The Clinical Effectiveness Institute publishes research and clinical writing examining how psychological change actually happens in psychotherapy, including the conditions that allow clients to reorganize toward greater regulation, agency, coherence, health, and alignment with their own goals. New essays publish most Tuesdays.
Anna had been seeing her therapist for almost a year when something in the sessions began to change.
“You keep asking me what I feel,” Anna said one afternoon. “Sometimes I think I have already told you, and then you ask again. It makes me feel like I said it wrong.”
The therapist considered this. “I can see how asking again might make it seem as though what you said was not enough.”
Anna nodded. “Exactly.” So the therapist became more careful.
The next week, Anna described an argument with her sister. After listening for several minutes, the therapist said, “I wonder if part of what made that so painful was how quickly your sister decided what you meant.”
Anna stopped. “See, you just did it too.”
“Did what?”
“Decided what I meant.”
The therapist felt a quick surge of concern. “I meant it as a possibility.”
“I know. But you still decided.” So the therapist apologized.
Over the next several weeks, questions began to feel risky. Maybe the therapit’s interpretations felt intrusive. Perhaps silence could feel withholding. Explanations could sound defensive. The therapist started checking more often.
“Does that fit?”
“Am I understanding you?”
“Is that what you mean?”
Anna listened for whether the therapist had gotten it right. The therapist listened more and more for whether Anna had been hurt by what the therapist had said. Eventually, both began to feel trapped. Anna felt as though she had to keep protecting her experience from a therapist who repeatedly imposed something on it. The therapist felt as though every response was being scrutinized and that there was an increasingly narrow range of things that could safely be said aloud. Both the client and the therapist had a compelling account of what the other was doing.
Jessica Benjamin gave us a way to understand this kind of interaction. She called it the complementarity of doer and done to, but the concept is not as simple as one person doing something and the other person being the recipient of it. In a doer–done to dynamic, the relationship organizes itself around two positions: one person feeling like the one acting and the other feeling like the one being acted upon, and those positions are created in relation to each other rather than fixed to either person.
Anna may experience the therapist as the doer because the therapist is questioning, interpreting, and affecting her. At the same time, the therapist may experience Anna as the doer because Anna’s corrections and reactions begin to determine what the therapist feels able to say. Both people can end up feeling like “I am only responding to what you are doing to me.”
“Doer” and “done to” name positions that are created between two people and can shift back and forth within the same interaction. Anna feels acted upon: she feels interpreted, questioned, and managed. But Anna is also acting on the therapist. She corrects the therapist multiple times. She protests when she disagrees or feels boxed in, and she is continually evaluating the therapist against a standard the therapist is unaware of, which puts pressure on the therapist to say the right thing.
The therapist appears to be the doer. The therapist is the one making interventions and trying to repair what happens. Yet the therapist also feels done to: she feels scrutinized, constrained in what she can say, and responsible for producing the right response. The experience on both sides can become:
Look what you are doing to me.
Anna thinks, I would not have to keep correcting you if you would stop deciding what I mean.
The therapist thinks, I would not have to be this careful if everything I said did not become another problem.
Each person experiences their own behavior as a necessary response to the other’s behavior, which helps make the pattern self-reinforcing.
Benjamin contrasts complementarity with mutual recognition. Complementarity is the relational pattern that can emerge when mutual recognition breaks down: the relationship becomes organized around doer and done-to positions. She defines intersubjectivity in terms of a relationship in which each person recognizes the other as another subject: another center of feeling and perception, similar enough to be understood and separate enough to have a mind that remains real within the relationship.
In Benjamin’s use of the term, a subject is a person experienced as having a mind and agency of their own. A subject has feelings, intentions, perceptions, desires, and a point of view that originate in that person and cannot be completely determined by someone else.
The opposite position is that of an object. This does not mean treating someone as an object in the sense of being cold or dehumanizing. It means that the other person is experienced primarily in relation to oneself. When the other is an object instead of a subject, the experience of the other person is as the person doing something to you. The person who frustrates you or frightens you or reassures you or controls you, or even gives you what you need. The other person’s separate inner life recedes from view and becomes harder to hold in mind.
The distinction between subject and object helps explain what happens in the doer–done to dynamic. When Anna experiences the therapist mainly as the person who is imposing interpretations on her, Anna has difficulty holding onto the fact that the therapist is another person who is trying to understand, thinking imperfectly, responding to Anna, and having her own experience of the interaction. When the therapist experiences Anna mainly as the person who scrutinizes and constrains her, Anna’s separate mind can disappear in the same way.
Mutual recognition requires something specific in the dyad: I remain a person with a mind while recognizing that you are a person with a mind too. Your experience of me is real. My experience of what happened is also real. I can be affected by you without reducing you to what you are doing to me.
However, not every difference between us reflects two equally accurate understandings. Sometimes the therapist has simply misunderstood the client. If the therapist says, “You sound angry,” and the client replies, “No, I am frightened,” the client is giving the therapist information that should change the therapist’s understanding. Good clinical work requires that kind of revision.
When a meaningful difference remains, the question becomes whether each person can continue thinking about what happened without requiring one person’s experience to cancel the other’s. Can the difference become something the two people are curious about, or does one person’s experience have to disappear? The therapist may begin revising every thought because the client is providing important information. Or the therapist may begin revising every thought because having a separate perspective has become dangerous or unsettling in the relationship. The first is responsiveness. The second is the loss of a mind in the room.
In Anna’s therapy, the therapist eventually noticed the difference. During another session Anna said, “What you just said felt judgmental.”
The therapist felt the familiar impulse to explain it to Anna or to reassure her and find a better response. Instead, the therapist stayed interested and curious. “I want to understand what felt judgmental about it,” the therapist said. Anna explained it to her.
After listening, the therapist said, “I can understand more about why you heard me that way. I also notice that when we experience something differently, we can get pulled very quickly into trying to establish which experience is the right one.”
Anna was quiet. “So you still think I am wrong.”
“No. I think something important happens between us when we do not experience a moment the same way. I want to understand your experience without either of us having to give up our own sense of what happened.” The therapist does not have to choose between validating Anna and maintaining a separate mind. The therapist can recognize that Anna is a subject while remaining available as another subject.
When a session becomes stuck, therapists usually begin thinking about what to do next. They may explain more clearly or validate more carefully. Perhaps the therapist may interpret more firmly, apologize, or soften the remark. Therapists can set a limit, or even just say less.
Any of these responses may be appropriate. But the therapist may already be caught inside a doer–done to structure and be trying to solve the problem from within it. In those moments, each effort to correct the interaction can strengthen the same pattern: the therapist becomes increasingly responsible for doing something that will make the relationship feel right, while the client increasingly experiences what happens next as something the therapist is doing to him or her.
Benjamin gives the therapist another question to ask. Instead of asking only, What should I do? the therapist can ask: What kind of relationship are we creating right now? Can each person still experience the other as a separate subject? Can each person recognize their own participation in what is happening rather than locating agency entirely in the other?
Mutual recognition has to emerge between two people. The therapist can help by noticing and interrupting the complementary structure, creating the conditions in which both people can once again think about the interaction, rather than simply react within it. Only then can the therapist determine what the moment actually requires: revising an understanding, clarifying an intention, acknowledging a mistake, making a repair, or staying with a difference long enough to understand it more fully.
At that point, the next useful clinical move is not simply a better intervention. The task is to help restore a relationship in which both people can recognize that they are affecting one another, both can remain psychologically present, and neither person’s experience has to erase the other’s.
Sarah Ozol Shore, MS is a clinical trainer and founder of the Clinical Effectiveness Institute. She trains clinicians to become more effective, including how to discern what kind of therapeutic work is possible in the therapy room at any given time.
Paid subscriptions support the development of independent research, clinical frameworks, and educational resources through the Clinical Effectiveness Institute.
Please consider supporting this research with a paid or free subscription.
Monthly Online Seminar Series: Why Good Interventions Fail —
The next monthly online seminar takes place September 4, 2026 12:00–1:00 PM Eastern.
The series runs monthly, is free of charge, and is designed for clinicians who want to develop the capacity and discernment required for truly effective psychotherapeutic work regardless of modality, technique or orientation.
No posts

Comments
Nothing yet. Say the first thing.
Sign in to join the conversation.