Do some therapists have "it"?

Updated: Jun 15

A few weeks ago a friend attended one of my trainings. Since then she's taken a deep dive into the world of Deliberate Practice. She sent me a follow up email full of insightful questions. So I asked her if I could publish it, and she said yes. You'll clearly see from the email that she's really taken the whole concept of Deliberate Practice to heart.


I love it when people take this stuff on and make it their own.


Enjoy!

 

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Hey Jordan,

So I’m reading Peak and I have a ton of thoughts about applying this stuff to therapy and clinical supervision, but there’s one thing in particular that I think is foundational that I’m unsure about.

Do some people have better energy than other people do?

Maybe that sounds nuts, but I hope you know what I mean. Sometimes you walk into a room with another clinician and immediately you just feel tense and uncomfortable. Sometimes, the opposite – some clinicians help you feel more comfortable because of how they hold themselves. I think it’s probably an attachment body language thing, but it has a profound effect on the efficacy of therapy.


Now, it seems like the idea with deliberate practice is that no one is just born vastly more talented than anyone else – we get better because we practice and consistently push ourselves out of our comfort zones with the aid of a teacher so that we can get closer to being the best. But attachment style and whatever else contributes to your relational energy – those don’t seem like something practiced. Some people have that energy as kids. Some never develop it. And it’s so essential to being able to practice therapy with clients who struggle with attachment (which is most of my population).


So my question is, those people who are gifted with “good” energy – was life their deliberate practice because of the attachment figures in their lives who modeled what practicing attachment looked like? Or is that something that you either develop or don’t, but it’s a whole separate thing from deliberate practice?


Any thoughts?

- L

***

Hey L,


So, there’s two answers to your questions. The first answer is, “yes, of course some therapists are better than others. That’s clearly borne out in the research. And that’s why we use deliberate practice, to help you improve your outcomes.”


But what you’re asking is a little deeper. You’re asking “don’t some therapists just have the ‘it’ factor.” I think the obvious answer, and this is a clinical answer, is yes. It’s obvious that some clinicians just have the “it” factor. I remember a while back working under my former boss, a woman I really respected. I was going through some hard stuff, and suddenly I just found myself bawling like a baby in her office. I generally find it hard to cry, but something about her presence made me open up. And it wasn’t conscious. I couldn’t but let myself cry in her presence. Whatever “it” is, she had “it”.

Alez Vaz

There are different ideas about what this “it” factor is. Some, like my friend and mentor Alex Vaz, call it therapist Charisma/Persuasion. He recently wrote a paper about this subject [1] . Others like myself, believe this is due to the therapists’ ability to create safety in the room, or what Stephen Proges calls being a “Super Co Regulator.” If you’re not familiar with Porges’s Polyvagal Theory, basically, it’s the idea that humans manage emotions through using relationships, co-regulation. His theory is cousins with Attachment Theory, but whereas Attachment focuses on internal models of self and others, Polyvagal Theory focuses on external cues of safety and how the body processes those cues.


The truth probably lies somewhere in between the two.

For instance, one of the best therapist we have on record, Eri Vlass, often has clients dramatically improve within 2-5 sessions, and the majority of the change happens before the formal interventions. So there’s something about her presence, and not her model, which is evoking change. If you listen to her, it’s clear that she has a natural charisma (she was already a popular teacher before she was a therapist) and that she really works hard to calm her nervous system so that she’s receptive to others[2]. It would seem that she’s got the “Charismatic Coregulating” thing down.


I suspect that there’s some percentage of people who will just never be the Charismatic Coregulator. They just don’t have it. Let’s say it’s 10% of the population. And I would bet there’s another 10% on the other side, they just have it. I think the rest of us, the other 80% can train at it. And I think Alex would say the same thing. To develop this skill would take a combination of learning therapy skills, but also training charisma and state regulation. You’d have to master verbal therapy skills, but also nonverbal skills like speaking slowly or talking with conviction and confidence. You’d also need to do things that calm your nervous system and help you be more receptive. Eri Vlass does 1 hour of yoga every morning and swears by it. It probably works, not because “yoga is magic” but because it calms her nervous system enough to make her that much more receptive.

That being said, I do believe there are innate cues of safety and charisma that you can’t training. These are most likely physical. For instance we know that attractive people, as identified by facial symmetry and skin clarity, are generally more charismatic. As are tall people. Also, certain things can exaggerate these effects. Wearing makeup, for instance, can make your skin look clearer, and therefore make you look more attractive, increasing charisma.


To answer your final question, how did those natural Charismatic Coregulators come to be that charismatic bastion of safety? I suspect it’s a combination of 1) having some of the physical cues (being tall, having a symmetrical face, clear skin), 2) being raised by parents or caregivers who were responsive enough, and 3) have some sort of background in sports or something else which trained their ability to manage their physiology.

So that’s my answer. I hope that’s clear. Thanks for asking! I welcome any follow up questions!

Best,

PS. You may enjoy this.

[1] Alex actually wrote his dissertation about this, and has since published an article on the role of persuasion in counseling. Happy to send you a copy if you’d like.


[2] I honestly don’t love this interview with her. I don’t think she shines through that well. Before the interview she told me she was going through a major life transition. I won’t say what it was out of respect for her, but she’d had some difficult things she was personally struggling with. I think that impacted the quality of the interview.

 

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