When I told people I was training to become a therapist the reaction typically was, "That will help you so much as a writer. You'll get so much story material!" Actually, it turned out to be the opposite: being a writer helped me as a therapist.
For example, much of a therapy session is conducted through metaphor. Longing for a father may be expressed through frustrations with a boyfriend ("He's just not there for me"). Similarly, a loss may be too painful for someone to address directly so we talk instead about appliances that are "always breaking down". The therapist's job, then, is to stay within the metaphor. "So your house is still a mess," I say with earnest understanding. To jump in with an interpretation early on would be too much, like shining a too-bright light in someone's face. Had I said, "Who are you kidding with this 'messy house' stuff? You talk about the disarray around you as a code to describe what you feel inside," she would have run screaming out the door. The indirectness of metaphor allows clients to work out struggles at their own pace.
I also learned as a therapist that character in a literary sense loomed large. As in the novelist's truism, character determines fate. Things happened to my clients that could have happened in just that way only to them, events that derived naturally, even inevitably, from their personalities. I could have predicted Melanie would be late and miss the train. Of course Jason would come close in a competition but falter at the last minute. As a result, they come across as exaggerated, almost Dickensian characters. And just like Dickens' creations, exaggeration reveals the truth.
The best way to explain what goes on in a therapy session is the concept of dramatic irony--when the listener understands the significance of what's being said but the client remains oblivious. It is within that particular space, the gap between the facts and their unconscious meaning, that the therapist does her work, carefully linking the unconscious to everyday consciousness. And when the client makes the connection herself--"Hey, you think when I obsess about impressing my professor, it's the same as when I seek my mother's approval?"--she gets that vaunted "Aha!"
As a clinician, I found the link between writing and therapy compelling and empowering. But in my own therapy I pushed it too far--I let the narrative aspects of the treatment blind me to what was really going on. I got hooked on interpretation, coherence, meaning, suspense; I was too invested in my own metaphors. This is the story I write in The Therapist's New Clothes, a cautionary tale I wanted to share so that others don't succumb to the seductiveness of therapy--and for those who have, to know they're not alone.