Why do therapists not give advice?

By Chris Henshaw

One of the biggest misunderstandings new clients have about therapy is that they think they’re going to get advice about how to live better lives. But giving advice is actually one of the things I’m most cautious about in therapy, and in fact I rarely do. So why are therapists so stingy with advice?

In my experience, advice just doesn’t work that well. If it did, we wouldn’t need therapists. People are full of advice; everywhere we go and everyone we talk to is ready with a piece of advice for us on how we should solve our problems.

What happens when you open up to a friend? You tell them all about your problems, the pain and struggle you’re going through, and nine times out of ten your friend will try to help you by telling you what they think you should do in your situation. This is well intentioned and comes from a place of love, but let’s be honest.... How often do we actually follow our friends’ advice? The majority of people just don’t, and this is because, simply put, advice just doesn’t work all that well. This is because of a gap in knowledge between the person giving the advice and the person receiving it.

Here I have to briefly introduce two concepts. Professional Knowledge and Personal Knowledge.

Professional Knowledge is exactly what it sounds like: the knowledge that a professional has regarding their job and their scope. In a clinical setting this knowledge is gained through formal study at school and university, and comes from a knowledge base gathered from scientific inquiry and the repository of past clinical experience.

The thing about professional knowledge is that it’s general. For example:

• Here’s what we know about depression.

• These are the patterns we observe in people who grow up with abusive parents.

• This is what tends to happen after an acute trauma.

This type of knowledge is invaluable, but it’s lacking something really important for good advice giving, and that is context.

Here we need to talk about Personal Knowledge.

Personal Knowledge is all about context. It’s about who you are, where you are, what your parents are like, cultural norms, and even things like weather and traffic, which make your situation unique to you. It is impossible for me as a therapist to account for all these things when giving advice.

No matter how well I know my client, there will always be a near infinite set of things I can never know about them, just through my lack of experience in living their lives. This is the primary reason that advice fails: because it isn’t tailored to the context.

Let’s look at an example.

Everyone knows that exercising has significant positive impacts on mental wellbeing. Some research even suggests these impacts on depression are at least as significant as the effects of antidepressant medication.

It would therefore not be ‘bad’ advice for me to tell my clients to go for a jog in the mornings before work. Now here’s the question. Does my client have an injury? Where do they live? Is it safe to run in the mornings? What is their current morning routine like? Do they barely have enough time to feed the kids and have a shower before they need to get to work? Do they hate running after being forced to run laps in school as punishment?

These are a tiny handful of the millions of factors that aren’t considered in the advice above. No matter how much I try to find out, there will always be blind spots that I’m unaware of.

But do you know who knows all of these things? Who has a lifetime of experience and knowledge about just this very thing. The client themself! They know more about their lives than anyone else on the planet. At the very least, they’re the only person who is privy to the contents of their own mind.

So this knowledge gap is a massive problem for advising, and is one of the main reasons why it doesn’t work. But it is far from the only problem with advice, and to understand that, we need to understand what therapy is really trying to achieve.

If advice doesn’t work, then why the misconception? Why do people think that therapists are just going to tell them what to do? I suspect that this comes from a deeper misconception as to the purpose of therapy.

If we think that the purpose of therapy is to give clients solutions for a specific problem, then advice-giving is the obvious step that would have to occur. But in my view this isn’t what therapy is for.

I believe that one of the primary purposes of therapy is to cultivate understanding. When we have greater understanding of a situation, not only the external but the internal landscape around the issues we struggle with, coming up with solutions is often a natural and simple process that doesn’t require much external input.

Problems do need to be solved, but unless we understand the problem, the environment, and ourselves well, the solutions we craft will be poorly fitted to the situation. So how do we cultivate understanding through therapy?

Well, the primary method by which we do this is through listening. This may sound like nothing is happening, but through good active listening, both myself and the client come to greater understanding of themselves and their situation.

Advice on the other hand tends to block active listening and prevent deeper explorations and understanding. This is because when we advise, we are saying that we’ve heard enough, understood enough. We now know enough to make a judgement. This attitude is the end of exploration and understanding.

So now we understand the issues with advice from the perspective of the knowledge gap and the purpose of therapy. There is one further problem with advice in therapy, and to understand that we need to dig into what therapy actually is.

The giving of advice is emblematic of a further underlying issue that is the death of good therapy. The power dynamic. When advice is given, it creates an imbalance of power in the relationship. The advice giver is the knower. The wise one who will impart to the student what they ought to do.

The reality is that therapists are not smarter than you. We rarely know more than you either. What makes us effective is not that we are able to diagnose you and tell you all the things that are wrong with you. What makes us effective is the opposite, collaboration.

There are services in which an expert helps a passive individual. Think of a patient in need of a surgery. They come to the hospital with a problem, and the expert surgeon solves that problem by knocking them unconscious and cutting them open. The patient plays little to no active role in the process or outcome of their treatment.

Therapy doesn’t work like this. Therapy is a collaborative process, in which the client is a participant who is as, if not more, important than the therapist. The therapist like the surgeon has expert knowledge, and has seen many similar cases. But unlike the surgeon, the therapist cannot unilaterally make changes in the client. All change ultimately comes from the client themselves.

The client is in a state of understanding, changing, and becoming. This is not a passive process. The client gets better by about as much effort as they put in. Therefore the advice model is deeply flawed from the start.

By having the client be an active collaborator in their therapy, a few important changes happen that would be impossible without this kind of engagement.

Perhaps most importantly, by being an active participant in therapy, the client learns how to help themselves. One of the most important features in therapy is moving clients from a place of powerlessness to a place of efficacy and self determined action. This requires not only that the client knows what to do, but that they understand the process by which we reach that point. This allows for a tremendous growth in the client as a person.

A client who is powerless needs to seek help from external sources to resolve their problems. They are not in control of their actions and certainly not in control of the outcomes. But through learning to be an active problem solver in therapy. By listening to themselves, thinking through the patterns of behaviour, learning to be kind, patient, and understanding with themselves, they can learn that they have the ability to change things both internally and externally. This is the foundation of flourishing, and it cannot be achieved if the therapist simply tells the client what to do.

This is not to say that there is no place for advice in therapy. Of course there are clear examples in which a therapist advising a client is appropriate and expected. Safety issues, dealing with immediate crises, informing about resources (legal, medical, social) that the client can access are all areas where the therapist is right to advise their clients. But these do not form the core of therapy, and tend to take less time in the therapy room than clients often expect.

Instead I focus on listening, building understanding, independence, and problem solving skills. The outcome of this is that the client becomes independent, and eventually no longer needs me as their therapist. They are able to go out on their own and explore the world, face uncertainties and deal with problems themselves.