Do you want an ‘affirming’ therapist?

I’m here not speaking specifically about any particular type of affirming (trans-affirming, LGBTQ-affirming, neuro-affirming), but just affirming in general.

I’m asking the question of whether a good therapist is one who affirms everything you think, say or do.

A moments reflection should make it obvious that the answer has to be ‘no.’ Surely any sane person can see that some of the things we do, say, and think are misguided or sub-optimal. 

But it seems to have become common for certain therapists to just affirm everything a patient brings into the room and for patients to seek a therapist who affirms everything they bring into the room. It’s sort of the equivalent of ‘people need to accept me for who I am’ or, in clinical language, the famous ‘unconditional positive regard’ (UPR).

Therapists of many stripes have long considered unconditional positive regard to be an essential element of a good therapeutic relationship.

For Carl Rogers, the populariser of this idea in the 1950s, unconditional positive regard involved laying aside one’s own views and values in order to “enter another’s world without prejudice.” It meant creating a type of caring relationship “in which clients are accepted as they say they are.”

Who could possibly object to such an idea? Well, many people actually, myself included. And as is often the case, the devil is in the detail.

The first problem with UPR is that it can trivialize people’s experiences. There can be an assumption, as we find in Rogers’s humanistic psychology, that each of us is an isolated individual, a closed circuit of self-defined meanings and idiosyncratic experiences. “Man,” Rogers writes, “lives essentially in his own personal and subjective world.” Each of us has our own personal truth, we might say, which emerges from our own private and “essentially” arbitrary choices. Our experience, in this view, “just is what it is,” observes the psychologist Louis Sass, and since it is subjective and incommensurable, “there is little point in criticizing its validity.” (Sass, 1988)

Validating a person’s perception of their experience, understood in this purely private and arbitrary way, becomes something of an empty gesture. It has no more significance than affirming a person’s favourite brand of ice cream and a serious conversation is not taking place.

Second and related, UPR risks shutting down curiosity and bringing unwanted pathologisation. Signalling an immediate acceptance of a person’s account of their experience in therapy or other close relationships can shut down any discussion of their reasons for their actions or feelings. Why did they act as they did or feel how they felt? Reasons are important; they are how we establish our moral agency, our full personhood, and our responsibility. Without knowing the reasons, we cannot consider a person’s thoughts, behavior, or feelings as meaningful responses, as justified or appropriate to the situation. Their experience is left open to, or even invites, the interpretation that it is reasonless and, therefore, abnormal.

So I would highly recommend you do not seek out or remain with a therapist that just affirms everything you think and say. I’m even going to say it in a slightly stronger way: Seek out a therapist who is judgmental.

Why on earth would I do that? I’m saying it to be provocative in a way, but I mean it, in the literal sense. How?

Well, first, all therapists are judgmental, because all humans’ are judgmental. The idea that anyone can be morally neutral simply isn’t true. By this I just mean that all of us – unless we are dead or in a coma – have opinions about what behaviours are more likely to lead to human flourishing and which one’s aren’t. We call the one’s that we think lead to human flourishing ’good’ and the one’s we think don’t, ‘bad.’  It’s become popular in recent times for people to think or to say they are ‘non-judgmental’ but this is neither possible nor actually even desirable. 

Why is it not even desirable? Imagine a therapist who had no opinion or preference when it came to say, genocide or rape. Imagine they thought raping and non-raping were both equally valid options for you and you could just flip a coin to decide which way to go – neither course of action would be better or worse than the other. This is an extreme example but it serves to make the point that there simply are things that we think are bad.

What people usually mean when they say they want a non-judgmental therapist – or at least what I hope they mean – is that they want a therapist who isn’t overly judgmental. They want a therapist who is compassionate. I was about to write ‘empathic’ but I didn’t because actually even empathy is not necessarily desirable as Paul Bloom so clearly lays out in his book on the subject, Against Empathy: The Case for Rational Compassion. Empathy is another one of these words that sounds good (like ‘affirming’ or UPR), but empathy turns out upon closer inspection to be a capricious and irrational emotion that appeals to our narrow prejudices and one of the leading motivators of inequality and immorality in society. What people mean when they say they want a non-judgmental therapist – again, I hope – is that they want a therapist who will judge behaviours but not judge them (often people really want their therapist to judge other people in their lives!).  On this I think we are on stronger ground. We’re essentially arguing for what Brene Brown argues when she says that shame is feeling inadequate or bad as a person, while guilt is feeling bad for something we've done. I actually think that even this is too simple. I believe that every emotion – including the so called ‘negative emotions’ such as guilt, shame, regret, depression, anxiety – is important and mainly helpful. I think it’s important for us to feel ashamed sometimes (like when we’ve done something shameful) and guilty (like when we’ve done something wrong) and anxious (when there’s something worth worrying about). These feelings are vital to being a healthy person. Without them we’d be vastly impoverished, sub-human even.

So if we’re not looking for empathy or affirmation or non-judgmentalism in a therapist, what is it we are actually looking for, or should be looking for?

Love.

Love is what you want. Love is what will heal you.

Love doesn’t affirm everything you do or agree with everything you say.

Love doesn’t ‘unconditionally’ think you are amazing and wonderful and perfect.

No. Love is much, much stronger. Love tells you the truth even when it’s hard to hear. Love, defined by M. Scott Peck, is ‘the will to extend oneself for the purpose of nurturing one’s own or another’s inner spiritual growth.’  Love isn’t easy. Loving requires effort. It’s easy to tell people what they want to hear. It’s much harder to tell the truth.  Truth without love is harshness. But love without truth is just sentimentality. Truth can be truth without love. But love can’t be love without truth.

All these terms – affirming, empathy etc. – are words that skirt around the real thing which is love. They are, one could say, cheap imitations of love, or small satellites that orbit around Love.  Because they don’t have truth as a necessary component to them, they’re flimsy, vapid even.  Love is the Ultimate. It’s what you want in a friend, a partner, a brother, a sister…and…a therapist.