What Should I Do

"What should I do?" is a common question posed by patients to therapists. Experiencing an empathic connection with the patient, the therapist may then think to himself or herself "What should I do?" The inclination might be for the therapist to attempt to give advice. However, prescribing action ahead of gaining some level of understanding of the nature of the patient's difficulty may ultimately be unempathic. Advice often fails to mirror the patient's internal reality (Alonso & Rutan, 1996). Their difficulties may in fact serve an undiscovered purpose in their lives. Therefore, thoughtful assessment of a patient's experience will be more helpful than a therapist directly answering the question "What should I do?"

In group psychotherapy, the therapeutic agenda of exploring and uncovering the full nature of the individual group member's difficulties may seemingly be undermined by other group members' maneuvers to quell the anxiety inherent in the process. Among methods that group members employ is answering the question "What should I do?" or offering advice. At first blush, this might seem to corrupt the very purpose of therapy and lead some group therapists to discourage group members from giving advice. After all, many patients have first sought advice from family, friends, radio talk shows, and self-help books. Thoughtful and caring advice has been ineffective in helping the group member resolve his or her issues. However, member to member advice given in the context of a therapy group can be an essential vehicle for furthering self-exploration.

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