by Paddy Logan
I open the door and another human being is standing there. This person has come to see me. As the one holding the therapist’s space at the outset, I realise that I am putting myself on offer. There is a fee involved – as perhaps there should always be, however modest, to allow clients their rights as consumers and also their independent right to expect ethical and professional conduct. By accepting a fee, I place myself in the service of the client. I am in one way a commodity. However it has evolved, I have accepted the term psychotherapist in the eyes of the client and by standing under that sign I open shop and the client arrives with a valid expectation of looking for something. I am a human being who has chosen to train as a psychotherapist, meeting another human being who has chosen to make use of me for psychotherapy. If I go into the barber’s shop it is because there is a sign outside offering that service. The same applies to the sign that says – I provide psychotherapy. It is a hat I wear from the outset and to a varying extent the client will understand what that actually implies. Something called therapy, probably talking. Telling someone I don’t know something private that is often difficult to speak about. Hoping that will change something.
A question of who
I’ve often asked a group of therapists – “When you first meet the person called client what do you consider is the most important question you could hold regarding that person?” There are usually a number of responses, such as: “Why have you come?”, “What do you hope for in this?”, “How can I help you?” I realised that although they are each central and need to be clarified, for me the most significant question to be held in the therapist differs from these. I consider the most relevant question that the humanistic therapist can internally orient from is “Who are you?” It is there for the client also in regards to the therapist – “Who are you?” That question hangs in the air between us. How I respond to that will be influenced by the theories through which I integrate my understanding of what is taking place between us and also my ability to be present, and congruent with, the experience I have within the relationship. I have always been impressed with the IAHIP definition in the Code of Ethics describing the contours of this and the recognition it gives to the phenomenon of individuation. I can see, as a person working within the influences of humanistic and integrative perspectives, that the relationship landscape manifested between myself and the client holds many access points to understanding their experience of who they are within the difficulty they present with. The degree of freedom I have to be myself within the process experiment seems very relevant if we are to share a relationship that could require deepening trust and intimate risk. Our joint humanness is the most fundamental dynamic we share. It seems to me, from a humanistic and integrative perspective that is an experiential backdrop we create in beginning a relationship – what we share as members of the same species. Regardless of their level of resistance, fear or uncertainty, the person undertaking this is reaching out to themselves; seeking to find a form of being who they are that is free from an experience of suffering, an experience of suffering that appears beyond their capacity to resolve alone. As a psychotherapist accepting their invitation to meet them at that place, I am implying availability for relationship and the necessary skills and experience for accompanying them into an exploration of what are often unexplored and even unknown areas of their self-relationship and sense of self. If the relationship is seen as a core therapeutic resource, then the humanity of the therapist has a central influence in the outcome. In that respect I have come to see ordinariness rather than expertise as a more congenial orientation when setting out. Taking time with the client to settle into our encounter, being curious and attentive and understanding the reason why the client has turned up are obviously essential and equally so is clarifying that my understanding of the client’s personal experience within the presenting scenario is accurate. I am primarily seeking to understand the client’s experience of self, “who are you in this difficulty?”
From the first face to face encounter, we recognise it is important to sense as well as conceptualise; to pay attention to what is felt and observed as well as what is provoked in thought. It is a shared event and, as such, an onus is also on the therapist to make her/his experience within the contours of the process relationship available to be known. This is not suggesting a relationship between individual identities and a sharing of histories, as that would not be congruent to the client holding the central focus of attention rather a relationship between two humans who share fundamental similarities of attributes inside that focused space. We think, we feel, we experience. One of whom is undertaking to attend to the relationship with the skills of a therapist. That is what the client agrees to purchase – the skills you can provide. It is not possible to buy your humanness. That must be freely available or not. As a participant in the relationship, what is provided to me as thought, emotion and physical experience is a fundamental part of that relationship. I wouldn’t be having this thought/emotion/experience with you and about you if I had never met you.
Receptivity to contact
How effectively the three central aspects of me – my thoughts, my emotions and my physical experience – are blended and how accurately I can focus, assimilate and understand and express that information would seem important. It is important to me and for the client that I have a clear ability to know myself as a human being and a means to convey that within the therapy relationship. I see that the information I get within the relationship is always arising from myself – wherever its source is – it always comes through one or more of these three aspects – what I think, feel and experience. So as a participant in a relationship, I know I share basic human attributes with the client regardless of who I am in my uniqueness. What I offer to share is a receptivity to contact – contact with the other human being that I experience as happening in me – via a thought, an emotion, a physical experience, assuming I am available for contact to begin with. The information I can pick up in myself arises as a consequence of sitting in the room with the client. It is not possible for me to stop thinking, sensing or experiencing myself throughout the session. Here I discover another question, who owns that information?
The shared experience
At the outset we agree a contract. The contract includes how meetings are structured, fee payment arrangements and a commitment to confidentiality. There is also another aspect which it is important to recognise and that is the purchasing by the client of the skills of the therapist. This is implied by the therapist in offering the service of psychotherapy. The idea of an expertise that can help solve the client’s dilemma can be a common notion held by a client. It can be made clear that there are actually two sources of expertise present. Firstly, there is the client who is an expert in self, in being who they are, knowing who they are and having access to their history. Secondly, is the therapist who, depending on training, experience and self-knowledge holds a different form of expertise. To the degree that I am capable, my skills rest in understanding how we avoid or constrict the three interlinked layers of being human, how a person’s self-relationship can be impinged upon historically and how these limitations inhibit a person’s capacity to make clear choices. Choices that are based on a clear internal self-relationship and rise from a sufficiently unimpeded flow of information coming from a sufficiently integrated experience of organic, emotional and cognitive aspects of the self. That is a crucial distinction to be recognised in the formation of the therapeutic relationship. I bring to our relationship what skills and knowledge I have about the internal forces that affect a person’s ability to accept and maintain an open transparent self-relationship. I recognise personally, I see neurosis as a wounding to self-relationship and so it can be said I am optimistic enough to offer the possibility of clarifying how this occurred, its effects in the person and possible experiments, to discover routes out of the restrictions to self-relationship entailed by their history and sustained into the present. My contribution to this will naturally be enhanced or limited by the theoretical maps I make use of and also my ability to form a trustworthy and authentic connection with the human being sitting opposite me. Whether I speak or don’t speak, I am a participant in the relationship and because I am alive then that makes me an active participant with thoughts, emotions and somatic experiences in a constant motion of response. So the question of ‘who owns that information’ could be answered as it belongs to both. If transparency and congruence are to be valued, then I believe the other person has a right to know who I am in relationship to and with them.
Meeting the defensive aspects
As a participant in the process of the relationship with the other person, I do not want to communicate in a way that antagonises defences which the person has necessarily developed. I do not see antagonising the defensive requirements of the client as a productive initiative in early stages of getting used to each other. A deep defence is like a shield behind which some fundamental aspects of the clients self are encased. This shield did not emerge without a reason and it also serves a crucial purpose for the client in keeping at bay what was once unbearable and allows the retaining of a sense of self that is survivable. Trying to get under or over or through it by ruse or skill or wisdom is unreliable in respect of the client sustaining a movement into change. Skilled interventions may place the therapist on the inner side of the shield but it does not necessarily facilitate the client in finding a way out from behind it. I try to recognise the defence and to support the client in making that an obvious element in our relationship. I try to convey my acceptance of that defence as understandable – given the client’s history. I try to convey my acceptance of that defence as an authentic position for the client in our relationship. I do not want to inflame the neurotic elements in that defence primarily because I am attempting to get closer to the person in front of me, exactly as they are. That way I can come to understand their current relationship with themselves and this for me is the starting point. Who are you?
For me the most useful orientation I can hold at this stage is one of curiosity and from that position I can respond with interest to whatever position the client needs to hold and meet the material they present in a responsive rather than a reactive way. This usually opens up the history and leads into the impacts on the client which formed the choices made in experiencing being a self.
I wouldn’t want to convey an impression that I do not value what we call the counter-transference in the relationship, because everything that is experienced within the relationship belongs to the relationship and is material provoked through being in the relationship and is always valuable as a source of mirroring my experience of being in the relationship. If I find the material presented as disturbing or unsettling I will tell the client what I am aware of in myself – as a statement about me and not them. I imagine a lot of humanistic therapists do this.
It can often be a source of revealing transference in the client where, for example, the client hears what I share as judgmental and the exploration of negative projections are, of course, a vital and central part of the process attempt. So I always enquire what it is like for the client to hear what I share about my observation of my reaction or response to the material. Sometimes a person will hold tightly to an idea of being exposed and viewed negatively by me. I try in those experiences to bring out as clearly as possible the version of me that the client feels and will enact that back to them to get it as accurate as I can. This provides two possible routes. The version of me that appears in the projection can be brought out into view and engaged with if I am willing to hold it. If necessary the projection can be met within the relationship by both of us. Who is that version of me and what is it modelled on? The projection can also raise the questions of why would I want to do that? What value would there be in my holding that kind of projected attitude? How can that facilitate my position of wanting to be of use to the person in unravelling the difficulties they present? After all I have an agenda related to an optimistic outcome to our relationship. Clients can often fine tune my responses with their own internal self-knowledge and help to clarify my understanding of what is provoked in me in respect of knowing them more accurately in their self-relationship. In my experience there is much possibility enclosed within this form of interaction.
Is this directive or non-directive?
Since I am presenting myself as a psychotherapist it is not possible for me to be a neutral presence. What I am offering must have some purpose and it is to be assumed that for my participation in the relationship I am clear about what that is. I am not available to take part in a process relationship by accident or coincidence. I set out to learn about doing this and I set up in practice in order to deliberately engage in it with others. I come to this relationship with a purpose and out of that arises intention on my part and so I recognise I am not a neutral presence.
I do offer interpretations where and when they occur to me in the relationship and I stay continuously alert to valuable elements like projective identification and dreams, etc. Yet for me, this remains fundamentally a meeting between two members of the same species. The individual uniqueness of each is not the common ground. In all cases the psychotherapist is a member of the same species as the client and what we share are our attributes for knowing who we are – the three primary aspects already described. I am not there to talk ‘about’ myself but rather from myself. So for me the question of directive or non-directive is not as important as the question: “am I transparent or non-transparent?” in my participation. Through offering the mirror of this to the client, coming alongside the client with that awareness, I have seen that this can create a mutual space for observation and in that development clients can discover opportunity to begin to develop this observing aspect for themselves. In that space the many limitations, inhibitions, rules, regulations and developed habits of avoiding the self can become manifested and explored and, in time, hopefully resolved. Although I may need to willingly let go of that hope if it does not align with what the client experiences or wants for themselves. I have no right of power over who they want to be. I am not there to save, rescue or repair, but to meet. I also recognise that all of us will naturally resist what is unknown and potentially threatening and that resistance cannot be discharged and individuated beyond effectively except by the person who holds it. For me the person needs the experience of considering a decision to venture out from behind the defence because it is locked from the inside. I have techniques that can actively influence or induce them to emerge if they are open to such work and seek that yet the most reliable and sustainable change needs to arise from within their choice. Uncovering this place of awareness means implicitly running out of map and meeting a period of apparent stuckness. There is usually a developmental gap within this where the person doesn’t know or have experiential access to a different way of being. I don’t experience a difficulty waiting on the outside and recognising the client’s right to stay hidden. As this positioning becomes safe enough to be jointly recognised, we can usually begin to look together at that locked space and the possibility of forming a different choice in relation to its apparent necessity.
A triad of awareness
The person who sits in front of me stuck in such a dilemma is present in three fundamental ways. They have three essential sources of information for self-knowledge and three essential aspects for self-expression and three essential resources for creating change. How they experience being who they are in their physical aspect, how they feel as and about who they are within their emotional aspect and how they conceptualise their experience of who they are within their cognitive aspect. Sufficient information about what formed and sustains their internal world and their self-relationship and what caused the seeding of a neurosis which distorts this inner relationship can potentially be accessed and processed at this stage in therapy. This can be done through interaction with and exploration of these three aspects and where the immediacy of the body aspect becomes of significant value. This in turn provides opportunity for experimentation with changing the fixed positions that created limitations for a person’s choice in experiencing being, becoming, experiencing and expressing who they are. Self-awareness is consciousness of a self by that self. It might also be called presence. We have a cognitive function that collates and blends the information coming from the organic and emotional sources of self-awareness into a recognisable and internalized perception of being a specific human. Neurosis debilitates the efficiency, accuracy and fluency of this integration and causes a distorted response to the experience of presence. As therapists we can recognise that self-awareness is deeply affected by early formative forces within the environment called home. The formation of an inner self-relationship is always deeply influenced by such forces. These forces inevitably model the developmental formation of self-awareness and the child learns to adapt and intuit how to engage with the outer world from a sense of self that emerges under their influence. The opportunity in reaching this place of stuckness in the relationship and mapping it is one of creating new experiential experiments where the person may risk engaging with the deep struggle of emerging from behind the shield that is the character defence, individuating beyond the limitations of historical effects and experiencing something new about who they actually are.
The evolving client
The person who comes is in a state of continuous evolution and has come with the forces, impacts, limitations and insights arising from their intimate participation in being who they are. They also experience the patterning of self-relationship necessitated by their experiences. It is important to me to have a means of understanding those impacts and the patterning of their self-awareness in order that I might better be able to be of use as a mirror and a witness and an accompanying observer and explorer. Growing in consciousness is never easy and although every human being gets opportunity to become self-aware – and so more conscious as a human – the opportunity is often formed through some sort of impact that disturbs the equilibrium of the self. No-one escapes this because it is a part of our evolution, to evolve in consciousness. There are no perfect histories or families or childhoods. If you think about it, perfection is like a death. When something is considered perfect it gets put into a museum and nobody can touch it. Being perfect would mean coming to a full stop, having no further capacity to grow in consciousness and having nothing further to experience and discover about being and existing as me. If that were the case then the humanistic enterprise would be dead in the water. As it is, I am so glad to have a stairs to walk down which gives me time to think.
Paddy Logan is a partner in the Integrative Psychotherapy Practice in Rathmines, Dublin.