By: Suzanne Maiden
What is your therapist really thinking during the therapeutic hour? A lot. I can only speak for myself and what thoughts run a marathon through my head. So fasten your seat belt, here we go.
First, I assess the obvious physical/emotional presentation of my client. For example, are they within normal limits of height and weight, are they appropriately dressed for the weather and situation, do they have any uncontrolled tics, does their body posture match what they verbalize? Do they fidget, are they tangential in their speech, are they emotionally labile (crying one moment then hysterically laughing the next), and how comfortable are they in their own skin and in my office? Of course, I always must assess for signs of substance abuse and suicidal/homicidal ideation.
Second, I intently track their words. What my client is not saying is often so much more meaningful than what words pass their lips. I look for incongruent body posture with their words. What does that look like from where I sit? Well, when a client cannot hold my gaze, or they clench their jaw, or uncontrollably shake their foot back and forth, something is amiss. I do not play games as a therapist. I never intentionally trap or trick my client. When I observe incongruent posturing, I name it. I share with them my observation and plainly ask “What’s up….? I notice you say thus and such, but your body language suggests something else.” Oftentimes, they will smile, and admit that indeed something else is emotionally at work with them.
Third, I assess their defenses – that is, how do they protect themselves from painful stimuli and events? Some clients take a very aggressive stance and are trigger ready to fight, some emotionally withdraw and retreat, and some (but not most or they wouldn’t be sitting in my office) attempt to resolve conflict with an even keeled approach.
Fourth, if other family members are present (as a Family Therapist, this is often the case) I need to simultaneously track each person. And, I need to assess what inter-family dynamics exist between each member. It’s very exciting, but draining as a therapist. It’s like watching several toddlers in a big swimming pool and making sure none drown.
Fifth, as a therapist, I grow to love my clients. I mean I really, really, love my clients with such a tenderness I get chills thinking about it. No matter how kooky (that should be a clinical term), no matter how warped, no matter how ill they may be – I love them. I realize their inner turmoil and current level of functioning is a direct result of their woundedness. As C.G. Jung asked, “How is the symptom serving the soul?” He meant how are people’s neurosis their method of ‘fixing’ what’s broken. It may appear dysfuntional by others’ standards, but to know all is to understand all. It all makes sense if you discard logic.
I get the honor of sitting with them as they process their deepest woundings. I get the privilege of hearing their deepest secrets. I am often the first person with whom they share their most inner world. How could I not be touched by that?
The phrase that speaks to this so well, is Carl Rogers’ concept of ‘Unconditional Positive Regard’ for the client. I resonate with the Rogerian approach. I see my clients psychological warts and wrinkles, and they are still beautiful to me. This is what I think as a therapist. This is my therapeutic stance. Because no matter how brilliant my interpretations and predictions are, if my client does not experience a therapeutic lovingness from me, they will not permanently heal to their fullest capacity.