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The Seven Questions Project is a collection of responses to questions about psychotherapy posed to various practitioners and authored by Ryan Howes. Ryan has frequently encouraged his blolleagues here to respond to the Seven Questions in their own posts, so, following suit, here's my 2 cents.
How would you respond to a new client who asks, "What should I talk about?"
Invariably, I begin a session with a new client with the question, "So, what brings you in?" I do this while standing, usually with my back slightly turned; then I turn and sit down. I do this for several reasons, but the most important is to set an air of casual conversation, rather than "doctor-patient" interview or interrogation. At the same time, it acknowledges that there is a specific issue to be discussed and this is a safe place to just put it on the table.
One of the hard and fast rules that came out of my training was, "The issues, spoken or unspoken, will surface and resurface - just pay attention." So, over the years I have developed a rather conversational style of therapy that encourages just that - conversation - and within that conversation, I tend to look for patterns of thought and behavior that I can point out and which then encourages the overall process.
Everything is material and you can learn just as much about a person, and help them to learn about themselves, by discovering what kind of tires they put on their car, what kind of pets they own and what kind of films they prefer as you can poking around in their archetypal systems.
What do clients find most difficult about the therapeutic process?
There are two things with which, in my experience, clients struggle. The first is the shift in perspective necessary for re-framing one's reality, and the second is applying that shift in the real world.
People operate with a certain set of ideas, assumptions and expectations. For them to let go of those templates tends to be very difficult. For them to admit to those templates in the first place is sometimes even more difficult.
Once these things have been identified, then teaching the skills to recognize them and coaching the client into doing that and evaluating situations and relationships based on that recognition becomes the task at hand. Keeping them on task and shepherding the tendency to fall back into non-functional comfort zones then becomes the next imperative.
What mistakes do therapists make that hinder the therapeutic process?
The biggest mistake that therapists make is bringing their personal agenda to the process. Ego is a treacherous thing and for a therapist to make the mistake that they somehow "know better" and to then impose themselves and their values up on another person, rather than shepherding the person's process in a manner that is best suited to that person is very dangerous territory.
Your auto mechanic doesn't switch out stock parts for custom parts in your car's engine because s/he knows it'll run better if s/he does. S/he works with what's there to help the engine perform to its optimum potential. Why should a therapist be any different?
In your opinion, what is the ultimate goal of therapy?
The ultimate goal of therapy is to reveal to a person the vital magnitude of their own potential. The ultimate goal of the process is to reveal tools and strategies for exploiting that potential, as well as supporting the client's attempts to do so.
What is the toughest part of being a therapist?
There is no one thing that is "toughest" because every case and every condition is different. When one is working with a schizophrenic, it's about maintaining the container of ego; when working with a couple, it's about breaking down and re-tooling years of rigid dynamic; when working with an addict, it's about deflecting compulsion; when working with a borderline, it's about stabilizing boundaries.
No one thing is harder than any other -- all elements of the process are dynamic and one's energies are focused differently in each situation.
What is the most enjoyable or rewarding part of being a therapist?
My job is to put myself out of business. When a client feels that they no longer need me to support them in their transition into a new phase in their life, then the work is - for that time - complete.
I guess one could say, then, that rejection is the ultimate reward because it portends a milestone in the client's personal process of immediate and continued transformation.
What is the one pearl of wisdom you would offer clients about therapy?
If you have the strength to enter into the crucible of your own self-transformation, then you can do anything. Think of it like psychic bungee jumping - you think you're going to die, but in the end it's a total rush.
© 2009 Michael J. Formica, All Rights Reserved
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