Then and Now

A follow-up post to the post, Search Keywords/It Takes Two To Tango

In this post, I mentioned, in passing, that part of the therapist's job of learning about a patient is done by observation.  The reference is in the 6th-7th paragraph and is about the "clinical" aspect of a patient's behavior toward the therapist.  One of the readers, who especially liked that post asked me to expand upon those few sentences.

One thing that I said was that current action-on anyone's part- can reveal how that person was treated in the past.  (A related post is http://therapiststhoughts.blogspot.com/2009/10/depression-prevention.html).  For example, someone who was scorned as a child or ridiculed a lot---sometimes this can happen at the hand of other kids, siblings or peers but, it is most potent when it comes from a parent---can grow up to be a person who interprets many things from others as criticism.  It may sometimes be entirely incorrect but it is heard through the filter of the past.

A child of a parent who has lots of their own need for attention may learn to stay in the background, to not rob the parent of the limelight.  As an adult, they may be obsequious.  

There's but 2 of many examples possible.  A therapist can notice things like this and draw tentative conclusions.  In other words, the therapist will keep such observations in mind as possible avenues to explore.  In addition, the therapy relationship itself can be healing for this type of historical problem.  In the 1st example, the therapist is going to take a position of acceptance from the outset.  That will also usually be the fallback position.  Does the new client come in and begin to open up or are they very cautious and guarded?  This can tell a therapist something about their ability to trust.  Does the patient do a lot of scanning, trying to determine whether or not what they say is landing well with the therapist? This would be an indicator of possible substance abuse or addiction in the patient's family of origin.  I could write many examples; suffice it to say, the patient's behavior is information to the therapist on how to help. 

The therapist is not there to judge but to try to understand.  This attitude will provide a healing experience for that patient.  Also, if the therapist gives some feedback and the patient, through that

distorted filter, takes it as criticism (as in the 1st example), that can be worked through in the therapy process.  

It becomes an opportunity to mend that psychic tear.







(There is a post that mentions this topic from the patient's point of view:  http://draft.blogger.com/blogger.g?blogID=5358181067760673073#editor/target=post;postID=4634973442525805532)