries are in fact some of the aspects that are closer and at the same time more productive are to promote a change in the patient. Nor let us forget that whoever becomes a psychologist he does it because he wants to help others so that they can live their lives without limitations and without excessive suffering that allows a normal life.

Doubts about the therapeutic relationship

As you know, a large number of people with different problems come to a psychologist's office. The professional of psychology will try to respond to the demands that come to him in which he looks competent, trying as much as possible to be a useful help for the resolution of the problems, both expressed and not, for which he is consulted ( referring other professionals in case of not being competent). But nevertheless, It is common that doubts appear in patients due to the incomprehension of some elements proper to psychological therapy.

Next we will see a series of problems and doubts that some people have had regarding the consultation with a professional of psychology.

1. Client vs. Patient: What am I?

While psychologists generally tend to talk about people who come to him as patients, nor is it unusual for them to refer to them as clients or users . Some people may interpret this denomination as strange, but this question has an easy explanation. At the etymological level, a patient is considered to be a patient who suffers from an illness and requires external action to solve their problem. In this procedure the subject is a passive entity that receives the solution to his problem.

However, in psychology individuals who come to consultation will have to make a series of behavioral and cognitive efforts if they want to solve their problems, the psychologist being a guide or help to achieve this goal but always keeping the individual an active role in their recovery . That is why some professionals prefer to call people who come to your query clients or users before patients.

It is only a way of referring to those who come to consultation, and whether they are called patients, clients or users in practice, the processes and functioning of the therapy and sessions will be the same (the main methodological variations being those due to different currents that exist in psychology).

2. Lack of comforting response to emotional expressions

This aspect, although it can be taken for insensibility on the part of the therapist does not have to be. You have to bear in mind that the psychologist should try to be objective and observe from a distance the situation in order to be able to help the patient in the most efficient way, although it is true that the professional must establish a relationship of trust with the person who comes to the consultation so that it can get to speak with sincerity.

Furthermore, cutting the patient's emotional expression can be counterproductive, since altered emotional states may allow focus attention on the motive underlying them and to awaken the patient's own understanding of phenomena that he previously ignored.

Likewise, we must also bear in mind that throughout the day a professional of psychology sees multiple cases of people with very different problems, with which he must know how to put an emotional distance with his patients in order that his personal life and Your own psyche, in addition to those of later patients, will not be affected.

However, it is true that some professionals try to take this into account that they appear to be somewhat cold, which in turn can be counterproductive as the patient does not feel that his emotions are legitimate . You have to remember that the psychologist deals with people.

3. The one who speaks the most is me

It is common for many psychologists to wait a relatively long time before speaking, with some uncomfortable silences in the sessions. These periods of silence have as objective that the patient has time to elaborate his speech and dares to express ideas that with a shorter period would not relate. Thus, it is intended that he explore and declare the thoughts that come to mind with respect to the issues raised above, no matter how absurd he / she thinks they may sound. This may reflect contents of great importance for the treatment.

They also allow the professional to reflect on the most useful methodologies to apply according to the information the patient is reporting, restructuring what they know about the individual in question and achieving a deeper understanding of the case.

You have to take into account also that the level of directivity of the professional varies according to the theoretical current that follows . In spite of this, it is a fundamental requirement that the professional has an active listening regarding what the patient tells him.

4. My psychologist tells me things that are not the ones I consult

This issue appears in many cases as one of the issues that patients / clients / users least understand. It is common for the patient to explain a problem to a therapist and this is linked to something that apparently is secondary to the first.

In these cases it is possible that the therapist has considered that the problem for which it is consulted is due to another phenomenon that is considered to be of minor importance by the patient. In this way, it is intended to work the underlying cause of the referred problem , trying to attack its possible cause more directly.

5. The therapy is unpleasant

This aspect can be highly conflictive. Many people come to consultation with a particular problem of which they have a specific point of view. However, the actions that the professional can advise may clash with the expectations that the user had, and may result in any of the adverse proposals and contrary to their wishes.

It is necessary to take into account although some of the recommendations of the professionals may be unpleasant for the one who receives them, the therapist will always try to find the best possible method or the one that has proven most useful in most of the cases. cases to help solve your problem. Examples are therapies such as live exposure in cases such as phobias, which although they may arouse rejection in patients have been revealed as treatments of choice with a high percentage of success.

6. Same problem, different treatment

There is a large number of theoretical currents in psychology, varying the approach and the techniques used (although there is usually a great eclecticism). further each person has a different life, circumstances and even brain configurations .

In this way, what for a patient can be an effective treatment from the first moment, in other cases it can be ineffective and even harmful depending on the case. The professional will try to adapt as much as possible the treatment to the particular circumstances of its user / client / patient so that it is as effective as possible, always taking into account which treatments are usually more effective and varying strategy in case of non-compliance. be functional

7. Psychological therapy does not work

Many patients come to this conclusion after some therapy sessions. The truth is that generally It takes a certain time for the therapies to make a consistent effect . Also, keep in mind that the psychologist is not going to make the problems disappear. It is a professional help that guides us and facilitates the overcoming of the problems, but not without our own effort to achieve the change.

However, if all this is taken into account and after a relevant period of time the therapy is not effective, it is essential to inform the psychologist. In this way the professional can clear the doubts that the patient may have respect, vary the therapeutic approach (it is necessary to remember that the configuration of each psyche is different and that what some find useful to overcome a problem is not for others) or refer another professional with a different perspective of the problem that may be more appropriate to the case.

In the same way we must also bear in mind that the professional he must be able to know the thoughts and the events that the patient lives . The concealment of data that may be useful for the recovery of the patient or client can make it difficult for the professional to develop a useful strategy to treat the problems referred to in the consultation.

In addition, the fulfillment or failure of the tasks and challenges that the professional indicates and the generalization to the daily life of the professional indications (which can be difficult to carry out), will allow the patient to advance or not in his recovery, there may be big differences in achieving the desired results .


Throughout this article we have tried to clear up some of the doubts and misunderstandings that some patients present with respect to psychology professionals. The consultation of a psychologist is a space for guidance, help and treatment of many different problems. A good professional will try to do the best for your patient and to improve and recover.

However, this does not mean that in all cases the patients' doubts are due to ignorance or misunderstandings. As in all professions, there are individuals with more or less ability in the exercise of their functions, as well as cases of professional malpractice.

How to Grow Within a Relationship : Psychology & Mental Health (May 2022).

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