December 2019
by Dr
Elizabeth McCardell, M. Couns., PhD
I used to be an occasionally good university teacher before changing
professions to practicing psychotherapy full time. This was over in Perth,
Western Australia. We had a syllabus to follow, lectures and tutorials to run
and they followed a pretty standard course. For about a dozen years or so, since
then, I’ve worked solely as a psychotherapist. There are similarities to
teaching – we want the best for those under our care – but the way we go about
it is very different. As psychotherapists, we observe and guide the other
person(s), and we participate in their lives, aiming to bring forth insights,
understanding, different ways of doing things, as well as strengthening their
sense that only they are the authors of their lives.
Psychotherapy is art and science: fumbling, uncertain, creative, experimental;
it’s a growing body of psycho-social-spiritual knowledge, it’s an understanding
of the dynamics between people; it’s sometimes methodical, ordered, and follows
a clear beginning, middle and end; it’s helped by therapist self-awareness
(which is very important) and depends on just seeing what is effective and what
isn’t, it unfolds, it explores, and it’s not a journey that finishes with the
last therapeutic session. It’s part of a life time of self-discovery. Those
coming to therapy or counselling or whatever you call it should not expect clear
cut outcomes all the time; it’s not an anti-inflammatory pill for the mind,
despite what some might tell you. A course of treatment is a dubious way of
talking about what is a much more subtle and impactful process. Here is a
therapeutic conversation that has goals along the way, but they are reached via
improvisation, intuition, acute listening and trial and error. That is the best therapy, as I and several others
see it. Yes, we can strictly follow the protocols of psychotherapeutic schools
and models and rituals, but when we do so, we cease to actually listen to what
our client is saying in her words, her body, indeed her whole demeanor. When we
get caught up in saying the ‘right thing’ we have stopped listening to what is.
I fear I have missed quite a number of people as I’ve observed and participated
in their therapeutic journeys, by doing exactly this. For that, I sorry.
One thing I need to say with regards to not listening properly to a client is that it
forces me to sit with my own discomfort, to tolerate uncertainty and the hoard
of ghosts of self doubt, but to also aim to be more present, more sensitive,
next time. Erving Yalom says of this that such is a prerequisite for the
profession. Ours is a somewhat wobbly profession. We try to steer an even course
through uncertain waters, while knowing that this goes against much of the common perception of what we do. That idea
is that what we do follows predictable, measurable pathways but very often it
doesn’t work that way, and that’s ok. The outcomes may be quite different from
what could’ve expected at the outset.
Though I speak of such things, I also know that the journey we travel
together isn’t without a safety net, well, actually a few safety nets. Psychotherapists have been trained (in my
case, university trained at a post-graduate level), we have experience, we are
monitored by a colleague or colleagues in supervision, we participate in
ongoing professional and personal development, we are bound by a rubric of
ethics, we are insured, we abide by the laws surrounding our practice and,
basically, we just care what happens to our clients.
Ours is a caring profession. We guide, we accompany, we share, but we do
so from a fairly objective position. If we did it any other way, both of us
would be lost. But in participating with the client in a deeply human way, we
allow them, and us, to be changed at the very heart of the therapeutic
encounter. This is a rich, wonderful collaboration where both client and
therapist are nourished in a journey that reintroduces
the client to the authorship of their own lives, and that’s good to be
part of.
