Starting therapy is a lot like going into the woods in fairy tales. We go together into territory that is both like and very different from ordinary daily life. But sometimes people are casually dismissive of therapy, that it is just good listening and if friends could learn good listening skills, then therapy wouldn’t be necessary. Certainly listening empathically can and does provide catharsis and catharsis is an element of therapy. But it is only an element, not the whole thing.
When I enter a session with a patient I endeavor to do so without memory or desire — which is to say that any day as I meet with my patient, I put away thoughts about this blog, about my husband’s latest project, about other patients, and about our last session with each other and I prepare to meet her in the moment and without an agenda. I wait for her to begin and allow her to set the agenda for our time together. I follow the thread of her concerns and as I do so, bits and pieces of the other times we have met come to mind. I hear more of her themes and as we go along I am relating them to themes I have heard from others and what I know about such themes. I am aware of issues in her life that have led to her personality being structured as it is — this is a clinical piece where I touch into my database of experience with people who have similar histories and who have had the constellation of issues in their lives that she has has and what I know from more theoretical material as well. I challenge a bit here, ask a question there, offer a suggestion, share a personal experience. I watch as we do our dance of of speaking and listening and I see when an interpretive arrow hits the mark and when it misses.
I am patient with hearing the same story told many times over the course of our work together and I listen for the subtle ways it changes as we explore the nooks and crannies of her life, how she begins to see herself in her life a bit differently and sees others a bit differently as well. The story in its basic outline remains the same but it changes as well in nuance and color and emphasis.
I bring to my work over 40 years of training and experience, many years of my own personal therapy, 10 or more years of supervision by masters in the field, and 70+ years of my life experience. I do not ask nor in any way expect my patients to reciprocate with me and listen to me and my issues. I have no agenda for what they should do. No subject is off-limits, including the full range of feelings they have about me.
What I do is well beyond empathic listening, though that is part of what I do. And while I agree that anyone benefits from being able to talk about feelings with an empathic listener, I do not think that listening alone is sufficient for dealing with a wide range of the things people bring into therapy. For some, it is about a corrective emotional experience, for others a chance to look at their lives with a person who is not entangled in that life and can be neutral, for still others it is where deep psychic wounds can be opened so that they may heal. It is also a place where we can pay attention to dreams and symbols and archetypes and fantasies and discern the pattern of meaning in a life.
It is hard work. It is sacred work, I believe.