Saturday, December 16, 2017

In-house #7: Late thoughts on therapy

I have realized that lately, I put no effort into my work, into the hour, other than what the situation-at-the-moment calls for. This means rarely a technique, such as Empty Chair, sentence completion, Death Bed Situation, other feeling-reaching process, cognitive therapy procedure. I feel almost tabula rasa with each new person, and almost tabula rasa with regular clients at each new session. In the old days, I might see a client in the third session or after and assume he or she is already on a train of momentum: We are working on something, we are in the theme of healing. I do carry a knowledge base into each encounter, which is the knowledge that depth is true and the here-and-now is false. But after the person is shown this, it is applied only as it is workable and useful at the moment. The one energy or atmosphere, maybe, that is pervasive is the sense that the client needs some relief, and the kind that human communication can bring.

I have become less hopeful of great change, and thereby more compassionate, and my clients stay longer – long – and enjoy our times almost consistently.

We are the depth, always, but it’s not always good to re-experience it. After the beginning, I never go there again with some clients. Occasionally, someone is saved, and I mean literally saved, by knowing that the roots of her addiction and self-destructive life are her childhood with imperfect parents. It is not her fault. But mostly I have changed from militancy to the serious touch of affection, opening up, and insight.

I don’t really know why this has happened, but that it’s either that I’ve grown up (my parents always said I was a “late bloomer”) or that experience itself has evolved.

It’s true that real help will sometimes have to go to drastic depth. One elementary school teacher, after giving the brief history of her teen rape trauma and her derailing after that, talked mostly about her oppressive work with difficult students and their disengaged parents. One session, eight or ten in, I said, “Last time, we’d agreed to focus on you.” And she fell into old grief, revisited and relived this disaster to her heart and her feeling of being alive. So directly broached, so directly done.

Another woman, after a couple months we stared at her perennial tight fake smile, partially disabled it, then went into the feelings and internal map that life with a confusing and blood-sucking Borderline mother caused her, which that smile had always held under. What a good session. At the end of it she deceptively asked, “Do you think I should come every two weeks, or stay with every week?” How could she want to detach now, when we had finally reached a good place? As it was obvious what she wanted, I lied and said every two weeks would be fine.

We are “working on something” with some clients, but the fact is I can’t think of a single one, right now, whose theme is their past injury or even the solving of a current life problem. The “presenting problem” may have been depression or anxiety or bipolar or methamphetamine dependency, but what happens is that he or she just talks about serious things and fairly often becomes tearful, feels a little better, and talks about something else. Carl Rogers thought (if I remember correctly) that clients, doing this, were working out their conflicts. I don’t think so. I think they’re connecting to themselves in a place where they can put the brakes on their life, and so feel like the owner of it, and be seen to be the owner of it. For some that will be a good feeling, for some it will not.

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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.