Dedication to Therapy: Is there an emoji for that?

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Dedication to Therapy: Is there an emoji for that?

I’ve read this article several times now and it still makes my blood boil. From the headline to the conclusion, the author seems to have entered into a text message-based therapeutic endeavour with only the faintest interest. Though she admits to taking a half-hearted approach to the therapy, her major complaint seems to be with the therapist herself; some one who uses “motivational quotes” and “emojis”. Imagine using emojis over text! And while my immediate impulse is to write a scathing rebuttal to the author in defense of all therapists, perhaps the article is better served as a starting point to discuss the concept of dedication to therapy.

Numerous studies have indicated that the key component of therapy is the client-therapist relationship itself. That is, the relationship between a client and their therapist, more than any other factor, is likely to lead a client to progress, heal, and transform. But, such a relationship is impossible without dedication from the client to not just attending each session, but also to throwing themselves fully into the work. To dedicating themselves to the therapy. To dedicating themselves to themselves.

Dedication implies buy-in. Dedication implies effort. Dedication implies taking time. What this article suggests, about both the author and the platform is that none of those was present. The author speaks of being “half-hearted”, entering into it because she “doesn’t have the time”, and “doubting what kind of therapist believes they can solve…mental health issues…with the most surface form of communication.” In short, it would appear that this relationship was doomed for failure from the beginning.

Psychoanalysts, at least the few that I have met, prefer to see their clients several times per week. While this may seem onerous in 21st century Vancouver, for the wealthy, at-leisure, early 20th century elites of Vienna and London, this would have been very doable. Sometimes, I wish I could see my clients that frequently. Often, sessions end just when a client is hitting their stride or a crucial issue is being explored. Somewhere, straddling the poles of several in-person sessions a week and 30 minutes of texting, there must be a balance.

When clients seek therapy, their struggles are all about relating. How they relate to the world, to others, or to themselves. Therapists guide their clients, but this can only be done with the entirety of the client. Not just by reading their words. Not just by listening to them. Not just by observing them. But by letting all aspects of them impact the therapist. This requires the client to be present. To be fully engaged. To be dedicated to the process.

The importance of this dedication was keenly illustrated to me when negotiating an affordable fee with therapist I once saw. When I said that I could not afford his fee, he asked me how much I could I afford. I was unsure. He then asked if I went out to restaurants, bars etc. I nodded. And, he asked me how much money I spend on that every week? “Do you not think,” he continued, “that your mental health is worth at least that much?” And he was right. The same can be said of time. How much time do you think your mental health is worth? (Really, ask yourself this).

Therapy is not supposed to be easy. If it were, therapists would not spend years and years training and undergoing self-examination.

In fairness to the author, I doubt that the therapy-by-text platform would have provided her with change she seems to be looking for, even if she was committed to the therapy. The relationship between a client and therapist requires time and closeness, and texting, by its very nature, creates distance. It is difficult enough to convey what we mean and feel when we are in the same room as another person and we have all available senses with which to communicate. But, to be limited to unpunctuated, short text messages is never going to be sufficient, with or without emojis. Some studies have indicated the usefulness of text messaging to complement therapy and facilitate self-reporting, reminders, etc., but none of the them recommended text messages be the main component in on-going treatment. Needless to say, I do not offer text-based therapy. :-).