Thursday, 27 July 2017

on psychotherapy

Psychotherapy is sometimes taught and conducted as an I-It relationship between a therapist and a patient's problems. It goes like this:
Patient presents with some problems.

Therapist inquires into the presenting problems, uses history-taking, and his or her psychological knowledge, to develop a linking formulation.

The formulation is applied by the therapist to the patient's problems by way of explanation of them or by way of a guide to something called an 'intervention'.
Now, if someone did that to me I'd be furious with them! There I was, hoping that I would be understood, and all we get is someone offering me a causal explanation of my problems. Jeez - thanks!

What do we really want from therapy? We want a relationship in which someone will treat us seriously as a person. They will be able to call us out on our unwitting bullshit, show us love, show us understanding when we lose perspective, help extricate themselves and us from the unwitting internal and relational habits we fall into, and offer us a few words to help us put ourselves back on a trusting open self-possessed footing. Sure, sometimes they may rely a little on hypothetically handled objective psychological knowledge of human subjects. But really what we want is someone who 'knows people', not someone who 'knows facts and theories, or who develops hypotheses, about people'.

What is it for someone to 'know people'? It's to know how to relate to the patient aptly and spontaneously, to listen and make room for the patient in his sui generic nature rather than project oneself into the patient's shoes, to oneself be geared up and fortified in the requisite ethical and emotional and humane resources, to be able to receive and not be closed to the patient in his distress.

Someone whose interaction is mediated by knowledge about people is, one imagines, perhaps not someone who really knows people at all!

(Just imagine if someone were to respond to what I've written by saying 'Well, perhaps that shows that this kind of (clinical psychological) psychotherapy is not for you?'! ... 'Richard: I don't like it when you punch me in the face.' 'Psychologist: Perhaps being punched in the face is just not for you'.)