Core Rules of Therapy

     I have been thinking about the topic of core rules for therapy for some time. Perhaps better said: I have been thinking about core rules for how I do therapy for some time. There are definitely some principles that I think are at the very center of how I practice. What I hope to do is start an on-going group of entries that will serve to illustrate this idea.

1. Silence. It is my understanding - both viewing my own experience and what I see from others - that clinicians always want to talk. For the beginning therapist, silence is scary, as it might show weakness or perhaps give the client and therapist a chance to think a problem through to an un-therapeutic end. Silence, when done correctly, can increase rapport between parties, because it allows the client to take charge of their own thoughts in an environment that might seem under the control of another party: the therapist. It also give the therapist, possibly, time to think. Some beginning therapists equate silence with incompetence; they end up saying something half thought-out than a thought of real worth. As we are in a profession that holds intent of action in the highest regard, does it not make sense to be able to think properly about a response that is appropriate, rather than electing to engage in a random jump of (il)logic?
2. Not everything is about you. This can be meant in a couple of ways: 1) We can mean that the actions of the client have much less to do with us than we might think and 2) we might mean that we are in service to others in a session - not ourselves. Being myself, both of these sub-topics took some time for me to really internalize (if I even have) and I still need to remind myself of these lessons regularly. Let us go into the meaning behind the words. I will attempt the first hurdle. It is simple to be overreactive and hyper-vigilant in the beginning of our careers. We are attempting, I hope, in this time, to build up a bedrock of skills and techniques that will allow us to forge ourselves into the therapists who we wish to become. This leaves us open and vulnerable to others. As therapists, there are almost no peoples more important in opinion to us as our clients. Were a client to say: "You are a bad therapist," it would crush us. Whether that is a wholly helpful reaction or not is not my goal here. This bedrock that we have created has been cracked, allowing more doubt to leak in that is normal. Am I doing my job well? Is this the correct line of work for me? These are logical questions that we ask ourselves in this situation (well . . . as logical as the reaction as a whole can be). We fall into a classic blunder that we ask our clients not to enter: mind-reading. We attempt to exorcise thoughts from our clients' heads through mind-voodoo - that is, without actually asking. Were we to ask, a good conversation might result about the match between client and therapist or the events that transpired that pushed our client to say such a thing. Allow me to get away from the previous example and posit another: A client and therapist have a good session (in the therapist's estimation). The client does not present at his/her next session. The therapist might go back over the mental notes that he wrote to point to a reason. He might find no reason. Either way, the clinician is allowing an unknown to control his behavior, possibly impeding him from acting in therapeutically advisable  manners to following clients. When the therapist asks the client over the phone about the situation, he learns that the client had a family emergency. A situation that, in reality had nothing to do with the clinician, had everything to do with him in his own mind. This shows real weakness or deficit or [insert non-offensive term here] that that clinician must analyze. The reason: Such a circumstance occurs frequently. The answer: address it, if possible, and if not, let it go. This, of course, comes from time and possibly outside therapy. This writer does want to mention that a pitfall occurs here for some people. I myself flirt with it from time to time, but not much (which will lead nicely into my second sub-topic in a moment). We must ensure that we do not trip into a lack of caring as an overreaction response to the too-much-caring that we previously felt. As previously mentioned in this work, moderation is normally the best option. It is of highest priority, when working with a client, to consider them. When I use the word "consider" here, I mean that we must consider all parts of them, including their words, body language, look that day . . . everything. To really consider someone requires one to see past themselves. I would like to say that I do not mean that the therapist should block himself off, but rather use his or her whole self as an antenna for the use of the client.