Clinicians on the Couch: 10 Questions with Therapist Nathan Feiles

Clinicians on the Couch: 10 Questions with Therapist Nathan FeilesIn our monthly series, we give readers a behind-the-scenes glimpse into the professional and personal lives of psychotherapists. They share the triumphs, trials and surprises of seeing clients. They reveal what they’d like others to know about therapy (and life). And they share just how they personally cope with stress, among other tidbits.

This month we’re featuring Nathan Feiles, LCSW, a social worker and candidate in relational psychoanalytic and contemporary psychotherapy in the New York City area. Feiles is a regular contributor at Psych Central and pens the popular blog “Relationships in Balance.”

In his private practice, Feiles specializes in relationships — including couples counseling — life adjustments and transitions; stress reduction and prevention; depression; migraines; anxiety and social anxiety; and phobias. He also is the founder of the NYC Migraine Support Group and runs a comprehensive program to overcome the fear of flying.

For more information about Nathan Feiles, visit his website at

1. What’s surprised you the most about being a therapist?

As I work with people, there inevitably comes a point with each person where I see something (if not several things) that I can relate to. Having ways to relate to clients is a necessary component of being a good therapist (otherwise you’re relying on the power of pure altruism), but it’s surprised me how this seems to naturally happen with each person.

When [I was] first starting out as a therapist, the assumption was that I’d probably relate most with people who have shared a similar primary issue to something I’ve also experienced.

But I’ve found it common to be in the room with people of all different backgrounds and histories, and at some point end up thinking, “I can certainly relate to you, here.”

While as a therapist my job involves setting my own life aside in order to focus on the person (or people) in front of me, I believe that this ability to empathize below the surface and in some way connect with each person is one of the reasons I love what I do. Within everyone there is something to connect with and appreciate.

2. What’s the latest and greatest book you’ve read related to mental health, psychology, or psychotherapy?

I recently read The Marriage Clinic by Dr. John Gottman. This book resonates with aspects of my relationship therapy approach – opening communication and generally removing the idealizations from the relationship picture, while focusing more towards creating and harnessing positive sentiment for a healthier and more fulfilling relationship.

3. What’s the biggest myth about therapy?

There are many myths to choose from, but the myth surrounding venting grabs my attention. I’ve heard people say that if they need to talk or vent, why should they go to a therapist? Can’t they just go to a friend? Two issues with this: 1) not everyone has a close friend to go to; and 2) while venting is fully welcome and can be part of therapy, therapy is for more than just venting.

Venting can be useful to temporarily relieve stress (and venting can actually increase stress, if not careful), but at some point, a person in therapy will have to look into themselves and their own cognitive and emotional processes. The process that makes therapy effective isn’t as likely to happen effectively with a friend (even if the friend is a therapist). Therapy isn’t only talk and conversation, nor is it advice-giving (another myth).

Therapy involves a dynamic relationship in its own right, which a personal history conflicts with. That’s why it is unethical for therapists to work with their friends. Therapy is most effective when entered pure – without personal history. Therefore, while it’s nice to be able to vent to friends, if you’re looking for an effective therapy experience, this is much more likely to happen with a therapist than when talking to a friend.

4. What seems to be the biggest obstacle for clients in therapy?

The obstacle that I see repeat most is the desire to change and move forward, versus the unconscious desire to stay “comfortable” – even if the “comfortable” is unhealthy or harmful. In every person, no matter how much they want to change, there’s a subconscious desire to work against change. The unknown of change can seem daunting, at times, and this is where people often become the most unconsciously resistant to their therapy.

For example: A person who is used to isolating finds they are establishing a meaningful therapeutic relationship with their therapist. This is anxiety-provoking because the person is used to arm’s-distance relationships. As the therapy is about to go deeper, the person decides to stop going to therapy. Thus, the person breaks the process of moving forward, because the fear of the unknown change is more scary than sticking with something less healthy, but something they’ve survived for so long: isolation.

5. What’s the most challenging part about being a therapist?

The endings. At some point, whether after six months or many years, people finish their treatment. There is an alliance, care, and bond that forms with each person. When treatment ends, it can be sad for the therapists, too. While this is a given part of the work, it’s never easy.

6. What do you love about being a therapist?

The people (clients). The ability to know so many people, and help people create fulfillment in their lives is an incredibly rewarding journey.

7. What’s the best advice you can offer to readers on leading a meaningful life?

Focus on what you can control. There are things in life we can’t control. These things usually cause stress and anxiety. It’s much more useful to focus on what is within our control.

8. If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently, and why?

I’m very happy with what I do.

9. If there’s one thing you wished your clients or patients knew about treatment or mental illness, what would it be?

I wish people saw getting help as a sign of strength, rather than a weakness. People who attempt to do it all alone often end up struggling the most before they finally “give in” for help. Pride can make us think that there’s something advantageous to struggling through life without going to anyone for help. But in reality, there are no points awarded for struggling alone, nor is there shame in getting help with the challenges of life.

10. What personally do you do to cope with stress in your life?

As a therapist who partially specializes in stress reduction and prevention, I do my best to practice what I preach. Stress is a state of mind. Therefore, as mentioned above, I try to focus on what is within my control, rather than letting things outside of my control create unwanted stress.

While there are behavioral exercises that I can (and do) use in times of acute stress, I find that setting the environment for stress prevention is the most helpful. This involves such things as establishing boundaries between my work life and personal life, scheduling in some weekly form of self-care, and generally surrounding myself around people who make me feel good.

So I would say I cope with stress by preventing it as much as possible, and when I have a notable level of stress that I’m presented with, I have an internal list of cognitive and behavioral coping skills that I go to, which combine to physically relax me, as well as re-frame my mindset away from stress.

Click to visit original source at PsychCentral

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Shared by: Margarita Tartakovsky, M.S., Contributing Blogger

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