The trust transaction

She reports consistent tension in the neck and shoulders. At times it is painful and is very persistent. A history of regular headaches and at times migraines.

Has a considerable anxiety about letting self feel vulnerable with others. In her mind being vulnerable means one will be exploited. Trust issues.

This can manifest as never trusting anyone or at times trusting others who let her down or exploit her so as to reinforce the script belief of Trust = exploitation.

Some people are trustworthy and others are not
Identify associates who are trustworthy and those who are not. More correctly identify the ways and areas in which various associates are trustworthy and where they are not.



Identification is done using
Adult ego state
Little Professor ego state
Consultation

Identify Bad day at black rock scene where the trust issues evolved.

Graffiti

Doing bad therapy - client information.

KYLady states

“According to your diagram, as long as you never catch your client in a lie or he doesn’t admit lying to you, you can provide good therapy. What if the problem he comes to you with is that he lies all the time. Can therapy help somebody like that?” (end quote)


Here, I discuss therapists doing bad therapy when what they believe about the client is not true.

One can do bad therapy when the information they have is inaccurate and thus they believe things about the client that are not true.


Clients lie all the time. Indeed people lie all the time.



I have said before there are similarities between a police interview with a suspect and a therapist interview with a client. Both are seeking to identify the lies but for quite different motives. One is constantly cross checking information provided by the client to identify inconsistencies. The same question asked in different ways, in different contexts two weeks apart. At the beginning of a session I might begin with chit chat therapy as this is a good way to cross check information and just get information about the client. Their defences are more down compared to the interview situation of therapist and client.

For example, as I meet the client at the door she may talk a bit about what she did last night and may mention a restaurant she went to that I know. As we chat about it I may ask her about the meal she ordered. She reports a meal that is high fat and high calorie and she is skinny. What is going on there? The little bell rings in the therapists head - to be revisited later on!

By simply chatting about an evening at a restaurant one can get a lot of information about a client and their relationship to food, eating and so forth. Chit chat therapy is good as the defences are down. police so the same with good cop, bad cop. If they can create that situation in the crims mind the person will be less defended with the good cop person.



Now, I am not suggesting that clients are a group of pathological liars. When one meets a new client for the first time one has got to expect they are not going to get the truth or at least the whole truth. Clients sometimes talk about very intimate things and I am a complete stranger to them. If a woman is talking about a bad marital situation I may ask her if she has had an affair. At that point I know she may not be fully candid simply because she does not know me and there has not been the time for trust to develop. I would be the same if I was in her situation.

Secondly clients lie all the time because they lie to themselves. This is the lie the therapist is most often looking for. The client who says she loves her husband whilst shaking her head. She is lying to her self about her love for her husband. If the therapist does not see the lie then he will believe something about the client that is not true and do bad therapy.


Fake sun tan! Even body language can lie.

Coerced clients could be seen as more likely to tell falsehoods. If I was told I had to go to counselling I would be resistant at some level as well.

However in my situation where clients pay money to see me one can expect more truths to be told. The client knows if they tell me falsehoods, I will do bad therapy which they are paying for. However this does not always happen. I wrote a long time ago of a man I saw semi regularly over a 4 or 5 year period.

In the last 3 months of our meetings he told me that he required a heart lung transplant and it was quite likely he would not survive the operation. I had noticed he had trouble breathing at times and he said he was asthmatic. He wasn't. This piece of information significantly changed the course and form of therapy and he didn’t tell me for 4 years. So I did bad therapy for 4 years. It’s like working with someone to give up smoking when they are on death row. What’s the point.

Why he did that I am not too sure as I never got a clear answer to that question either. However as he slowly disclosed further information it became apparent that he was not doing all that he could, medically. Refusal of treatment for a life threatening illness? A suicidal act? Maybe?



Graffiti

PS. Oh! about my comment that clients lie all the time. I am just being a bit obtuse. I like clients.

Therapists, clients and trust

In a previous comment Harriet stated:

“But I am sorry that his lack of disclosure led to distrust on your part.”

This comment resonated with me and led me to muse on the topic of clients, therapists and trust. (I like words such as resonate and muse, they make me sound like I know what I am talking about!)

I mused - do I have a sense of trust or distrust with clients? The answer I came up with was in one specific sense yes, but I would say generally, no.

In my work circumstances of private practice I do trust clients in our business relationship. I deliver a service, then they pay once they have received that service. There is a small group of clients who come to therapy and have no intention of paying. Over the years I have seen all sorts of methods employed by people who are wanting to get sessions without paying for them. I never let new clients accumulate any significant debt so those who are not intending to pay may get a few sessions for free but that is all. Then they leave and I never see them again.



This indeed raises another interesting question in terms of the therapeutic relationship. If a client enters into a therapeutic relationship with no intention of paying how does that effect the therapeutic relationship. Perhaps I will muse on this some more for a later time. However in terms of our business relationship, I do have a sense of trust and distrust with a client.

Other than this the concept of me trusting or distrusting a client kind of does not make sense. In particular, as Harriet was mentioning, I don’t have a sense of trust or mistrust about a client telling me the truth and the whole truth. I just don’t see it that way. It does not ‘compute’ like that.



Clients, like everyone else have a Child ego state that is struggling to cope the best way it can, with the psychological resources it has, at a particular point in time. If the Child ego state feels it necessary to tell me a falsehood or not tell me the whole truth then I accept that. I do not feel like my trust has been betrayed by the client. I see it as them coping the best way they can.

I also know that clients, like everyone else, will behave in consistent patterns over time. I know that if a client tells me a significant falsehood about the facts of their life, then it is likely that they will do so again in the future in some way. Not because they are trying to trick me or deceive me but because they are coping the best way they can at that time. I don’t ‘win’ or lose’ anything if the client tells me the truth, just like I don’t ‘win’ or lose’ anything if the client tells me a falsehood.



Thus in relation to Harriet’s comment I don’t get led to distrusting a client if they tell me a falsehood. Instead I accept they are doing their best they can at the time and I know they may employ the same coping mechanism of telling falsehoods in the future.

Graffiti