T. Byram Karasu, MD

When we write about psychotherapy, we usually write about the patients and their cognitions and psychodynamics; or we talk about the techniques of psychotherapy, schools of psychotherapy, and efficacy studies. These are all songs of psychotherapy. But we rarely talk about the therapist-the singer.

 Meanwhile, when it comes to making referrals, we pay a great deal of attention to whom we refer a patient, and here we calculate many variables, especially “the person” of the therapist, and rightly so, because therapists are not a homogeneous group.

As a therapist, if you stay within one of the schools, whether psychoanalytical or behavioral-cognitive, you are likely to become a good technician of that school. However, to be a good psychotherapist, you have to transcend the technician role. First, of course, you need to become a good technician of that school and anchor in one single paradigm before you can transcend it. After all, you need to have something to transcend.

The therapist enters and remains in the patient’s mind in shifting paradigms. The way a therapist is perceived changes from one patient to another-even at times with the same patient from one session to the next or from minute to minute. It is by being present in the patient’s psychic life that the therapist can be effective. Therefore, who the therapist is becomes crucial, because that determines what he or she does-how one person affects another at a particular time during an authentic engagement.

Our literature on the person of the therapist is limited to the introspective-being empathic, intelligent, ethical, etc. These are necessary but not sufficient. One would like to see that person be something more than that, but what exactly? Jerome and Julia Frank

 wrote about the charisma, power of persuasion, and innate goodness of healers. We know what charisma and power of persuasion is. The leaders in any field tend to have these qualities. In psychiatry, such persons are the 

 (a trusted counselor and adviser; a mentor). But they do not necessarily have innate goodness. Furthermore, what is this goodness; how can we define it?

To find the qualities that determine such a person, we need to look elsewhere. Science progresses with small steps and occasional quantum leaps. Here I took a quantum leap to religious literature to find those qualities and distill the characteristics of a healer. (Incidentally, those texts read like philosophical and psychological textbooks.) In reviewing Eastern and Western religions, I found 6 formative tenets they all share: love of others, love of work, love of belonging, believing in the sacred, believing in unity, and believing in transformation.

The Art of Serenity: The Path to a Joyful Life in the Best and Worst of Times

Persuasion and Healing: A Comparative Study of Psychotherapy

. 3rd ed. Baltimore: Johns Hopkins University Press; 1991.


Articles

When we write about psychotherapy, we usually write about the patients and their cognitions and psychodynamics; or we talk about the techniques of psychotherapy, schools of psychotherapy, and efficacy studies. These are all songs of psychotherapy.

Author | T. Byram Karasu, MD

Articles

The Person of the Psychotherapist: Let’s Hear Not the Song but the Singer