All of the stories and cases that I can think of—those that have impacted the core aspects of how I conceptualize therapy, what “works” and how I “do” what I “do”— boil down to a few basic themes. Within each theme, there is one glaring force that trumps all. That is the quality and nature of the relationship I had with each person that came my way.
For my part, each story has to do with somehow managing not to plunge into action mode, not give in to the urge to do something, anything at all sometimes, too quickly. Some of the stories are about the times that I lost that focus altogether, missed something or times I let my own feelings and needs for something like a sense of purpose, clarity, effectiveness, or validation override my core beliefs about what therapy is. This guiding belief is that without first establishing a deep and broad sense of a person (their needs, unique history, habits, fears, their way of being in relationship and exactly how that makes perfect sense given their experiences) any effort to direct or firmly influence “therapy” isn’t likely to be a productive or healing experience. That is the core of what I believe therapy is; therapy is a specifically attuned relational experience first and foremost and that fact is what makes it healing.
People need time and space to unravel and expose themselves, to get truly grounded and ask themselves “Can I handle myself this raw?” They need time to test us too as they begin to wonder, “Can you handle my darkness? Can you handle my awfulness, my mistakes, my flaws, my neediness?” After all, it is often some mixture of these bits that drive all of the good we do, in wanting to be better versions of ourselves, but also the bits that drive a self-critical internal process about our badness, too. This is what drives us to seek someone who can help us make sense of it all. And it is why it is so critical that common requests to be labeled, advised, told what to do and not do, are often best held with compassion and loving-attention but rarely directly provided. To sidestep the relationship, the attuning, the deep work of getting-to-know, is to have both client and therapist fall for the trick of inadvertently validating that the client is exactly what they most fear, to validate that they are in fact broken and in need of some Other to tell them just how so and what they must to be okay, to feel fixed, to feel worthy.
Too much external influence at the beginning of establishing this kind of therapeutic relationship is distracting at best. Even directives and advice are desperately requested, often it is the case that rushed efforts to diagnose and treat, without at least a genuine knowledge of a person, are likely to yield impossible situations for both parties. This sets the client up to choose between rejecting the therapist’s authoritative stance on his process—or—he can abandon himself altogether and perform the role of “engaged client” to please the system. Said another way, such a choice becomes about honoring one’s own needs (whether known consciously yet or not) at the risk of disappointing the therapist or honoring the therapist’s agenda with the desperate hope of being accepted. It is reasonable for a client to conclude that his best option is to align with the therapist’s agenda and gain acceptance for his performance, however inauthentic. And of course; this has the promise of the healing and peace one seeks. While that dynamic may yield a version of the connection he seeks; without doubt, it will further reinforce his troubled understanding of how to get his needs met and feel “okay”. As a clinician, I can tell you, that psychologically and developmentally, this circumstance would be the catalyst for the worst kind of outcome. “Healing” that comes from submitting to a superficial diagnosis is not healing at all. It is desperate grasping that confirms the presence of wrongness, badness, an in-need-of-being-fixed-ness. Mostly, it is the lazy application of psychology. A healer must know someone, and evoke that person’s dormant well of self-knowledge, for a diagnosis to be relevant in the process of healing.
Following poorly paced treatment, individuals may continue to suffer from the same issues, or even more severe manifestations of those issues, later down the line. Worse, these individuals may have further compounded shame and identity fragmentation for having been through treatment to no avail. The message one walks away with is “I failed”. “I failed my parents”, “I failed my children”, “I failed myself”, “I am failing at living a good life”. In thinking about all of this I can’t help but wonder how many clients have been labeled “resistant” or “failures of treatment” when what is really lacking comes from the other side of the relationship. I am just as guilty as any well-intentioned clinician of wanting to feel sure and effective in the role of providing therapy. That drive is important to me, it is part of my identity that I am insightful, observant and effective in helping others make positive changes in their lives. I am grateful for this drive to be a healer. Where it can become ineffective, even dangerous, is when clinicians and programs act on that desire to be helpful without pausing to honor and absorb the bigger picture. Relational therapy has an organic way of unveiling that bigger picture. By bringing the focus so finely to an individual’s emotional process in the here-and-now without familiar distractions or excuses, these recreated microcosms become vibrant with the opportunity to notice, observe, explore and heal in profound ways.
Clients come to therapy programs with vast arrays of diagnoses and complex histories. Individuals present with everything from personality and mood disorders, drug and alcohol addiction, attachment disorders, symptoms that suggest an inability to resolve early life experiences, to launch forward and access their yet undemonstrated abilities to thrive. Some individuals come to us before their self-destruction reaches such an extreme. Our experience working with individuals and families from such varied walks of life suggests that—regardless of one’s age, culture, diagnosis, background, drug or habit of choice—nearly everyone stands to benefit from this kind of extended relationship building and introspective space. Diagnosis and targeted treatment have their very rightful place, and it is a place that ought to be utilized in tandem with, and never ahead of, the kind of connection I am attempting to describe. This container for development is rarely provided naturally in the larger society or even in our families no matter how they tried to know and love us. No one will ever convince me that parents, for example, do anything less than their personal best to provide this for their children—yet they too are searching for a roadmap through this suffering in an under-resourced, fix-centric culture.
Dr. Brad Reedy, a founder of Evoke Therapy Programs, has a saying I believe to be very powerful and true. He says, that the process of therapy “is about being found each week, over and over and over, until someone learns how to find and know themselves.” Nearly all of the people I work with have struggled long and hard to find themselves, to feel okay and to find a way of reasonably managing their lives. It only makes sense that time is required to “find” these individuals so that they may learn to find themselves. Otherwise, as professionals, we run the risk of finding something that we unknowingly put out for ourselves to find. Well attuned treatment programs and the loving professionals they employ have a way of filtering through illusions and distractions, unveiling for us what is true and real for a person. From that place, we gain access to an individual and engage in a relationship built on genuine intimacy and trust. The experience of living life out-loud with attuned professionals and guides—a dynamic such as exists in high-level treatment programs and courageous, attuned, authentic clinicians—can be foreign enough to crack us open to having a much-needed experience, and yet it can also be just comforting enough that we are moved and guided to connect with ourselves and each other in ways that have been long forgotten. It is through the balance of self-reflection and shared experience that our clients grow and begin to sense power and purpose in their lives in ways they have deeply wanted but often never thought possible.
