Monday, August 23, 2010

Cars and Psychotherapy

Now, some of you who know me will be aware that as a kid I worked in a garage (Yes, it may surprise you but I was almost a mechanic). One of my favourite things to do was to get a broken car in, try to figure out what was wrong with it, repair it or even make it better and better. Sometimes, that involved a re-spray, an engine overhaul, or simply a bit of polish. It was always fun to see a customer collect their motor and to have it in a better state than before. Now that strikes me as a good approach to most things in life.

Given that I trained for many years as a traditional therapist, I spent a lot of time reflecting and thinking about many things and the best ways to work with clients. In Ireland, part of therapy training is that students are required to 'gain insight into their own process' (do therapy as a client) before being allowed to work with real people. Luckily enough they deemed me suitable to be released on the world of clients.

My own therapy, as a student, involved sitting through many hours of 'head nodding' and great empathy from some therapists who clearly believed that the telling of a bad story seemed to create some kind of 'Understanding and Insight', much valued by some therapists. (and indeed, of much value(€$£) to others.. I recall at one point having a really bad therapist who answered her phone mid session and often called me by the wrong name. (Needless to say I decided not to continue with such attention and soul searching!). I had another one who kept telling me all of his problems - so i decided as I was paying him, it was not a good idea to continue. The poor guy had a lot of issues but I am sure he is working them out with his poor (and i mean the word literally) clients.

I often wonder why people feel that if they are talking about a bad situation they are going to feel better. Now compassion and understanding are things I value but wallowing has never made me feel better. If it works for you please let me know and I will add your comments to this article.

Some therapists seem to believe in the great value of exploring the past. And again, this does seem to be of tremendous value (ahem) to the therapist. I often wonder how useful this is for clients. You see, if you take the car thing mentioned above, this could be a bit like bringing your poor old banger to the garage very very often. Now the psycho-analysts would love you to bring the car at least 4 times per week and ask it to make random noises. The appointments would last over many years and the poor old mechanic would have a great insight into why the car didn't work in the first place.

With the work of Carl Rogers, we discovered the 3 Core Conditions of effective therapy (1) Congruence - the therapist being real, (2) Empathy and (3) Unconditional Positive Regard. These things I like and work with all the time, although I do like the challenges suggested by other theories such as Cognitive Behavioural Therapy and the creative wisdom of Gestalt Therapy. I do often wonder though how 'real' the head nodders are in the therapy relationship.

It is funny, we encourage clients to be real and yet don't tend to model a full selection of emotions. How many therapists do you know who would have the guts to be angry with a client? There may be some and I hope there are. I am also priviledged to know a handful of happy therapists.

Now of course, the Rogerian Approach with the car would be to have it call in once a week,over an extended time period; accept it lovingly, regardless of what it had done and give it unconditional positive regard (Nice wheels say I!).

Now this might appear somewhat cynical, and indeed all those years ago in therapy school, they used to give out to me for having a sense of fun. My reports used to comment on how I used my sense of humour 'inappropriately'. Seemingly, these well intentioned people felt that I masked my emotions by laughter. Now laughter is clearly linked to an emotion called fun. It's a kind of emotion I like to feel a lot. Funnily enough!, my clients seemed to get better even as a trainee. Isn't that strange eh? Encouragingly, my placement supervisor liked my approach and was fully supportive of the work I was doing - You see I was getting tangible results, people were getting lives, starting college, gaining work (ok it was a while ago!), finding love and some even got off 'madication'.

[By the way I am not anti madication, i just think it is over-prescribed. For example, my mother was killed in a horrific car crash, in which I was a passenger, About a month after I had a chest infection and went to the Doctor, who asked how I was feeling since my mother's death. (autocue sadness!) Eh I was 16 at the time and promptly broke down in tears. Guess what was offered - a nice little course of drugs and the quote "John, you don't have to feel this way". I declined and shortly afterwards changed doctor].

You see, Over the years I have worked with many clients who also were told they didn't have to feel ......The fact of the matter was that when clients laughed they started to feel better, when asked more about the future, rather than the past they seemed to be able to get an idea of what they wanted. Specifically, what they wanted to do, to know, to feel and to achieve. Now this does not mean that they don't need to tell their story - sometimes they do - and I have noticed that once we witness what they have to say it may be time to help a client move to a better place, naturally and easily.

A few years ago I did some training in Neuro Linguistic Programming, which is basically a series of techniques designed to make people feel better more often. (see www.nlp.ie for more info - I think they brainwashed me to put that link in!). Now this seems to work really well to help clients move forward in life.

Oddly enough I don't believe in a single best way approach to anything, I am trained as an Integrative therapist. That just means that I draw on a number of schools of thought when working with clients. I like to use empathy, humour, challenge and trust to create effective and lasting change with my clients. As I become older and more impatient I like to do shorter term fast work with clients.

Ooops, I can hear the old Humanistic therapists screaming that one should work at the client's pace, and I agree partly. But isn't it more fun to see people getting better faster.

That is the kind of work I like to do and I and my clients enjoy it. Sometimes I am controversial and very direct and usually this elicits laughter. I now get referrals from friends of former clients who frequently comment on how much better X is doing. I giggle and wonder why.

So therapy should really be about making people feel better faster - that's just my view but what would I know - ask my former clients.

As I write this I am aware that my car needs a service - should I go to slow motors limited or just get it sorted?

So in summary, I don't think there is a single best way to do therapy, and I like doing short term work - In the context of the poor car, that does make sense doesn't it?

Please feel free to add to this discussion - any contribution to dialogue can only be a good thing.

6 comments:

  1. Well said John it's always good to know that people get it and Carl Rogers was right...ish unconditional positive regard as long as the client is putting in some effort!...; )
    If they are not then its a whole different story isn't ?....; )

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  2. I love your style because it's real, human and honest. Why when it's so obvious aren't there more therapists like you. Luckily you're there, and outspoken ;-)

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  3. Ah yah, see we just need a few more good therapists. The kind of people who simply ask a client what they want to happen rather than the why stuff. me outspoken - sure I am as quiet as a mouse!

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  4. You are a really skilled therapist and a very wise and understanding person. Truly gifted.

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  5. John I am reading this and other comments on your website at 4am and not in the best place - You have made me grin from ear to ear! It is exactly the fear of the wallowing in the past approach that has kept me from sorting things out for myself for so long. Thank you, I might be brave enough now

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  6. I love the way you interact with your clients, because it's a real approach of humanity and honesty. That's what my London hypnotherapist did on me, and I would say that he really did a big change in my life since I started my hypnotherapy.

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