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A collaborative process.
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When I go to a party and someone finds out I'm a therapist, it's not unusual to see them roll
their eyes and ask in an uneasy tone, "So...I bet you're analyzing me the whole time we're talking, aren't you?"
It's easy to blame therapy's bad public image on movies like "Analyze This" or on the evils of the managed-care system.
But part of the problem is in therapy itself, and in particular the prevailing medical model for treatment.
For the most part therapists are trained to think in terms of "mental health," "diagnosis," and "pathology," an orientation
that does a kind of violence to the human soul.
Paradoxically, most people start therapy because they are hoping for a change, but most of us are also afraid to change.
We are used to our usual ways of going about things. In fact, we've learned to do things the way we do for very good reasons.
(The problem is that, although our usual ways may have helped us in the past, in the present they are getting in the way of
the life we long for.) As the therapeutic work progresses and people naturally find it difficult to change their life patterns,
therapists who think according to the medical model tend to talk in terms of the patient's "defenses" and "resistance" and
see their job as breaking through these as quickly as possible.
Happily, you can find therapists with a very different approach to people and the therapeutic process. You can't always
identify them by the letters after their names (some are even M.D.'s), but as you sit in the session you are likely to sense
a respect and empathy for you as a whole person. The therapist's focus on listening to rather than labeling the client and
her or his struggles has an enormous impact on the quality of the therapeutic experience, as Jean Baker Miller and Irene Pierce
Stiver of the Stone Center point out in the following excerpt from The Healing Connection.
"Probably a patient's greatest fear in therapy is the fear of changing, of giving up those ways of feeling and acting
that, although not really helpful, seemed to promise some power, some strength.
In other words, it can be terribly difficult to give up one's strategies for staying out of authentic connection
because they are in some sense adaptive -- that is, they arise when the only relationships that are available are in some
fundamental way disconnecting or even destructive: at some point in a person's history there was good reason to develop these
strategies.
Instead of labeling such behaviors in therapy as resistance, we think of them as lifesaving -- or mind-saving -- strategies
that people have developed for a reason. Sometimes patients are saying, in effect, "No, I won't engage with you because that
means I have to turn into what you want me to be, and if I did that I would lose myself." This stance most likely evolved
as a survival maneuver. It is a strategy that makes it difficult to form a relationship in therapy, but it deserves the therapist's
respect and attention....
This is important because these strategies are usually the parts of therapy that make the most trouble; they can
be very frustrating for the therapist. They are the parts that make many people seem most off-putting or angry-making. They
are the parts that lead therapists to put pejorative diagnostic labels on people, calling them narcissistic personalities,
borderline personalities, and the like, or describing them as "manipulative," "entitled," "hysterical," and so on. This kind
of labeling allows the therapist to stay out of connection and does the patient a great deal of harm."
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Last updated on
N.Y. Licensed Psychoanalyst
Certified, National Association for the Advancement of Psychoanalysis
Member, American Association of Pastoral Counselors
Individuals, Couples, Parent
coaching
Westchester County and New York City
914-941-6478
212-802-7333
Serving the online community as well as midtown Manhattan, 10016, 10022, 10017, Westchester Putnam Dutchess
and Fairfield counties, including Ossining Briarcliff Manor Croton-on-Hudson Yorktown Heights Sleepy Hollow Tarrytown Pleasantville
Pocantico Hills Chappaqua Millwood Mount Kisco Somers Katonah Mahopac Irvington Hastings-on-Hudson Yonkers and Valhalla.
Individual therapy, spiritual counseling, couples counseling, and parent coaching, as well as premarital
counseling and help with divorce, relationships and communication.
Copyright © 2005 Jean Fitzpatrick. All rights reserved.
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