Therapy, is it all an act?

 

To read the post:

https://open.substack.com/pub/3lack3ox/p/question-one?

My Substack posts are more logical, better English versions, distillations of the contents of this blog.

But to the question, is unconditional positive regard from your therapist all an act? My answer is, no. Or, yes - it could be. Therapy is a vocation for many therapists. And many therapists discover that therapy isn't about feeling rewarded by following their vocation. Others discover how to balance on a tightrope that stretches between hope and fear. And because they can do this, their clients likewise pick up the skill.

Not being phased isn't an act. It comes from a genuine trust in oneself. The vocation only led you here. Now you better find out what it's all about!

Going back to the subject, authenticity. Once the dreaded Kohuts were mentioned - read the post! I could not trust the therapist at all, well not as a therapist. He'd already blown his therapy credentials to bits by calling me a minx, by other things he'd said. Especially by a comment he made, very quietly..I interpreted it as a configuration of self (Mearns and Thorne). It was flirting. He'd grown up in the 1970s. So had I. It doesn't justify it. But the configuration of self theory, is interesting...

Overall I believe that the therapist performed therapy, it was a kind of role play. He felt justified in this because Mr Kohut had described what happens in collaborative therapy, as reparative. 

We collaborative therapists certainly don't see it that way! We don't see ourselves as the cure. We see rapport as vital. We see relationship as the medium, not the message. And so, collaboration must come from a position of authenticity, I don't believe that it can ever be roleplay. Yet I'm struggling here to pinpoint the difference. 

Perhaps it would help if I described how it feels as I work?

So collaborative therapists seek to hear and support their client's identity, narrative, agency. We collaborate with our clients by noticing and highlighting what has happened to them, and asking questions that bring the emotion and power of the catastrophe safely into the room - as evidence of our client's ability to survive, as proof of their courage. We set out on an exploration of the past to bring resources into the present and build the shattered memories into a strong foundation for the preferred future.

I notice when I'm interacting with a client's narrative in a way that creates more positive energy.  This cant be roleplay. It has to be genuine, because the client will smell the bull**t.

Possibly, what I'm doing is allowing a configuration of self to inform therapy? I feel as if I'm being 100% me. It feels natural. It is all about energy. It isn't an act. But in collaborative therapy - the third of the three postmodern therapies - the collaboration isn't about repairing the client. Collaboration has a single purpose, to empower and support the client's curiosity and humour, to go with the client into the depths of their fear story and stay with their emotional tone - whilst asking the questions. The questions are the keys to open up the prison doors of fear and injunctive rules of thumb that might no longer serve, but the language of the questions must fit the client's reality.

So, fundamentally - again I stress that this is from a collaborative therapy point of view - the Kohut concept of the client needing to have a safe argument with the therapist makes no sense. A client who wants an argument wants something to change. The therapist who respects the client's experience is going to use their default strategy; being curious, asking questions, to explore the difference between what is happening and what is needed, onwards to describe in concrete terms what needs to change, and how to do it in a way that improves the situation for both!

Surly this is obvious! 

How reasonable is it to assume that someone will feel healed by winning an argument with you? Surely the problem, for someone who isn't confident about arguing is how to argue well! I'm sure the Greeks and Romans wrote some great books. And there are debating clubs. If a client wants an argument with you, I believe that you both have a problem to solve. 

I didn't need it want argument. I had a complaint against the therapist. And I'm left believing that if my complaint about the therapist had been with Tesco I'd have got a better hearing from their customer's service desk.

It is important for therapists to know that there is much worse than experiencing an argument with a client.

A client who most needs changes may be too scared to argue. Can we really be certain that we have not stepped into a dynamic of unintentional coercive control? 

If a client can't name what is wrong in therapy because of their expectations of the therapist's response - they have reasons. And they might be wise to fear the potential consequences. Attributing a client's complaint to something outside the therapy... might be a catastrophic mistake.

Remember the power, threat, meaning framework!

My attempt to create an atmosphere and dialogue of curiosity and exploration - with a therapist who believed that therapy is all about his ability to play a reparative role! Was bound to crash and burn. What had happened to me before, was happening again. The therapist located the problem in the past. But it was in the room...

In response to my victim statement, instead of taking what I'd said seriously he chose war mode. All his talking about clients being in need of the safe argument because they don't feel safe arguing, applied totally to himself. He enjoyed safe argument, they reminded him of the 'coffee fuelled discussions' he had as a student. But a safe argument between us about types of therapy is very different to receiving a letter to say that there is a serious problem and I need it to be resolved.

Misogyny?

Was that part of the problem?

He knew that it would not be a safe argument...he would not be able to roleplay his way out. Because he had the recordings of the sessions. So the recordings must have been a real problem for him.

Well, nothing new here. I expect he role played going to the police as therapist 'demonstrating firm boundaries'. I see it as a therapist using fear to get his client to shut the f*** up.

I can also see it as a sign that he had unfinished business regarding shame and guilt. But, that unfinished business left this client suicidal. 

Which tells you a lot about my experience of therapy with him, nothing about therapy.

So it goes.