Friendship, “Therapy,” and Mystification

By Wade Lee Hudson

For some three months, I’ve been seeing a psychotherapist, Rebecca Crabb, Ph.D., weekly, for the first time in my life. I started not because of any crisis. I simply wanted to fine tune my life by learning how to be somewhat happier and less preoccupied with certain minor, nagging problems that have recurred. Even if the growth may be slight and subtle, I never want to stop growing. Thanks to Medicare, I can afford it.

The experience has been beneficial. I tell Rebecca what’s happening with me and my thoughts and feelings about the future. We discuss bumps in the road, my sense of what’s missing in my life, and how I might manage to enrich my experience. She’s a good listener, remembers what I’ve said, asks good questions that help me dig deeper or see matters from a different perspective, and occasionally offers suggestions for me to consider.

Though the focus is on me, Rebecca occasionally reveals herself. These revelations have reassured me that we are largely on the same wavelength, which helps me trust she can understand me.

I tell her what I would like to tell close friends, if they were willing and we had more time to talk. I’m completely honest with her. Though I don’t have time to share everything, there’s nothing I’m unwilling to share.

As the female Dr. Watson in the contemporary Sherlock Holmes show, Elementary, was a “sober companion” for Holmes, I feel Rebecca is my “intimacy companion.” I go to massage therapists to work on my body. I go to her work on my feelings.

But we are not real friends. The focus is on me and she gets paid. Our relationship is not mutual. I would like to be close friends with her, but that would be contrary to her beliefs (even if she wanted to be my friend, which is uncertain). And she may be right: not being friends, for one thing, might help her be more detached, which can enhance our work.

This experience has prompted me to reflect on the differences between therapy and close friendships and what others think about that question.

Recently, after discussing an issue with which a friend who was struggling, she commented, “Thanks for being my therapist.” Later, I thought to myself, “Really? I just thought I was being a friend.”

On another occasion, when I told a friend I was seeing a therapist, he said, “Good. That way you can go into things more deeply.” Later, I thought, “Really? Why couldn’t I go more deeply with my friends?”

Over the years, when I explored setting up different kind of loosely structured “support groups,” others have sometimes resisted, saying, “That sounds like therapy to me.” Those comments have puzzled me.

So the other day I posted the following on my Facebook status update:

Is therapy essentially different from close friendship? Do or would you communicate differently to a therapist than you would to a close friend, lover, or spouse? Are there some things that you would say to one but not the other?

After receiving five responses, I clarified my question with:

I did not ask if there are differences. Rather, I asked if there are essential differences: "Are there some things that you would say to one but not the other?" Perhaps, for clarity, my second question should have read: "Do or would you communicate differently to a therapist than you would LIKE TO COMMUNICATE WITH a close friend, lover, or spouse?"

Or, in terms of what you say, would you like to communicate to your close friend/lover/spouse the same thoughts and feelings that you would communicate to a therapist? And would you like the other to respond as you would like your therapist to respond?

This amplification elicited further responses.

One respondent commented, “My close friends are my therapists and often it is daily. :-).” And another said, “It's not so much that I would SAY anything different. The difference is what I expect to get back.... I expect active assistance in resolving issues. I've had to fire a lot of lazy therapists.” A third said, “If we turned more often to good friends & mentors, I think we'd all benefit from learning to listen better, from developing empathic sensitivity, and from discerning wise counsel.” And a fourth commented, “I'm thinking in terms of the transformation of society generally from a ‘tribal’ society in which affective bonds predominate, to a market economy in which contractual relationships take over. In an affective community presumably there would be no need to distinguish something called ‘psychotherapy.’”

I largely agree with those comments, though it seems close friends can offer active assistance in resolving issues as well.

But most of the responses, such as the following, indicated a different perspective:

Absolutely different. The therapist holds no judgment so you feel like you don't have to hold anything back at all. Also, she is trained to deal with a range of issues and can bring insight that a friend can't.... Yeah, I probably do want to tell my best friends a few things but I hold back for many different reasons, some because of me, some because of them....  I feel like I am paying for my therapist's education and experience. I'm not paying her to be a friend, I have lots of those. But I am going to her for her expertise. Just like I wouldn't ask a friend to fill my cavity, I also wouldn't ask my friends to offer me certain types of advice. 

You subconsciously choose friends who reflect your view of reality. A therapist can offer a completely objective perspective, and can present it without fear of losing the friendship. Also, one of the tools of overcoming shame is to self-disclose, but once you self-disclose to a friend, there is no taking it back. Consequently, people are more hesitant to share their deepest sources of shame to friends. Also, without training, even the most trustworthy, loving friend might not have the tools needed to help you process your experiences. Good intentions are not always enough. I highly recommend good friends, therapists and 12-step groups as three different but equally valuable sources of support and insight....  I would still say yes, there is a difference. There is no reason to burden my friends with my ancient shit. I don't tell my friends what I tell my doctor or my car mechanic, or my financial adviser - not because I'm ashamed, but simply because that's not what they are there for. 

When I pay someone, I have an agreement about what they will do for me when I talk about something. I will tell my therapist literally anything, but not my friends.

Survivor that I am, I discuss a lot of things that happened in my life that I would NEVER talk about in depth with close friends. I use my therapist a lot for education and information about abuse and intimacy issues, PTSD, etc. She knows the specifics of all the shit that happened. My close friends know there was trouble in River City but I don’t discuss the details. Way over the top for most people I've learned, even close friends. So yeah because of the education/teaching function with my shrink, it’s an entirely different deal that the deep talk about life and what’s it all about alfie with my friends. I like my friends the way they are and my shrink the way she is. Hope this helps

 Yes, very essential differences. All can be necessary at times in my experience, & a great bounty.

To my mind, these comments reflect a mystification of “therapy” and an exaggeration of the expertise that is involved. Most grandmothers, long-term bartenders, and others with rich life experience are as adept as are most therapists in helping others deal with personal problems. The analogies to dentists, car mechanics, and such don’t hold true for me. Good “therapy” does not involve a technician objectively operating on objects. Such objectification is a myth that reinforces the hyper-specialization that is spreading in our culture. This mystification disables, for it fosters dependency on supposed experts and undermines self-confidence.

Good “therapy” is a heart-to-heart human relationship, even if it is largely one-way. I place “therapy” in quotes because I do not consider the process to be a matter of a doctor administering treatment to cure an unhealthy condition, which is the definition of medical treatment. The conditions addressed are normal ways to cope, given the situation. A shift in perspective can help one cope more effectively, and others can assist in that shift. But most of the work is internal and does not involve an expert applying a medical method analogous to giving a drug or doing surgery.

Rather than “therapy,” I prefer to think of a “special friendship,” one that is commercial and largely one-way. One might also call it counseling, mentorship, or coaching.

I understand that many people prefer to compartmentalize their life by having different relationships to meet different needs. I see that some matters can best be discussed privately. And I recognize that some people are fully content with their life and feel no need for any self-improvement. So maybe I’m being judgmental. But I can’t help but feel that it is unfortunate that so many people so frequently feel that they have to hold back even with “a close friend, lover, or spouse,” which is the phrase I used in my original post.

In 1985 and 2004, researchers asked Americans: “From time to time, most people discuss important matters with other people. Looking back over the last six months—who are the people with whom you discussed matters important to you?” From 1985 to 2004, the percentage who said they had no such confidante increased from 10% to 25%. In 2004, 53% reported they had no one outside their immediate family with whom they discussed important matters. The average number of confidantes decreased from three to two.

I know there are many understandable reasons why people withhold their feelings, including the fact that others find it “over the top.” And it becomes a habit that we develop as a way to cope with authority figures. As I discussed in “Facing Fear,” Howard Thurman summed up the dilemma aptly when he said, “This fear which served originally as a safety device…becomes death for the self…. The weak have survived by fooling the strong…. [But] the penalty of deception is to become a deception…”

So it saddens me that people are so often afraid to be fully present, open, and transparent with one another. If I need to discuss some issue with a therapist, I would like to be able to also discuss it with a close friend, lover, or spouse.

In the busy, modern world, spontaneous, natural human friendship is becoming less frequent. My intuition is that, for many people, it would help to develop some simple structures and formats that would facilitate heart-to-heart communication. One example is a “listening dyad,” which I did with one friend for a few months (before I left the country). We’d meet for an hour with a bag lunch and one person would talk for 30 minutes about what was happening in his life and the other would just listen. Then we’d switch roles. That was it. And each of us seemed to benefit immensely.

Another example is the “soul session” that I convened twice in Mexico. About eight people gathered in a private home. Without a facilitator or any predetermined agenda, we simply “spoke from the heart.” Both sessions seemed to be valuable, but a particular interpersonal conflict interfered with its continuation. Nevertheless, I feel that if participants were selected more carefully to assure an adequate comfort level, this method could work.

But such methods are not for everyone and regardless, they are secondary. No tricks will work unless the participants are authentically curious and compassionate. So long as self-centeredness remains the norm, social isolation will persist and when crises emerge, people will go to a therapist to try to get fixed. Myself, I believe better, mutual friendships among peers would prevent many of those crises and enable many people to live richer and more meaningful lives.