In Treatment 2 -- Reflections on the Season

This will be a post in progress as I reflect on the season -- so there will be additions to it as the week goes by.

One thing  I thought of this morning is that this year we got glimpses of other patients Paul works with. I think this was quite helpful in a very subtle way as these others seem more ordinary as patients. So we can fairly conclude that the 4 patients we have followed have been those who most touch into Paul's own issues and thus present significant challenge to him. No therapist could stand the stress of a practice full of people like this -- it would simply be too much, so we rarely have more than a very few at a time.

Although there has been chatter about Paul's boundaries and acting out this season, and I have written about this, actually he has not really done much of it at all. Last season Paul was deep in his own crisis in his marriage and this gave rise to what we saw happen with Laura. Though he has had to deal with the aftermath of divorce, and of course with the lawsuit, nevertheless, on the whole this has been a year of resolution and so his personal stress has been decreasing. If we think of the two seasons together as a single year, which they seem roughly to be, then the crisis which marked the early part has been resolved by the divorce and this season shows us as he moves into a new normal. In the background is the building of new relationships with his kids, his own emergence from the devastation of divorce, development of his new practice. Through the windows of his office we have seen the season change from the snow of winter to spring as indeed is true in his life.

Major crises in a therapist's life are bound to create issues in his work life as well. That is true for any professional because we are all only human and not able to keep the personal completely out of the professional all of the time. That Paul made significant errors last season is not surprising. I have seen this in therapists I know. Indeed during my own divorce years ago, I struggled to maintain my focus as my own personal issues threatened to engulf my work. It would be lovely if at times like these we could take a leave of absence, but as most of us are in private practice, that is rarely feasible. So we muddle through doing the best we can to show up and do the best work we can in the moment. Yes, this means we will make mistakes, but mistakes are always a possibility regardless of our personal issues. Striving for perfection is doomed to failure as nothing in nature, not even the very best therapist, is perfect. What we have seen this season is Paul working his way through his crisis and in the end coming to a place of better understanding of hat his work is about, thus enabling him to be a better therapist going forward. We are all works in progress.

I have also been thinking more about April and why she will not be back to work with Paul. I have argued before that Paul's decision to take April to chemo and to call her mother were the right choices. And I believe they were. But they also effectively spelled the end to the therapy. It was a boundary that Paul crossed, yes, but I believe he would have been remiss to do otherwise because the circumstances were dire and what he did was what she needed. It was indeed a life or death choice -- and making the choice for April's life meant also choosing the death of the therapy, something Paul may have known unconsciously.  These are very rare kinds of choices. But when the well-being of the patient stands in opposition to the life of the therapy, what choice has  the therapist except to act for the patient?

© Cheryl Fuller, 2018. All  rights reserved.