Saturday, November 2, 2013

Change, part two


I often write lengthy, detailed and psychodynamically investigative progress notes from therapy sessions.  During my years at community-funded mental health centers, this practice was frowned upon for “cover your ass” reasons: Don’t give the adversarial lawyer ammunition against your client; or more generally, Don’t shake Big Brother out of his tree by potentially antagonizing potentially anyone.  Be minimal and generic: “processed client’s maladaptive cognitions”; “worked to stabilize mood.”  As an independent contractor now, I’ve had free rein to write as I want.  And this freedom has enabled a paradox: The more moving – even life-changing – a session, the fewest words I care to write.  A client may – on a beautiful blue moon – be riding deeply within and fall one step further into the undiscovered self.  It is likened to an orgasm of revelation: wordless change, wordless knowledge.  He has found and returned to himself.  Later that evening, still feeling the music of that session, I’ll write little more than: “Client reached deep catharsis.”  There are no words for music.  And, I’ll know that “catharsis” means something superficial next to what happened.

This paradox around the client hour reflects, in a lovely way, one within it.  For many weeks or months someone will be talking about all manner of events and feelings.  Insights are offered; insights are struck, copper but not gold.  A woman learns why she is “bored” with the nice guy, or why she stays with abusive men, or why he searches for love beyond marriage.  Someone talks about her self-centered mother and intolerant husband, hated State job and halfway house alcoholic brother.  Words and more words are the inflated currency of therapy.  Then one hour that can’t be predicted comes, and a person falls inside and her tears are a conflagration burning away everything but her heart.  She greets her lost self.  She is changed.  Guilt is gone.  She realizes something startling and miraculous: I can breathe!  Everything is different, forever.

And there were no words.

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.