Interact Journal Integrative Ideas for the Process-Oriented Psychotherapist

Categories Supervision Dialogs

On how am I doing

What if someone wants to know how he is progressing?

If he simply wants your professional viewpoint, schedule an evaluation session. An evaluation session is not an ordinary therapeutic session, although it can be very therapeutic. It is a time for both of you to summarize resolved and unresolved issues, therapeutic goals, and your guesses as to the course the therapy will take if it continues. More clear about his own goals, he might appreciate the ground he has covered and renew his contract with himself.

If he finds that movement toward a clear goal gives him permission to do more of his work, put the question back to him and encourage him to track his own progress toward his objectives.

If the question comes in the middle of his work or is part of a larger pattern to avoid his work, his request puts you in the position of a deity who knows more about his internal progress than he does. In answering, you are participating in and reinforcing his looking to externals for validation.

He often asks me, “How’m I doing?”

Pay attention to process.

“Wonderful. What happens for you when I say that?”

“Terrible. What’s your experience when I say that?”

“I dunno. How’m I doing?”

Vacate your chair and invite him to sit in “the therapist’s chair.” Direct him to evaluate himself.

Wonder out loud who taught him to look externally for approval.

Wonder who you represent. Most likely it is the-one-who-knows-how-I’m-doing.

Well, some clients demand feedback.

“Demand,” not “feedback,” is the operative process here. Deal therapeutically with the issue of demand (control).

Direct him to be even more demanding with you. Little by little, give him something to represent everything he wants. Keep it up until there is nothing left in the room to give him.

Him: I want a million dollars.

You: Okay. (pours a small basket of poker chips into his lap.) Here you go. How’s that?

Him: Two tickets to Tahiti.

You: Okay, (gives him two pieces of something that represent tickets) What’s happening now?

Him: More

You: (gives him a pillow, stuffed animal, or . . . ) What do you notice now?

Refuse him everything he wants. Direct him to focus on his responses.

Invite him to yell, “yes,“ or “Give me what I want” over and over as loud as he can while you respond with, “No.” Then switch: you yell Yes, and he does the No part.

Encourage him to act out extremes of demand and rage until he is regressed, having a temper tantrum, and yelling some version of, “I want what I want and I want it right now.”

Assist introspection and connection with his anger, disappointment, and grief when he does not get what he wants.

Encourage awareness of how he uses your refusal to reinforce his low self-esteem.

Invite exploration of expectations and how those expectations interfere with positive relationships. ¯

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