The Emptiness of the Therapeutic Alliance for Men – A Voice for Men

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Author: Dr. Douglas W. Texter

I don’t like therapy. It’s never worked for me. Some people would say, “That’s because you haven’t found the right person.”

They would be right.

I haven’t, and recently it dawned on me when I was reflecting about why I’ve never found therapy useful: I never will find that person because of the nature of therapy itself.

Across treatment modalities, therapists proclaim that the most important factor in outcomes is the strength of the therapeutic alliance or relationship.

It’s exactly the therapeutic alliance that I’ve never been able to build. Is the reason for this lack of connection that I’m an emotional weenie, an introvert, and a misanthrope?

No, I’m an English professor.

My stock in trade consists of teaching the work of people who make a living producing emotions, either in literature or works of rhetoric. I’ve even produced a few pieces of fiction and non-fiction that have evoked pretty strong emotional reactions on the part of readers. I work productively each year with hundreds of students and, for the most part, enjoy teaching them. Through the course of my life, I’ve enjoyed many, many tight friendships. I have served as a volunteer at a Catholic Worker soup kitchen. As an alumni admissions interviewer, I’ve enjoyed talking with hundreds of applicants for admission to the University of Pennsylvania, my alma mater. I’ve also served as a reader at three Catholic Churches. I’ve read to crowds of over 2000.

I like people, and I’m very verbal. Some of my students and interviewees have said I’m a good conversationalist.

I try.

Yet, I’ve never made a connection with any therapist. And I never will.

I suspect that many men have experienced this lack of connection, and this non-bonding is the real reason why men don’t seek or stay in therapy. The word on the street, of course, is that men don’t want to seek help for their problems.

I don’t actually believe that.

When my Fiesta makes strange noises, I motor over to the Ford Garage. Last year, when my right leg wasn’t functioning very well, I limped to the office of the nearest orthopedic surgeon. When my cat began yowling and fell over, off to the emergency vet clinic we sped.

I get help when I need it. I think most men do.

The trouble is the nature of the help that therapy offers, especially to men.

In 1979, the therapist Edward Bordin described what he termed the “therapeutic alliance.” Bordin opined that this relationship has three parts: agreement on the goals of treatment, agreement on the tasks, and the development of a personal bond made up of reciprocal positive feelings.

It’s the third element of the therapeutic relationship that I’ve never really understood, the bond. While I’ve tried therapy a few times, I was always deeply impressed by the utter lack of bond I’ve had with any therapist.

Why is that?

It’s that it is impossible for me to form a bond with a therapist. I think it’s impossible for most men. The reason for this impossibility stems from the way I form non-romantic bonds with people outside of therapy. For me, there are several bases on which I form anything resembling a trusting relationship with someone. Those are the following: shared experience, shared values, shared sensibility, shared interests, shared sense of humor, and shared intellectual life. I haven’t experienced any of these commonalities in a therapeutic session.

And I rather doubt I will.

These are exactly the qualities that are missing from any therapeutic relationship, and they always will be.

The therapeutic relationship, from what I can tell, is based on nothing but sales techniques and, ultimately, word salad. There’s no depth or genuineness to it. It’s precisely this lack of depth that makes it not a true connection.

If you think I’m being cynical, let’s take a look at a British therapist, Mark Tyrell, who on his Youtube channel outlines ways in which a practitioner can build a therapeutic relationship.

He begins with what I will call the Big Three: Mirror, match, and lead. To his credit, Tyrell is honest about where these techniques come from: sales and marketing. They probably also have their origins in interrogation techniques, especially in what the FBI calls sympathetic interviewing.

Mirroring is using other people’s words so that they perceive (and that’s the key word here) that you and they are on the same page, whether you really are or not. Matching, which, as I’ll explain in a moment, I’ve done, becomes a little spooky. With this technique, not only do you use the other person’s words, you imitate his or her posture, gestures, and, if you’re really on your game, even breathing patterns. Finally, once you’ve mirrored and matched, you’re ready to take control of the interaction and lead.

All of this constitutes a relationship based on real mutuality?

Of course, it doesn’t.

I know that these techniques don’t really lead to anything building into a true relationship because I’ve used them myself fairly successfully. When I was in college and in graduate school, I earned money not by flipping burgers but by serving as both a door-to-door and phone fundraiser for non-profits such as Ralph Nader’s Public Interest Research Groups, Greenpeace, Cleanwater Action, and Michael Harrington’s Democratic Socialists of America.

Do you remember those annoying young people who would, clipboards in hand, knock on your door on summer nights and ask for money? I was one of them. Say what you will about the groups I’ve mentioned above, but one of the things they are stunningly good at is teaching 18-year-olds techniques that any interrogator would love to know. One of the first techniques we learned in training was “Mirror the door.” Give the impression that you agree with them on everything. Try to imitate their speech patterns. Of course, you’re mirroring after you’ve already done a fair bit of reading of the situation. As a canvasser, I learned to read signs that most people wouldn’t think about: what kind of car was parked in the driveway? Volvos are the best. What stickers were on the bumpers? Were there windchimes on the porch? Checks and chimes go together. Did the living room have bookshelves? Readers are givers. Were there clues about occupation? Teachers and lawyers were best; physicians were the worst.

In addition to mirroring speech patterns, I was taught by one of the best fundraisers I’ve ever met how to match. I will never forget Lucas, a manager at Citizen Action Membership Center in Minneapolis. He and I did a role play that the interrogators at Guantanamo would have envied. I answered the fictious phone. After hearing his brief introduction, I said, “How you dooin?” Beginning to match and mirror me immediately, Lucas said, “How you dooin?” I heard him slow down to match my speaking speed. I noticed that his chest movements were matching mine. Lucas was a good teacher and fundraiser. I sat beside him on nights when he brought in thousands of dollars by mirroring, matching, and leading.

The trouble is that these three techniques are great in getting a short-term result: a check at the door or a credit card number on the phone, or, in darker circumstances, a confession. But, as I know, you’re not really getting to know the other person in any real way, and are you building a relationship? Not in the least.

Indeed, I once had the experience of following behind the next year in a canvassing cycle one of the best door canvassers I had ever met: Brian. He was the sort of person who never missed quota and who would vow not to leave a person’s front door without getting a check. He would mirror, match, and lead potential donors into submission.

But if you had to canvass a turf that he had done the year before, doors slammed in your face. People remembered him and not in a good way. He hadn’t built a relationship with anybody; rather, he had destroyed the turf by bludgeoning people with the Big Three.

Departing from Brian on a porch in Minneapolis and returning to Mark sitting in his therapist’s chair in England, I am willing to argue that the mirroring offered by therapy results in, at best, a shallow trust and, at worst, a feeling of being manipulated.

Interestingly, Tyrell offers another technique beyond the Big Three, one that he says is sure to build a solid relationship with a client. He says that a therapist can talk about the interests and experiences of the person even if the therapist doesn’t share these interests. Once rapport is established through faux bonding, the therapist can lead the person.

Fake it until you make it.

Tyrell argues that to bond, all the therapist needs to do is listen to the person and just use terminology from that person’s interests.

If, for example, someone is a bowler, the therapist could say that he has a technique that is right up the person’s alley. If somebody is a soldier, the therapist could talk about going into battle together. This use of words seems to me to be condescending and manipulative: form without substance.

What’s objectionable here is that Tyrell doesn’t seem to advocate actually understanding the person; such a task might entail listening; reading; and seeking out, where possible, experiences similar to the ones engaged in by the client. In other words, the therapist would have to work at it as anybody in any normal relationship would. Tyrell, though, isn’t really seeking deep mutual understanding; rather, the therapist simply wants the client to perceive that the therapist understands him or her.

Moving for a moment from therapy to my own field, as an English professor, I had to go through a fair amount of pedagogical training in my PhD program. Newbie instructors, who don’t know very much about their subjects yet, are taught a range of, to be honest, rather dubious pedagogical techniques: written student self-reflection, small group discussions, and large group discussions. And of course, there’s the kicker. When a student asks a question the professor doesn’t know the answer to, the professor can say, “What do you think?” An instructor uses these techniques when he or she knows little about the subject under consideration. An article I read in graduate school called these techniques “clinical practices.” The article contrasted these against disciplinary mastery. The article said that, in all cases, disciplinary mastery trumps clinical practice in teaching.

For example, I have taught courses on dystopian literature. I won a 25k fellowship in graduate school to write my dissertation on the subject; I read about 100 dystopian and utopian novels, and I read quite a bit of the secondary criticism. I’ve published several articles on the subject. Much to the amazement of my students, I can quote lines at length from both 1984 and Brave New World. I have disciplinary expertise in this sub field and don’t have to resort to pedagogical parlor tricks in order to talk with students about dystopian novels.

If I’m going to allow somebody to give me advice about shaping my personal life, I’m going to want to know that person well, and I’m going to want them to know me and not just parrot back throw-away lines or faux agreement with my world views or the way I think. Such behavior doesn’t build trust with me; it destroys it.

In addition to Tyrell’s work on the web, there are several fascinating videos about the therapeutic relationship made by the late Jeremy Safran, a former therapist and professor at the New School of Social Research in New York. In a bit of tragic irony, Safran was murdered a few years ago by someone who broke into his house. I don’t know the details, but if Safran tried, as I would have, to talk with his assailant, he failed miserably and was bludgeoned to death.

He doesn’t do much better on Youtube.

In one video, Safran role plays a session in which a woman is unhappy with therapy because she feels like she’s not getting anything out of it.

“I don’t know. It sucks. This therapy, I’m not getting anywhere. Like it’s not doing anything.”

Safran makes three grunts, which I think are affirmations. He replies: “My sense is you’re trying to say something but kind of gave up there.”

To my way of thinking, she didn’t give up. She said she’s not satisfied with the service he’s rendering and which she’s paying for.

Safran doesn’t say what I expected: “Why are you unsatisfied? Is there something you would like me to do that I’m not doing?” Both of these would be statements I would expect from any professional whom I’m paying. They’re also what I would expect from a friend or partner.

She says that she’s disappointed that she came to therapy and is not feeling better. Her feeling seems quite reasonable to me. If this were a real session, she would have paid by now hundreds if not thousands of dollars. When money changes hands, there’s an expectation that effective service will be rendered.

Safran seems a manipulative genius here. He turns her concerns, which he never addresses, into a conversation about the woman feeling uncomfortable confronting him. He says, “Part of it sounds like you’re concerned that I’m going to think you’re blaming me.”

Of course, she’s blaming him.

She says that she “feels like I’m alone in this therapy. I’ve been coming here and trying, and I’m not getting anything from you.”

He replies that this information sounds important. “It sounds like it’s hard to say this to me. You’re feeling angry at me.”

He’s telling her how she feels, which I have always found to be an obnoxious practice.

“I’m glad we’re talking about this. We’re talking about it,” Safran says.
“I’m feeing a little anxious. It’s better that it’s out there,” the woman replies.

“At least it’s out there. We can go from here,” Safran says.

Where I would go from here is straight out the door.

In this conversation, which has lasted five minutes, Safran has mostly engaged in mirroring and telling her what her feelings are. Before his tragic death, Safran was regarded as a leader in the field of research on the therapeutic relationship and fixing ruptures. His work is heavily cited. In other words, he was one of the best, both as a researcher and a clinician.

I would hate to see one of the worst.

My own reaction to this role play is that I would have walked out of the room after about two minutes. There was no ownership of Safran’s role or professional responsibility. Indeed, I didn’t even feel that he was expressing himself as a real person. He seemed really flat and offered no solutions. There was no content here at all, just mirroring.

I understand that therapists might say that I’m missing the point: that Safran was acknowledging the feelings of someone who has trouble expressing herself in relationships, that this acknowledgment is the real service that Safran was performing: hearing her.

I might argue that he’s deflecting. More important, for me, the value of simply being heard is not really very high. And I expect that that’s true for most men. That’s nice that you hear me and that I hear you. But the questions that are far more important to me would be the following: Do we agree? What are we going to do based on the fact that we hear each other?

Don’t validate my emotions; validate my parking.

I would find this mirroring almost offensive. Especially offensive is the use of “It sounds like.” If you listen very carefully to what Safran is doing, he’s slightly changing the subject of the conversation from his behavior and apparent professional failure to her feelings. I would find such a move smarmy and manipulative and would end the interaction almost immediately.

In an experience I had with a therapist, I told him that I wasn’t happy with what he was doing and felt I was wasting my money. He replied: “I’m sorry you feel that way.” In the online article from Candidly about how to apologize, Audie Metcalf writes, “If you notice that you say things like ‘I’m sorry you feel that way’ or ‘I’m sorry if I hurt you,’ congratulations, you are the reason articles like this exist. You’re not there to apologize for their feelings. You’re there to apologize for your own actions and words, and being thoughtful about how to express that is paramount in helping them to feel acknowledged, not belittled.”

The website Drive Thru goes even further than Metcalf by saying that “I’m sorry you feel that way” is a non-apology. “When someone says, ‘I’m sorry you feel that way,’ it’s not a real apology. Why? Well, let’s parse it out. ‘I’m sorry YOU feel that way,’ places the blame back onto you. They’re not actually sorry you feel that way. They’re sorry that your emotions are causing them a problem. So, the blame is shifted back onto the receiver.”

The anonymous writer at Drive Thru actually terms the use of non-apologies a form of gaslighting: “It’s a way to emotionally abuse another person and victim-blame them for basically having feelings. This type of fake apology makes the receiver feel like their emotions aren’t valid and that they’re the one with a problem.”

So far the therapeutic relationship seems to be about mirroring, matching, leading, and gaslighting.

Could it get worse?

Unfortunately, it can.

On the Youtube channel Research 4Psychotherapists, Dr. Juan Martin Gomez Penedo from Universidad de Buenos Aires identifies two kinds of ruptures: avoidance/withdrawal and confrontation. For avoidance ruptures, he recommends refocusing the client back on the conversation at hand. Slightly more serious is his recommendation for dealing with confrontation ruptures. These are ruptures that occur, as in the Safran example, because the client isn’t happy with treatment or offers a criticism of the therapist.

Penedo says that psychotherapists should “communicate with the patient what we’re feeling so he can empathize with what other people are feeling in interpersonal relationships.” He views the rupture as an opportunity to show the patient what he’s doing wrong in his other relationships. In other words, the only reason someone might object to something the therapist does is because the client is having problems in other relationships.

Is something missing here? Yes, and one commentator on the Youtube video nailed the problem down perfectly: “I find it concerning that you make no mention at all of the need for the therapist to consider their contribution or responsibility for a rupture.” Penedo never offered a response to the commentor.

So, if the communicative parlor tricks don’t work for me to build a relationship or bond, what does?

Precisely the things I outlined at the beginning of this essay. And because of the nature of the therapeutic relationship—except maybe in relational therapy, which has its own ideological problems—the entire encounter is boundaried so that the client learns very little about the therapist. There’s no grounding for any bond.

In the remainder of this essay, I will briefly describe the ways in which all the criteria I customarily use to establish a trusting relationship are absent in therapy.

Shared experience. One of the ways I bond with people is having gone through something with them: employment, education, travel, shared volunteer work, shared recreational activities, or, in my own professional world, a shared classroom experience. If we’ve taken actions together, the other person and I know how we react. I also learn whether the person is worthy of my respect. I suspect that many men believe what I do. I learn about you not through your words but through your actions, the way you conduct yourself, how you spend your time, your accomplishments, and, maybe more important, your failures.

Now, one of the pioneers of therapy, Carl Rogers, said that necessary to forming the bond is unconditional positive regard. I find this prescription disingenuous. Certainly, if one is reasonably healthy, one doesn’t wish ill of anyone, and one hopes that the other person does well for him or herself. In the Buddhist tradition, unconditional positive regard is called loving kindness. One of the Lam Rim exercises I use when I meditate asks me to consider everybody my kind mother. While I can do this, this technique doesn’t mean that I’m going to get along with or be understood by everyone. I can feel goodwill toward somebody but not particularly want to spend any time with him or her.

Shared values. Since 2018 in the United States, it’s been clear that I will never have shared values with any therapist who is a member of the APA. In that year, the American Psychological Association basically declared war on heterosexual men in their then-new treatment guidelines. The guidelines begin by saying that masculinity is socially constructed. I might argue that different expressions of it are, but some of it is biologically based: the protector-provider impulse seems to be universal for men. The guidelines say that “in Western culture, the dominant ideal of masculinity has moved from an upper-class aristocratic image to a more rugged and self-sufficient ideal (Kimmel,2012). The citation here is significant. The author is Michael Kimmel, a former sociology professor at Suny Stonybrook. A male feminist who told men that their relationships with significant others would be so very strong if men only shared in housework, Kimmel retired from teaching after being accused of sexual harassment of one of his own female graduate students.

I couldn’t make up such irony if I tried.

Since I am a straight only child of two teachers who stayed together and didn’t divorce, it’s pretty safe to say that my masculinity is somewhat traditional. The APA guidelines say that my “traditional masculinity ideology can be viewed as the dominant ‘hegemonic’ form of masculinity.”

I’m hegemonic?

When did I start being hegemonic? Isn’t that what Vladimir Putin is? I don’t feel hegemonic. If I’m hegemonic I want to live better than I do, with a castle, tanks, and an honor guard, not in a one-bedroom apartment with a cat.

The guidelines go on to say how privileged I am: “In the aggregate, males experience a greater degree of social and economic power than women or girls in a patriarchal society.” These statements reek of the worst of my graduate school experience. I’m a Gen Xer; with a few exceptions, almost all of my work supervisors have been females, who make more money than I do. When I left graduate school and tried to get a job as a professor, I watched female classmates—who wrote dissertations on such scintillating topics as menstruation in Shakespeare and feminist laughter—get multiple offers. What did I write about: just George Orwell and the future of western civilization. At one school at which I served as an adjunct instructor, I was told to not bother applying for a fulltime job because they already had enough white males.

Clearly, I do not share the institutional values of the American Psychological Association. I would never trust a therapist who is instructed to see me a representative of an oppressor class. Why would I bond with anybody who sees me basically as the enemy?

The simple answer is I wouldn’t.

Beyond values, if I’m forming a relationship, I look for shared interests or experience. Shared interests might indicate that the therapist and I have shared personality attributes, that he or she and I might be able to understand each other because of what we’ve done. My interests are wide. I teach English. I’ve lobbied for Amnesty International. I interview for Penn. I’ve flown gliders as a student pilot. I’ve worked for a couple of US political campaigns. I’ve been a literacy tutor. I’ve worked as both a copy editor for a major US medical publisher and a developmental editor for a major textbook publisher. I coordinated a birthday-cards to Death Row Inmates project for a local Amnesty group. I’ve published some fiction and essays. I’ve backpacked across Europe and have experienced a few war zones: Guatemala, Northern Ireland, and Yugoslavia.

The problem is that I’ve never really met a therapist with very wide interests or experience. And I certainly haven’t met one with a sense of adventure or even with political sensibilities (and I don’t mean wokism, either. I mean real politics.). Most therapists that I’ve met have seemed pretty bland to me. I’ve also met off-duty therapists at retreats. Again, most of them seem pretty blah, not people I would ever cultivate friendships with. If that’s the case, then there really is no grounding for any emotional bond. My sense is that most therapists today see themselves as small business owners, not as intellectual explorers or pioneers like Carl Jung, Sigmund Freud, or Ernst Becker.

I’m just not that into them.

Finally, and I know I run the risk of sounding pretentious here, one of the ways I bond with somebody is through a shared intellectual life. I don’t say this because I’m an English professor. I don’t over identify with my professional role. That role will end eventually. Barring Alzheimer’s, my intellectual life won’t. However, since I was about 14, I’ve actually had what most people in the US don’t really have: an intellectual life. And this intellectual life shapes me and affects how I view the world. In high school, I read social contract theory by writers like Hobbes, Locke, and Rousseau; Kant’s categorical imperative; and John Rawls’ Theory of Justice. In college, I started reading Harper’s and the Atlantic. And I became deeply interested in the work of Paul Fussell, James Kincaid, Wendell Berry, Bill McKibben, and William Gass. Among the most recent books on my Kindle are John Taylor Gatto’s Instruments of Mass Instruction, William Hartung’s Prophets of War, Erich Fromm’s You Shall Be as Gods, Andrew Cockburn’s The Spoils of War, and Chris Lehman’s Rich People Things. These aren’t what I read for work or work-related writing; they’re what I read for “entertainment.” I’ve never met any therapist who has any kind of intellectual life beyond self-help books.

In conclusion, the therapeutic relationship is not one that I think is possible for me or for most men. It seems to be a relationship that is based on a smarmy Carl Rogers notion of positive regard and manipulative techniques most appropriate for financial advisors or interrogators. And, frankly, the very qualities I need to bond with someone are absent in the therapeutic relationship, which seems to me to be quite empty. Finally, in the United States at least, the values of most therapists construct me as a deeply flawed human being even before I open my mouth. That attitude is certainly not one of my values.

In the final analysis, I have say to therapy as a whole: I’m just not that into you.

Original Story on AVFM
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