Thursday, August 19, 2010

Therapeutic Distance


I've been in and out of therapy for a good part of my life, in an attempt to "work through" my own issues or those of my immediate family (birth and adult-made ones). My mom is a psychotherapist and I'm also trained as a social worker--a community organizer as opposed to clinical work--so, I've been sensitive to the roles of both therapist and patient.

A difficult marriage and a poor employment history since getting married prompted me to enter individual therapy again.  It was in addition to couple’s therapy which began shortly after the wedding. Recently, the issues surrounding the survivability of the marriage have brought both components to a head.

My wife [W] has been adamant in desiring access to my individual therapist. I have long resisted this demand--despite her [W] argument that she's paying part of the costs--with the consent of my therapist. It's his position that he's my advocate alone.

By extension, I have kept her individual therapy and therapist at arms length. When she decided to switch people, I allowed her to do as she wished (though frankly, I don't believe the "lack of progress" was a result of the therapist's approach as much as the desire of the patient to seriously and consciously confront the deeper [as opposed to surface/superficial/immediate] issues of her life). She has expressed satisfaction with the switch, though I continue to believe the same issues are unresolved and present.

I had the "opportunity" to meet her new person when he was invited and came to the last two couple therapy sessions. W demanded that we switch to a new person who would conduct a short-term therapy cycle (instead of the on-going relationship with the immediately previous person). In an effort to jump start the process and determine the total agenda as well as attempt to bring all the different players into one room, all the therapists to our couple’s therapy. At the first of the two joint sessions, my person was unavailable due to another work commitment and was on vacation for the second session. W's person came to both.

Frankly, I really didn't care whether he came or not. My issues were with W and the (new) therapist and his presence was generally unremarkable.

That said, I found his behavior and approach to be extremely problematic. Rather than maintaining a professional distance; providing critical feedback to his patient's behavior (both in the couple therapy session as well as what happened during their individual sessions), I found him to be like a cheerleader and "lawyer"/advocate for W. Rather than seeking to use his perspective to assist W to seek accommodation with me and my needs, he appeared to uncritically promote the status quo.

I was really unimpressed with his style and approach.

What am I looking for? I look for someone who will confront me with inconsistencies, to catalyze my own ability to reflect on my behavior and change/adjust my behavior(s). In other words, I remain responsible for my own behavior but the therapist helps me to clarify my thinking and prods me to make the needed changes to reach my stated goals. I want to be gently challenged, forced to think through my issues and how I respond to challenges to my ego and impulses. To merely allow me to continue on my self-delusional path is reckless and negligent therapeutic behavior.

To do this, the therapist needs to maintain enough distance to avoid getting caught up in my 'fantasy world' and cut through my fog machine, but at the same time be close enough to have my trust to bring me to a/the place where I can cut through the smog on my own.

(As I reflect on the above, I look to a therapist much in the same way I look to a teacher. As someone to help me acquire the tools to deal with future challenges, be in the deeply personal/psychological arena or the academic world.)