Therapists’ Obligation to Be Polite in Therapy: A Foundation for Ethical and Effective Practice - Luuk L. Westerhof, MSc

Introduction

The therapeutic relationship represents a unique and intricate bond that relies heavily on the foundational elements of trust, respect, and collaboration between the therapist and the client. This bond is not simply a transactional interaction but an emotional and psychological connection that can significantly influence the therapeutic process. One of the most crucial aspects of this dynamic is the therapist's commitment to maintaining a polite and respectful demeanor. This politeness should not be viewed merely as a social nicety; instead, it is an essential therapeutic tool that fosters an atmosphere of safety and openness. When clients perceive their therapist as respectful and considerate, they are more likely to engage fully in the therapeutic process.

An important responsibility of the therapist is to seek permission before delving into personal or emotionally charged topics. This approach demonstrates sensitivity to the client’s feelings and boundaries, allowing them to feel more in control of their narrative. By honoring the client's autonomy, the therapist establishes a collaborative partnership where both parties have a voice in the direction of the therapy. Additionally, therapists must respect the existing life strategies and coping mechanisms that clients have developed. Acknowledging and validating these strategies fosters a sense of empowerment in clients, reinforcing their efforts to manage their challenges. This respect builds trust and encourages clients to explore new perspectives while feeling supported.

Moreover, a co-creative environment is essential for effective therapy. This involves therapists collaborating with clients to co-develop goals and explore issues rather than adopting a one-size-fits-all approach. By valuing the client's experiences and insights, therapists can facilitate a more dynamic and responsive therapeutic process. Incorporating these principles into practice allows therapists to create a safe, welcoming, and empowering space. This environment is conducive to profound personal change and growth, benefiting the client's overall well-being and resilience. By recognizing the importance of these elements, therapists can enhance the therapeutic experience and help clients navigate their journeys with greater confidence and autonomy.

The Ethical Foundation of Politeness in Therapy

Politeness in therapy is deeply rooted in professional ethics, including principles enshrined in frameworks such as the American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct and the British Association for Counselling and Psychotherapy’s Ethical Framework for the Counselling Professions. These codes emphasize respect for client autonomy, dignity, and individuality, which politeness helps uphold.

Politeness plays a vital role in ensuring that therapy is conducted with high sensitivity to the client's emotional state and personal history. It encompasses a range of behaviors, including active listening, validating feelings, and using a respectful tone. These behaviors create a supportive environment where clients feel safe to explore their thoughts and emotions.

Research has consistently shown that a respectful and empathetic therapeutic relationship is one of the most critical factors influencing positive outcomes in therapy (Norcross & Wampold, 2018). When therapists embrace politeness in their interactions, they signal their commitment to the client’s well-being and autonomy. This respect fosters an atmosphere of trust and encourages open communication and collaboration between the therapist and the client.

By valuing the client's perspective and experiences, therapists can better understand their client's unique challenges, allowing for more tailored interventions. Moreover, a polite demeanor can alleviate anxiety and resistance, making it easier for clients to engage in the therapeutic process. A foundation built on politeness and respect empowers clients to participate actively in their healing journey, facilitating growth and positive change.

Resistance should not be perceived merely as a form of opposition or a reluctance to engage with one's emotional struggles. Instead, viewing it as a protective mechanism developed over time is essential to help the client navigate and function effectively in their daily life. Recognizing resistance in this light allows therapists to create a safe space for clients, fostering an environment of trust. When clients feel secure in the knowledge that their therapist understands and respects their resistance, they are less likely to experience heightened emotions or anxiety. This sense of safety enables clients to engage more openly in the therapeutic process without fearing being pushed too far too quickly.

Moreover, it is important to understand that resistance often has deep-rooted connections to subconscious processes outside the realm of conscious thought. This neuroceptive aspect of resistance highlights the complexity of human emotions and behaviors. By acknowledging that resistance may stem from unconscious fears and defenses, therapists can better navigate the therapeutic relationship and create tailored strategies that respect these underlying mechanisms. This nuanced approach honors the client's experiences and facilitates deeper exploration and healing over time.

Seeking Permission: A Gateway to Collaboration

Therapy often involves discussing personal and potentially distressing topics. Asking for permission before delving into these areas is polite and crucial for maintaining the client’s sense of safety and control.

For example, rather than abruptly asking about a traumatic event, a therapist might say:
"I would like to explore some experiences that might be related to what you are feeling now. Would it be okay if we talk about that?"

This approach respects the client’s boundaries and creates an environment of mutual consent. Studies show that when clients feel they have control over the therapeutic process, they are more likely to engage and benefit (Bohart & Tallman, 2010). Permission-seeking also models respectful communication, reinforcing the collaborative nature of therapy.

Recognizing Client Agency in Therapeutic Progress

Therapists come equipped with expertise, techniques, and tools designed to facilitate healing and personal growth. However, therapy's ultimate success and effectiveness depend significantly on the client's willingness, ability, and active engagement in confronting their challenges. This interaction between the therapist's and the client's participation is crucial; it highlights the importance of the client's role in the therapeutic process.

Understanding this dynamic fosters a sense of humility among therapists and underscores the value of the client's agency. It serves as a reminder that therapy is not a one-sided endeavor but a bilateral collaborative journey. The client's insights, efforts, and commitment to the process are essential for achieving meaningful therapeutic outcomes, making it imperative for therapists to encourage and empower their clients to take an active part in their healing and development.

A therapist might say:
"I am really impressed by how much effort you have put into understanding yourself and making these changes. This progress is a testament to your hard work."

This acknowledgment shifts the focus from the therapist’s role to the client’s achievements, fostering a sense of empowerment. Research in positive psychology underscores that celebrating client successes enhances motivation and reinforces adaptive behaviors (Seligman & Csikszentmihalyi, 2000).

Co-Constructing New Modalities: A Collaborative Journey

Therapy is most effective when it is a partnership. Co-construction involves exploring new perspectives and strategies collaboratively, ensuring they align with the client’s values and goals.

For example, instead of prescribing a solution, a therapist might say:
"It seems like this strategy has been helpful for you in some ways. What do you think about exploring a slightly different approach that might make things even easier?"

By inviting the client into the process, therapists avoid imposing their views and instead empower clients to take ownership of their growth. Co-construction respects the client’s lived experience, aligning with humanistic and constructivist approaches prioritizing collaboration and mutual understanding (Rogers, 1951; Neimeyer, 2009).

Honoring Existing Life Strategies

Every client brings a set of coping mechanisms shaped by their life experiences. Though not constantly adaptive, these strategies often reflect a survival instinct that has served a critical purpose. Criticizing or dismissing them can alienate the client and undermine their trust in the therapeutic process.

Instead, therapists should validate these strategies. For instance:
"This approach has helped you navigate some tough situations. That is incredible. Would you be open to exploring some additional tools that might build on this foundation?"

This validation acknowledges the client’s resourcefulness and resilience, paving the way for introducing new strategies. Research highlights that when clients feel their existing efforts are respected, they are more open to exploring alternatives (Linehan, 1993).

The Role of Respect in Creating a Safe Therapeutic Environment

Respect and politeness play vital roles in creating an environment that promotes safety, which is essential for effective therapy. When clients feel respected, it enhances their perception of the therapeutic relationship and positively impacts their overall therapeutic outcomes.

From a neurobiological standpoint, the sense of safety is closely linked to the activation of the ventral vagal system, a component of the autonomic nervous system that plays a critical role in emotional regulation and fostering social engagement (Porges, 2009). When clients perceive that they are respected and treated with politeness, their nervous systems can become more relaxed. This relaxation is crucial because it creates the optimal conditions for clients to engage in introspection, self-reflection, and emotional growth.

Moreover, politeness is fundamental in minimizing the risk of re-traumatization during therapy sessions. By ensuring that clients feel in control of the therapeutic process, therapists can significantly reduce feelings of anxiety and overwhelm. A secure and respectful environment fosters vulnerability, which is essential for healing. In this safe space, clients are encouraged to confront and integrate dissociated aspects of their experiences, allowing for a deeper understanding of their emotions and histories. Overall, respect and politeness help establish trust between the therapist and the client and facilitate a therapeutic landscape where healing can occur.

Facilitating Emotional Regulation and Integration

Therapists prioritizing politeness and respect help clients regulate their emotions and address underlying survival-based behaviors. For example, a client who has relied on avoidance as a coping mechanism might, in a respectful environment, feel safe enough to explore and challenge these patterns.

Practical interventions include grounding exercises, validation statements, and collaborative problem-solving, all framed within a respectful and empathetic approach. Such techniques align with trauma-informed practices emphasizing safety, choice, and empowerment (Herman, 1997).

Practical Applications for Therapists

Therapists can integrate politeness into their practice through several strategies:

1. Language: Use permission-seeking and collaborative phrases.
2. Nonverbal Communication: Maintain a calm and open demeanor.
3. Reflection: Regularly assess whether their approach respects the client’s autonomy and values.
4. Training: Engage in ongoing professional development on respectful and client-centered techniques.

Scripts and examples can be invaluable. For instance:
"Thank you for sharing that with me. It sounds like this has been a significant part of your journey. Would it feel helpful to explore this further together?"

Challenges and Considerations

Maintaining a sense of politeness within a therapeutic setting can be particularly challenging, especially when clients display behaviors that push the limits of acceptable conduct. Therapists are tasked with the delicate balancing act of respecting their clients while being firm in establishing and maintaining boundaries. This is crucial, as failing to do so may undermine the integrity of the therapeutic process and hinder progress.

Therapists can benefit significantly from regular supervision sessions to navigate these complexities. These opportunities for professional guidance allow therapists to reflect on challenging interactions, gain new perspectives, and develop strategies for managing difficult situations while remaining compassionate and respectful. Additionally, regular self-reflection is essential, as it enables therapists to assess their responses and emotional triggers, fostering greater awareness of maintaining professionalism in the face of adversity. Therapists can reinforce their commitment to fostering a safe, supportive, and productive therapeutic environment through these practices.

Summary

Politeness in therapy transcends mere etiquette; it emerges as a fundamental obligation underpinning the therapeutic relationship, ensuring respect, safety, and collaboration. To cultivate an environment conducive to growth and healing, therapists must prioritize seeking explicit permission before delving into sensitive topics or employing particular techniques. This practice affirms the client’s autonomy and agency and empowers them to engage actively in their own therapeutic journey.

Moreover, honoring the client's existing strategies and coping mechanisms is crucial. This approach acknowledges clients' resilience and resourcefulness in therapy, validating their previous experiences and insights. By integrating these existing strategies into the therapeutic process, therapists can reinforce the client's sense of competence and confidence.

Additionally, fostering a co-creative process is essential, where therapist and client collaboratively explore and navigate the therapeutic landscape. This partnership should be characterized by open communication, mutual respect, and a shared commitment to the client's goals. As therapy continues to evolve, these principles of politeness and respect remain central to ethical practice and effective therapeutic outcomes. Emphasizing these elements enhances the therapeutic alliance and promotes a safe space where clients can genuinely thrive and explore their innermost concerns.

References

1. Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. Journal of Psychotherapy Integration, 20(3), 191-204.
2. Herman, J. L. (1997). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books.
3. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
4. Norcross, J. C., & Wampold, B. E. (2018). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 55(4), 303-315.
5. Porges, S. W. (2009). The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(Suppl 2), S86-S90.
6. Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Houghton Mifflin.
7. Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5-14.