Best and worst clients

Maybe it's a peculiar way that clients are supposed to be reactive in therapy. It's not just mutually interactive – a conversation of surface and deep thoughts and feelings. It's not just where the client receives information and has an adult-plane emotional reaction to it, though an adult-plane understanding of the insight may trigger deeper understandings and feelings. It's not just the client's inner dwelling, his awareness of his problems and feelings, that is expressed in sometimes-long narratives and a few tears. None of these behaviors will shake anything loose at the core of his disturbance, of his self. The adult cannot heal the child.

Our worst clients will be those who remain on their adult plateau and who believe that's who they are. Many clients, then, are our worst. I believe this is mostly a factor of the modern psychology culture with its "here-and-now," happiness, mindfulness, everybody-knows-their-psychiatric-name conceit. Back in Freud's day, the rallying cry was "id." Serious men in suits and high positions (who were probably raping their daughters) lay on the couch and free-associated about their bizarre fantasies and sexual fixations. They descended to their symbolic and literal bowels and their dormant, itching psychoses. But shallow is deep today; feeling is commodity today, as Cole Porter might have sung.*

Our best clients are those who collapse in memory and tears and who, in that place, join with us in their worst, give us their pain. Bruno Bettelheim, who blamed "refrigerator mothers" for their children's autism, knew this: "I speak here of the child's private world. . . . Each of us is implying in his way that one cannot help another in his ascent from hell unless one has first joined him there."

I have a few good clients.

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* https://www.youtube.com/watch?v=r7NJ9ylAhos