Reflections on Taking on a Client
By Jude Fay
Starting my fledgling practice as a psychotherapist, and still novice enough to get a thrill with each new client, I’m reminded of the old adage: “Be careful what you wish for…” I find my mind lingering on the question of what is being sought, and what is being offered. I usually ask a new client to outline what brings them to therapy at this time, and what they hope to achieve. I, in turn, outline how I work and between us we decide whether or not to proceed. I know that these early explorations are of necessity a simplification on both sides, and as the work proceeds, early goals may be overtaken by other issues. I wonder though, to what extent a client understands what is being offered, and to what extent what she is looking for remains unknown or unspoken.
Thinking back to my own first experience as a client, I can remember my therapist talking about how she worked and what I might expect, but I can remember little of what was said. To tell the truth, I was so fearful that she might decide that I was a hopeless case and refuse to take me on, that I was incapable of taking in much about the process. I barely grasped the practicalities of the day, time and fee. I do remember that although I was seeking help for specific problems, I was less concerned about her expertise in these matters than her willingness to spend time with me and to take me and my troubles seriously.
I remember too, as time went on, often wondering about the role of the therapist. Having experience of professionals in other fields, my expectations were shaped with those other encounters in mind, and as the work progressed, I realised that here was an animal of a different kind altogether. I also came to realise that my expectations were shaped by much older experiences, long buried in the unconscious, of which I only slowly became aware.
So what is a client looking for?
A client seeking therapy may, on the face of it, be looking for help in dealing with current life issues, with or without the awareness that these may be influenced by past events. Under the surface however, they are looking for more than that. Some are looking for answers to questions, some for understanding, some for healing. Some are looking for attention, some for a parent to tell them what to do. Some are looking for all these and more. Can or should these expectations, known and unknown, be met in therapy? As I listen to a new client outline her story, and search for the clues to her expectations of the process, I think about the deeper meanings behind her aspirations.
The Miracle Cure
Take those who want to be fixed, for the “flaws” or “bad bits” of themselves to be somehow magically transformed into something more acceptable to their view of how they should be. I find myself thinking about the word “fix,” and its various meanings of repair or mend, fasten or secure. And what about the word “cure,” which can mean to heal or make well, and also to preserve. I wonder if the client who wants to be fixed or cured is really seeking change, or is she looking to be confirmed in her view of the world? And I wonder what our explorations will bring, what will be found to be worth conserving and what can be let go? I wonder if my client may end up making friends with those aspects of herself that she so dislikes. Will she find perhaps, that they represent who she really is, rather than who she thinks she should be?
Questions and Answers
And what about the client who’s looking for answers? Is she also seeking to set or fix something, to make certain or permanent that which is essentially unknown or ever-changing? Will the answers to her questions give her, not the certainty and knowing she so desires, but rather, an opening to yet more questions? Like the mice in Douglas Adam’s novel, The Hitchhikers Guide to the Galaxy, we might find an answer, but will we know what it means?
Meaning is a powerful tool. The meaning we placed on our experiences as children can shape our whole lives without us ever realising its influence. The meaning we give to the actions of others can leave us laughing or crying, enraged or enthralled. Will therapy help the client to find new meanings, and alter her future experiences? One of the things that I love about this work, is that we can find similarities in stories and experiences, and yet, the meaning for each of us is unique.
Some people are looking to understand. Understanding accompanied by re-experiencing lost feelings, can lead to acceptance and forgiveness, and can help us to move on. But understanding may also be a way of avoiding the pain, focussing on an intellectual analysis, rather than confronting the reality of our own experiences. Some clients are looking to be understood, and I wonder about the assumptions attached to that desire. Am I also being asked to agree with the client’s view of the world? I may understand my client, but I may see her differently from how she sees herself.
What is the client really looking for?
So when I meet a new client, these and many other expectations hang, often unacknowledged, in the space between us. And I ask myself, what is this client really looking for? Even after many years as a client, I am aware that I don’t know the answer to that question for myself. I have been looking for something I can’t articulate, and sometimes I find I’ve almost grasped it, only to find that it quickly changes.
As the years have gone by, I have discovered that much of what I’m looking for, whatever it might be, is not for my therapist to provide. The loss of what I didn’t receive when I needed it can never be repaid in the present. The time and the need are past, and only their echoes remain to be mourned.
And What Might I Offer a Client?
So what might I offer a client, in the face of these as yet unexplored expectations? I can remember in training we discussed at length what therapy could offer a client. The words included relationship, space, holding, empathy, unconditional positive regard, accompaniment, acceptance and authenticity; somewhat different from what the client might think she needs.
Of those qualities, I aspire to offering all these and more. The mother in me wants to help the broken child within the adult sitting before me, the trainer in me wants to see the client develop and grow, but I am acutely aware of how far what I am able or willing to offer may fall short. I know I can’t always see the hurt and broken child sitting opposite me, clearly or at all. I can’t promise always to fulfil the expectations I have of myself. And a client may evoke a response in me quite different from that which I may want to give. I may be unable to feel empathy for her. I may feel angry, or dismissive towards her. Far from the acceptance and unconditional positive regard which I aspire to, I may feel disdainful or critical of her. I may feel scared. What then can I offer? I am learning that with some clients, or perhaps at times with all clients, maybe all I can offer is a willingness to be in relationship, to be myself with her. Maybe that’s all there is – you, me and what is between us.
So What Do I Say?
As I sit with a client for the first time, and we negotiate the parameters of what is being asked and what can reasonably be offered, it seems premature to explain that it may not be so much in the meeting of these expectations that the work will take place, but perhaps, in the expressing of the desire for them to be met, the failure to meet them, or the realisation that they were not met when we most needed them. And yet, that is what is in my mind.
There is a reckless desire in me to warn the client off, to say “Don’t do it. It’s painful and hard, and it takes a lot of courage. And you may end up somewhere quite different from where you wanted to go.” It’s a desire to be brutal in laying out the limits of what may be ahead, to anticipate not just the positives that might be achieved, but to issue a warning as if we were embarking on some dangerous adventure sport, which in a way we are. If I were to speak candidly about what may happen, I doubt whether any client would wish to continue after the first session.
A client recently told me that what she most wanted was a mother, to replace the one who had been unable to care for her as a baby, resulting in a childhood of being passed from one inadequate carer to another. This client is smart and well informed. She knows that I am not her mother, nor can I be, and yet, at some level, that is what she wants of me. Is it what she needs? I imagine that somewhere in our relationship, if we manage to muddle along for a while yet, she may find that I too am unable to care for her as she would wish, and that my failure to meet her expectations will trigger that earlier abandonment. I have no wish to cause her more pain, and yet I know, that if she is to free herself from the pain of these old wounds, that is where we may need to go. And I can go with her, but I cannot do it for her.
For me, this is the paradox of doing this work. I can do the best I can, offer myself in relationship and be open to the client with my thoughts and feelings. I can be conscientious, use my skills and training, think deeply, and reflect on the work. And yet, it may not be in any of these offerings, it may not be not in my strengths, but in my weaknesses and failings that the client may find what she needs. She will make use of me to find the path to her own healing, or not. She may not find what she needs at all, and leave in disappointment. And maybe that’s how it’s meant to be.
And despite my ambivalence, despite my cynicism, and my reckless (and un-indulged!) desire to dash the client’s hopes before we start and dismantle her illusions, I still have faith in the process. I can’t quite explain it, except maybe to say, it worked for me. I don’t know how, or why, but it did work. And when I step out of the role of client, I will be stepping out in an infinitely better place than I stepped in.
And so the answer to my question, “Can I or will I give what is sought?” seems to be “Maybe, more or less.” Maybe I can offer both more and less than what is sought. Maybe what the client receives is both more and less than what I give. And maybe what happens between us is both more and less than the sum of our parts.
Reflecting again on my own experience as a client, I ask myself if I’d have wanted to know more about what was in store. I’m not sure it would have made any difference to me at all, because I wasn’t in a place where I could have grasped what I was looking for and what was being offered. So when I sit with my next new client, and hear myself talk about what they might be looking for and what I might offer them, I’ll just smile inwardly, knowing that the detail of what I’m saying may not be as important as I think it is. At the end of the day, I can only offer myself, and I am both more and less than what I say.
Jude Fay is a pre-accredited member of IAHIP, practising as AnneLeigh Counselling and Psychotherapy in Naas and Celbridge.