Dancing with Clients: When Helping Becomes Something Else

Internship

Like many therapists I know, I began my internship in grade school.

I grew up in a dysfunctional family. Dad was an alcoholic; Mom was depressed. While they were together, they fought. After they divorced, their illnesses intensified.

My childhood was anxious and confusing, like swimming in water with a strong undertow, always at risk of being dragged under.

I learned early to stay afloat by managing the feelings of people around me.

I did not think of it as managing them. Kids don’t. To a kid, it just feels like paying attention.

I remember sitting at the top of the stairs, listening to my parents argue below, trying to guess from their voices whether it was safe to come down. After the divorce, I could walk into my house and sense, before I saw her, whether my mother was having a bad day.

That kind of attention becomes a skill.

Do it long enough, and it becomes a personality.

Eventually, if you’re not paying attention, it becomes a career.

Not every therapist comes from a house like that. But I’m never surprised when I meet one who has.

Such households quietly set a child up to find a legitimate, respectable home for their childhood job—reading rooms, managing feelings, making people okay.

Psychotherapy, I’ve come to believe, will hire you for exactly the skills you built to survive.

Practicum

In retrospect, my family served as a sort of unsupervised practicum.

A child who monitors other people’s moods develops sensitivity. A child who anticipates trouble develops vigilance. A child who keeps peace becomes skilled at mediation. A child who puts other people’s needs first may become unusually attuned to them. A child who survives by understanding adults may become unusually interested in why people behave as they do.

I learned these skills mostly in the way animals learn to avoid fire: painful experience.

What began as survival skills can, years later, look like gifts.

So I entered adulthood both oddly gifted and oddly damaged.

And I entered the profession not entirely clear on where one ended and the other began.

I do not believe therapists enter the profession only to work out childhood problems, or that empathy, sensitivity, curiosity, or a wish to help are pathological.

I mean something simpler: a child may spend years learning skills that adulthood later rewards.

Psychotherapy rewards them. Paying close attention to other people’s feelings is required. Understanding people is a professional skill. Helping is expected. Relieving suffering is part of the job description.

For someone trained early to manage the emotional environment, this feels familiar.

The problem is not that the childhood adaptation survives. Most do. The problem comes when it remains unexamined and continues doing the same emotional job it did when we were young.

Then helping can become Plan A with a license.

Plan A

By Plan A I mean the conclusions we develop as children: assumptions and rules about life, feelings, relationships, and how to handle them.

I tell clients we each have a Plan A, learned unconsciously in our family.

No one sits us down at the kitchen table and says, “Listen up. Here’s how you do Life.” They just do Life themselves, and we watch, listen, and soak it up.

Kids have limited opportunities for comparison, so their conclusions can become firm, unexamined internal truths.

That’s how I see what happened to me.

I came out of childhood carrying conclusions and assumptions that now seem a virtual invitation to professionalize my Plan A:

If I can understand what is happening, maybe I will be safe.

If I can keep everyone calm, maybe nothing bad will happen.

If I can be useful enough, maybe I will matter.

If I can become what other people need, maybe they will keep me.

If I can solve the problem, maybe I will not have to feel helpless.

The therapist can say much the same things in more sophisticated language.

If I can understand this patient, I will feel competent.

If I can relieve this patient’s anxiety, I will feel effective.

If I can get this couple to stop fighting, I will feel successful.

If this patient trusts me, I will know I am trustworthy.

If my interpretation lands, I will know I understand.

If the patient gets better, I will know I am good at this.

Nothing is wrong with a therapist wanting any of those things.

The trouble begins when the therapist needs them.

Invitation to the Dance

And when those needs enter the therapy room, they also enter the relationship.

Of course, none of this is unnamed territory.

Therapists have long had a term for reactions shaped by the therapist’s own history: countertransference. Winnicott (1949) and Racker (1957) helped establish its clinical importance; contemporary research continues to connect countertransference awareness and management with psychotherapy process and outcome (Abargil & Tishby, 2024; Hayes et al., 2018).

I am not claiming to have discovered that therapists bring their own reactions into treatment. What I’m describing is a pattern I discovered after I began to notice.

Once triggered, my reaction to a client doesn’t sit there—it moves.

A sort of unconscious dance begins.

The dance has five steps:

(1) Something makes me uncomfortable.

(2) I misread the discomfort as a problem that must be fixed.

(3) I try to fix it by controlling something I can’t or shouldn’t control.

(4) My control attempt fails.

(5) I misread the failure. Instead of questioning the strategy, I decide that I must try harder to gain control.

And the dance starts all over again.

None of this is a new phenomenon. Countertransference has been part of psychotherapy theory for decades.

What was new for me was seeing my reaction not just as something I felt, but as a sequence I participated in—something that moved from discomfort to misreading, controlling, failure, and then back to discomfort again.

That mattered because a sequence has places where it can be interrupted.

Supervision, personal therapy, and self-awareness remain sound responses. Research also points to self-insight and emotion regulation in managing countertransference (Hayes et al., 2018). What I still needed was something to do in the moment, as a specific reaction was happening.

Seeing the dance provided a start. At each step, I could ask myself, What can I do instead?

Then things got trickier.

Two Dances

It took time to distinguish my needs from those of my clients.

A therapist should want to help and want treatment to work. We should care whether the client improves, question ourselves, change course, and try again.

That is functional control.

But if I need the client to improve so that I can regulate my own helplessness, anxiety, guilt, shame, or self-doubt, helping becomes something else.

On the surface, I may still look attentive, thoughtful, and committed.

Below the surface, I’m needing something from the client.

I’ve basically given him a second job.

The client is now responsible not only for his own therapy but for my emotional equilibrium.

That is where the therapist’s dysfunctional controlling begins.

And because the client brings his own Plan A into therapy, my needs don’t operate in isolation. They interact with his.

So now there are two dancers.

I remember as a client how sensitive I was to my therapist. Therapy gives clients reason to watch the person across the room. The client brings vulnerability; the therapist brings authority. Therapy intentionally exposes the client’s pain.

How, then, could the client not try, on some level, to win approval, avoid rejection, and watch for cues about what the therapist is thinking and feeling?

If the therapist is acting out of similar Plan A-based motives, there are two dances going on in the room.

The client (I need your approval so I can feel okay) is trying to regulate the therapist.

The therapist (I need you to improve so I can feel effective) is trying to regulate the client.

What could possibly go wrong?

Why Controlling Fails

And here’s the icing on this dysfunctional cake:

Neither client nor therapist may see it as a problem.

Their dances may interlock in mutually satisfying ways.

Say the compliant client improves, or reports improvement, and the therapist feels effective. The therapist’s relief communicates approval. The client experiences that approval and becomes still more compliant. Both may experience the therapy as going wonderfully.

In some ways, it may be.

But the relationship is also rewarding the kind of controlling I have been describing as dysfunctional.

The urge to control is not inherently unhealthy. It becomes a problem when we try to control things we cannot or should not control. Another person’s inner life—what they feel, want, believe, choose—is not ours to control.

A client enters therapy to heal and grow, not to appease the therapist. A therapist’s job is to help the client better understand and manage their emotional life.

Two dancers, then, to the extent they are trying to control each other, are engaged in a second transaction going on beneath the therapy.

That transaction is closer to mutual self-soothing.

Each uses the other to feel more okay.

Feeling okay is fine, up to a point.

But what happens when this transaction breaks down? When the client doesn’t improve, disagrees with the therapist, expresses anger, or begins to suspect that what the therapist wants for her isn’t what she wants for herself?

What happens when one or the other experiences a loss of control, and neither has learned how to deal with that?

Controlling fails not simply because it never gets us what we want. Often it does. That’s precisely why we keep doing it.

Controlling fails because our emotional equilibrium has been made contingent upon controlling something ultimately outside our control: another autonomous person.

So when controlling fails, equilibrium collapses.

And even when it succeeds, it remains dysfunctional for both of us, in more ways than one.

The Slippery Slope

One difficulty with therapist dances is that we don’t necessarily enter them with unhealthy motives.

I may begin by caring about a client and wanting him to get better. That’s my job. I may think about a difficult case between sessions, work harder when treatment stalls, consult a colleague, or try a different approach. All of that may represent good therapy.

But there isn’t necessarily a bright line separating dedication from compulsive helping.

The client continues to struggle. I become more invested. I think about him more. I work harder. His progress begins to matter differently. When he improves, I feel relieved. When he doesn’t, I feel frustrated, anxious, helpless, or incompetent. Without quite noticing, I am no longer simply trying to help him; I need something from the helping.

That’s the slippery slope.

Because my behavior may look the same from outside, the warning signs have to come largely from inside me. What am I feeling? What am I needing from this client? What happens when she rejects my suggestion, stays stuck, gets angry, or decides to leave?

But monitoring my internal experience isn’t enough. I also must keep in mind—just as I would with a client—my own history.

My history tells me where the slope is most likely to get slippery.

If helplessness was intolerable long before I became a therapist, helpless clients will pull on me. If approval once meant safety, I should notice when a client dislikes me. If being needed gave me worth, rescue may remain an occupational hazard.

Knowing my history doesn’t immunize me, but it tells me where I’m most likely to slip.

When I was a new therapist, nothing scared me more than angry clients. Even a whiff of client annoyance activated my Plan A. For a while I could not help but act out that Plan and steer into placating, appeasing, even the occasional apology. This made for lousy therapy, since my need for control prevented both the client and me from getting to the bottom of the anger.

It was one of the first dances I learned to notice and interrupt. I began connecting my Plan A reactions to my angry, arguing parents, and developed a self-talk script:

You’re okay. This isn’t about you. It’s safe to just sit and let him be angry.

That created a new internal boundary between the client and me. I no longer had to make his anger go away in order to feel safe.

I became not just a better therapist, but safer, calmer, and more present in session.

Conclusion

In many ways I’m still the grade-school intern.

I still carry my Plan A deep inside me, and I still use the skills I learned in my unsupervised practicum.

I still read rooms, monitor feelings, anticipate trouble, and try to help.

The difference is that I’m getting better at noticing when those skills stop serving the client and start serving the kid inside me.

And I’ve come to see this as essential to my continuing education: learning to recognize when the professional job I trained for quietly turns back into my childhood job.

And when it does, to stop dancing.