Tuesday, May 31, 2016


     In my continued attempt to question all things about therapy that I have learned (which is something that I think everyone in their chosen field really should do; such action brings innovation), I will now discuss the topic of compartmentalization - something all, if not most, therapists are told to engage in. The question for this entry is: Is engaging in compartmentalization beneficial to the relationship?
     Budding therapists are told that compartmentalization is key in therapy, as thoughts about one's own life might obstruct the work occurring in the session. Is this true? I'm not entirely convinced one way or the other. As with many such fundamental principles, we must take a look at why the "rule " was at first imposed. I see two ways of looking at this: 1) the Freudian method and 2) the everyman graduate school method. I must preface  this specific talk with the warning that I am not a Freudian analyst nor a ghost mind-reader. Therefore I have not the training or the "skill" to claim what I will do. Nevertheless, I will still engage in such palaver, as this is my work and I'd like to see if/how my thoughts change the future. I'm thinking that Freud thought that any interference from the therapist is/was bad (hence his arcs into counter-transference). He wanted the client to be able to open up in any way they see fit in order to get to their own solution, rather than a solution that the therapist thinks is appropriate. This led to the stereotype of analysts' taciturn natures in therapy. I do give Freud much credit here because he is still one of the main forces behind a clinician looking into his/her own countertransference to engage their deep-seeded motivations. Unfortunately, in our effort to ensure that no countertransference exists, many therapists still do engage in a fear-oriented therapy that is more about them in the end than the client. The other way to look at this problem might be to engage it from a more modern and educational approach: How are current therapists taught (or not) to compartmentalize? I will only speak for myself in this section and what was explained to me in my own Master's-level training. As far as I can remember, we, as aspiring clinicians, were taught that whatever didn't begin in therapy room was to stay outside that room. I'm thinking that this might have been so stressed to future clinicians in order to assure that our own issues do not impede the work being done in session. Otherwise stated: We, as beginners, need to assure that the session is for the client, not for the clinician. This is a good point, but I do wonder how far this mantra should be taken.
     Now that I have explained some of the origins of this idea as I see it, the next step is to figure out what the helpful and the harmful aspects of compartmentalization actually are. Furthermore, who does it help or hinder to engage in such action? As with most "fundamental" issues such as this one, there is some give and take either way. I think that the positives (or helpful factors) in  compartmentalization really do exist more for the young, or budding, therapist than for the elder, more experienced, one.
     It is, to some extent, a learned skill to block out personal issues in life. A therapist must be able to do this while in session - or a therapist must be able to disengage from therapy completely. This is where I think a critical argument one way or the other must be had. The former forces a therapist to cut off pieces of himself - not quite the "genuine person" that Rogers spoke of. On the other hand, to not cut some of it out might lead to the session being more about the clinician than the client. This can be useful if the meta-curriculum of that session is one where such a role reversal provides helpful insight to the client. This, alas, is a more senior technique and one that I'm not ready for yet. To be able to disengage from therapy completely is a luxury that many clinicians do not have, leading, possibly, to burnout or resentments of the job. There is much healing to be done in taking some time off to process such compartments created and figure out whether they are really needed anymore.
     As previously mentioned, I do laud Freud in his idea that researching one's own countertransference is very important. It can make a clinician better at his/her job. I do worry that compartmentalization takes us away from some of our more primal parts, leading to less data from which the therapist might work. I think that there is some merit to allowing some of the walls to drop and to permit the client's message to bounce around in some of the dark corners of the self. Sure, this might bring to the surface some very complex issues for the clinician and it is here that the clinician might start the compartmentalization process - understanding that they need to throw light upon that inner conflict at some other point. To an extent, leaving these compartments up might actually lead to stagnation in the self, in the client, and in the practice in general.
     As mentioned, if a client's pain resonates personally for the clinician, it is his/her job to undergo some kind of supervision or therapy to gain insight into that issue. This leads to personal growth, bringing things that were in the unconscious to the conscious to be played with and changed before allowing it to be re-submerged into the unconscious. We put that thought back in its place to change some of the other issues around it and to achieve wide-spread health. We also put that thought back into the unconscious because we can't hold it in the conscious for very long and doing so provides us with some measure of anxiety, as we add more to our plate than what we might be used to. Putting these barriers up might actually lead to a lack of means to more productive advancement.
     One main reason why a therapist exists is as a sounding board for the client's thoughts. I always visualize this in my mind as a literal board on which clients throw their concerns. It seems to me that compartmentalizing actually decreases the surface area of this board, allowing for more good material to pass a clinician by. As mentioned, we put ourselves out there to feel with the client. In order for this mutual feeling to occur, there must be much to fasten onto, whether that is the lighter or darker parts of ourselves. I think that it is sometimes the darker parts of ourselves that resonate the most with clients. If we don't allow ourselves to be open with clients, then there is really minimal space for the therapeutic relationship to thrive and heal. I can see how a teaching program might push compartmentalization in that, were they to teach the radical openness that I am quasi-advocating for, a fresh student might take the lesson too far and over-share or not temper their sharing with experience or reason (the former of which they have minimal or none).
     This brings me to talk a little about openness in therapy. It seems to me that there is a culture of lack of openness. It could have something to do with the ideas previously mentioned or more cultural/societal fears of liability and judgment that might come of self-disclosure. We must always temper such fears with the assessment of our clients' wellbeing.

Monday, May 16, 2016

Client Responsibilities

     A very good book idea might be one where I outline not the process of therapy, but rather the responsibilities and right of the therapee. Expectations of therapy would be vital. I would talk about stages of therapy, but constantly re-inform the reader  that they must ask their therapist questions. Asking questions to and of the therapist is a client's best tool. It allows a client to shield themselves from counter-transference; it allows a client to gain more understanding of themselves - something crucial in practice; it allows the client to increase their knowledge of the clinician in such a way to increase the bond between these two disparate points.
     I think that a client must be told that his/her self is the most powerful force in the therapeutic alliance. A clinician receives and reflects only; that is, a good clinician receives or reflects with very minimal else. The clinician and the client do work together; the clinician does not do work in spite of the client. This is called psychoeducation and is not true therapy.