The Most Effective Psychotherapists Are Those Who Really Listen

By Stephanie Kirby

Updated January 30, 2019

Reviewer Dawn Brown


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In addition to having the educational training and certification, a therapist must have and be able to show empathy toward his/her patients to understand the reasons the patients are seeking help. It does no good to offer platitudes and suggestions if the therapist does not, first and foremost, have empathy and give the patient their full attention. An effective therapist must ask questions to determine the underlying causes of a patient's dilemma or illness. The questions should not be posed to be insulting or humiliating but rather asked to elicit responses to uncover the patient's true feelings and thoughts. If the therapist does not listen, they and their patient will not be able to discuss ideas and solutions rationally. When someone feels they are not being heard, they either shut down or become angry and aggressive; this can become an obstacle that prevents further communication and understanding. People need to know that what they feel and what they say is important and will not be dismissed as not worthy of attention. It also does no good if a therapist relies on lecturing the patient as this also destroys communication.

There is a rule adopted by some therapists called the 80-20 rule, which means the therapist encourages the patient to talk 80% of the time and the therapist offers comments 20% of the time. Sometimes allowing the patient to vent and not keep things bottled up can have the effect of the patient being open to suggestions. Even if you are not a therapist, it can be difficult to have patience and not interject with comments. A therapist has to choose the right time to interject or to prod the patient to continue to express their feelings.

Not every therapist is right for every person, and some don't really help anyone. Finding a therapist who can help you create a better life for yourself can seem like a daunting task. There is so much to consider. You need to find someone who understands what you're going through, has a treatment philosophy you can get behind and can guide you with the right questions, encouragement, and support to help you make the changes you need to make. To do all this, they need to pay attention to what you say. The bottom line is that the most effective psychotherapists are those who know how to listen.

People who are finding it difficult to cope with the demands placed on them at work, at home, or in society in general often make assumptions that may not be true, although the feelings they have about the assumption is real. This can cause an extreme disturbance in their ability to think rationally and have a persecution complex rather than thinking they may be part of the problem. When this happens, the therapist must be ready to lead the discussion to challenge those assumptions if they are wrong or biased. This will encourage the patient to offer reasons for their beliefs and open the door to constructive communication.

Changing an attitude is not easy to do, especially if that attitude has been held for a long time. It is the therapist's job to determine the attitudes that may have a bearing on the difficulties the patient is experiencing. Having to change one's attitudes can be frightening because of the unknown potential results. The patient is facing an unknown future if he relinquishes his beliefs or changes them. A good therapist will recognize this and gently lead the patient through conversation to understand what may be causing his distress or mental illness.

Even though a patient may be suffering from delusions or having false assumptions, they must be respected. It is an effective tool for a therapist to help the patient recognize their strengths as well as weaknesses. It is up to the therapist to listen intently to what the patient is saying and search for underlying meanings. But a therapist must also encourage the patient to listen because by listening and not "jumping the gun", they can all learn better strategies to overcome obstacles and make better decisions.

Addressing the Issues That Are Important to You

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When a therapist doesn't pay attention to your words and nonverbal communications, they decide for themselves what problems you need to address. For example, if you come into their office with the smell of smoke on your clothes and hair, they might assume you're there to stop smoking. Yet, you may already have a viable plan for that and what you need to talk to them about is something totally different. When a therapist listens to you first without making assumptions, they can help you with the problem you actually need help solving.

Identifying Problems You Don't See

Many people go into therapy with only a vague idea that something's wrong. A therapist who doesn't listen may make guesses, but they'll probably be wrong most of the time. When you work with a therapist who engages with you, they might identify the true source of your uneasiness. Often, it's what you don't say, as well as what you do say, that shows what is bothering you. A therapist who interacts with you on a deep level can see problems you might not.

Avoiding Lectures

Typically, therapists who are stuck in their own little world resort to lecturing. Rather than a healthy give-and-take, they take complete charge of the sessions. They lecture you without even understanding what you need to hear. A therapist who listens rarely lectures at all, because they know that their job is to guide you in finding your own answers.

Finding Solutions That Are Suited to You

A therapist who listens to you gets to know you in a way, that one who doesn't never will. So, rather than giving you a cookie-cutter solution, they help you find solutions that work for your unique personality and situation.


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The Most Effective Psychotherapists Are Those Who Are There to Listen to You

Psychotherapists have a unique profession in that they are paid to listen and uncover underlying reasons for patients' suffering mentally or emotionally. They are paid to help their patients find solutions to cope with their conditions or to recommend ways to accept treatment. These conditions could be health-related and life-threatening, such as cancer, alcoholism/liver disease, drug addiction, ALS, HIV/Aids, etc. The conditions could also be a mental illness, such as schizophrenia, bipolar disorder, psychotic disorders, dissociative identity disorder, or major depression.

Why did your therapist choose to spend their time counseling others? Was it perhaps a money motive or an unhealthy need to control other people? While you probably won't know the answers to these questions immediately, you'll probably be able to discern them as time goes by. The most effective therapists may need to earn a living and may like being a leader, but their first and most important motive will be to listen to the people that come to see them and help them find solutions to the problems that bother them.


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