Parallel Process

Parallel process is a term that emerged from within the psychoanalytic tradition in reference to the experience of mirrored emotional response and reaction between therapist and patient. Patients feel, think, and behave in very personal ways. Interestingly, during the course of their work with any given patient, therapists may find themselves experiencing similar feelings and thoughts and behaving in ways that are more like that patient’s behaviors than their own, especially when confronted with situations or relationships that mirror the ones they are exploring together in therapy.

Have you ever worked with a patient or family whose thoughts were scattered, who talked about “everything and nothing,” who jumped from topic to topic, question to question, seemingly unwilling or unable to complete thoughts and found yourself, later, having trouble focusing or concentrating?

Have you ever started off the day feeling fine, strong, ready-to-go, only to walk out of a very depressed patient’s room feeling lethargic, empty, fatigued?

Have you ever left a meeting with a patient, maybe even a new patient with whom you haven’t had much if any contact, feeling devastated by their bad news, helpless, and hopeless in the face of the prognosis they were given? These kinds of experiences, in our everyday work lives (especially in oncology), are a type of parallel process that can, if left unchecked, increase stress and lead to burn-out.

Whenever our emotional reactions seem extreme, or simply more in-keeping with something happening with one of our patients than with our own personal situations, parallel process may be at play. Learning to recognize it in ourselves gives us a powerful tool for re-establishing boundaries and, potentially, for helping ourselves to de-stress as we separate what “belongs” to us from what “belongs” to our patients and families.

Recognizing parallel process can also give us a window into the hearts and minds of our patients and their loved ones, an opening through which great healing can be fostered. Our experiences of parallel process may help us to better recognize the needs of our patients and to offer insight and support in ways that can touch them deeply.

We do not necessarily need to disclose our experience of parallel process with our patients to be helpful; rather, we can choose to let these genuinely “shared” experiences inform and guide our approach to care as we strive to best address their needs in the moment.

What has been your experience with taking on the behaviors and feelings of your own patients? Has this happened to you before? If so, how did you ultimately handle the situation?