BODY, MIND, and BALANCE
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As mental health practitioners, therapists, healers, counselors, spiritual guides - whatever you choose to call yourself - we “create,” in that we are working to “create” individuals who emerge from the creative process of psychotherapy with overall improved mental health. Our clients come to us for help, both willingly and unwillingly. They have a set of problems that are part of their bodily and emotional makeup. In terms of creativity, our clients are like blank canvas on which we are expected to paint, or they can be thought of as blocks of stone, on which we are expected to sculpt. Our “completed creations” are our clients themselves. In the story of “Pygmalion” by Shaw (or “My Fair Lady,” the musical based on Shaw’s play), Henry Higgins is the linguist who sets out to “create” a fine lady in Eliza Doolittle, the street urchin flower seller with no manners, couth, grace or poise. Something happens between Henry and Eliza in that Eliza becomes independent enough to make her own decisions/choices. Henry becomes upset and frustrated, realizing he has come to have an emotional attachment to Eliza, and that he expects to always be in control of her. He has “created” his own living breathing object, to his exact specifications (more to his rather than to hers - all she wanted was to be able to get a job in a flower shop and have a nicer place to live), and his plan was to continue to “own” her for himself, but his plan is thwarted by Eliza’s own free will. How often as clinicians do we encounter the same kinds of circumstances? For whatever reason, we might become emotionally involved with or attached to a client, and we find ourselves enmeshed with this client for whatever reason. Perhaps the client has begun to improve in treatment, and is moving towards termination of treatment. Instead of celebrating this fact, we find ourselves changing the focus of treatment, or encouraging our clients to begin working in another direction. Sometimes we direct our feelings towards our clients - frustration, anger, sadness - just as Henry Higgins does towards Eliza in “My Fair Lady.” Luckily, Henry has people around him - his mother and his friend the colonel - who step in to remind him that he is behaving in an immature way that is completely unacceptable. Here’s another example - we are working with a client who abruptly chooses to terminate treatment. Instead of accepting this client’s choice, we find ourselves reaching out to this client in an attempt to encourage (or even coerce) him/her to return to treatment and continue working with us. In that our clients entrust their mental health to our care, they provide us with an opportunity to be in a position of power over them. Our clients are vulnerable and therefore allow us to create an environment of control within the context of the therapeutic relationship. If we are not careful, we are likely to behave like Henry Higgins, as we may abuse our power and attempt to exert control over our clients in an unhealthy way that ultimately damages the client rather than empowers them. In “My Fair Lady,” Henry Higgins is a researcher, teacher and trainer who enjoys learning about new ways to “create” and he conducts his research using Eliza Doolittle as his experimental instrument. As clinicians, don’t we use this same process? We speak of creating change within our clients, and while that is all well and good, we have to be careful to see our clients as individuals not only capable of making change but also of making their own choices. We don’t serve the client’s best interest if we conduct ourselves in the style of Henry Higgins, and if we allow ourselves to arrogantly control not only the therapeutic process of change but our clients as well. And, like Henry Higgins, if our clients exercise their right to their own free will, we may find ourselves behaving immaturely and inappropriately. We should know by heart the following phrase: the only person you can change is yourself. In terms of striking a balance between creation and control, we need to stay open to changing ourselves continually in order to be able to “create” in our therapeutic work with clients while allowing those clients to retain control of their outcome. Returning to “My Fair Lady,” Eliza Doolittle finds herself with feelings for Henry Higgins, just as he has feelings for her. And, like Henry, initially she rejects this idea - she tells him she doesn’t need him any more because she now wants to follow her own path, make her own way going forward with her life. Sometimes our clients react to us this way in therapy. They push away from us, demonstrate resistance in treatment, or choose to terminate abruptly from treatment. They come to us because they have an obstacle they say they want to remove, they have things they want to change about their lives. Then when change begins to occur because the client and therapist have “created” the change together (i.e. the client has changed his/her thinking and perhaps also changed actions and reactions in behavior), the client may quit therapy at that point. This can come from two different places. One aspect is that the clients are too scared of how the new thinking and behavior feel for them, so they retreat from both and from therapy as well. The other is the clients have learned to believe in themselves - they know they have been empowered by the therapist to maintain/sustain the new thoughts and behaviors, and they are ready to move away from depending on us for weekly reassurance. Back to Henry and Eliza. Henry and Eliza finally figure out how drawn to each other they are. Henry teaches Eliza to be a different person. He accepts the challenges involved in teaching her, but then realizes she is an even bigger challenge once she has mastered what he taught her. Eliza finds challenge in him too, but also regards him with awe and respect for how he continues to believe in her ability to change no matter what obstacles she brings to that process. Our clients are the same - they come with their obstacles and challenge us to help them. Their resistance to change and to our abilities pose those challenges. Our clients also challenge us to reject them, so often believing that nobody can help them. And we prove our worth and our belief in our clients as we continue to meet this resistance with acceptance and understanding and patience and willingness. Naturally the therapeutic connection is an emotional one. It’s an ongoing conversation that on the surface doesn’t seem like much (If I had a dollar for every time someone has said, “You mean people pay you just to listen to them talk? What kind of treatment is that?”) I appreciate when the skeptics come in, the ones with their arms folded across their chests, and they sit with me and dare me to help them, just as Eliza does with Henry. So our first act of “creation” is to find ways to meet our clients wherever they are at in their journey. We create the safe place of the therapeutic relationship, in which they can be as human as they need to be as they gain knowledge of themselves. In a healthy process, the client and therapist work as one towards the goal of a happier individual who goes back out into the world and lives life in a more positive way. That’s a creation by the therapist while allowing the client to retain control, as I stated earlier. But what of the therapist - or world leader or cult figure or anyone else in a position to exert power over other people - who abuses the power of the creative process? We all hear stories about therapists who cross over the boundaries to date their clients for example. I have gone to ethics workshops where this topic is always raised, and I am always amazed that there are therapists out there who attempt to make cases for why this is all right. This example leaps into my mind as a clear-cut one of abuse of power, though there are certainly many others. In thinking of ourselves as creators, it’s important to remain humble and realize that while we can certainly look to our skills and how they aid our clients, that it’s the client’s willingness to trust him or herself that ultimately drives the therapeutic process to the successful outcome of healthy termination. We don’t have to man the trenches alone in this clinical treatment process. I believe therapists do their best work when they themselves are staying focused on their own work in their own ongoing journey. I am a devotee of supervision, and I participate in it much more for myself than for the legal reasons that make it necessary. How wonderful for me to have my own safe space where my supervisor works along with me as my guide. We are spending our careers supporting others - it stands to reason that we ourselves are entitled to replenish ourselves through supervision. Conferences like this one are also renewing for us. To be able to meet colleagues and exchange ideas, well it’s just another opportunity to build and strengthen our networks of support, just as we teach our clients to do the same. Intuition also plays a huge part in knowing when to go for more help. At some point, so many of us choose to work independently for many reasons. This makes having the above two items - a supervisor and network of support - so crucial for us. We will always come up against obstacles that we need to process with someone else - resistance we don’t think we can break, intrusive and difficult family members of our clients, insurance companies who choose to deny treatment at a point in the therapeutic process when the client/therapist relationship is in a positive and healthy working state, when our clients pay us with checks that bounce and our banks charge us the overdraft fees, when we have a string of no-shows, or just when it seems like every client is completely “stuck” and we find ourselves doubting our ability to help anyone! And what of Henry and
Eliza? Well, their relationship went through many stages, but at the end of the
day they admitted they cared for and about each other, just as we do with our
clients. People ask me if I ever have clients I don’t like, and I say yes. But
I have never encountered a client where the benefits of even one exchange were
not realized by both of us. Is there always a successful outcome? Of course
not. But I receive as much from my clients as I give to them, sometimes more,
and I remember to stay focused on joining the clients wherever they are at, and
that I’m not the one who changes them because that’s not really my purpose. In
the end, they change themselves - I’m just the guide who can help them find the
way. |
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Created: 12/24/05 |
