How Therapists Listen

By Sara LaCasse

If you were to look at a therapist in action, you might not see much action.  There I sit opposite the client, looking intently, commenting on occasion and, yes, sometimes just nodding in agreement while a client speaks.  What could possibly be happening that makes this at all effective?

The answer begins with how a therapist listens.   It is a very different kind of listening than we associate with other kinds of conversations.  I am listening to what clients say, of course — the actual content.  But I am also listening for patterns and themes that emerge, the particular way clients express themselves that reveals more about how they think and feel, and how they view themselves, the world, and their place in it.  I listen for history and life experiences so that I can hear what clients say in context and absorb the meanings of their stories.  I listen to a client’s body, watching how each movement, change in posture or expression adds dimension to the content.  I listen to myself, following my own thoughts, emotional reactions, memories and associations in response to what I am hearing so that I can more fully empathize and bond with the client. I draw on my clinical knowledge and my training to understand even more about what is being said.  And I listen to what is happening between us, knowing that the relationship we form reveals even more about the person. How does the client see me and react to me?  What is the client wanting or expecting from me?  When is the client delighted with me or disappointed with me?  How does this reveal more about a client’s strengths and struggles?

Perhaps the word “listening” doesn’t even accurately describe what is happening.  I not only listen to clients, I attune to them.  It’s what some in our field call a “therapeutic alliance,” in which I connect with clients, empathize with their experiences and their pain, formulate what their internal world is like, and become a unique companion and guide.  As a result, I can formulate more precise and effective responses, suggest a more useful direction, and truly tailor the best strategies for making progress. With such profound understanding and trust, clients feel heard in ways they might never have imagined and we move forward together in partnership toward change.

By Sara LaCasse, M.A.

Published on November 10, 2017