Wednesday, August 24, 2016

Honesty and the Therapeutic Alliance

     I believe that I have written before on the subject of therapeutic relationship and its central nature in any therapeutic endeavor. Today, I am going to write about the crossover between therapeutic alliance and honesty.
     Honesty in therapy is, I think, a different topic. When I write about it, I am not necessarily writing about bluntness. Instead, I would rather discuss the use of honesty and its use/misuses right now. Honesty, I think, comes up very much when a clinician is asked questions. We are told/educated to be wary of questions. I don't disagree that some caution should be shown; I guess my main problem here is when you have an honest response, but it might be detrimental to therapy. Frequently, instead of answering the question, we choose to process it to hell and hope that the client forgets that he'she has a question. Heinz Kohut remarked at one point in his life that it is impolite not to answer a question.
     Not answering a question can inhibit a relationship because it can lead to an assumption of dishonesty, backfiring the processing response. Answering a question, even after some processing, can lead to a negative response, as well. A clinician does have to be careful, but to lie shows infidelity, to some degree, to the client. Processing out the reaction after the answer can very much strengthen the relationship.
     I guess one of the main things that I am trying to say here is that there is a direct relationship between honesty and the relationship. When one is strengthened (relationship), the other can grow. At the same time, the more one is honest, the stronger the relationship  may grow. There is a balancing act that takes place here . . . one that is very essential to future work. If one is too honest (or blunt, I guess) too soon, he risks, in a real way, the suffering of the relationship. I guess that this is the clinical implication of bluntness. This might happen when a therapist is burnt out or when their empathy, for whatever reason, is low during a session. The phrase that pops up in my own head some days is: "Well, let me tell you what is going on here." This is the language of interpretation. The difficulty with this is knowing when not to "give the truth." We must, obviously, be as intelligent as possible about when we us such means.
     As previously mentioned, a counselor must be honest with his or her client, especially when answering questions. Malingering must be remembered as things that take away from the amount of data processing space between the two members. If an honest answer leads to some problem, as mentioned, it is appropriate to process the disconnect. It is very important here to remember that apologizing should only be used when a real misdemeanor has been committed. It should not be the go-to response. What does frequent apologizing  do but attempt to push the relationship backwards in time with the unsaid understanding that that is bullshit. An apology, or a string of them, can only function as a weak "coping mechanism" for the relationship. Apologies aside, processing out the issue forward the meta-curriculum of honesty for the relationship. I have already been in situations where I have committed some unknown social slight, which led to a good lesson for me about cultural matters. Such a lesson could not have been learned without process willingness