The Myth of the Therapist as a Blank Screen: Normativity Masquerading as Neutrality

The Myth of the Therapist as a Blank Screen: Normativity Masquerading as Neutrality

Let’s put it succinctly: when the idea of therapist as a “blank screen” was invented, therapy was being practised for the most part by urban white bourgeoise psychoanalysts treating urban white bourgeoise patients. Within such a homogenous culture, one can imagine how the idea of the therapist being a mirror to the patient made sense. But as soon as you start to scratch the surface of that mirror, you run into trouble, even back then.

There are good theoretical reasons the blank screen was suggested. First of all, by removing the personality of the analyst from the encounter, unconscious processes like transference and projection could reveal themselves free from contamination. They could be witnessed, understood, and interpreted. The second reason was that a non-judgemental "neutral" space allowed the patient to free-associate without being swayed by the unconscious desire to either gratify the therapist or fear disappointing them. By refraining from sharing any moral, political, or cultural values, the theory was that the patient became freer to discover their own.

This dynamic was later referred to as a “one person psychology" model whereby the "one person" in the room is the patient. The therapist's person is meant to be effectively absent - which is further effected by their sitting behind the reclining patient in the classical manner. In essence, there is some wisdom here. It makes sense to preserve the patient's space by not filling it up with the therapist’s expectations, desires, and ideas. But what works fine in theory doesn’t really pan out that way in practice.

Values assert themselves whether we they are explicit or implicit:

Freud’s brilliance in identifying unconscious processes like transference and projection continues to be useful today, but many of his cultural values remain firmly situated in the 19th century, for instance his attitude towards women (who made up the majority of his “hysterical” patients), as well as many implicit ideas about psychological health (for example the idea that masturbation caused "neurasthenia"). Since the technique of the blank screen post-dated Freud's famous case study of "Dora", his lack of neutrality in it clearly exemplifies these values.

Dora was a 14-year-old girl who arrived on Freud's couch with a variety of symptoms after suffering the sexual advances made towards her by an older man, known as Herr K. Not only was Herr K. a family friend of her parents, but Dora’s father also happened to be having an affair with his wife. When Herr K. made his sexual advance to Dora by a secluded lake, she quite rightly rebuffed him with a slap and made her way off. Freud, rather than empathising with a young girl who'd been sexually assaulted by an older man, suggested that a more appropriate response would have been a corresponding sexual interest from her. This is a reading that was suspect even at the time, and has ever since earned him the scorn of feminists everywhere. To Dora's enduring credit she dismissed Freud almost as quickly as she did Herr k.

Freud had not yet developed the technique of the blank screen, so these events quite transparently belie the explicit values that he embodied at the time: values that would not disappear with neutrality, only become perniciously implicit.

Neutrality is never really neutral: it is rather a reproduction of normative cultural constructs prevalent at any given time.

Not that you’d guess it from this example, but Freud’s lifelong attention on sexuality was intent uncovering how damaging Victorian-era sexual mores were on his patients. Freudian thought developed to liberalise and open sexual values rather that reproduce them as they were. Notwithstanding his positively anachronistic views on women, even for his time, many of his other views on sexuality were astonishingly progressive for his time. Sadly, these progressive views were not carried forward after his death in 1939.

From bad to worse:

Many of the psychoanalysts fleeing Nazi Europe found themselves in a United States that was even more prudish than the Europe they'd left. Eschewing most of Psychoanalysis's progressive views on sexuality created a new kind of medicalised sexual normativity as it developed into Ego Psychology which arguably focused on creating "good citizens" who'd be well adapted to their culture.

Departing from its subversive Freudian roots in the 1940s and 1950s, Ego Psychology was explicitly homophobic and heteronormative, holding up the monogamous married couple as the gold standard of a healthy psychological life. Whereas Freud held that heterosexuality needed as much explanation as homosexuality, and did not see the latter as pathological, homosexuality in the 1950s and 1960s was  approached by the psychiatric establishment as a perversion that needed correction. Lesbians, gays, and bisexuals availing themselves to psychotherapy in those days, often against their will, were subjecting themselves to harmful practices that tried to analyse (or worse, electrocute) the gay out of them. Those blank screens and "neutral" medical environments were cauldrons of judgement and conventional expectation – harming rather than healing.

Richard Isay, one of the first openly gay psychoanalysts, kept his sexuality to himself throughout his entire training analysis in the 1970s as  he knew well that the masquerade of neutrality was a trap – and that by availing himself to being truthful in his analysis he would risk his career.

After finally passing his candidacy and coming out in the 1980s, he wrote that for gay analysts to present themselves as a blank screen, particularly when working with other sexually minoritised individuals, would be tantamount to a violence of withholding. This is because “neutrality” assumes the underlying dominant power structures, which  in this case is heterosexuality. In other words, if the analyst didn't come out as gay, the patient would assume they were straight. While there has been a lot of progress in this area since Isay's time, other contemporary dominant structures, like binary gender, continue to make therapeutic spaces unsafe for transgender and non-binary individuals.

For anyone who experiences themselves as different from conventional norms (and the vast majority of us do), being in a neutral therapeutic space is more likely to feel like oppression than care.

But therapists don't still do blank screen though, do they?

For the most part, no. In practice, though, most therapists do generally practice descendent of that in the form of neutrality in the interest of preserving therapeutic space for the client. In theory, this is fine – but, again, in practice it quickly gets problematic. Important personal aspects of the therapist’s identity are plainly evident and easily disrupt the fantasy that any space can be neutral.

Objective qualities like the location and decoration of their offices, for example, or more pertinently, personal qualities like race, accent, class, gender, disability, or sexuality may be evident from the very first meeting. More subtle giveaways may be political or religious affiliations, spiritual beliefs, marital status, or attitudes towards drugs or sex, which may become evident over time often by disclosure or more subtly by omission – those things unsaid, unaddressed, or worse, subtly recoiled from.

The development of Relational Theory in the 1980s has done much to uncover and challenge the idea of neutrality and the “one person psychology" model through what we have come to understand as “intersubjective space”, that is the co-constructed space between a therapist and client which becomes of primary interest. This development in theory is the result of integrating other disciplines like critical theory, post-structuralism, post-colonialism, feminism, and queer theory, to inform contemporary therapeutic process.

The aim of Relational Theory isn’t to tell therapists how neutral or not to be in the consulting room, but rather to think more critically about how power might be deployed between therapist and client so they can understand it together for the benefit of the client.

Relational theory alerts us to how power is deployed implicitly – for example, between people from different classes, genders, races, or cultures. It does not offer a solution to dealing with difference so much as acknowledging that when we accept  that neutrality is a myth the relational dynamics between therapist and client become the object of interest as they arise instead. This is truly a “two person psychology” approach – accepting both the psychology of the therapist and the client as a co-creation - but one in which the therapist still retains responsibility for the frame.

While it may feel more comfortable to think about what we have in common, Relational Theory  gives us insights and models into how we manage and contain difference – from difference of opinion and personality style, to differences in skin colour, gender, class, neurodiversity, or disability.

Blank screen: white screen

The idea of the blank screen developed out of white practice in a largely white environment of  Europe in the early 20th century. Even under those conditions it was unrealistic, but today it is wholly inappropriate. As we have discovered, whenever we assume some kind of neutrality we are reproducing normativity instead. If we have learned anything over the past decades it is that any institutional structure is imbued with the cultural values of its day lurking in the background. Even today, in 2021, the world of psychotherapy continues to be largely white and middle class (present company included), and attempting to call it "neutral" does nothing to neutralise those values.

Black, Indigenous, and People of Colour are woefully under-represented throughout the profession, many of whom report experiencing trauma at the oppressive way in which their trainings have been delivered. This creates a vicious cycle that continues to underserve these communities as well as staving off the creative, diverse, and inclusive developments in the theory and practice that's lost by their absence. And it’s not just race. We must also confront issues of class, economic opportunity, neurodiversity, disability, sexuality, gender, age, religion, and ethnic and cultural diversity.

Part of the solution is ensuring that we find ways to encourage this diversity of life experience to safely participate in the field more widely as therapists and trainers, and make trainings safer (not neutral) so that this can happen. In the therapy room there is no simple guide to how we go about resolving these issues, but it’s glaringly clear that pretending that we can be neutral isn’t one of them.

That doesn't make it all about me:

Neutrality is oppressive because it is defensive, and its defensiveness is probably part of why it was invented. A therapist can hide behind it to keep themselves safe from exposure and vulnerability or from confronting an important interpersonal conflict that’s happening in the room. But I’m afraid to say that its reverse is not at all the cure either. Bringing too much of the self into the room via self-disclosure can be equally defensive and oppressive. Nobody said this was going to be easy!

So the question for the therapist isn’t what or how much they might say or do, the question is, "Is it in the service of my client?" A question that might be answered by, "Who benefits the most from this omission or disclosure?"

By eschewing neutrality, therapists drop defensiveness and make themselves more vulnerable and hence available to their clients. After all, therapists expect clients to be vulnerable with them – so it’s only fair that there's some degree of reciprocity there, even if it's not equal: what Lewis Aron calls "asymmetrical mutuality".

For clients, the therapist's lack of defensiveness allows space for them to develop trust in another complex human being who is different from themselves - not an opaque or blank screen that feels at best forced, at worst, unsafe. The relationship becomes more honest and more human.

For therapists, authenticity doesn't mean letting go of that important job to do - being a therapist: neither a spouse nor a friend. It is here that those therapeutic boundaries remain crucial. But there is also an acknowledgement of the inherent shared humanity, sameness, and difference in therapist and client, and it’s there – not some imagined neutrality – that the real work is done.

Aaron Balick, will be hosting an event on Therapist Self Disclosure on December 2nd at Stillpoint.

Dr. Balick is a psychotherapist, writer, and director of Stillpoint, an international hub for exploring psychology inside and outside the consulting room. He is the author of The Psychodynamics of Social Networking connected-up instantaneous culture and the self; Keep Your Cool: How to deal with life’s worries and stress; and The Little Book of Calm: tame your anxiety, face your fears, and live free. He is an honorary senior lecturer at the Department for Psychosocial and Psychoanalytic Studies at the University of Essex.

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