“Events of mutual aggression are unavoidable in the course of a life lived together, but, by the same token, the possibility of their clarification and resolution carries with it the possibility of further strengthening and deepening the relationship.” (Kernberg, 2012, p. 288)
Aggression Isn’t the Enemy in Therapy
There is a difference between “kind” and “nice.”
Therapists often resist their own aggression or insist on “niceness.” Yet doing so can actually impede patients’ awareness and expression of their own angry, dissatisfied feelings toward the therapist, which can thwart the integration of aggression into its healthy forms of realistic anger and assertiveness.
Instead, suppression of the therapist’s aggression can drive a turn against the self, which some patients are apt to do in the form of shame and self-loathing as well as self-destructive behaviors. Thus, the illusion of a safe and constructive therapeutic relationship is preserved even as the harmful patterns for the patient are reinforced.
Stigmatizing therapist aggression insidiously fuels patients’ shame and defensiveness around their own feelings and impulses, making them harder to access and metabolize as part of themselves and their inner world. When any of us cannot access fundamental and emotion-laden parts of ourselves, we suffer in one way or another.
Moreover, the therapist’s aggression can be an important component to the aspects of therapy which require confronting patients’ maladaptive patterns and defenses and maintaining the therapeutic frame. Security with one’s own aggression actually lessens the risk of reactive, punishing confrontations (perhaps masked as “tough love”).
The regular recognition of and responsiveness to frustrated or hostile feelings encourages the therapist’s metabolism of these feelings, using them to understand themselves, the patient, and the process of the work, rather than unthinkingly acting them out. Still, it’s important not to get ahead of ourselves—there are certainly instances where such acting out still happens for the most experienced therapists as enactments are generally considered a “when” rather than “if” clinical phenomenon.
It is not uncommon that therapists share the same fears as their patients when it comes to aggression—namely, that it is the destroyer of relationships—and so it is avoided in therapeutic relationships in similar measure as in personal ones. In reality, aggression in and of itself is not the enemy of connection, rather, it ensures that connection is imbued with vitality and the reality of our complex drives and feelings. In fact, Kernberg (1991) even emphasized the significance of aggression in romantic life as an integral element to gratifying sexual intimacy.
Aggression in Professional Life and Larger Context
Psychological health and stability rely on the integration of creative and destructive drives—libidinal and aggressive energy. Just as aggression is not the enemy of connection, nor is it the enemy of creation.
Our creative pursuits and value-driven goals need not be threatened by our aggression. Instead, efforts to suppress aggressive drives threaten to subdue passion, facilitate fatigue, and interfere with collegial relationships (which are much-needed sources of support and sustenance in their own right).
Healthy aggression can be seen in assertiveness as well as competition within one’s self or amongst peers, pushing us to grow. This is in contrast to aggression that is rejected, denied, and generally unintegrated, which is thought to drive envious and devaluing attitudes towards others. This type of aggression may be partly behind the seemingly rampant online practice of devaluing peers, positioning one’s self as superior in comparison:
- “This new or specialized therapy solves all the problems that these other therapies have.”
- “I’m better than all these other therapists because I do this instead of that and everyone who does ‘that’ is harmful or ineffective.”
Note the lack of nuance, context, or individualizing in statements of these kinds, which implicitly pit therapies and therapists against each other despite supposedly supporting the same aims of helping people in pain.
Disavowed aggression can also be an underlying issue for the therapist who appears “bland and uninvolved… [because they are] terrified of their own rageful feelings.” (Lunbeck, 2014, p. 73). Perhaps a provocative explanation in contrast to the more palatable “compassion fatigue,” which may also be accurate but potentially incomplete to understanding personal factors which contribute to fatigue.
We shouldn’t, of course, overlook the systemic forces, including sociopolitical, economic, and institutional factors, that are absolutely implicated in the problem of therapist burnout. Therapists’ collective permission and encouragement to connect with and foster natural aggressive sources of energy do not pardon those forces, but rather offer sustenance in the face of them, maybe even energy to organize together and engage in advocacy efforts.
In short, we can and should look to aggression for resilience to burnout. Our values guide what we want to invest in, but we must draw from varied sources of energy to support that investment.
Conclusion
To survive, to thrive, and to go on caring, therapists, like all people, need healthy aggression. In this case, healthy aggression refers to angry, passionate, competitive, conquering drives, feelings, fantasies, etc. which are integrated into one’s inner world and self-concept. Due to the development of healthy aggression as being a process in one’s inner life, the specific outward manifestations are likely (and welcomed) to be personal and culture-laden, rather than universal and prescribed.
Within the therapist role, it is easier to specifically identify how healthy aggression plays a role in effective treatment such as setting and maintaining the therapeutic frame, healthy interpersonal boundaries, respect for, rather than denial of, power dynamics, non-shaming or judgmental confrontations, and the kind of endurance and sturdiness which requires both a clinical and personal backbone.
In the broader overlapping personal and professional spaces, healthy aggression is better identified by attitudes and interpersonal functioning rather than specific behaviors– as in, engagement in and relative comfort with competition and disagreement for the sake of growth and good practice, resistance to devaluing, admiration rather than envy, passion and liveliness versus deadness and disengagement, and so on.
When all is said and done, embracing aggression helps us to know and embrace ourselves and others more fully and remember that “fighting the good fight” indeed requires “fighting.”
