Monday, April 18, 2016

Appropriate Emotional Investment

     It is important for a clinician to be emotionally interested, but not emotionally invested in his or her clients. There is an important distinction here that must be mentioned in order to further the point. A clinician who is emotionally invested in clients ties a string to clients' development, taking themselves along for a ride, which depends upon someone else's motivation. This, of course, brings up many issues regarding boundaries between clinician and client. A clinician does not want to be at the mercy of the client; this might cause ripples to be felt throughout that therapist's whole practice. The opposite end is where the emotionally cut-off clinician practices - a place that does not necessarily engender good therapy and creates (possible on purpose on some level) no emotional connection or attachment with the clinician. This, just like the opposite end, can lead to echoes into other therapy sessions. So what does the middle look like? And why am I so afraid of the extremes? And how have I seen myself going into either extreme?
     Betwixt these two extremes, a clinician finds the land of emotional interest without emotional investment or dependence. This is a space where the clinician is comfortable with being present and appropriately emotional/empathetic with the client without allowing his or her personal life to bleed through into the session (non-therapeutically). To some degree, I think that it takes time to find this balance.

Friday, April 15, 2016

Arguing Against Progress

     There are many things that I am afraid of - one of the more curricular ones is the quasi-inevitable heath-death of this field. Sarcasm and hyperbole aside, the lack of forward development in the field is of huge concern. What does a lack of change really mean? It means that the answers have been found and/or no one cares anymore. A good parallel is language: language develops until another is created from its ruin or something better or more efficient takes its place. I do worry about this because I don't see as many people asking the important questions in the field and engaging in deep introspection and supervision, in order to develop themselves. This baffles and hurts me. Without each member of our field asking questions that further themselves and the field as a whole, we will stagnate and possibly start to see what we have already accomplished as enough. This would surely be the death of the field. As our culture, society, and clientele change, so must we. One could say that culture, society, and clientele will always be changing, so the field will as well. The added component here must be pride. Man is full of pride (and laziness) in his work, wanting the effect to stop when homeostasis is reached. It is important to never feel lazy in this fight. To some degree, there should always be someone who is the nay-sayer or the devil's advocate; someone who is ready to push the envelope, point out the weaknesses, or instill doubt. One could almost say that we are not looking for a Unified Theory (as this would surely mean the end of the field), but rather the continued dialogue and struggle to find that within ourselves that helps another - and surely each of us can contribute something (a lesson, perhaps) that is wholly our own, wholly subjective.
     To argue is to seek continued survival; to find perfection is to encourage death. This is odd, in that one could think that I am purposefully undermining a perfect theory - but that is the exact problem: there is no perfect theory! We each must continually question how we practice in order to be better ourselves.

Teaching Theories and Basic Skills

     I still have some major internal conflict on the topic of teaching theories to therapists. I'm still unsure of whether it is a good idea or not. I think that the main counseling skills of true active listening, empathy, reactive choices (interpretations, reflections, minimal urges, etc.), and appropriate self-disclosure. Of course, some of these skills come easier to some student of the field versus others. This should be monitored, as we do not want to continue teaching the expert. I'm starting to think that some mastery of these skills should be shown before moving on to deeper theories of the field. To put this whole paragraph a different way: While theoretical orientation is of high impact, it should not be taught before the basic elements of the craft are honed in the budding clinician.
     Theories are all well and good (and I will get to these parts in a moment), but they do not fulfill the needs of the therapeutic dyad that the basic counseling skills do in full. A therapist without active listening is deaf; a therapist without empathy is cold and uncaring; a therapist without correct reactions is ineffective; and a therapist without a personal and semi-transparent identity is not a true person, but a cheap mask. No amount of theoretical knowledge will help that therapist - he or she is not a researcher, an occupation where warmth, though encouraged, is not vital. Simply being intelligent in theory might increase the positive content of the message, but as every good therapist knows, how a message is conveyed is not of secondary importance.
     While it might seem as if I am bashing theories, allow me to be the first to quash this idea. Theories provide us with important information about what might be going on behind the eyes of a client. They also inform us as to what reaction might be appropriate for the clinician and the client. It must also be said that the basic counseling skills can be learned, and even monitored, by anyone, without the necessary education that therapists undergo. The layman is, of course, capable of reading any text that a budding or expert therapist might, but I would say (hesitantly) that the layman is not able to understand the implications of the text without the same education. This is, to some small degree, what separates the therapist from the natural-born thinker.
     It would be very difficult to measure the ability of trainees in the basic counseling skills. Observers would need to be use, in order to grade trainees in real interactions with clients. Pen-and-paper exams would be useless here. This would further push the impact of professors and instructors in their job as gatekeeper for the field. Were they to observe a student who shows no aptitude in these basic skills, they would need to take action for the sake of their university's program and, more importantly, to keep the bar set high for incoming professional therapists.