Sunday, March 7, 2010

Who gives counsel


Hello Zbig,

I suppose its a bit cold in Poland at the moment being winter and all.


You stated: “And having read this blog entry I ask myself: isn't it supposed that we have problems, overcome it, and the therapist helps us not only with the immediate relief but also should give us a "fishing rod" so we can deal with our future problems without repeatedly going to the therapist. And your entry suggests that it's the opposite - I have my therapist and my children will have problems so they will have to go to the guy like me? Isn't it that I, being experienced and kind enlightened, can help my children (I mean in most typical situations, of course I don't cover extreme traumas here) to cope with their every day struggle on their own?

What do you think?”

(end quote)


This started out as a response to your comment but became longer so I made it a post


You make a good point about therapy and fishing rods. I have a number of responses to it.


The majority of my clients I would see for less than ten sessions. Most come with some difficulty and want it fixed up and then they leave satisfied to varying degrees. This probably fits with what you presented as your understanding of the therapeutic process.


However regarding fishing rods I disagree with you to some extent. My personal view is that it is a sign of psychological health to have a therapist (unofficial or official) in your life from birth to death. That is someone whom you can go to, to emotionally unload when need be, be kind of a mentor or confidant.


For most people in adulthood this would usually a be a partner or perhaps a close friend or relative. To have a dependency on this person in this way to some degree and thus to have completely your own fishing rod in my view is a retrograde way to live life.


This confidant is what I see as an unofficial therapist. That is they fulfil some of the functions that an official therapist does. For most people this works OK but it has some potential pitfalls. It is most important for a husband to remain a husband and not become a surrogate therapist to a wife, as that will quickly kill a marriage. So a wife can confide in him and emotionally unload with him but only a little bit such that he remains a husband and does not become the wife’s therapist.


When friends and partners advise each other they will always have an agenda of their own.


Also when someone seeks me out for counsel I have no other relationship to them so I do not have any other agenda. If a wife seeks advice (counsel) from her husband then his advice may be tarnished by his own agenda in that he will advise her to do what suits him also. If a wife is having difficulty in her relationship with her mother the husband’s advice maybe for her to withdraw from her mother but that can be partly due to his own dislike of his mother in law rather than what is best for his wife. He has a conflict of interest and that will influence his counsel to his wife even if he is trying to avoid such a thing. With an official therapist this does not (or at least should not) occur.


Also there is the confidentiality issue and a therapist is far less likely to gossip than a friend or spouse will about your inner thoughts and feelings you have disclosed to them. For most however these are minor complications and their unofficial therapist will suffice. For others they may have access to an official therapist who they feel comfortable with and thus they are used in that role as some may use a spouse to be a confidant or sounding board.


Sometimes in the psychotherapy or counselling subculture to have a therapist is like having a fashion accessory. It is the acceptable behaviour in that subculture and thus some people can seek counselling partly for these reasons such that they feel like they fit into their subgroup in society. People like Dr Phil have made a significant contribution to this development in attitude in some societies. He has made it trendy to have a therapist.


Sometimes people come from backgrounds that were very dysfunctional and thus the giving of a fishing rod to the client becomes a much more difficult and protracted process. Some times the problems resulting from their early life have left scars on the person’s very core or sense of who they are. It takes time, sometimes a very long time to assist the person to reduce such scars and the effect they have in their day to day life. Realistically very few of them will ever really get their own rod in a fully substantial way.


Graffiti

24 comments:

  1. Nice post Tony - particularly liked the paragraph about the therapist having no personal agenda since there is no other relationship. Something I am struggling with myself in my own therapeutic relationship.

    OLJ

    ReplyDelete
  2. Hello OLJ,

    When i talk with my sons in a sort of advisory way I always try to be careful of my hidden agenda, but on the other hand I want to make sure i am a normal father and not a therapist to them. Sometimes a hard line to negotiate.

    hope your world is good and that you resolve your struggle

    Tony

    ReplyDelete
  3. Very good explanation, thank you!

    Yes, it's winter here, I can't wait for the BBQ season (I moved to a house with a piece of lawn in suburbia). Well, I can at least console myself that we are not threatened by tsunamis ("sir, this is police, we have a tsunami red alert, please don't put your life at risk and get out of the water or I will have to shoot you.")

    In my culture the "official" therapist is something people won't admit publicly very often (generally this way you'd admit there's something wrong with your brains, maybe except some situations where unexpected loss was expererienced). We don't live here like characters from Woody Allen's movies :)

    So people do their therapies in secret and try to finish them, thus scoring a "success" and sort of "liberation" - solving a particular problem that led them there. And there's much more room for "unofficial" therapist to whom you can complain (our national sport - complaining :)

    Well, that's the average view on it here, and I - I am making my way from emotional numbness to literacy ("intelligence with a heart" as C. Steiner put it).

    ReplyDelete
  4. A drawing that I cam across

    <http://www.dailymail.co.uk/news/article-1256190/Revealed-The-horror-drawing-Jon-Venables-weeks-killed-James-Bulger.html

    which purportedly jon venables drew as a kid...

    ReplyDelete
  5. Hi Kahless,
    I had a look at the diagram, thanks for the article.

    Just like the press to not let the facts get in the way of a good story

    Cheers

    Tony

    ReplyDelete
  6. Realistically very few of them will ever really get their own rod in a fully substantial way.

    Thank you for being honest about this.

    ReplyDelete
  7. Thanks Tony - my world is pretty good now. It's sunshine and 50s here now - spring is on the way. Does your business slow down in better weather.

    Funny your comment about your sons and being a parent-therapist. I was talking with a therapist friend yesterday. She mentioned trying to sell her kids on therapy because she feels it is good for everyone to examine themselves more closely. Of course her kids have no interest.

    Oh - and although my early life was full of dysfunction - I hope that I get my own rod :) Thanks for stopping by my blog a few weeks ago.

    OLJ

    ReplyDelete
  8. Would it be easier if we learned how to make our own fishing rod or even our own spear? That way when our rod/spear gets blunt or broken, we can at least keep feeding ourselves by making some other tool to find food with.

    There is this saying - 'feed a man a fish and he lives for a day, teach him how to fish and he can feed his family and teach them how to fish too' - well, that's not actually how it goes... i can't remember how it acutally goes but its something like that.

    I would prefer to feed someone for a short time while they learn how to make their own tools to catch their own food. Then hopefully there will be enough able people to help others who are less able.

    Gosh! You know what Tony... i have this whole magical world happening in my little idealistic mind. Honestly, its so nice... there are even butterflies and stuff in it!

    *giggles*

    ReplyDelete
  9. Hello OLJ,

    I am different to your therapist friend in that I have probably gone the other way and gone out of my way not to mention therapy or psychology to my sons. I rarely will bring it up and if anything they are the initators of such conversations.

    I am sure the fishing rod will come by yor way piece by piece.

    Tony

    ReplyDelete
  10. Hello Sara
    thank you for your kind comment.

    Tony

    ReplyDelete
  11. Roses,

    When Zbig first mentioned the fishing rod that was the story I assumed he was referring to. the one you just recited above. And as I said to him its OK to be dependent on others in some ways at some times, in fact I say it is essential for psychological health. So it is a bad thing if everybody has completely their own fishing rods. Its OK to need others.

    As sara highlights my comment there are some who have been psychologically scarred so deeply that for them to ever get a full fishing rod and reel is not realistically going to happen. However there can be some significant reduction of the scarring but never complete repair which can happen with others whose scars are more superficial.

    My dream and this is a real lame type of dream that I am almost embarrassed to say publicly. Dreams are meant to be about winning zillions in the lottery or about being famous and the like but I have another dream anyway.

    Some rich philanthropist buys a place that can become a residential therapy centre. I live there with my family as it is my home but it also has accommodation for others to come and live there. People can come and stay there and live there for say up to three years.

    They would have jobs or study and their lives would go on as normal but we would all be living together and it could have up to a maximum of 15 people at a time. Say three days per week would be therapy days were various forms of psychotherapy would occur and there would especially be a significant amount of group dynamics work because they are all living together. However there would be plenty of other individual regressive therapy done as well.

    If people could live in such an therapeutic environment for such a length of time, I think that you could have a significant reduction in the psychological scarring of people who had very deep scars after about two years. So there is my very lame dream.

    So when I say realistically very few will (as sara highlighted) that is not so much that it can’t happen but that governments would never spend that kind of money for the gains of so few. So it is caused by lack of resources as much as by the difficulty some have to change psychologically.

    Tony

    ReplyDelete
  12. Nice statements about therapy Tony.

    cheers

    ReplyDelete
  13. Your dream Tony?

    Sounds like we're in it now. Here and in other ways. Nice dream - and i am excited to see that dream (or rod?) progressively grow into what it can in its own good time. I do hope you realise that your dream may not reach its heights till well after we have died of old age.

    Lovely legacy! I thank you for it now.

    Roses

    ReplyDelete
  14. Hi ken,
    After I read it I realised I had missed out the most important part from a treatment point of view. The reason why I thought of that structure was because with people with core psychological damage as you know it is the transference relationship that assumes great importance in their remediation.

    So having a structure that is that intense. Client residing with the therapist in close quaters in the same facility for most weeks of the year for an extended peiod of time (2 years) then what I have seen of how transference works in the last 30 years, that should optimse its curative powers. At least it would be a good place to start.

    cheers

    Tony

    ReplyDelete
  15. interesing idea, that of this center. maybe worth a new entry.

    but, who would decide on who can qualify?

    you? in that case it's possible that you'd have the inclination to pick people you see in advance there won't be much trouble with.

    not your influence: randomized? or the founder decides?
    then you might not enjoy that job so much if there are too many types who won't cease their games easily.

    In both cases the net yield produced by such a center might be not so high.

    ReplyDelete
  16. Hi Zbig, this is getting a bit hypothetical but it does make some points about different approaches.

    One of the main flaws in almost every psychotherapy approach that is invented is they take a one size fits all apporach. what I am hypothetically suggesting is an approach that would work for some and not others.

    I have met many people with a third degree impasse who could work very well in such a structure and the transference could be very helpful indeed. I am also a realist and know others who are equally damaged who wont do that and they get into the mental health system and then play around. Fighting the system, conforming to the system when they run out of chances given by those in authority and authority plays its side as well to the games.

    So it is not a matter of having a selection criteria. If i was running such a hypothetical institution I have a personality and those coming in have a personality and sometimes the tansfernce happens and sometimes it does not. I suppose you could call that a selection process infact one could definitley call it a selection process.

    I have little interest is such matters and just want to work with people who will gain considerable benefit from such an approach. if that is not fair enough for all concerned then i guess it is never going to happen for these political reasons as well as the lack of funds reason.

    Cheers

    Tony

    ReplyDelete
  17. I imagine that there are more than one house Tony. Because you are unable to live in many houses each other house will be home to other families who are able to work as you do.

    The White House Foundation.

    *giggles* Its fun to imagine isn't it?

    ReplyDelete
  18. Tony -
    Nice idea and the concept seems valid. I'm thinking I should ask my therapist if I can move in with her :)

    I've heard and read lots about the attachment issues with therapy. At some point, I will need to learn about detaching.

    Take care,
    OLJ

    ReplyDelete
  19. Interesting idea, Tony. Certainly could help plenty of people - but I'm not sure the "therapy" part is the key (formal therapy, activities, exercises); rather, I think it's more about rebuilding the kind of "community" that the modern lifestyle has eliminated. Something sort of like family or extended family, or a small town/community, or religious/cultural community would have been in the past.

    ReplyDelete
  20. Well that is an idea OLJ, moving in with your therapist

    Why do you need to learn about detaching?

    Tony

    ReplyDelete
  21. Yes Sara, I agree with you but I just used different words when I talked about transference. I see the transference relationships (sense of community) in the group as the main factor that would help people heal in such a therapeutic environment. Like you suggest.

    The formal therapy techniques are important for the issues being addressed but also for the group to build it sense of commnity (Transference). If you have ever done group therapy you see this immediately when other group memebrs watch one member regress and go through their pain you don't get a much better team building exercise than that.

    Tony

    ReplyDelete
  22. Why do I need to learn about detaching? The therapeutic relationship is odd, IMO, because so much is placed on developing the relationship (attaching to me) and at termination time, I would think you have to learn to detach since you won't have a relationship outside of the office. I'm thinking this applies more to long term therapy, but perhaps not. And at termination time, I guess one should be "healed" enough to leave without major consequences.

    Take care,
    OLJ

    ReplyDelete
  23. Hello OLJ.

    Therapists have lots of differeing views on the termination of therapy with the client, so it is a bit hard to generalize. But yes it would involved detachment of some kind from the therapist.

    Do you find it particularly hard to detach in relationships?

    I am not too sure what "IMO" means

    Cheers

    Tony

    ReplyDelete
  24. IMO = in my opinion - kind of redundant since we write our own opinions.

    As for trouble detaching in relationships - I will have to think about that one. I have to think of those I've detached from.

    OLJ

    ReplyDelete