Interact Journal Integrative Ideas for the Process-Oriented Psychotherapist
Q: She is low functioning, low fee and wants only to discuss a particular book. Although she is delighted when I invite her to connect with her responses to the book’s passages, I still find myself dreading sessions.
A: After exploring the matter a while, you agreed that if you were being paid a thousand dollars per hour, you would not dread seeing this client at all!
Q: He resists working in metaphors. He is intelligent but insists he has no imagination.
A: Think to yourself some version of, “Oh, goody, now I get to use my imagination. One thing you might try is to make a sandtray while he is talking, resisting, and insisting.
Q: He exhibits only two parts of his personality. Both are childlike, and argue about who is to be in control.
A: One of the psychotherapist’s roles is to act as temporary parent, unconditionally and positively regarding every part of the client’s personality. Over time, so the theory goes, the client will introject the positive regard and become that Positive Parent to himself.
Q: How can you maintain unconditional regard if you direct a client in some way, impose an intervention on him, or do anything besides listen and reflect?
A: Reflective listening is a powerful therapeutic tool because it is structured, as are all therapeutic interventions, to call a person’s attention to their own process.
Q. I’m not the man with the answers. Yet she frequently asks me what to do.
A. Even though you never have the answers, you can always tell her what to do in any given moment. Here is what you can tell her.
Q: I’m concerned I might re-traumatize my client if I ask him to do something he isn’t ready to do.
A: From my perspective, that point of view implies that the therapist knows more about this man than he does, that the therapist knows better than the man’s psyche, Mother Nature, and by extension, the creator of the universe.
Q: Give me an example of how to work through a trauma. Like when you’re hit by another car on the highway.
A: Are you thinking of something that happened to you?
Q: I’m uncertain how to work with people who were abused as children, who have been in prison, are divorced, addicts, dying, have a history of . . ., a diagnosis of . . .
Q: This client’s presenting problem is (fill in the blank). I can’t treat that. What do I know that would be of any help at all?
A: Psychotherapy is not about, “Something is wrong with that person so now we get to fix him.”
Q: I hate being a slow learner. I feel so dumb.
A: Accept that you are dumb. We are all dumb. The sooner you understand that you do not know anything, the better psychotherapist you will be.
Q: A man keeps putting the attention on me. He threatens to quit therapy if I won’t answer personal questions or if he discovers he is more spiritual than I. I reflect everything back to him but it is really difficult for me, since I would like to be more spiritual.
A: You manage to stay out of the system in session, so get out of the system outside of session. Say goodbye to this person now. Yes, here in supervision. Let go of needing him to continue to see you. In your heart, give up your attachment to him as your client. That way, he can’t threaten you with leaving. (Because your psyche thinks he’s already gone. Get it?)