Does It Pay to Be Nice as a Therapist? Attachment Issues in the Dyadic Relationship

Thirty-five years ago, when I first started my psychotherapy practice, I was overwhelmingly nice to my clients: I offered them coffee and tea; I was gracious in allowing them to go over session times; sometimes I even made home visits when they couldn’t show up. In one case with a particularly nervous client, I walked around the block with her in order to calm her down. I was grateful to have their business, especially with the competition growing each day in the Bay Area. I was also single at the time and mistakenly made my clients and my work an extension of my personal life.

Kindness from a Therapist

As my practice and reputation began to grow and I became more confident in my skills, the very “nicey-nice” part of me began to morph into a more contained and boundaried practitioner.

I write this article not to disparage my urge to be a loving presence to my clients. Quite the opposite: I’ve grown to be a skilled and patient listener with great respect for the patients I serve. Yet I now see that being too nice to my patients was an expression of my early, unresolved attachment issues and my fear of failure, rejection, and abandonment. This article is a dialectical exploration of the positive and negative issues of being too nice.

What exactly does the word nice mean? According to the dictionary, in the late 13th century, nice meant stupid and foolish. The word held various meanings over time, including wanton, extravagant, strange, thin, and shy. By the middle of the 18th century, it had gained its current meaning—pleasant, agreeable, good-natured, inclined to put the needs of others before one’s own.

Does it pay to be nice? Some people would say yes. Linda Kaplan, CEO of the Kaplan Thaler Advertising Agency in New York, gives several reasons why being nice puts people at an advantage. Her view is that nice people make more money. What new therapist doesn’t want to fit into that category? Similarly, according to research from Rutgers University, being nice in business leads to a 1% increase in revenues. According to many people, nice folks live longer, have happier lives, and stay healthier. In addition, research has shown that doctors and other health care providers, including psychotherapists, who spend more time chatting with their patients and being pleasant to them have fewer legal problems. As a long-term therapist I know about this. I once advised a client to change her eyeglasses in order to meet her goal of upgrading her personal appearance. The client took umbrage at this and eventually attempted to report me to the licensing agency for emotional injury.

Is being nice always the best strategy? Studies of successful leaders have shown that personality characteristics like narcissism and unwarranted self-confidence, along with behaviors like self-promotion, actually aided people in their careers. Successful people are often not terribly nice. Look at Steve Jobs. He was judgmental, critical, demeaning, and very difficult to work with. At the same time, everyone in his industry wanted to work with him. People are drawn to success and will sacrifice their egos to bow down before it.

Being nice and caretaking others are particularly strong aptitudes in women. Their caring and nourishing talents often take them beyond the scope of just being nice to the point of splitting into two people. One person appears very confident, contained, and professional, while the other is hidden, ashamed, needy, secretive, fearful.

I’m not exactly sure when, as a young therapist many years ago, I finally woke up to valuing myself more. Suddenly my two selves were confronting each other, the one asking the other why I was so tired at the end of the day, why I was grasping for more reassurance from my clients, why I was feeling burnt out, empty, and hollow. The way I was treating myself was the polar opposite of the way I was advising my own clients to treat themselves. This awareness, which was really simple and obvious from the start, took on a crystalline quality. It was as if I were taking apart my own ship and using its planks to rebuild myself.

Several factors played into this subtle transition. First, growing older helped me to get real with myself. Because time moves in only one direction, I realized there was no time to lose when it came to being true to myself. Second, I got caught up in making more money, in being sought out and well known. Third, the inordinate pressures the big insurance companies put on therapists to perform and meet goals in four to six sessions depersonalized the work for me. And finally, the current emphasis on short-term, time-limited, solution-focused therapies made the work less intimate. All of these factors, for good or ill, helped me overcome my need to be nice.

In the world of therapy it’s essential that we feel compassion and empathy for our clients, yet there are many pitfalls. If we take on the client’s emotions, for example, we can get overwhelmed, become ineffective, or compromise the work. If we are not clear about our own unmet needs, fears, and desires, such as a fear of being abandoned, a need to control, or a wish to be needed, the treatment can be muddled. Countertransference issues need to be explored. The job of being a therapist is particularly seductive for anyone with a strong inclination to want to fix others. Although the job can provide a sense of importance or an escape from one’s own personal issues, one can get trapped in the role.

For me, it was shameful and humiliating to see myself encouraging my patients to be vulnerable and elastic while hiding out in my own safety and cover. I strive to remember and wonder what kind of demons of my own are coming up in the therapy room. I question myself—can I make myself more genuine, less of a therapy machine? After many years of being a therapist, I have come to enjoy my work more profoundly than ever. My need to be nice has given way to a more substantial understanding of my insecure attachment needs. As a result, I laugh more, find the client’s material more intriguing, and feel less overwhelmed by our dynamic. My newly constructed ship sails on semi-even seas. In looking back, I often wonder—if we’re thinking psychoanalytically—who was actually the good mother to whom? In sum, there is a place for being nice in your therapy practice—yet too nice can be dangerous.