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.
The point of view you mention suggests (to me) that keeping him away from his trauma is the way to resolve the trauma, that resolution is impossible without further damaging him, and that the best thing to do is to coax him away from and teach him to distract from the path upon which his psyche has lead him every day since the original trauma occurred. To me, this is a mind set of disbelief in, and distrust of, the psychotherapeutic process.
Whereas I believe that a) this person’s trauma is a part of his everyday existence, b) he lives in and acts out his trauma through his relationships with nearly every person and every thing in his life, and c) his wandering around on the edge of his trauma extends from a natural yearning to resolve it.
Let’s do an experiment. (Takes a tissue, blows nose, crumples tissue up, and holds it in fist). This tissue represents an opinion, belief, or anything else that a person can “hold onto.” See if you can convince me to let go of this tissue.
Let go of the tissue in your hand.
The tissue in your hand.
I don’t have a tissue in my hand.
Yes you do.
No I don’t.
Open your hand.
My hand is open.
No it’s not.
My hand is open and upside down. I can’t let go of anything because there’s nothing in it.
I see something in it.
(sighs) I guess there is nothing I can do here.
That’s correct. Until I become aware that I’m holding onto something, I cannot let go of it. I might be invited to look (turns hand up, opens it, looks), but as I don’t believe it’s there, I probably won’t see it. Hmmn, in this case, I see it but I’m deciding to keep it (closes hand over tissue, puts hand in pocket).
Or, I might discover that I don’t like this thing I’m holding and let go of it (pulls hand out of pocket, looks, says, “eeuw, it’s full of snot,” and drops tissue on floor).
What could I have said to make you aware of it?
Possibly nothing. One thing you might have suggested is that I do what I was doing more, in effect squeeze my fist harder and harder, until I became aware how uncomfortable I was, possibly until my discomfort wormed its way through my denial.
Well, I’m not against resolving issues, but I think we have to be careful not to push the client into a more intense place than they can handle unless we have been careful to give them resources with which to handle the intensity.
If by resources, you mean the following three abilities, I agree.
• The ability to introspect
• The ability to take responsibility for and own one’s experience in-the-moment. “Essentially, I am experiencing this,” as opposed to, “This is happening to me.”
• The ability to have an experience, observe it, and share it, all at the same time: “I am here, right now, with you, experiencing this.”
Probably 4/5 of all psychotherapy time is taken up by inviting people to learn, practice, and embrace those three activities. Here’s my rhetorical question to you. How are you going to know, for sure, when the person is ready?
I say that neither of us know enough nor are we intelligent enough to make anything better than a wild guess. Instead, I suggest we teach him how to say “No” to us, then suggest he move closer and closer to the edge of his personal precipice while we have faith, given he is not psychotic, that he will step off when he’s ready. That said, how will you know which resources he needs? How will you know if he can handle something unless you invite him to handle it and observe what happens?
Are you saying they’re inside him, already?
Probably so, hidden under the trauma. Once he moves through the trauma, those resources will be more available, certainly more quickly learned.
Nah. It’s that as they approach the trauma, they will start acting out and unless they have resources not to do that, they sometimes get lost in the trauma.
I see where we disagree. You think there are some things we, as professionals, should stay away from, because it might harm the client. Whereas I think we can work with anything the client brings to the session. From my perspective, if he starts to act out, then the therapeutic response is to drop all attachments to “working through the trauma,” and attend instead to the working through of the acting-out. We stay with the client’s process as it changes moment to moment.
If, for example, at first his process is considering-the-trauma, we work with “considering.” When his process changes to approaching-the-trauma,” we work with “approaching.” Should he resist by acting out, we work with either “resisting” or the specific process of however he is acting out. This is a client-centered therapy where we go wherever the client goes. Our job is not to tell him what to do or where to go, it is to illuminate whichever path he chooses to be on at the moment.