Psychotherapy and the grateful client: failure and success in psychotherapy

Sometimes I feel like Jerry Garcia. The Grateful Dead frontman used to question himself in an enviable way. The rock group that was the best-selling live act of the 1980s, making groundbreaking music for 30 years, was treated like a religion by their ardent fans, and supported and provided a livelihood for hundreds of people: band members and their families, road crews, administrative staff, tour managers, merchandising staff, sound and construction engineers, and transportation and others it was headed by García and possibly without him (and this became evident after his death in 1995) it was finished. However, Garcia felt brave enough to ask, “Is death a good thing?” Some feel that he felt unable to disband the corpus of the Dead organization on the basis of abandoning consciousness of him by serving such a large community, which depended on him and the gang for its livelihood.

Now, back to the analogy: many times I have questioned and re-questioned therapy and its stated and implied goals, essentially asking myself if it works and, imitating Garcia, asking “Is therapy a good thing?” Of course I’m not the only one who does.

From Crocodile Dundee, who spoke with the voice of the common man when he commented about someone seeking advice “What, you don’t have a partner?” to the renowned rebellious Jungian analyst James Hillman, co-author of the book “We’ve Had a Hundred Years of Psychotherapy and the World Is Getting Worse,” psychotherapy has had many detractors.

The criticisms are legion, well known and well phrased: Can people really change? Don’t therapists just try to make their patients/clients think and feel like them? They only want your money. What do they know anyway?

In one of the first studies, Hans Eysenck concluded that two-thirds of psychotherapy patients/clients improved or recovered on their own, whether or not they received psychotherapy.

Indeed, the history of psychotherapy is wrought with suspect examples of so-called cures. From the acclaimed “treatment success” of Anna O by Sigmund Freud, about which Jung declared “nothing of the sort” (she was admitted after possibly being misdiagnosed in analysis) to the modern account of Paris and Donovan verbal and emotional. abuse of power at the hands of an abusive therapist (see Richard Zwolinski’s book Therapy Revolution), the reasons for doubting or at least mistrusting therapy seem to make sense.

Let’s go back to Jerry Garcia’s question about the Dead. To paraphrase: “Is therapy a good thing?”

As a therapist, I am naturally biased. But I am also by nature curious and integral. I really don’t want to waste my time on a quest that doesn’t have a positive effect, that I can’t pursue in good conscience, that is fundamentally flawed in its focus and effectiveness.

Sometimes therapy doesn’t work, or doesn’t seem to work. But this is a difficult subject, difficult to measure and to track and evaluate. I remember a guy in a personal growth group with whom I had an incident where we ‘fought’ and he left the group. A failure? A few months later he wrote to me to express his gratitude. In the intervening time, he realized that he had transferred (originally a psychoanalytic term meaning to redirect feelings to another person) his father complex onto me. The incident in the workshop had unlocked all sorts of useful internal material, which he had addressed in individual psychotherapy and transcended, resulting in profound healing for him. So was this a flop that turned into a hit?

But other times it doesn’t really work and mistakes are made. I remember a client who ironically became the focus of my supervision sessions. My supervisor, an analyst with extensive therapeutic experience, encouraged me to choose one of my clients and focus on him each week. The idea was that receiving intense supervision on a single therapy client would have an effect on my overall practice.

However, the result was that I, as a young, ambitious and aspiring therapist, became too focused on this client. I became overly concerned with him as supervision deepened my involvement in his life. One day he showed up in my office looking awful and I asked him what had happened. He explained that he was testing a new drug, not yet fully safe or proven, for an allergy he suffered from. He was outraged, not so much with him, as with the medical authorities that allowed such a practice. The medication was clearly not doing him any good. I told him, to my lasting regret, to stop taking the medication. He left the room. He had entered directly into the transference of his parents, who always told him what he should do and denied him the right and ability to choose in matters related to his own life. After a final invective session, he left and I never saw him again.

Of course, we have no way of knowing whether or not this client had any insight or clarity, like the previous one who transferred me to his father, and therefore benefited in the long run from my excessive care. Also, we have no way of knowing whether the client who had subsequently benefited took a long-term negative turn to their detriment.

And the grateful client? Perhaps people who have been in therapy shut it up today when the stigma of seeking help has been reinstated in direct contrast to the self-proclaimed and shared glory of the 1970s in personal and collective awareness. But my walls have been covered and overlaid with cards containing euphoric proclamations of gratitude over the years. Nowadays, emails tend to replace cards, of course. But recently, when I was putting together my website and my web designer was dealing with the weight of testimonials, we made a joint executive decision to minimize and use a select few so as not to appear too “full of ourselves.” And this despite the fact that, in general, the majority of clients who are therapeutically successful most likely do not write or e-mail their therapists.

My point is not to show what a good therapist I am, but rather that therapy works and when it does, not necessarily the beneficiary or grateful client will be screaming from the rooftops.

Having said this, we must be painfully aware that not all therapists are good. It is beyond the scope of this article to go into what we should or can do about it when inadequate short-term training produces therapists and healers of many descriptions and the general public is totally ill-equipped to distinguish between them and a multiple variety. qualified, effective and talented practitioner. The new requirement of a university degree as a prerequisite for training in psychotherapy is not likely to inspire greater confidence in the user of therapy services either. Most therapists are aware that untrained therapists can be fully capable and often of higher quality than trained ones; such is the nature of the work that compassion, wisdom and insight, possibly essential, are probably impossible to teach.

My conviction has been in my continued objections and criticisms of the field of psychotherapy. I have maintained a surgical approach to useless and shady theories, approaches and methodologies that I felt were suspect. Fortunately, I have become so extensive in the area of ​​therapeutic endeavor that, as the years have passed, through writing (there is no better way to expose unclear thinking) and practicing therapy with individuals, couples, groups and communities, I shaped my direct life. experience in an understanding that encompasses a philosophy and psychology of how therapy works and I have summarized these as the three stages of awakening.

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