On Becoming a Person: A Therapist's View of Psychotherapy - Essay Example

Skill Essay 3rd trimester The previous trimester was very challenging yet was also rewarding at the same time. In this last term, the prospect of embracing the vast humanistic modality was exciting as well as overwhelming. Although some of the main theories and concepts were already identified in my foundation course, in this trimester a much deeper understanding of the formers as well as the centrality played a key role in the skill sessions of what Clarkson (1995) calls person-to-person relationships and the importance of the social, cultural, and economical context, which made a very interesting and rich milieu in which I had to carefully maneuver. Due to the word limit with the essay, I will look into some of the aspects that have been taking place during the therapeutic process. I will also look at the components that have been fundamental for my growth both at a clinical and a personal level. I will highlight and concentrate on the humanistic concepts, tools, and skills that I have learned, experienced, and used during the sessions. I will also refer to some past notions that are now part of my way of being in the therapeutic room. These are embedded in the psychodynamic and existential modalities. I have realized that a very individual a personal approach has been germinating in me. Moreover, I will take into account the important and essential feedback that I have received both from my colleagues and my tutors. I will concentrate on two of the many sessions that I have played the role of the therapist—in both sessions the client was the same. The client was a well-educated English man in his late twenties who had recently broken up with his girlfriend of five years. Moreover, his father died of cancer two years ago and he was still battling to come to terms with his death. He said he felt overwhelmed by daily responsibilities and called himself a “fixer.” The relationship between a client and a therapist is for me at the core of the therapeutic process. Carl Rogers, in this Humanistic trimester, has elucidated the importance of the former. From the classical psychoanalysis in which the therapist was seen as the expert in a kind of doctor/patient relationship, one of the Rogerian revolutions was to bring a collaborative and equalitarian rapport that replaced the earlier idea into the therapeutic room. In addition, Rogers’s view on the therapeutic relationship between the client and the therapist was as follows: “If I can provide a certain type of relationship, the other person will discover within himself or herself the capacity to use the relationship for growth and change, and personal development will occur” (Rogers, 1961, p.33). Roger’s core conditions that are the cornerstone of the person-centered approach are a constant presence during the skill sessions. Although, reflecting back they were also in the skill sessions of the two previous trimesters. This made me to think about their universality among different approaches and modalities. I reflected on the humanistic influences that Rogers weaved into his core conditions that allow the freedom of the client to be who he wants to be, which compounds the idea of individuality that our culture supports. In one of the sessions, ideas around sexuality and age came about. Although not directly explored with the client, it was one of the narratives that I was made aware of during the session. I am a gay man and at least fifteen years senior to my client. Although I did not feel that the client had any issues with my sexuality, which I openly explored with him and the rest of my colleagues during the earlier part of the term, I felt there were some interesting ideas present in the room. The client’s main narrative, which was focused in the lack of being understood by the people around him and the state of isolation that he felt after breaking up with his girlfriend, was part of a process which prompted me to ask the client if he felt lonely in the room. To this the client responded negatively after a long pause. After the session ended, I asked myself some questions about what went on in the session. Although we were both males, our preference in partners and sexuality was dramatically different; this could have been a possible concern for the client. Did the client think that I could not completely understand his heterosexual world? I also reflected that the only way I could have some of his questions answered was to have done something different during the session. This was to address this idea of mine with the client and verify if the latter was my own, was his, or indeed came from both of us. Any further discussion about it would have brought further insight into our therapeutic relationship. The above example also helped me to think about the importance of one’s sexuality during a therapeutic alliance and the many implications that the former can stir up. A paternalistic attitude that I had towards the client was pointed out in the feedback received both from my peers and tutor. The former was something that I felt when the client voiced his need to rest and to let someone else take up the responsibilities he had to attend to and honour. Our age difference, and possibly my more formal outwear, highlighted that paternalistic relationship that I was possibly providing for the client. When the session ended, I realised that some form of transference (Freud, 1905) had taken place. I reflected that I could have explored with the client the feeling that I sensed in him of wanting me to provide fatherly support, and if the latter role was the one that he really wanted. In addition, I had to take into account the fact that the client’s father died two years previously and that his death left the client possibly some responsibility to fulfil to do with the absent figure that he was possibly trying to bring back into the room during the sessions. Our difference in nationalities was something that I was aware of, and ideas around multiculturalism and the centrality of one’s culture in psychotherapy was a very sensitive subject that was introduced by Padersen (1998). He defined multiculturalism as the fourth force of psychology. Although I had been living in this country for a very long time, my cultural background was something that I would always carry with me. As such, it was something that I should always consider in any therapeutic alliance. I was bringing into the sessions with the client my native and adopted cultures, beliefs, stereotypes, and prejudices. I was also aware of the client’s culture, which is equally important. Being Italian with a distinctive accent was a reminder to the client of the potential stereotypes and prejudice they might have about Italians. Despite this fact, I hoped that our nationalities and difference in culture would not come in the way of our therapeutic relationship. However, I noticed that during one session I had some concerns with regards to my accent and to my command of the English language, which was brought to my attention when the client asked me to repeat something that he did not understand. My thoughts went straight into my ability to make myself understood—a lack in confidence overwhelmed me. However, after I repeated the sentence back to the client and received a positive response, I felt better and managed to relax back into my therapist’s role while, at the same time, my confidence grew in strength. The latter scenario made me aware of how much I had to still work on my confidence and that on that occasion the misunderstanding had nothing to do with my command of the English language. After the session I learned from the client that the difficulty in understanding my question was due to his deep and self-reflecting state that the previous intervention had left him in. During the process, I could have avoided that anxious state of mind that I felt by asking the client if I had been clear and if there was a language problem that prevented him from understanding me. The clarification with the client would have addressed an important issue, at least for me, to be considered in the future sessions, as well opening up a possible exchange in the areas of differences, prejudice, and assumptions, just to name a few. The client started to talk about his difficulties in trying to overcome the recent split from his long-term girlfriend, which he stated brought chaos into his life. In his words, “an uncontrolled flood of emotions and feeling like a waterfall.” The latter comment prompted me to carry out an intervention that contained metaphorical content. The metaphors offered me a way to communicate with the client in a less concrete way and with a possibility to bypass some of the limitations or inhibitions that the client was struggling with. I tried to explore with him the feelings of the waterfall and its meaning, texture, colour, and wishes, or the lack of them. This gave me an opportunity to be creative and construct with him an imaginary world of meanings that seemed more accessible and controllable because they were less personal. However, an insightful observation that the tutor made about the use of metaphors, which required an intellectual and articulate mind, was something that I never considered before receiving that feedback. When I reflected on that, I did appreciate the fact that the language of the metaphors can be quite complex. Also, the risk of being misunderstood or not understood at all could easily occur. In some of the sessions I felt a sense of urgency. As a result, I had set a fast pace during the process with the client. The latter was also pointed out in my feedback. I realized only after the sessions that the urgency and pace were imposed by me on the client rather than the other way around. I somehow ignored the client’s sense of time and where he really wanted to go with his process; instead, I was pushing and challenging him too quickly into areas that he possibly did not want to enter. This was incongruous with the “non-directive” approach of humanistic psychology. On my part, there was certainly a sense of wanting to achieve quick results, or possibly the realization that there were issues coming from the client that I felt uncomfortable about dwelling on; I wanted to move away from the situation as quickly as possible. In addition, there was the pressure of performing a good job, as both my colleagues and tutor were observing me. Learning to let the client lead their own process at their own speed was frustrating at times. However, I had to learn to allow the process to flow naturally and at its own speed, as this forms the basis for a sound working alliance. With the above example, I realized that some aspects of the humanistic approach that I had learned, especially in the person–centered approach, were easier to understand than to put them into practice. On reflection, I should have listened more to the client’s wants and needs and asked the client what he was experiencing. Also, to let him articulate and express his emotions so that I could facilitate and explore those with him rather than speeding up the process. One positive outcome of the latter approach was made clear to me when I connected with the client at that level because his responses and interaction changed. We were able to immerse ourselves into a relationship of different kind. The awareness of what we were processing and the responsibilities as well as the choices that we have were able to surface and be named—this made the client less anxious and more open to questioning his own feelings. I was also able to better connect and be aware of the client’s nonverbal communication and use the latter to access his feelings as well as looking at the possible incongruence with the feelings expressed. Although this term has been focused on in humanist psychotherapy, what I brought into the therapeutic alliance was not just the modality of this last term but also some of the theories, skills, and ideas that I have been familiarising myself with and have made an impact in my practicing term. Additionally, I also feel more comfortable with them. Both the psychodynamic and existential modalities of the past terms have been a good foundation from where I have been building my own distinctive way of being and have been able to integrate them into my therapeutic sessions. However, the search for my own style and integration is a process in a constant flux. At this stage of infancy it is exciting but also very challenging. The feedback I have received has been of fundamental importance during this academic year and has opened my mind to providing my own self-reflections and understanding the process better and what I could have done differently. Moreover, the vast amount of feedback that I have received will be a great source of learning and have made a tremendous impact on the person who I am today. Bibliography Clarkson, P. (1995) The Therapeutic Relationship London: Whurr Freud, S. (1905). Fragment of an Analysis of a Case of Hysteria (Dora). In The Freud Reader, P. Gay, (Ed). London: Vintage. Pedersen, P. (1998) Multiculturalism as a fourth force. Routledge. Rogers, C. R. (1961) On becoming a Person: A Therapists View of Psychotherapy. London: Constable and Company Ltd. Read More