by Aisling McMahon
As therapists we are called upon to enter into our clients’ phenomenological worlds, to bear witness to their personal experience in a way that can affect us at various levels – cognitively, emotionally, somatically, spiritually. Much of the resonating that occurs within us when with our clients happens outside our conscious awareness and the richness of the knowing that is available to us can be missed or unrecognised unless we give it the space and attention it needs. In this article I would like to offer an illustration of some valuable work that can take place when we open up our awareness of how we are affected by the client’s unique voice, relationship style or idiom and offer some of that awareness back to our clients.
In my practice as a clinical psychologist and integrative psychotherapist, I work with individual adult clients over varying lengths of time – some people come for only a short period of work, having a more pragmatic focus or a defined piece of exploration that they want to do, and others come for, or end up staying for, deeper, more long-term or substantial work. As my original training is as a clinical psychologist, I am relatively well know within that field and more people come to me or are referred to me within that role, often having an expectation of more short-term, cognitive work. I, of course, will readily meet with people at that “head level” but will also invite them to connect with themselves and with me at deeper levels too, even in short-term work – this invitation being gentle and respectful of the readiness and vulnerability/strength of the client. I have become increasingly aware that, even in short term work, the client’s idiom is strongly present and strongly communicated to the therapist, often even from the first session, and that aspects of this can usefully be received, partly digested, articulated and offered back to the client to be worked with, and more fully chewed on together.
The client’s idiom and the therapist’s countertransferential knowing
A definition of “idiom” from the New Penguin English Dictionary (2002) is: “a characteristic style or form of artistic expression…from Greek idioma individual peculiarity of language, from idios one’s own, private.” (p.696). Christopher Bollas (1987) brought the term into the psychotherapeutic field by talking of the client’s idiom and his or her idiomatic use of the therapist, the client creating a unique interpersonal environment. To understand and come to know the client’s idom, Bollas richly describes the value of therapists exploring and respectfully working with their countertransference in the therapeutic relationship. Similarly, David Sedgwick (1994) offers wonderful illustrations of working with layers of inner experience that are evoked in the therapist in relation to clients. In relation to working with the countertransference, Robert Young (1994) writes of the interactive, phenomenological or dialectical space between therapists and clients, where meaning is mutually constructed and where both the therapist and client learn most through evocative knowledge – that is, by what we evoke in each other. I am only lightly touching on a few theoretical references here as I want to give most space to describing my work with a client, Deirdre, to offer a fairly simple but meaningful illustration of how an important aspect of the client’s idiom can come into and be worked on in the therapeutic relationship. The client’s name has been changed and she has given permission for our therapeutic experience to be described here.
Deirdre came to see me for six sessions at her workplace’s request as she had remained on sick leave for many months following a bereavement. While therapeutic work was new to Deirdre and she was initially unsure if this was what she wanted or was comfortable with, she in fact settled into the work quite quickly and Deirdre showed good engagement with me and with her emotions. While I felt very welcoming of Deirdre and I felt comfortable offering her a safe space to work through her grief, I found another layer of judgement as I reflected on our first session together. After I had taken note of the main themes in her life and in relation to her grief, essentially the content of our work together, I asked myself how I received Deirdre, how I felt about her and what fundamental statement she was making to me about herself or what statement I was making to myself about her. I then noticed a critical voice in me, a judgment that Deirdre was “just” a mother, “just” an office worker, that she didn’t have that much to say that was deeply interesting, that at some level I was dismissing her as someone whose range was limited.
In the following few sessions, as we worked on Deirdre’s bereavement and on the impact of her loss on her other relationships and her own sense of meaning and worth, I had an evolving sense in each session that Deirdre had a lot to say that was interesting and meaningful and that she had many facets to her that were not obvious or expressed most of the time. My felt experience was that Deirdre quietly and gradually blossomed and deepened over the course of each hour – my internal reaction to this was both pleased discovery as well as guilt as I was meeting my own judgment of Deirdre each time – I kept underestimating her each time we met and she kept surprising me with her depth and breadth. While I am emphasising these experiences here, this was a subtle underlying layer to our therapeutic relationship that I had to consciously invite myself to pay attention to, both during sessions and after sessions – in some ways, it would have been easy for me to miss this or to deny it as my critical judgement of Deirdre felt mean and so contrary to my consciously held all-accepting, humanistic values. At times I would tell Deirdre how I found some aspects of what she was sharing to be very meaningful and interesting but I held back my sense of guilt that I was surprised by her and that I was continuing to underestimate her – what good would it do to tell her that – I felt bad about it and surely it would only hurt her to hear my judgement?
In our final session, the last of the designated six sessions, Deirdre was happy to finish our work. She had used her time well, had expressed and understood much of the impact of her bereavement on her and believed that she could continue working through this on her own, while also feeling open to coming back to do more therapeutic work in the future if needed. We both felt that we had engaged well in the work together, short enough though the time had been, and that the work had been meaningful and timely. However, in this last session, something interesting emerged that felt more significant than anything else we had worked through. In this session, Deirdre was describing her lifelong experience that she found it hard to follow up on things, that she tended to give up on herself and not reach her potential, and that others didn’t support her when she expressed plans to develop herself. She couldn’t understand why those close to her seemed to consistently put her down and she was struggling to articulate the quality of this experience for herself. While supporting Deirdre’s exploration, I was strongly aware of my own guilt here too, once again somebody supposedly close to her having (albeit internally) put her down and thought less of her than was warranted. I could see this was an opportunity to bring my experience into the session and that it may be valuable so, after a little deliberation, I told Deirdre that I wanted to say something that I had been aware of since our first meeting. I gently but clearly told her that I had underestimated her and, while I felt guilty about it and it felt wrong, that I had kept doing it and not appreciating all of who she was. Deirdre reacted strongly – through flowing tears, she spoke with energy: “That’s it, that’s the word I’m looking for – I am UNDERESTIMATED – that is exactly what people have done to me my whole life!” The rest of the session was deeply meaningful as we explored together how this had happened again with me. We realised how Deirdre had contributed to my judgement of her by holding so much of her depth and breadth back until she felt more accepted and comfortable with me and in herself, and how healing it was for both of us to admit our failings and judgements (including Deirdre’s own underestimation of herself) and to feel the soft sadness of that as well as the real potential to move beyond it.
This experience with Deirdre had a strong impact on me as I realised how easily this work may not have happened – how a core part of Deirdre’s idiom, of how she experienced herself in relationship and how she is experienced, may never have been addressed in our work together, even though it was strongly present below the surface. A few things held me back from expressing my internal reaction to Deirdre – my guilt at the unfairness of my judgement, my fear of hurting her, my sense that this was short-term work and that there wasn’t a strong enough therapeutic relationship to allow exploration of this sensitive relational issue, and my awareness that I did not fully understand it yet and hadn’t fully digested it. And thankfully, before we finished our work, Deirdre offered me the opportunity and context I needed to engage with her on this. Since that time, I have been more mindful of the value of not only continuing to open myself to exploring the inner landscape of my experience of my clients (including the “shadow” negative judgements and feelings which I find can be more clearly observed early on, even from the first session), but also taking more risks to offer some of this back, while still somewhat raw and unformed, so that we can work on understanding it together. This, of course, has to be done in a respectful and timely way, with appropriate awareness of the client’s ego strength and readiness, and while taking clear responsibility that this is my feeling, my thinking, that it may be a statement about me as much as about the client, and that it is offered with a sense of collaborative curiosity rather than as a statement of fact. But, with all these provisos and various other appropriate personal and professional inhibitions (for e.g., see Robbins & Jolkovski, 1987; Davis, 2002), it can be easy to miss the opportunity to open up the work into a fascinating and pertinent relational field. In my experience, respectfully and gently taking the risk has always been worthwhile and my clients have responded to my countertransferential offerings sometimes with emotion, sometimes with a sense of knowing, but nearly always with a sense of curiosity and engagement that continues on into following sessions and into their external relationships.
Aisling McMahon is a Senior Clinical Psychologist and Humanistic & Integrative Psychotherapist working in private practice in Lucan, Co. Dublin. She is an accredited member of IACP and IAHIP and a registered member of PSI. Correspondence may be sent to the author by email at firstname.lastname@example.org
Bollas, C. (1987). The Shadow of the Object. London: Free Association Books.
Davis, J. (2002). Countertransference temptation and the use of self-disclosure by psychotherapists in training. Psychoanalytic Psychology, 19 (3), 435-454.
Robbins, S & Jolkovski, M. (1987). Managing countertransference feelings: an interactional model using awareness of feeling and theoretical framework. Journal of Counselling Psychology, 34(3), 279-282.
Sedgwick, D. (1994). The Wounded Healer: Countertransference from a Jungian perspective. London: Routledge.
The New Penguin English Dictionary. (2000). London, Penguin.
Young, R. (1994). Mental Space. London: Process Press.