Tuesday, 28 June 2022

Being Careful What One Says in Therapy by Dr Elizabeth McCardell, M. Couns., PhD

 

July 2022

 

 

I’ve always thought a really good conferences paper would be to present an examination of what not to say in the psychotherapeutic session.  You can really ruin a perfectly good hour by careless talk, and other dodgy contributions. You need to be mindful of your responsibility to prepare the client to re-enter the ordinary world as well as nurture their ongoing healing beyond the hourly session. This means gently disengaging them from the thickness, as it were, of any emotionally charged material through conversation about everyday things. I might, thus, talk about how beautiful the sun feels after really cold, chilly days, or something like that.

 

The therapeutic hour has a rich density about it. It is bounded by a greeting at the beginning to a see you next session at the end. In between, though, there is a contained conversation that is therapeutic and driven by the therapeutic capacity to hold the space safely, with confidentiality. It is, as I’ve said, thick and rich, for it is quite unlike any other conversation any of us will have out in the rest of the world.

 

Erving Polster wrote a significant book that, in one flash several years ago, gave me an understanding of therapy that I really didn’t have before. His book, From the Radical Centre, The Heart of Gestalt Therapy (2000), had encaptulated, in one sentence something that I’d only intuited, but not articulated. He wrote, in so many words, that therapy is the space between a deep hypnotic trance and a light hypnotic trance and that the continuation of the therapeutic work needs to not only nurture what is learned in that rich space, but not damage it. This accelerated my understanding enormously and, as an offshoot, encouraged me to do a Diploma of Clinical Hypnotherapy on top of my existing Master of Counselling degree. It brought a mindfulness to the doing of therapy and thus a more careful consideration about the words (and actions) I use before, during and around the point of concluding a session. It also delivered greater thoughtfulness about what therapy actually is, something that I continue to mull on umpteen years later.

 

How we conduct ourselves as therapists really matters. In this article I am focussing on the words we speak, but our actions can damage this relationship.  Talking about oneself too much (a little is therapeutically useful), boundary violations (for example, sexual advances, unnecessary touching, and associated invasive speech), and just plain thoughtless chatter, all have the capacity to absolutely destroy the therapeutic relationship. Right conduct is essential for the containment of the therapeutic experience and a sense that what is learned in that session may be carried on beyond the hour to the rest of the client’s life.

 

So, what words might one sensibly not say?  Direct reference to a presenting problem right at the end of the session when in the process of saying goodbye is unhelpful: not least in bringing the client’s attention again to the thing that they are fighting against, making it seductively more attractive. We all know how thoughts about the thing we are trying to give up become like sirens singing to sailors: come hither and taste the forbidden potion. I remember doing periods of fasting and having difficulty because I was preoccupied with the idea of fasting. Abstinence became an obstacle rather than an absence.

 

“I guess you won’t want to smoke/drink/play the pokies, doubt yourself anymore,” puts to mind a focus on the thing that you don’t want your mind thinking about. The less one sys about the presenting problem the better right at the end of a session.

 

What needs to happen here is a gentle re-introduction to ordinary life, and so I talk about such things as  the weather, or suggest my client has a good cup of something enjoyable,  a hot fragrant bath, a wander around a garden, a visit with friends, or settle down with a good book. The absence of focus on the thing troubling them is the whole point. Healing happens at an unconscious level from the therapeutic work and beyond.