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Archive for the ‘The Therapist’s Job.’ Category

Yes, I think so.

The job of the therapist is to use yourself as an instrument, and be aware of how you ( your instrument) reacts. If you feel angry, irritated or bored with a client, very likely other people would also. So you use the information you’ve received, by your own reaction, in some manner that would be helpful to the client. The trick here is note your feelings to yourself, think about why the client is probably acting the way he is, and not express them as they are felt, for example – not speak angrily. The therapist’s job is to find a way to explain to the the client, so he can understand, how he is creating this reaction in another person without sounding critical. Then it’s the therapist’s job to help the client understand what is going on within himself.

Similarly, if, as therapist, you are “tiring” of your client, or getting bored, it is a signal (to me anyway) that the client is not being authentic, or is not going anywhere useful, i.e. being repetitive. This too can be communicated to the client without judgement and in a clarifying way to help the client in self awareness.

This takes skill, more than simple self control, because you as therapist have to know how to reach that particular client.

What you say may be experienced by the client as a confrontation but one that includes having the therapist’s arm around you, metaphorically.

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That’s a very important question – in that it could be devastating to a client to be “fired” by his/her therapist. It’s tantamount to having your parent dis-own you, because of the transference.

After close to 40 years of doing therapy in private practice I think I have told a client I couldn’t keep working with them 3 times: once, the client was refusing to engage with therapy and only wanted to “use me “ much the way he used prostitutes – to feel better emotionally – and refused to have even have an area he wanted to improve himself about and ‘work on’. Another time it was very similar with a woman, and a third time I was seeing a man for the first time and intuitively felt in danger being alone with him in my office. I later heard he had attacked a female nurse in a hospital situation. In the first two examples I considered what I was doing to be therapeutic – in that the impact of having me refuse to continue seeing these people was my *final* BIG statement to them about the importance of dealing with their behavior.

All of which is to say – if you take someone on as a patient and you are not legitimately over your head with them – you have a moral obligation to them to work with them. It’s really OK to admit to a client that you don’t know how to help them and refer them to someone you think can help them. So yes, I think some therapists probably do give up on clients. Hopefully not often. It’s important for therapists to learn how to “size up” clients who show up at their door and decide if they want to work with this person or not.

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That’s a very important question – in that it could be devestating to a client to be “fired” by his/her therapist. It’s tantamount to having your parent dis-own you, because of the transference.

After close to 40 years of doing therapy in private practice I think I have told a client I couldn’t keep working with them 3 times: once, the client was refusing to engage with therapy and only wanted to “use me “ much the way he used prostitutes – to feel better emotionally – and refused to have even have an area he wanted to improve himself about and ‘work on’. Another time it was very similiar with a woman, and a third time I was seeing a man for the first time and intuitively felt in danger being alone with him in my office. I later heard he had attacked a female nurse in a hospital situation. In the first two examples I considered what I was doing to be therapeutic – in that the impact of having me refuse to continue seeing these people was my *final* BIG statement to them about the importance of dealing with their behavior.

All of which is to say – if you take someone on as a patient and you are not legitimately over your head with them – you have a moral obligation to them to work with them. It’s really OK to admit to a client that you don’t know how to help them and refer them to someone you think can help them. So yes, I think some therapists probably do give up on clients. Hopefully not often. It’s important for therapists to learn how to “size up” clients who show up at their door and decide if they want to work with this person or not.

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Snakes live in the forest. Every day they travel over rough ground – pebbles, rocks, fallen trees with uneven bark. Every Spring they get a new skin, and it happens this way:  the old skin stretches and loosens. It eventually detaches, over time, from the snakes body, and  the new skin  shows up underneath.

The old skin never falls off until the new skin has had the time to toughen up and manage the rough terrain the snake goes through. When It first appears, the new skin is delicate and pink, but by the time it is ready to protect the snake from it’s daily environment, it has become brown and strong.

It’s never the therapist’s job to pull he skin off a snake.

 

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Here’s another question I’ve been asked about the therapist/client relationship. My answer is “Yes, I think so.”

The job of the therapist is to use yourself as an instrument, and be aware of how you ( your instrument) reacts. If you feel angry, irritated or bored with a client, very likely other people would also. So you use the information you’ve received, by your own reaction, in some manner that would be helpful to the client. The trick here is note your feelings to yourself, think about why the client is probably acting the way he is, and not express your feelings straight out as they are felt, for example, speak your mind angrily. The therapist’s job is to find a way that the client can learn what he is doing that is evoking anger in another person. It’s very important that the client not feel criticized, and to learn what is going on within himself at the time.

Similarly, if, as therapist, you are “tiring” of your client, or getting bored, it is a signal (to me anyway) that the client is not being authentic, or is avoiding something important. This too can be communicated to the client without judgement and in a clarifying way to help the client in self awareness.

This takes skill, more than simple self control, because you as therapist have to know how to reach that particular client.

What you say may be experienced by the client as a confrontation but one that includes having the therapist’s arm around you, metaphorically.

Read Full Post »