J o u r n a l of Religion and Health, Vol. 26, No. 3, Fall 1987
Keeping the Therapist Alive WILLIAM E. COLLINS ABSTRACT: This article focuses on ways in which therapists can m a i n t a i n vitality in their work with people. Becoming more aware of personal dynamics, particularly of the need for control and power, is essential. To r e m a i n open to new theories and approaches avoids the pitfall of professional encapsulation. Experiencing the client as a person not only facilitates empathy but involves therapists in the growth process as well. Developing a tragic awareness of life enables therapists to m a i n t a i n a sense of awe, wonder, and grace toward the h u m a n predicament, thus bringing "depth" or "spirituality" to t h e i r work.
'Tis a n a w k w a r d t h i n g to p l a y w i t h souls, A n d m a t t e r e n o u g h to s a v e o n e ' s own! --Robert Browning
It was a long day at the hospital. The mild, m annered therapist, being overtaxed, overburdened, and underinspired, was busy trying to "fix it" with one client and falling asleep with another. It should have come as no surprise, then, t h a t when one of the clients returned the following week, she brought with her an essay entitled: "Some Days My Therapist Should Pay Me." The therapist, somewhat t aken aback, was nevertheless able to r e m ai n open to what the client was saying about their relationship. As a result, the session was one of the most enlivening they had ever had. I would like to share with you some excerpts from her essay. D e a r T h e r a p i s t , as I t h i n k b a c k o v e r l a s t w e e k ' s s e s s i o n . . , it's too b a d i t all got off to s u c h a p o o r s t a r t . F r o m t h e m o m e n t I w a l k e d t h r o u g h t h a t door (10 m i n u t e s l a t e , I a d m i t ) , I c o u l d t e l l y o u w e r e u p t i g h t , a n x i o u s , w o r r i e d , or s o m e t h i n g . A n d w h e n y o u ' r e l i k e t h a t , y o u t e n d to r a c e a h e a d of m e . . . . A n d s o m e t i m e s , it e v e n feels l i k e y o u r a c e over me. A n d e v e n t h o u g h I d o n ' t m e a n t o . . . I r e a c t b y bec o m i n g s i l e n t . I c a n n o t m o v e . I c a n n o t s p e a k . I o n l y sit a n d w a t c h y o u r w o r d s raci n g o v e r me. T h e n I feel as t h o u g h I ' m b e i n g b a c k e d i n t o a c o r n e r . A n d s i n c e t h e r e is n o es-
The Reverend William E. Collins, M.Div., is Mental Health Chaplain at Harding Hospital in Worthington, Ohio. He is also editor of The Harding Journal of Religion and Psychiatry. 206
~ 1987 Institutes of Religion and Health
William E. Collins
cape, my a l t e r n a t i v e is silence. My protection a g a i n s t anyone who is forcing me to do a n y t h i n g . . , whether it be to listen, laugh, cry, shout, be a n g r y or even feel l o v e d . . , is silence. You ask me what characteristics I look for in relationships. Well, I t h i n k I've fin a l l y found one: someone who can be silent with me. Not the wall kind of silence. The bridge kind of silence. Someone who I can be with, and never say a word to, and they are not offended by i t - - s o m e o n e who doesn't automatically assume I'm holding something back or hiding something. Sometimes, there is just n o t h i n g to say. Sometimes there are no words to match my feelings. Or answers to questions. Sometimes. I just need to know t h a t if I'd sit here for 30 m i n u t e s and never say a word (and I haven't), you wouldn't be mad at me and t h i n k I was b u i l d i n g a wall. S o m e t i m e s . . . I don't need a therapist as much as I j u s t need to know I have a friend who u n d e r s t a n d s my silence. You've also asked me who I am. Who is Jennifer? Well . . . one t h i n g about J e n n i f e r is she's slow. I'm not a terribly fluent person about my feelings. But is t h a t so bad? My words are measured most days. And I try not to waste energy on useless conversation. I don't w a n t to j u s t talk about "fried eggs." I'd r a t h e r not say a n y t h i n g at all some days. J u s t give me a c h a n c e - - a silent c h a n c e - - t o talk about what's real to me; what's i m p o r t a n t and vital. Some days I walk into your office and you treat me like Jennifer. And those days are great! Because someone out there is connected with m e . . . and really helped me see who I am. But some days, I'm just a n o t h e r client with a history, a problem, a diagnosis. At those times I can feel how detached you are from our relationship. That's hard on me. I'm sorry, b u t it makes me feel like we are strangers, without a past. A n d I could find a lot of strangers to talk to, but it's a friend I'm looking for. I g u e s s . . , after all t h i s . . . I'm left with several questions. Maybe you can answer them. Do you see a difference between a "wall" kind of silence and a "bridge" kind of silence? Have you experienced either of them? How do you m e a s u r e the success of a counseling session? By the a m o u n t of talking done, or by how much better the client appears to act and feel? Is the therapist the only one who can have a n objective viewpoint in the courtseling situation? Or can the client separate herself enough from the session to know whether or not she's working hard enough at it, and growing? Can a therapist be a therapist and a friend at the same time? Or should t h a t be a consideration a t all? Maybe these questions should be your a s s i g n m e n t for next session . . . . Oh, I see by my watch t h a t our time is up . . . . See you next week. F o r t u n a t e l y for t h i s t h e r a p i s t t h e c l i e n t ' s e s s a y w a s j u s t w h a t w a s n e e d e d to g e t s o m e h e r e to fore v a g u e i s s u e s a b o u t c o m m u n i c a t i o n , r e l a t i o n s h i p s , etc., etc., etc., o u t i n t o t h e o p e n so t h e y c o u l d b e " d e a l t w i t h . " B u t t h e c l i e n t ' s e s s a y d i d f a r m o r e t h a n t h a t . I t h a d t h e p o t e n t i a l to m a k e a n i m p a c t o n t h e t h e r a p i s t a s welt. I t b r o u g h t t h e t h e r a p i s t ' s o w n b e i n g i n t o m u t u a l a w a r e n e s s a n d b e c a m e a s o u r c e of s e l f - d i s c o v e r y a n d g r o w t h . I t e x p o s e d s o m e of t h e t h e r a p i s t ' s
Journal of Religion and Health
deadening attitudes and dynamics t hat so often get in the way of therapy and p r ev en t it from "staying alive." And that's what I would like to e x p l o r e - - h o w to stay alive both personally and professionally. First let us do some background work. C. Gilbert Wren rightly observes t h a t while the professional education of a therapist often focuses heavily upon client issues and all the facets of the therapeutic process, what is frequently overlooked or given scant attention is the person and individuality of the therapist. Yet, who the therapist is as a person influences what goes either right or wrong in t h e r a p y relationships and outcomes. The therapist is his or her own most sensitive instrument, most powerful tool, says Wren. 1 But if the therapist is unacquainted with himself or herself, and is unaw are of how to use himself or herself, then t hat "most powerful tool" is likely to become a "most dangerous weapon." For instance, Rollo May maintains t hat m a n y individuals who choose a career in the helping professions are often unaw are of their own needs for power and control. Indeed, May says, we play "ostrich" to the "tragic, demonic aspects of power. ''~ May concludes t h a t the type of individual attracted to a career as a therapist is in danger of repressing his or her own power needs, and consequently these repressed needs t he n have room to come out in the therapist's tendency to control other people in therapy, or in the mystical power of"laboratory techniques and machines." In candidates wanting to be trained as therapists, May often sees "the p a t t e r n of the isolated person who wants a relationship and gets attracted into doing t h e r a p y because it gives a simulated relationship. ':~ Such an artificial intimacy may cause the therapist to feel less isolated. But t h e r a p y then becomes a "captive love affair or friendship," May says, "which is of course no love or friendship at all, and a failure of t herapy to the e x t e n t th at it is captive. TM This means if we dare do t h e r a p y with people we had better be aware of our own internal process, drives, needs, and styles of relating to others. Unless we have dealt with our own issues, we may be tempted to focus on our own u n m e t needs r a t h e r t h a n the needs of the client. When this happens, therapy is not alive and productive for anyone. So the first step in staying alive is to "know thyself," as Socrates said, and to "use th y s elf wisely" as an agent of healing. The second t hi ng we must do to stay alive as therapists is to be o p e n - - b e open to new ideas perceptions, attitudes, theories and techniques, philosophical approaches, and what have you. We have all learned m any valuable things in our training, but we hope we can remain open and keep growing. The enemy of openness is encapsulation. E n c a p s u l a t i o n - - a s Johnson and V e s t e r m a r k have defined i t - - m e a n s we surround ourselves with a protective Cover of beliefs, values, attitudes and concepts t h a t keep intact our security,
William E. Collins
t h a t protect us from the necessity to change, t h a t encourage rigidity, and interfere with seeing people and things as they really are2 For example, to follow only what is valued by our profession, our social class, or a favorite school of thought is encapsulation. "To long for 'the good old days' is encapsulation. To live by 'old s a w s ' . . , is encapsulation. To associate [ourselves] always with the 'pretty side of town' because a n y t h i n g else is uncomf o r t a b l e - - t h i s is encapsulation. ''~ Johnson and Vestermark conclude t h a t tunnel vision, ivory-towerism, dogmatism, egocentrism, prejudice--and, I might add, t u r f i s m - - a l l involve encapsulation. And when we cling to these attitudes, we are no longer alive, or at least as alive as we could be. Encapsulation not only affects the therapist, it also prevents t r e a t m e n t from being more effective. Encapsulated therapists don't care much for new, fresh approaches toward treatment, and are in danger of becoming stale, stagnant, and uninspired in their work. Psychologist Bernie Zilbergeld observes: Few are the insight-oriented therapists who treat phobias with behavioral methods, although the behavioral approach has repeatedly demonstrated its effectiveness. Few are the therapists partial to individual therapy who will treat a marriage problem by seeing the couple together, despite evidence that seeing the partners separately reduces the effectiveness of treatment and increases the possibility of harming the relationship/ The t h i r d thing we need to do as therapists is to see the individual sitting in t h a t chair as a p e r s o n and not simply as a client. The story is told about a conversation Carl Rogers once had with the Jewish philosopher, Martin Buber. Rogers contended t h a t his brand of therapy was a true "I-Thou" relationship. Buber sat silently for a moment, and after seemingly much reflection, said, "The moment you become the therapist you have destroyed the possibility of an I-Thou relationship." In m a n y ways, I think Buber is correct. By its very nature, therapy prevents the relationship of equals. The client looks up to the therapist as being allknowing or extremely wise--perhaps even clairvoyant, capable of reading the mind of others. Such myths die hard with m a n y people who seek therapy, and perhaps even with some therapists themselves. And yet, there is a way by which an I-Thou relationship can be approached appropriately and t h e r a p e u t i c a l l y - - a way t h a t is enlivening to both client and therapist. The therapists who seem most alive to m e - - a n d who come closest to establishing an I-Thou relationship with their clients are those who practice the skill of empathy. It is through empathic awareness t h a t they stay in touch with the personhood of their clients. E m p a t h y means we do not separate ourselves from the feelings of another, but we experience the "felt-sense" of the person sitting opposite us. To do this runs the risk t h a t we might get h u r t in
Journal of Religion and Health
the process, t ha t our place of security might be threatened, or worse yet, t hat we might come face to face with something within us t hat needs transformation. E m p a t h y is a merging process in which both the therapist and client are being changed. Carl J u n g puts it this way: "The meeting of two personalities is like the contact of two chemical substances; if there is any reaction, both are transformed. ''~ We all believe the therapist should have influence on the client in tr eatm ent , but this influence only happens when the therapist, too, is transformed. Being in touch with the personhood of the client not only enables empathy but also involves the therapist in the process of change and growth. During his interviews with families, Carl W hi t a ke r tells t hem he wants something out of the session for himself. Some would react with surprise and shock at such a seemingly self-interested attitude. And yet, no one can stay alive doing therapy all day with people unless he or she is also learning, experiencing, growing. One way I find myself growing is when I am faced with a client's near impossibility to change. At times like t h a t I am often overwhelmed not so much by despair but by what Wayne Oates calls the tragic sense of l i f e - - t h a t poignant wistfulness of the professional person, who, after having done everything possible, is faced with a t r e a t m e n t failure, or perhaps the suicide of a client. Instead of bringing forth guilt or despair, sensing the tragic in life produces a "glorified sadness" t h a t is often inspiring and soul-searching. As Stanislaus Breton once said, "Glorified sadness can be linked to the greatest joy," a joy which keeps us humble, aware of our h u m a n limits, open to the unknown and unknowable, the m y s t e r y of life. This causes us to experience more grace and empathic hum or toward ourselves, our families, and those we work for and with. And where there is grace and empathic humor there is hope, meaning and life. And this brings me to my fourth and final point: To stay alive as therapists we mu s t have depth. To have depth means we do not limit our perspective to only horizontal values, but we are in touch with and sensitive to those vertical values within ourselves and those we seek to help. Horizontal values are necessary to get us t hr ough life, but vertical values (sometimes called religious or philosophical values) give life depth, breadth and meaning. Focusing exclusively on horizontal values (like making a living or keeping up with the Jones') can leave us existentially and spiritually bankrupt. We know what we "should" or "ought" to do, but we ask, "What's it all about anyway?" C.G. Kemp points out t h a t if all we do is to assume our task is to help people fit more comfortably into the scheme of things, to get along in their family system, to do well in t hei r jobs, etc., we are only helping t hem to be more adequate in superficial living. 9 I reflect Kemp's questionings when I ask: Is this all the client has a right to
William E. Collins
expect? Where is he or she going to learn the deeper meanings of life? How does he or she learn about trust, values, integrity, and responsibility? Who is going to help with the questions concerning the meaning of life? Some therapists turn this over to the clergy, and perhaps in m a n y cases t h a t is appropriate. But should not the therapist be a reliable resource in this realm too? 1~ After all, whether we realize it or not, therapists are the "secular priests" of today's society. H I believe t h a t m a n y people who are in trouble emotionally are also in trouble spiritually. I am not necessarily talking about religion here. Spirituality is a much broader concept than religion. Religion is a sense of systematized belief. It is the ritual of a particular faith community. Spirituality involves more t h a n t h a t - - i t involves our sense of purpose, motivation, and meaning. It has to do with our p e r s o n a l perception of a higher power, our individual destiny, and our value and worth as persons. Muriel Carter sees spirituality as having to do with the fullness of life as opposed to emptiness, deadness, or mere routine. 12 Most of all it has to do with t r u s t - - t r u s t in ourselves, others, and God. It has to do with our "experience of and relationship to birth and death, work, leisure, sexuality, love and the possibility of marriage and community," thus embracing all of life. 13 One of the ways I explore the spiritual depths with people is through metaphor. Using metaphor is the "right-brained" side of t h e r a p y - - a practice which can bring much energy and "life" to therapeutic encounters. As August Lagem a n suggests, "The vocation of the therapist is to discover the metaphors t h a t enhance h u m a n transformation. ''~4 I would a g r e e - - t h i s is what Jesus did in the telling of parables. ! would also agree with Lageman's observation t h a t metaphors have both a negative and positive impact: they can help persons see where they are stuck and help them transcend their situation by giving t h e m a direction in which to g r o w . ~ Metaphors can present a striking tableau of our life situation. Because metaphors convey an intensity of truth, they are capable of breaking through our defense mechanisms. They capture a deeper reality t h a n our intellectualizing can defend against. Such use of metaphor often brings depth, insight, and conviction to the counseling process, and also promotes spiritual discovery and breakthrough. A good biblical example of the therapeutic use of metaphor to provoke insight and change is found in 2 Samuel 12:5-14. Nathan's intervention with King David is effective because the prophet uses the touching story of "the little ewe lamb" to get his point across. This s t o r y - - b e i n g a powerful metaphor of David's own life situation--pierces to the very depth of his being. So I hope we will seek depth in our work as therapists. Taking some metaphors from Kemp, TM I hope we will not be content only to move around in the "shoals and shallows of life," but t h a t we will occasionally "set sail and push out to sea." With anticipation, I hope we can "drop our lines into the depths," and maybe find t h a t far down beneath the surface there is a f o u n d a t i o n - - a ba-
Journal of Religion and Health
sis of trust, v a l u e a n d b e l o n g i n g in the u n i v e r s e - - t h a t is not only dependable b u t gives m e a n i n g a n d perspective to each of our "voyages into the unknown."" I will close w i t h a few more m e t a p h o r s - - b o r r o w e d a n d a d a p t e d from a friend of m i n e ' S - - t h a t I hope will be both a challenge a n d a charge: Go into the world, and in your going Overcome the evil within you with the love that God has given of which you are afraid. Be strong in your vulnerability which heals others. Feel the hurts around you and anoint these with the oil of your grace. Oppose distrust and its cosmetic smiles with truth and competence. Beware of the pitfalls of professionalism in the tinsel of apathy and in the cellophane of encapsulation. Flee the edges of extremes and rest in the meadows of authenticity. Be not ashamed to taste the salt from your own tears. In the loneliness ofmutuality, capture silent promises shared Be aware of your caring, which caresses, upholds, challenges, provokes, encourages --slips away. 9
through and with your humanness to the beauty of your completion.
William E. Collins
Fall into the silences of love, linger there, and be transfigured. Rise up, even when you are weary, and reach out to the stranger, who so often is a j u d g e m e n t upon us. But do not forget to rest a n d r e j u v i n a t e your own soul. 9
the nonsense w i t h i n you, for you will need its relief.
With abandon, risk your life for those who come and who keep coming in i n c o n v e n i e n t ways. Most importantly, seek not a benediction from God, b u t be u n t o H i m a benediction.
1. Wren, C.G., "Editor's Introduction." In Johnson, D.E. and Vestermark, M.J., Barriers and Hazards in Counseling, Boston, Houghton Mifflin Co., 1970, p. vi. 2. May, R., Psychology and the H u m a n Dilemma. Princeton, N.J., D. Van Nostrand Co., 1967, p. 205. 3. Ibid. p. 206. 4. Ibid.
5. Johnson and Vestermark, op. cir. p. 34. 34. 6. Ibid., p. 35. 7. Zilbergeld, B., "Psychabuse," Science 86, June 1986, 52. 8. Jung, C.G., Modern Man in Search of a Soul. New York, Harcourt, Brace & Co., 1933, p. 57. 9. Kemp, C.G., Intangibles in Counseling. Boston, Houghton Mifflin Co., 1967, p. 127. 10. Ibid. 11. Lowe, C. M., Value Orientations in Counseling and Psychotherapy. Cranston, R.I., Carroll Press, 1976, pp. 16ft. 12. Carter, M. M., "Spiritual and Religious Needs of Mentally Retarded Persons," J. Pastoral Care, June 1984, 38, 2, 146. 13. Ibid. 14. Lageman, A. G., "Myths, Metaphors and Mentors," J. Religion and Health, 1986, 25, 1, 60. 15. Ibid. 16. Kemp, op. cit. p. 130. 17. Ibid. 18. MacDonald, C. B., adapted from "Benediction," unpublished manuscript, May 28, 1978.