Opposition in Psychotherapy by Dr Elizabeth McCardell, M. Couns., PhD

February 2022

      Sometimes, not often, a person comes for therapy who is uninterested in allowing me to do my job. They have a fixed idea about what I should be doing. They tell me they don’t want to share their history; they just want me to “fix” what’s troubling them. I tell them that I can’t possibly know what to do from a description of their symptoms and nothing else; I need to have a fuller  sense of where they’ve come from and something of their current life, ideas, things that make them happy, as well as points of distress. Psychotherapy isn’t like prescribing a pill for a condition. Taking a careful and thorough history really matters.

   Psychotherapy is a collaborative enterprise. It isn’t me doing stuff to you; it is me listening and guiding you to another way of looking at the issues that are causing difficulties, and working with you so that life is easier for you.

      As I’ve said, sometimes, very rarely, a person comes for therapy but from the outset doesn’t want to tell me anything about themselves. I remember when I was learning my art, I had a client that when I said I’m interested in understanding her, she said, “I don’t want you to know anything about me.” What was I supposed to do with her, and why was she there?

      Another person reported irritation with me when asked about her past. She couldn’t see a purpose in my questions. For her, my investigation didn’t fulfill her objectives. I replied, they fulfilled mine. I was the one trying to understand  her. She may well have felt that her resistance to my inquiries was realistic, but really it wasn’t. There was more: she missed sessions and she was late paying my fee. I realized there was a mismatch at work and we needed to drop the whole thing. Not everyone can work together. It’s also probable that she wasn’t ready to actually do psychotherapy at all.  Everything has a season, as they say.

     It is important for therapy that a strong working alliance is developed and if the client resents the therapeutic strategy taken by the therapist, then no alliance can actually develop.

     Note here, that I prefer not to use the word ‘resistance’. The reason for this is that that term developed out of Freudian psychoanalysis where  power relations between therapist and client are intrinsic to that purpose of therapy. Psychological resistance is seen by psychoanalysts as a case of clients clinging to their disease at an unconscious level in defence against the parent-therapist (using the concept of transference as what is seen to go on between therapist and client). That idea, I think, is flawed and suggests the therapist always knows what is going on, and the client is always just oblivious. Therapy, as far as I and many others see it, is much more horizontal than that hierarchical model. We are two people working together, both relatively capable of choice making.

     Opposition in therapy may not be aimed at a disagreement concerning the therapeutic strategy adopted by the psychotherapist. Sometimes it arises from an opposition to specific techniques used in session, or non-compliance with agreed exercises (for instance, collecting dreams, keeping a journal, or some other homework) or a dislike of words or phrases used by the therapist, or resistant body language, or repeated non-attendance at planned sessions. Sometimes it manifests in other ways. A client might not want to talk about certain things and will change the subject repeatedly when those subjects come up. Sometimes their objections manifest in not paying the session fee, or delaying it for longer than is polite. All these need to be properly addressed by the therapist and client, and not left to insidiously rupture the therapeutic alliance. When they are effectively addressed by both psychotherapist and client, then two things can happen: a strengthening of the therapeutic relationship resulting in an intrinsic healing, or total rupture.  Sometimes total rupture is the only way, but that depends on the choices we make. It’s ideal that both parties agree to what happens next, as good communication is essential in an effective therapeutic transaction.

 

All the waters of the world by Dr Elizabeth McCardell, M. Couns, PhD

December 2020

     Most people who know me know that my passion is swimming, snorkelling, and diving. Just being in the water is bliss. These days, it feels to me that all the pools, ponds, lakes, rivers, seas and oceans I have ever swum in are gathered together in the singular swim of the day. It is as though all the waters of the world are present in the now of this swim.

     I have swum in the North Sea (Scotland, England, the Adriatic (off Italy),  the Andaman (off Thailand), the Indian and Southern Oceans (Western Australia), Fonty’s Pool, Manjimup (WA south-west),  in the Pacific, the Atlantic (Iceland) multiple rivers, streams, lakes (including Lake Zurich in Switzerland), the Silfra Fissure in Lake Thingvallavatn in Iceland (water temperature, 3-4 degrees Celsius); hotel and public pools (last year I was in Berlin swimming in their pool on top of a shopping centre, and Caracalla Spa in Baden-Baden), etc.,  etc. I actually dream of swimming across whole countrysides, and it feels fantastic. 

   One thing I love to do when diving, is swim upside down gazing at the underside of the shimmering water’s surface. I’ve had dive masters try to save me, thinking I’m drowning! This, I guess, is the legacy of nearly drowning when I was four years old. That time, I wasn’t yet a strong swimmer and couldn’t follow the group of swimmers who left me behind, so was going under. Far from being afraid, however, I was fascinated by the underside of the surface of the water with the light streaming through. It was magical. I was pretty cross on being saved and told to play on the beach like the other little kids. I guess the reason I didn’t drown was the children’s capacity for stilling the breath, something I consciously practice these days.

     I have a hankering to free dive the kelp forests off Tasmania, and plan on doing this in the next couple of months. I bought the useful extra long free diving fins and added them to my existing rather large fin collection (I’m the Imelda Marcos of swim fins).  My Octopus Teacher, that beautiful documentary made by Craig Foster on the way in which an octopus taught the man about octopus-life, has added fuel to this desire. The dance of waving kelp seduces me.

     So, what has this all to do with psychotherapy? Far from being a remotely connected idea, understanding what being in water requires and understanding what being in the presence of other people in the psychotherapeutic realm necessitates, gives a very clear pointer to how the one reflects the other. 

     Being in the water and working with clients requires in-the-moment attention; it requires focus, listening, awareness of everything around me, and all done while alert and yet relaxed. The nature of both and all the interconnections within is an imperative of the therapeutic communication. 

     It is no accident that water is often seen as the essence of communication, a word that shares its meaning with “communal”, or “togetherness”. Sound travels long distances in water. A microphone dropped beneath a boat captures whale song of those swimming many metres away.

     In astronomy, Sedna, the planetary body beyond Neptune, was named after the Inuit goddess of marine life. She, or it, in this romance, usefully could symbolize the coming of  consciousness from a backdrop of watery unconsciousness. This is our task in psychotherapy, and in life. It’s also what I endeavour to do while swimming, that is, swimming with awareness.

     Water is subtle in her currents, shifts in water temperature, clarity or murkiness, volume (it took awhile to perceive in my body depth perception), the delicate sense of water tension, and the strange way in which the swimmer can sometimes forget that there is a watery substance, but just the natural environment of the marine animal. Swimming the waters of the world is how I’m coming to know how interconnection, individuation and consciousness all roll into the doing of participation in the art, craft and process of psychotherapy. I swim for the enjoyment of coming to know my work, my life.

Exploring communication by Dr Elizabeth McCardell, M. Couns., Ph

      
Aug 2011

     I am sitting in a plane on the way to Perth for a long awaited holiday and thinking about what to write for this issue of the Nimbin Good Times, but by the time you read this I’ll be well and truly home. Two topics spring to mind and I wonder why they arise together. Terminals, on the one hand, seem a worthy topic and the business of a friend trying to get me to organize his stuff is the other topic worming its way through my mind. Are they somehow connected?

 

     I am intrigued. Let me wander around these ideas for a moment. Of terminals I am reminded of two things. The first is the movie The Terminal, with Tom Hanks in it, and secondly, a wonderful book I read years ago called Angels, a modern myth by Michel Serres. Angels is about creating a philosophy of communication, of movement between people, while the Hanks movie is concerned with miscommunication, getting stuck in a place (denied entry into the US and unable to return to his own revolution-riven country) more usually associated with transitions. Interestingly, both book and movie are set in airports, places where normally you arrive, you leave, you arrive… 

     As to this other topic, of this friend attempting to get me to solve his problem by asking me to organize the removal of an item of furniture from his house to store in mine, prior to his departure. The item was attractive to me, but not so much that I was prepared to drop everything I was doing in order to get removalists doing the job in time for an, as yet, unknown departure date. Here was a mixed message from my friend: you can enjoy a beautiful, difficult to move object, but you’ll have to organize its removal because my friend was going away (when?). The problem was, I was leaving on my own holiday soon too. Ultimately I simply refused to do what was asked of me. The dynamic, if I may speak in this way, was all wrong and I resisted it.

     Good and honest communication between people needs to be a free flowing thing, not bits obscured, and withheld. It was not up to my friend to request I organize the removal of a large object from his house in time for his undeclared departure date, just because he thought I would enjoy using this object, and my enjoying it was a good enough reason for off-loading his own responsibility onto me. He really needed to organize the transport, or disposal, of the object himself.

     Angels are intermediary entities, transporting clear messages between, classically, god and humans. Airports, those massive tracts of strange spaces warmed up by homely touches of shops and eateries, are intermediary places. Both connect meetings across vast skies and both depend on clear communication at all nodes. Travellers, and meaning makers, need to know their journey will be safe. 

     So, now I know why the topics of terminals and my friend off-loading his responsibility onto me occurred together. It is about communication and the  between of communication that interests me. Clarity of intention is needed; muddied desires obscures too much unsaid stuff that can easily terminate friendships. Funny, this word “terminal” and that word “terminate”. The Terminal, the movie, was about, as I’ve said, getting stuck and yet airport terminals are determinably not places to get stuck (though sometimes it seems airport staff are hell bent on making this happen). The word terminal can mean “end” and it can imply articulations between nodes (as in electric power stations). Words are articulations between sender and receiver: the clearer the intention and the delivery of all the facts the more favourable the reception. Understanding depends on it.

     I have much faith in the writing process, and recommend to many of my clients to keep a journal, for it is in writing that greater understanding is reached. The printed word is an intermediary, like angels and terminals, and connects thought to thinker and writers to readers. In writing we come to know what was once half intimated, half felt – an inkling that doesn’t really go anywhere. Writing connects.

 Copyright @ 2013 Dr Elizabeth McCardell