“I feel completely useless to him. I feel like I could fall into a coma mid-session, and he wouldn’t even notice. He’d just keep jabbering away.”
I had initially found Tony’s volubility refreshing. Unlike those one-word-answer clients with whom I was struggling to connect, he would answer each question with enough detail to obviate my follow-up questions. Everything about him seemed expressive, even his thick, shape-shifting mop of black hair seeming to change each session as though reflecting his current mood.
Week after week, month after month, he shared his story, telling me about the father who had always seemed intent to one-up him and the mother who would drunkenly come into his room at night and, through tears, complain about her marriage. I started to see how he replicated these childhood conditions in his romantic pursuits, choosing self-involved and emotionally unavailable partners.
Some weeks, his hair spikier than normal, he would describe the wonderful weekend he’d had with his girlfriend—going rock-climbing, going to fancy restaurants—and wonder if she might be the one. Other weeks, his hair noticeably droopier, he would recount with tears in his eyes how she hadn’t once over the past week shown any interest in him. “It might seem like I’m playing a game, but I’m just trying to gather information. Every night last week, I asked about her day, and I’d listen and ask more questions as she went on and on about her horrible coworkers. All the while I’m waiting for something, for anything, for just one question, one piece of evidence that she’s interested in me.”
When Tony would say that he was going to start looking at engagement rings, I would feel my muscles tense and tell myself to keep my opinion to myself. When he would describe yet another way she had mistreated him—“She gets jealous if I’m on the phone with my sister too long, but like every day she’s texting her old boyfriend”—I would ask what he wanted in this relationship and what he believed he deserved. I would sometimes try to explore the similarities between his girlfriend and his parents, but he never seemed interested in that inquiry.
I initially felt such a strong connection with him, I was now telling Ari, but then something seemed to change. It now felt like it didn’t matter if I was even there, like it wouldn’t make any difference if he spent the hour talking to my plant. He would just go on and on without even pausing. If I wanted to ask a question or share an observation, I would have to interrupt him.
Ari asked some questions and then fell silent. Ari does not have expressive hair, but I’ve noticed that sometimes his brow will reveal his emotional state, and just then his forehead lines deepened. “It sounds like you’re doing good work with him,” he finally said. But I wasn’t doing any work with him, I countered; that was the problem. “When I was starting out as a therapist,” he said, “I felt a lot of pressure to say the right thing and make the right interpretation, but that’s not always what our clients need.”
Ari said that there was probably a reason Tony kept coming to see me. I thought about this and realized that he never came to sessions late, and if he ever needed to cancel a session, he would always make sure to reschedule that same week.
“You’re listening to him,” Ari continued, “you’re paying attention. It doesn’t sound like his parents ever really listened to him. It doesn’t sound like his girlfriend really listens to him.”
When Tony entered my office later that week, I felt, for the first time in several weeks, excited about our session. Moreover, my changed mindset caused me to see him differently. I still saw the energetic 30-something with ever-evolving hair — today’s style making him resemble Rob Lowe from The Outsiders—but as I looked into his eyes, I also saw the little boy he’d once been. I saw his excitement and fear, his longing to be heard and loved.
The session itself felt different. I had wanted to help Tony all along, but it took Ari to help me see what type of help he really needed. I had wanted to make life-transforming interpretations, but I could now see that he was not yet at a place where he could receive such interpretations.
Tony first needed the corrective experience of being heard. He needed to know that I cared enough to give him my complete attention and move at his pace without forcing my own agenda upon him. There might be time later for interpretations, but that’s not what he needed now, and understanding that made all the difference, for him and for me.
Questions for Thought and Discussion
In what ways are the author's experiences like those of your own?
What are some of the methods you found effective for working with Clients like Tony?
What have you found to be some of the more effective uses of supervision?
File under: The Art of Psychotherapy, Musings and Reflections
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Navigating Challenging Therapeutic Waters
I spoke these words to my clinical supervisor, Ari. I had been a therapist for just a few months and had no idea how to help one of my clients. Tony, I told Ari, had arrived early to our first session, and before I could even ask, he began telling me his goal for therapy. “I need to learn how to cope with things, especially my girlfriend. When we get into a fight, all I can do is obsess over her. I can’t function at work; I can’t even get myself to do the laundry. I just sit there, looking at my phone, waiting for her to text me.”I had initially found Tony’s volubility refreshing. Unlike those one-word-answer clients with whom I was struggling to connect, he would answer each question with enough detail to obviate my follow-up questions. Everything about him seemed expressive, even his thick, shape-shifting mop of black hair seeming to change each session as though reflecting his current mood.
Week after week, month after month, he shared his story, telling me about the father who had always seemed intent to one-up him and the mother who would drunkenly come into his room at night and, through tears, complain about her marriage. I started to see how he replicated these childhood conditions in his romantic pursuits, choosing self-involved and emotionally unavailable partners.
Some weeks, his hair spikier than normal, he would describe the wonderful weekend he’d had with his girlfriend—going rock-climbing, going to fancy restaurants—and wonder if she might be the one. Other weeks, his hair noticeably droopier, he would recount with tears in his eyes how she hadn’t once over the past week shown any interest in him. “It might seem like I’m playing a game, but I’m just trying to gather information. Every night last week, I asked about her day, and I’d listen and ask more questions as she went on and on about her horrible coworkers. All the while I’m waiting for something, for anything, for just one question, one piece of evidence that she’s interested in me.”
When Tony would say that he was going to start looking at engagement rings, I would feel my muscles tense and tell myself to keep my opinion to myself. When he would describe yet another way she had mistreated him—“She gets jealous if I’m on the phone with my sister too long, but like every day she’s texting her old boyfriend”—I would ask what he wanted in this relationship and what he believed he deserved. I would sometimes try to explore the similarities between his girlfriend and his parents, but he never seemed interested in that inquiry.
I initially felt such a strong connection with him, I was now telling Ari, but then something seemed to change. It now felt like it didn’t matter if I was even there, like it wouldn’t make any difference if he spent the hour talking to my plant. He would just go on and on without even pausing. If I wanted to ask a question or share an observation, I would have to interrupt him.
Ari asked some questions and then fell silent. Ari does not have expressive hair, but I’ve noticed that sometimes his brow will reveal his emotional state, and just then his forehead lines deepened. “It sounds like you’re doing good work with him,” he finally said. But I wasn’t doing any work with him, I countered; that was the problem. “When I was starting out as a therapist,” he said, “I felt a lot of pressure to say the right thing and make the right interpretation, but that’s not always what our clients need.”
Ari said that there was probably a reason Tony kept coming to see me. I thought about this and realized that he never came to sessions late, and if he ever needed to cancel a session, he would always make sure to reschedule that same week.
“You’re listening to him,” Ari continued, “you’re paying attention. It doesn’t sound like his parents ever really listened to him. It doesn’t sound like his girlfriend really listens to him.”
When Tony entered my office later that week, I felt, for the first time in several weeks, excited about our session. Moreover, my changed mindset caused me to see him differently. I still saw the energetic 30-something with ever-evolving hair — today’s style making him resemble Rob Lowe from The Outsiders—but as I looked into his eyes, I also saw the little boy he’d once been. I saw his excitement and fear, his longing to be heard and loved.
The session itself felt different. I had wanted to help Tony all along, but it took Ari to help me see what type of help he really needed. I had wanted to make life-transforming interpretations, but I could now see that he was not yet at a place where he could receive such interpretations.
Tony first needed the corrective experience of being heard. He needed to know that I cared enough to give him my complete attention and move at his pace without forcing my own agenda upon him. There might be time later for interpretations, but that’s not what he needed now, and understanding that made all the difference, for him and for me.
Questions for Thought and Discussion
In what ways are the author's experiences like those of your own?
What are some of the methods you found effective for working with Clients like Tony?
What have you found to be some of the more effective uses of supervision?
File under: The Art of Psychotherapy, Musings and Reflections