Psyched in San Francisco: A Different Understanding of Fit: Or How Psychotherapy is Different from a Pair of Shoes

A Different Understanding of Fit: Or How Psychotherapy is Different from a Pair of Shoes

By Michael Korson, MFT

People come to psychotherapy looking for a good fit between themselves and the therapist. I often suggest that a client meet with me for a few sessions so that we can get a sense of the fit. In a few sessions we get a sense of fit, but in the ongoing work we establish the fit between us.

In our modern, fast world our understanding of “fit” is of something that also happens quickly. We think of fit as something instantaneous. We try on a shoe and it fits or not. We shop for a new shirt and, of course, we don’t take one home which is two sizes too big. Something fits or it doesn’t. I suppose “fit” in the sense of being in shape is something that usually takes some time. Though there are plenty of gadgets and diets marketed on late night and cable TV purportedly to make one fit in a hurry.

This idea of fit as something that happens quickly has infiltrated the world of relationships. There is Speed Dating – where within a matter of minutes a person evaluates the possibility of a fit for a lifetime. Online dating has become a mainstay for the way that people now meet. While it greatly helps those dating and provides a good alternative way to meet others also looking to meet, still it inherently involves a process of sizing up the fit in the speed of a click of the mouse.

Fit is an important element of all relationships. By it I suppose we mean that there is some compatibility, a way of relating comfortably. There is a certain feel and that feels right. There are, however, other ways of understanding fit as something other than quick. Sometimes it is something that takes time. I am particularly heartened by those stories of couples who recall, many years later, their first thoughts about the other which were anything but positive. I love hearing when a woman says of her partner, “I couldn’t stand him when we first met.”

Fit, as I understand it in the context of psychotherapy, is not something that happens instantaneously, but requires some time and attention. It is not so much about similar interests or common likes between client and therapist. It is not about similar experiences. Of course, it has something to do with how well-understood the client feels. And most fundamentally, it is about the way that the two can come to understand and articulate the client’s needs. Fit in this context is a living process that two people engage in – a process central to the work of psychotherapy and, I believe, to all human relationships, particularly intimate ones.

In psychotherapy, one doesn’t so much discover a fit as the two people work to create it. Central to this process is discovering what are the client’s needs in the relationship and then encouraging the expression of those needs. This is particularly important for all clients, but especially those who come into therapy with a history of negating their needs, both the expression of them and even the realization of their existence. Often if a person has in some fundamental ways not had needs met, that person will disavow any need connected to another human being. It is crucial, particularly in the early stages of treatment but throughout the work as well, that the client identify and express those needs as they relate to the therapy and to the therapist. Perhaps the client needs more involvement from the therapist; or perhaps less. Perhaps the client needs to know the therapist’s opinions or how she feels about the client.

The other essential part of this process is for the therapist to discover to what degree he or she can meet those needs. It is my belief that psychotherapy is a process by which both people change -- both people, including the therapist. In any successful therapeutic treatment, client and therapist undergo some transformation so that they are not quite who they were at the start of the process. In this way, the psychotherapeutic relationship mirrors the process for any intimate relationship: two people change and influence each other. Regarding change, psychotherapy addresses fundamental and complicated questions: How can one change while remaining essential oneself and not contorting into something one is not? And what defines a “good” relationship, something real, though inevitably failing to reach the heights of fantasy?

In all types of relationship, fit is often a matter of “good enough.” There are no perfect relationships just as there are no perfect human beings. No one relationship provides all of what someone needs. A key to accepting relationships and maintaining them long-term is for each person to understand what “good enough” means and then to strive for it. Perhaps that statement may sound somewhat controversial or pessimistic. After all, Hollywood and other image-making enterprises suggest that the ideal can be reached. Aren’t we encouraged to think that anything less is unacceptable? A key ingredient in any successful relationship is the acceptance of limitations, the other’s and one’s own. From that vantage point, “good enough” can be quite good.

It takes a long time to get to know someone, to be able to see that person free of our own projections (our hopes, wishes, fears and how they color perception) and the influence of the past (how that person reminds us of someone from the past and how our experiences from the past, particularly those of disappointment or rejection, influence the way we experience the present). While there is certainly much to say about trusting one’s intuition, an important part of the total person, relying on that part of the human psyche can be confusing. First impressions may be glimpses of some deeper truth about someone, or they may be products of one’s fears, anxieties, and associations to the past.

Fit is a process that takes time. In the psychotherapist’s office, it takes an active dialogue. Psychotherapy provides a valuable opportunity to engage in this process not only to establish the fit between client and therapist, but to practice and develop relational muscles for all of one’s most important relationships. To come to understand what is good enough; to have an experience of articulating to someone what one’s needs are and having that person generally interested in understanding and meeting them…those are some of the experiences that psychotherapy provides. I suppose I could summarize by saying that fit in this sense is something that involves trying on, adjusting, and wearing for a while… eventually walking with more comfort and a spring in your step through your life and the world.

Michael Korson, MFT, CGP has a private practice in San Francisco and Berkeley, California. Michael works with individual adults and adolescents, couples and families. He is a certified group psychotherapist by the American Group Psychotherapy Association. Michael provides supervision to interns at local counseling centers and has a private practice intern under his supervision. For many years he was the chair of the Intern Support Committee for SFCAMFT. He is a first-year candidate at the Psychoanalytic Institute of Northern California. More information on Michael can be found at his website www.michaelkorson.com.