Why Psychotherapists Don’t Give Advice

People often enter treatment searching for wisdom, searching for advice that hasn’t already been given.

In the popular HBO show In Treatment, Paul, the psychoanalyst and show’s protagonist, confronts his clinical supervisor, Gina, and asserts his decision to begin a romantic relationship with his patient and to shut down his practice, choosing instead to become a life coach, who offers guidance. In arguing for his choice, he notes that Laura, the patient, needs good advice, which psychotherapy can’t offer. Gina, challenging Paul, retorts, “She’s coming to you because she can’t take advice.” To Gina, the problem isn’t that Laura needs better guidance, or in this case, a guru; she needs help removing the barriers she erected to the guidance already afforded to her.

Resentment toward the significant others in our lives engenders walls that prevent us from asking for help. Some of my clients are labelled by others as stubborn or arrogant because they don’t solicit, nor take seriously, others’ perspectives; they, simply, don’t value them. Therapy, then becomes a first step in the process of learning to trust, and even enlist, other people. Many of my clients were reared in environments with authoritarian (the my way or the highway mindset) and/or dismissive parents. They learned early on that they could only rely on themselves, believing that others would and could never have their best interests in mind. Some develop a high degree of paranoia, chronically wondering what others are after or whether they’re trying to sabotage them. When I ask them about their inability to accept compliments, it’s as much about the strength of their negative core self-conceptions as it is about a deep-seated mistrust of people. Fundamentally, they’re hypervigilant, always on the lookout for scams, spending the majority of their time precluding suffering.

We learn from our parents about the state of the world. Some of us find it to be a place of cooperation and neighborly love. Others possess an overly-developed drive to compete. In the latter instances, the individual is trapped in zero-sum thinking, wherein one individual wins and the other loses. Dog eat dog. Now, consider advice. Do you think that therapists can really give you advice that’s unavailable to most others? And if so, how good could it be? We aren’t a secret society of wizards. And, in reality, most of our wisdom comprises of platitudes. One of my clients, after offering advice to a friend, told me that she considered it crazy for her to give the same advice that she normally refuses to take. But, in an aha moment, she realized that the platitudes, more often than not, represent reality. In this case, she realized that, maybe, she should try to love herself more because she has good reasons for doing so. Known for her stubbornness, she came a bit closer to trusting compliments. She agreed with me that people aren’t terribly articulate and, therefore, use platitudes as a way to express something important in an easy way, which doesn’t necessarily discredit the clichéd comments.

When I was in therapy, my therapist, Jennifer, challenged me, maintaining, “It seems like you don’t want therapy to help you. Everything you do is a big fuck you to psychology.” And she was spot on! I hated asking for help, having had my self-worth entangled with the notion of rugged individualism, or grandiose narcissism; I mean who can even tell the difference? If therapy was anything, it was just a way for me to reinforce what I already believed. I frequently wanted to prove I knew more than my therapist, or at least possessed the foreknowledge of our future sessions. I was quite a fucking annoying patient. Therapy, to me, was was all about winning.

So, contrary to popular opinion, therapy isn’t about gleaning advice; it’s about developing the capacity to seriously consider the advice you’ve already received. If your client had authoritarian parents, he may view advice as a means of control. To him, advice is little more than a symbol of a puppeteer’s strings, representing the need for dependence. And I believed the same when I was meeting with Jennifer. I thought that therapy was trying to strip me on my authenticity, to box me in and form me into a respectable citizen; it was there to confirm my fear that I was inferior, a bastardized replica of an adult. But, that wasn’t the truth. Jennifer, seeing what others saw, attempted to understand why I was self-sabotaging, essentially failing to take advice that was so obviously good for me. She wanted to know why I refused to even consider it. So, I told her that I didn’t want to feel like a failure. I needed to be successful on my own, and I wanted therapy to tell me that I was on the right path.

But, if therapy isn’t merely about receiving advice, it also isn’t about unconditional support. Its purpose is to challenge you more so than to teach you. Consider therapy as finding yourself in the middle of a hall of mirrors, surrounded by your reflections, with nowhere to hide. At some point, I could, finally, hear it in my mind when I mentally noted Jennifer’s expressions: “You idiot! I’m trying to help you.” Yet, there was so much resistance. It wasn’t that I didn’t want to be well; it was that I was willing to blow it all up if I were forced to share the spotlight of my triumphs.

Unfortunately, most people don’t have the capacity to dig deeper and challenge their loved ones. So, that’s what therapy does. It will grant you a platitude and won’t leave you alone until it discovers why you won’t embrace it. It will push and prod, and make you feel profoundly uncomfortable. (One of my clients actually sweats and becomes incredibly itchy during some of our sessions.) It will explore, contradict, and even embrace some of your beliefs. Good therapy will leave you more open-minded, for, again, its purpose isn’t to change you; it only seeks to persuade you that at least some of the people who love you want what’s best for you.

Essentially, therapy that provides advice is infantilizing, as most people already know what they “should” be doing; therapy that explores and tries to help the client overcome the sources of the barriers to, and fears of, accepting commonplace wisdom is nurturing.

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