“ Short of doing nothing at all, therapy takes its most passive form when process is reduced to procedure ” therapeutic encounter, the request for help may well be present as an attack on the therapist. Treating fear as information, the therapist is more likely to form a productive engagement if the client’s protective strategies are recognised and respected. Again, where expressions of need are met by emotional unavailability, the client will have learnt to ‘cut off’. Here, the therapist needs to look beyond the absence of obvious signs of distress, seeking connection with the client’s internal world. Equally, a particular child in the family may be ‘allocated’ the task of keeping others happy. As the client acts out the old story, the therapist needs to be wary of seduction. Faced with the oppositionality that can be a feature of a childhood characterised by restrictive or punitive controls, the therapist will do well to side step the transferential invitation to be controlling in favour of humour and playfulness. Where the need for intimacy has been experienced as a threat, either in terms of intrusion or abandonment, the therapist may find themselves allocated the role of applauding audience. Productive intervention will require that this passive position is declined and connection is made with the frightened, lonely toddler hiding behind the desperate performance.
Enacting the drama Different theoretical models will account for the enactment of the drama through a range of established theoretical constructs. They provide an understanding of why people ‘persist’ in repeating their early love stories, even when these are systematically disadvantageous (Hoffman, 1993). Daniel Stern et al (1998) introduced the concept of ‘implicit relational knowing’ to describe the infant’s experience of their mother’s love. Operating on the basis of prediction, ‘implicit relational knowing’ underpins all our interactions and informs ‘how to be’ with another. Our experiences of love thus inform the
The Psychotherapist
shape and form of all our relationships. The client has come to therapy because what had started with the potential to be a love story or romance has become a tragedy. Central to the tragedic experience is the notion of ‘harmatia’. An incident in the plot leads the protagonist on a path of tragic error. In therapy, the client is both author and protagonist of his or her own tragedy. As therapists, our appreciation of the client’s courage in adversity is not enough in itself. We are required to join the client on stage and take an active part in the drama – to take on the role of a deus ex machina. In the therapeutic encounter, the therapist is craned on to the stage in order to interfere with the tragic outcome of the client’s drama. The human romance is far too conflicted and complicated for simplistic intervention and even good endings are seldom happy. At the same time, predicted outcomes can be confounded and the way opened for a richer narrative to replace a thin and predictable plot.
The core of therapy It is now well established that the quality of emotional connection between the client and the therapist is at the core of therapy, regardless of theoretical orientation. This requires active engagement and, significantly, an open heart. While training and personal work will have some impact, they do not render the therapist immune to the emotional dilemmas that have shaped their own place in the world. Whole stretches of time are spent in a confined space where painful stories are told and powerful emotions are expressed. The therapist can find him or herself feeling inadequate, angry and inclined to do the least helpful thing – retreat from the client. This may take the obvious form of simply giving up on them. Therapeutic passivity provides more subtle variants. The therapist can find any number of ways of avoiding engaging in the relationship with the client. One way of being unavailable is by putting the theory before the client – they become a case rather than a person. This opens the way to the ‘glamour of
“ Therapy requires active engagement and an open heart ”
“ Implicit relational knowing underpins all our interactions and informs how to be with another ” theory’. Elegant conceptual constructions provide fascinating accounts of the problem, preferably with references to obscure papers. Here, the therapist is more in love with their approach than concerned to make emotional connection with their client. At the other extreme, therapeutic passivity can show itself in a kind, mindless, warm relating. While this gives the appearance of valuing the client it misses the point by privileging a set of generalised relational principles over the complexities of the client’s emotional world. Arguably, short of doing nothing at all, therapy takes its most passive form when process is reduced to procedure. The encounter can be rendered entirely safe by doggedly following a set of prescriptions laid down by the model. When the unpredictable shows itself, it is neutralised by a distraction in the form of a contentbased activity. Timelines, geneograms and objective setting can be particularly helpful in keeping away the turmoil and uncertainty that arises when two human beings connect emotionally. In essence, what we have here is a range of strategies for ensuring that love does not enter the therapy room. P
References Bott D (2001). ‘Towards a family-centred therapy. Postmodern developments in family therapy and the person-centred contribution’. Counselling Psychology Quarterly, 14( 2), pp111–118. Bott D and Howard P (2012). The drama of the therapeutic encounter: a cross-modality approach. Sage. Hoffman L (1993). Exchanging voices: a collaborative approach to family therapy. London: Karnac. Howard P (2008). ‘Psychoanalytic psychotherapy’. In S Paul and S Haugh (eds). The therapeutic relationship. London: Process Press. Kirschenbaum H and Henderson V (eds) (1990). Carl Rogers dialogues. London: Constable. Stern D et al (1998). ‘Non-intepretative mechanisms in psychoanalytic therapy: the ‘something more’ than interpretation’. International Journal of Psychoanalysis, 79, pp903–921.
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Love in the therapy room
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